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Occupational therapy in fall prevention: current evidence and future directions
Natalie E Leland1, Sharon J Elliott, Lisa O'Malley
1Division of Occupational Science and Occupational Therapy, Herman Ostrow School of Dentistry, and Davis School of Gerontology, University of Southern California, 1540 Alcazar Street, CHP 133, Los Angeles, CA 90089-9003, USA. nleland@usc.edu
Occupational therapy shows promise in preventing falls among older adults through environmental changes and exercise. However, more research is needed to support its role in behavioral modification, footwear, and medication management for fall prevention.
Area of Science:
- Gerontology
- Public Health
- Occupational Therapy
Background:
- Falls are a significant public health issue for older adults in the U.S.
- Existing fall prevention guidelines from the American Geriatrics Society (AGS) and British Geriatrics Society (BGS) do not clearly define occupational therapy's role.
- Community-dwelling older adults are a key population for fall prevention efforts.
Purpose of the Study:
- To conduct a scoping review of published research on occupational therapy's role in fall prevention interventions for community-dwelling older adults.
- To structure the review based on the AGS and BGS fall prevention guidelines.
- To identify evidence gaps in occupational therapy's contribution to fall prevention.
Main Methods:
- Scoping review of published research.
- Categorization of interventions based on AGS and BGS guidelines.
- Analysis of occupational therapy's documented involvement in various fall prevention strategies.
Main Results:
- Evidence supports occupational therapy's role in environmental modifications, exercise-based interventions, and multifactorial/multicomponent fall prevention programs.
- The Occupational Therapy Practice Framework: Domain and Process (2nd ed.) acknowledges efficacy research for some interventions.
- Limited or no research was found on occupational therapy interventions for behavioral modification (e.g., fear of falling), postural hypotension management, footwear recommendations, and medication management.
Conclusions:
- Occupational therapy is involved in fall prevention research, particularly in environmental and exercise-based interventions.
- Significant evidence gaps exist regarding occupational therapy's role in other crucial fall prevention areas.
- Further research is needed to fully establish the scope and efficacy of occupational therapy in comprehensive fall prevention strategies for older adults.
