Falls and injuries related to fall, such as fractures, can lead to functional impairment, long standing pain, lowered quality of life, raised costs of healthcare, and possibly mortality. Due to this, various single and multiple component strategies of intervention have been designed for fall prevention and subsequent injuries. Physical therapy approach that is most effective for preventing falls and fractures is regular multicomponent exercise that combines strength and balance strength training.
Assessment of hazards in the living environment and their modification, use of assistive devices, like walkers and canes, prove beneficial. Use of hip protectors is found to be effective while nursing home residents and those who are at high-risk of fall. Also, use should be made of anti-slip shoe devices. For effectiveness, multifactorial preventive strategies must have a component of exercise along with individually tailored measures geared towards persons who are in the high-risk category.
Some of the physical therapy approaches are,
Assessment and removal of risk factors
Fracture refers to a break in a bone that disrupts the bone’s continuity. Several types of fractures are these, such as,
Open / compound: The skin’s surface is broken by the bone
Closed / simple: The skin’s surface remains intact
Stable: Single fracture in the pelvis
Unstable: More than one fracture in the pelvis
Transverse: Fracture placed directly across the bone
Oblique: Bone fracture placed at an angle
Spiral: Fracture that is twisting
Comminuted: Bone has broken into several pieces
Greenstick: In young children where the bone breaks on one side and bends on the other
Simple: Single fracture
Complicated: There is damage to other structures, too, such as to blood vessels
Treating a Fracture
Realignment (reduction) of the broken bone has to be done. This can be done surgically and is referred to as open reduction or by applying force and is called closed reduction. Surgery for complicated and unstable fractures requires fixation that can be external or internal. Closed reduction techniques are conservative treatments that are used for fractures that are simple and stable.
Physiotherapy for Fractures
Physiotherapy needs to begin right after the immobilisation of the fracture. Physiotherapy at the time of healing of the fracture will focus on,
Promoting weight bearing
Maintaining strength in the weakened muscles
Maintaining movement range in the affected part and its surrounding joints
Once the fracture heals and the cast is removed there will be continuous physiotherapy for between 3 months to a year, till full level of function is regained. Physiotherapy will aim to,
Gain full function
Optimise movement range in the affected joint
Provide activities for progress weight bearing
Provide full range of movement and strength to joints / muscles
Provide sport-specific rehabilitation
Early falls and fractures treatment in Hebbal, Bangalore includes,
Provide patients help and advice for ambulation by using assistive devices while performing tasks like walking and climbing stairs. It is critical to take into consideration weight bearing restrictions of the patient and advising them how to ambulate within the boundaries of their restrictions. With safety being top priority, patients should be comfortable and proficient with using the prescribed devices before they are discharged.
Provide education on using and removing slings in case of an upper extremity fracture
Massage of the soft tissue, specifically for managing swelling and oedema
Management of post surgery scar
Stretching exercises for regaining range of movement in the joint
Manual therapy on the joint and its mobilisations to regain mobility of the joint
A progressive and structured regime for improving strength
Gait, control work, and balance re-education, if needed
Injured area support with taping / supports swelling management
Return to regular activities / provide advice, if needed
Book an appointment at Manipal Hospitals to know more about treatments with the help of doctors in Bangalore.