Natalie E. Leland, Sharon J. Elliott, Lisa O’Malley, Susan L. Murphy; Occupational Therapy in Fall Prevention: Current Evidence and Future Directions. Am J Occup Ther 2012;66(2):149-160. doi: 10.5014/ajot.2012.002733.
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Falls are a serious public health concern among older adults in the United States. Although many fall prevention recommendations exist, such as those published by the American Geriatrics Society (AGS) and the British Geriatrics Society (BGS) in 2010, the specific role of occupational therapy in these efforts is unclear. This article presents a scoping review of current published research documenting the role of occupational therapy in fall prevention interventions among community-dwelling older adults, structured by the AGS and BGS guidelines. We identified evidence for occupational therapy practitioner involvement in fall prevention in environmental modifications, exercise, and multifactorial and multicomponent interventions. Although research documenting the efficacy of occupational therapy interventions is identified as part of the Occupational Therapy Practice Framework: Domain and Process (2nd ed.; American Occupational Therapy Association, 2008), we identified little or no such research examining interventions to modify behaviors (e.g., fear of falling), manage postural hypotension, recommend appropriate footwear, and manage medications. Although occupational therapy is represented in the fall prevention research, the evidence for the profession’s role in many areas is still lacking.
Occupational therapy contributes to fall prevention among community-living older adults through environmental modification interventions, exercise, and multicomponent or multifactorial interventions.
Clinicians should be cognizant of the evidence supporting the efficacy of fall interventions. Much of this research has not been carried out in the United States, and barriers to carrying out these programs may exist in the U.S. context.
Occupational therapy research examining the efficacy of fall prevention interventions targeting the modification of fall risk behaviors (e.g., reducing the fear of falling), management of postural hypotension, medication management, and recommendation of appropriate footwear among community-dwelling older adults is needed.
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