Amy J. Litterini
© 2015 Kirsten Bombardier
Background and Purpose – Falls are the leading cause of death from injury in persons greater than 65 years of age. The risk of suffering a fall increases with age, but falls are not an unavoidable aspect of the aging process. By maximizing an individual’s balance, gait and strength, their risk for future falls can be decreased. The purpose of this case report is to provide an overview of the physical therapy (PT) plan of care for a patient at high risk for falls. Case Description - The patient was an 84 year old female who suffered a fall likely due to structural deformities secondary to rheumatoid arthritis that impaired her balance and ability to safely ambulate. Her fall resulted in a right olecranon fracture and subsequent open reduction internal fixation for surgical repair. Once medically stable, the patient was transferred to a skilled nursing facility for continued care. She presented with deficits in strength, endurance, balance, coordination and overall functional mobility which heightened her fall risk. Procedural interventions focused on balance and gait training while accommodating for the patient’s bilateral foot and hand deformities secondary to rheumatoid arthritis. Outcomes - The patient improved her endurance, strength, balance, bed mobility, transfers and gait which subsequently decreased her fall risk. She was discharged to an Assisted Living Facility as she was not an appropriate candidate to return home independently. It was highly recommended that she continue to receive PT through home-health services to continue improving her function. Discussion - Patient-centered PT, with a focus on balance and gait training, appeared to make significant improvements in this patient’s overall function and decrease their fall risk.
Bombardier, Kirsten, "Balance And Gait Training To Reduce Fall Risk In A Patient With Bilateral Foot And Hand Deformities Secondary To Rheumatoid Arthritis: A Case Report" (2015). Case Report Papers. 29.