This document discusses tools and techniques for falls assessment and prevention. It covers supine to sit transfers, sit to stand movements, phases of rising from a chair, standing balance strategies, gait characteristics of fallers, turning risks, types of assisted walking devices, and stair negotiation. Exercises are also mentioned as part of falls prevention.

1. Falls Assessment
Tools , Gait Deviations
and Exercises
By : Mel Veneracion, PT

2. Supine to Sit
- Uses the U.E. instead of neck
flexion to initiate the
movement
- Avoid using forward trunk
flexion by using trunk lateral
flexion and rotation
- Use elbow to broaden base of
support

3. Sit To Stand
- Sit to stand ability is
fundamental to transfers and
gait
- Requires the greatest ROM and
strength from the knee and hip
as compared to gait or stair
climbing
- Rising from a chair can be
divided into three distinct
phases

4. Phases of Rising From a
Chair

5. Flexion Phase

6. Extension Phase

7. Stabilization
Phase

8. Standing
Balance
The ability to maintain the
center of gravity over the base
of support
Normal limits of stability:
The maximum distance that an
individual can shift his or her weight
in any direction without loss of
balance.

9. Standing
Balance
Recovery
To maintain standing balance , 1
of 3 strategies must be selected
Ankle strategy
Hip Strategy
Stepping Strategy
Faller typically have:
-Loss of one or more
balance strategies
-Inappropriate strategy
selection
-Simultaneous activation
of two opposite strategies

10. Ankle Strategy

11. Stepping
Strategy

12. Hip Strategy

13. Gait
Characteristics
Of Fallers
-Shorter single leg stance -
reduces the amount of time
spent balancing on one leg
-Decrease stride length -
reduces forward momentum
and allow more time for balance
recovery
Phases of Gait
- Heel strike
- Foot flat
- Mid stance
- Heel off
- Toe off

14. Turning and
Falls
Falling while turning is
8x more likely to result
in hip fracture due to
landing on the hip, than
falling while walking
straight.

15. Hemiplegic Gait

16. Diplegic Gait

17. Neuropathic Gait

18. Myopathic Gait

19. Parkinsonian Gait

20. Ataxic Gait

21. Proper and Safe
Use of Assistive
Device
Use of the following:
Single point cane
Small Based Quad Cane
Large Based Quad Cane
Hemiwalker
Standard Walker
Front Wheeled Walker
Four Wheeled Walker

22. Stairs Negotiation
Ascending Descending
Fall Risk
Balance
Vision
Leg Advancement
Lower Higher
Less required More
required required
Less required More
required required
Step up Step down
with the with the
“Good” “Bad”

26. Exercises