The cold weather is upon us and that means icy, slippery conditions and an increased risk of falling. For advice on avoiding dangerous spills, we turned to three MossRehab physical therapists – Ali El-Kerdi, PhD, DPT, Jennifer Gulla, DPT, and Stephanie Tornquist, DPT. Together, the three therapists recently created the MossRehab Community Falls and Injury Prevention Initiative.
Who is most at risk for falls in cold, icy weather?
Everyone is at risk. Physical therapy clinics become inundated with patients two months after winter starts due to people slipping on ice. Obviously, individuals with balance deficits—whether they are older or younger—are at particular risk, along with people with neurological conditions and individuals with special needs. Further, anybody who uses an assistive device —a cane, a walker, crutches—is usually is at higher risk, as well.
Why do people using assistive devices need to be extra careful?
People often use devices to improve their balance during walking, so any amount of ice or slippery material in front of them is going to make it harder for them to walk. They will face more challenges, and they are at a higher risk of falling.
What tips do you have for those people who still need to get out in this weather?
It is all about planning. In slippery conditions, never be in a rush to get anywhere. Allow enough time to get to where you are going. Find out if there have been road closures. Find out if your streets or sidewalks have been plowed. Slow down, slow down, slow down. Don't be in a rush. Plan where you are going. Give yourself enough time to get there.
What else can people do to prepare before going out in icy weather?
Wear warm clothing to avoid hypothermia if you do fall and are unable to get up. Have a cellphone or some other device to call for help, if needed. Do some planning in case you get stuck somewhere and can't get home. Bring an extra dose of medication. If a blizzard comes and you are stuck away from home, you'll need your medication. Plan in advance for the worst-case scenario while hoping for the best.
Any other advice?
Proper footwear is key. Wear shoes that have good grip on the bottom. If you do have a balance problem or are using an assistive device have someone else clear out your steps and sidewalk and make sure to throw sand or salt down to decrease ice buildup. It's a good idea to install rails next to steps to give you something to hold on to. Go out with someone else who has better balance who you can hold on to and can be more reactive if you fall or slip, Just having someone else there can make you a little more safe.
Any tips for walking if you find yourself on an icy patch?
Walking on ice, you have to change the way you walk. Usually in therapy we teach people to take nice long steps, contact first with your heel, push off with your big toe. The opposite is true for walking on ice. On ice, we want short steps. Contacting on the middle of the foot, never on the heel. Keep assisted devices tight to the body. Short, choppy steps. (See video above.)
Tell us more about the MossRehab Community Falls and Injury Prevention Initiative.
The goal of the program, which was funded by Einstein Healthcare Networks' Albert Einstein Society, is to prevent falls year round. We screen individuals who might be at risk using a series of clinical/biomechanical assessments. Then we make recommendations based on the results. For people who are not at risk, we suggest they get tested annually. For people at medium risk, we offer the option of coming to an eight-week training program to work on balance training. For people who are at a higher risk of falling we recommend they undergo skilled therapy as soon as possible. The program will be up and running in early 2015.
Who would most benefit from this screening?
Anybody can come in for a screening if they believe they have some kind of deficit, but we are targeting community dwelling elderly individuals right now. That's our primary goal.
How does someone know they need to undergo some sort of assessment?
There are many signs. Using furniture for help when walking around for instance. We call that "furniture surfing." Not being able to stand up from a chair without using their arms. If they feel unsteady even when using an assistive device. Feeling dizzy or having vertigo. Certain medications can affect balance as well. It is beneficial for any senior (over the age of 65 -70) to have a fall screen just to have some sort of baseline to see where he or she is. If seniors get screened yearly, we can see how they are progressing and, hopefully, intervene if their balance starts to falter before an incident happens. We hope to run a preventive program rather than a reactive one.
If I feel like I or a family member needs a fall assessment, how do I take advantage of this program?
We are currently based out of the MossRehab at Tabor Road office. People can call us at 215-456-9800 or email us at MossRehab_Falls_Prevention@einstein.edu. They can make an appointment to come see us or come to one of our screening sessions out in the community. We'll be going to senior centers not only to do the screening, but to educate people about how to prevent falls in the home.