ABSTRACT
Table 1 Risk factors associated with falls. Adapted from reference 4
Impaired mobility, disability Impaired gait and balance Neuromuscular or musculoskeletal disorders Age Impaired vision Neurological, heart disorders History of falls Medication Cognitive impairment
ment of gait, mobility and balance are the most consistently identified risk factors for falls and fall-related injuries. The ability to maintain postural control and avoid environmental obstacles depends on proprioceptive, vestibular and visual input translated into appropriate motor responses. Thus, the risk of falling increases with reduced visual acuity or diminished sensory perception of the lower extremities. Chronic illnesses, such as various neurological disorders, heart diseases, stroke, urinary incontinence, depression and impaired cognitive functions, increase the risk of falling. Medications such as hypnotics, antidepressants or sedatives are associated with falls. Environmental factors include potential hazards that can be found in the home, such as slippery floors, unstable furniture or insufficient lighting. The orientation of falls influences the consequences of falling. Indeed, the points of impact of a fall determine the type and extent of injury. When falling, the elderly tend to land on the hip. In contrast, middle-aged adults tend to fall forward, with the main impact on the wrist. Several reflexes and postural responses are initiated during a fall which can prevent or reduce the injury. The effectiveness of
reflex actions depends on the speed of execution and the strength of the muscles initiating the protective movement. The impact of falls can be absorbed by surrounding soft tissue. The apparent protective effect of higher body weight may be due, at least in part, to the local shockabsorbing capacity of muscle and fat.
