FallProof

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FallProof

• A Comprehensive Balance and Mobility Training
  Program developed by Debra J. Rose Ph.D.
• Presented by Cathy Harbidge, Margaret Low, and
  Janet Schroder
• Calgary Fall Prevention Clinic

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Fall Proof

• Provides a multidimensional balance and mobility
  program.
• Targets community residing seniors at moderate to
  high risk for falls.

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Presentation Outline

• Description of Program.
• Achieving certification.
• Present principles of the Fall Proof Program.
• Assessment tools.
• Components of exercise program.
• Outcomes.
• Calgary Fall Prevention Clinic Application.

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Goals

• Improve postural alignment
• Increase limits of stability
• Improve integration of sensory information
• Increase confidence
• Improve performance of activities of daily living
• Heighten awareness of risk factors and
  circumstances
• Improve walking ability
• Improve ability to recover from loss of balance

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Client Eligibility

• Able to rise independently from a chair.
• Able to stand independently for a minimum of 2
  min. with minimum supervision.
• Able to safely ambulate a distance of 500 ft.
  without a walking aid.

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Client Eligibility

• Absence of cognitive impairment likely to
  adversely impact judgement and / or decision
  making abilities.
• Absence of any unstable medical condition.

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Classes

• Provided by Certified Balance and Mobility
  Specialist Instructors.
• Timing Classes held 2 sessions per week for 60
  minutes duration.
• Provide 8 weeks of lessons.

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Certification Program

• Accepts qualified professionals (Certified
  Fitness Instructors, Physiotherapists, etc.).
• Complete on-line learning modules of approx.100
  hours.
• Written competency exams after each module.
• On-site training to administer the appropriate
  multi-dimensional assessment tools.

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Certification Program (cont.)

• On-site training to teach pre-designed exercise
  modules.
• Practical competency exams are held at 2 sites.
• Required re-certification consisting of
  documented hours of treatment and assessment.

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Principles of FallProof

• Knowledge of systems contributing to balance and
  mobility.
• Emphasis on client safety.
• Age associated changes.
• Extrinsic and intrinsic risk factors.
• Associating assessment findings with balance and
  mobility deficits.
• Applying motor learning principles.

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Screening / Assessment

• Disease / Pathology / Activity
• Health Activity Questionnaire.

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Screening / Assessment

• Impairment
• Senior Fitness Test.
• Modified Clinical Test of Sensory Integration of
  Balance (M-CTSIB).

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Screening /Assessment

• Disability
• Composite Physical Function.

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Screening / Assessment

• Assessment of Functional Limitations
• Berg Balance Scale.
• Fullerton Advanced Balance Scale (FAB).
• Walkie Talkie Test.
• 50 ft. Walk Test.

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Exercise Components

• Center Of Gravity Control Training.
• Multi-Sensory Training.
• Postural Strategy Training.
• Gait Pattern Enhancement and Variation.
• Strength and Endurance.
• Flexibility.

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Ecological Theory of Perception, and Bodily
Orientation
Seated

• Moving

Standing
Task Demands
Single
Multiple
Cognition
Surface Type
Environmental Constraints
Individual Capabilities
Strength
Lighting
ROM
Visual Flow
Sensory Loss
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Center of Gravity

• Maintain an upright position in space.
• Improve postural control within sway envelope.
• Move the body through space more quickly and
  confidently.

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Center of Gravity Control

• Altering task demands

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Center of Gravity Control

• Weight shift

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Multi- Sensory Training

• Designed to train each of the 3 sensory systems
  to function more efficiently.
• Coordination of eye and head movements.
• Force use of systems when impairments are
  temporary or changeable.
• Compensate or substitute for system impairments
  which are permanent or progressive.

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Eye and Head Movements
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Vestibular Training
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Postural Strategy Training

• Designed to enhance the three postural control
  strategies ankle , hip and step.

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Postural Strategy Training
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Gait Pattern Enhancement and Variation Training

• To achieve a gait pattern that is efficient,
  flexible and adaptable to changing environment
  demands.

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Gait Pattern Enhancement and Variation Training
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Strength, Endurance, Flexibility

• Identified as essential components of any balance
  program.

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Outcomes

• Demonstrates decreased fall risk with completing
  one or more rotations of the Program.
• Improvement in targeted impairments and
  functional limitations.
• High compliance rates.

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Calgary Fall Prevention Clinic Balance Training

• Completion of first full cycle.
• Used in small group format.
• Clients are fallers.
• Adaptations to program.

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Conclusions

• The Fall Proof concepts can be used for group and
  individual training.
• The systematic application of the lesson plans
  ensure that balance and mobility impairments are
  addressed.
• Dr. Rose is working on developing lesson plans
  applicable for more frail individuals.

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References

• FallProof by Debra J. Rose Ph.D.
• Senior Fitness Test by Roberta Rikli and C.
  Jessie Jones.
• Promoting Functional Independence Among At
  Risk and Physically Frail Older Adults Through
  Community-Based Fall-Risk-Reduction Programs
  Debra J. Rose, Journal of Aging and Physical
  Activity 2002, 10, 207-225.

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Contact Information

• Calgary Fall Prevention Clinic,
  Cathy.Harbidge_at_CalgaryHealthRegion.ca,
  Janet.Schroder_at_CalgaryHealthRegion.ca
• Calgary Health Region Fall Prevention Project,
  Margaret.Low_at_CalgaryHealthRegion.ca