A survey of fall prevention knowledge and practice patterns in home health physical therapists

Falls are a common problem for older adults, often resulting in injury, fear of falling, and decreased quality of life. Fall risk can be decreased by modifying risk factors. Because many of the modifiable risk factors involve physical function, physical therapists play a key role in both risk factor assessment and intervention. The purpose of this study was to determine home health physical therapists' (1) knowledge of fall risk factors and interventions, and (2) practice patterns regarding assessment of fall risk.

A survey was developed and pilot tested for content validity and ease of use. Physical therapists working in home health were selected as participants because many of their patients are older adults at risk for falling. A list of home health agencies was obtained through the Alabama Department of Public Health website and agencies were contacted to determine the number of therapists working in each facility. One hundred and twenty three surveys were sent to 47 agencies. Forty seven surveys were returned for a response rate of 40%.

Most home health physical therapists assess older adults for fall risk and provide interventions to decrease risk. However, slightly less than half of the surveyed therapists did not link interventions with specific risk factors. In addition, less than half of the therapists routinely refer patients to other health care providers to address fall risk factors. In order of importance, the highest ranked risk factors were environmental hazards, postural hypotension, and polypharmacy with muscle weakness the lowest ranked risk factor. Approximately 80% of the therapists listed balance training and strengthening exercises as interventions, whereas footwear and referral to other health professionals were listed only by 13% and 25% of the therapists, respectively.

Home health physical therapists are knowledgeable concerning fall risk assessment and intervention strategies. However, these therapists are less likely to refer to other health care professionals to address fall risk.