#PhysioTalk Transcript

Healthcare social media transcript of the #PhysioTalk hashtag.
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physiotalk @physiotalk
Good evening and welcome to tonights #physiotalk It is hosted by @caldwell_pt - thank you!
physiotalk @physiotalk
@caldwell_pt We are going to be chatting all about #falls tonight #physiotalk remembering that it is #OlderPeoplesDay today
Helen Caldwell @caldwell_pt
@physiotalk No problem - always up for chatting Falls! #physiotalk
Joe Middleton @_JoeMiddleton
RT @physiotalk: @caldwell_pt We are going to be chatting all about #falls tonight #physiotalk remembering that it is #OlderPeoplesDay today
physiotalk @physiotalk
So - to get us started can you all say hello - who you are and where you are tweeting from! #physiotalk
Anna Spiteri @spiteri_anna
@MargaretSouthc1 @BEHMHTNHS Loads of expertise @BEHMHTNHS on this subject #physiotalk #falls and all staff welcome to contribute. You don’t have to be a Physio or work @BEHMHTNHS. But if you do hello and welcome.
Jo Lockyear @Jolockyear1
RT @physiotalk: @caldwell_pt We are going to be chatting all about #falls tonight #physiotalk remembering that it is #OlderPeoplesDay today
Pamela Hansford @PamKHphysio
@physiotalk @physiotalk #physiotalk Please repeat setting up tweetdeck instructions didn't manage last time but did manage 3rd sept
physiotalk @physiotalk
We've got a few of the new @physiotalk team joining in the background tonight as well #physiotalk
Leah Palmer @Leahphysio577
@physiotalk Hello! Leah from Manchester #physiotalk
physiotalk @physiotalk
@PamKHphysio Here they are! https://t.co/di2Q189DEx #physiotalk
Mari @mariand84
@physiotalk Mari from Sweden. Looking forward to this chat! #physiotalk
Alice Kilby @AliceKilbyPT
Signing in for all things #falls with @physiotalk to celebrate #olderpeoplesday #physiotalk
Helen Caldwell @caldwell_pt
@physiotalk Excellent - you can help me out if I get lost!! #physiotalk
Farida Lingard @FaridaLingard
Hi @physiotalk and @caldwell_pt. Not done this before so not sure how it works! I'm Farida @FaridaLingard, Physio in Older People's Mental Health @NottsHealthcare #physiotalk
physiotalk @physiotalk
A reminder to you all to use the hashtag in all your tweets tonight That's #physiotalk in all of your tweets
Fran Hallam @FranHallam_PT
@physiotalk Hi! Fran from Nottinghamshire #physiotalk
Christie Robinson @christiephysio
Hello from Plymouth 👋#physiotalk
Suzanne Smith @suzsmu_tbh_phys
@physiotalk Hi #physiotalk, I'm Suzie Smith - physio in Hand Therapy & Rheumatology in sunny Torbay.
James Armstrong @PhysioArmstrong
@physiotalk Hi all, my name is James and I'm a 2nd year Physiotherapy Student from the University of Plymouth @PlymUni #physiotalk
Louise Brennan @Louise_Brennan_
@physiotalk Hi everyone! Louise here, tweeting from Seville #physiotalk
Emily Daymond @physio_edaymond
@physiotalk Hello Emily from Coventry Uni! Currently on placement with an intermediate care team so looking forward to tonight’s #physiotalk
physiotalk @physiotalk
Why is this important? Well its how we all follow the chat and no #physiotalk hashtag also means your tweets wont get pulled into the transcript at the end!
Alice Kilby @AliceKilbyPT
@physiotalk Hi @caldwell_pt looking forward to this evening’s chat #physiotalk
Joe Middleton @_JoeMiddleton
@physiotalk Hi, I'm Joe. I am a physio in the South West of England. #physiotalk
Helen Caldwell @caldwell_pt
@physiotalk I always need this! #physiotalk
francis rogan-physio @francisrogan
@physiotalk Hello, Francis tweeting from South Africa #physiotalk
Anna Spiteri @spiteri_anna
RT @physiotalk: Why is this important? Well its how we all follow the chat and no #physiotalk hashtag also means your tweets wont get pull…
Anna Spiteri @spiteri_anna
RT @physiotalk: A reminder to you all to use the hashtag in all your tweets tonight That's #physiotalk in all of your tweets
Emily Daymond @physio_edaymond
RT @physiotalk: @caldwell_pt We are going to be chatting all about #falls tonight #physiotalk remembering that it is #OlderPeoplesDay today
Velocity Physio @_velocityphysio
@physiotalk Brighton! 🙌 #physiotalk
physiotalk @physiotalk
Great to see so many of you joining in tonight #falls is a topic that's is important to so many on #OlderPeoplesDay #physiotalk
Helen Caldwell @caldwell_pt
@physio_edaymond @physiotalk Perfect timing #physiotalk
Catherine Bowdler @clbowdler
@physiotalk Hi, I'm Catherine, community physio from Cheshire #physiotalk
physiotalk @physiotalk
So - lets get started with our first question.... #physiotalk
physiotalk @physiotalk
Q In your place of work, whose responsibility does it tend to be to ask about falls? #physiotalk
Central Health @central_health
#physiotalk Click now to read our #OlderPeoplesDay blog! https://t.co/yNjKQMbThM
IPTOP WCPT @iptopwcpt
The #physiotalk chat on #falls has started - join in! #geriPT
suzanne avington @avington_suzann
@caldwell_pt Tea made by my daughter! 😲...#physiotalk #falls
Christopher Tuckett @HealthPhysio
@physiotalk Hi, I'm Chris from West Essex and a falls practitioner. Looking forward to the chat. #physiotalk
Mari @mariand84
@physiotalk I work at a health care centre so I would say the physio. #physiotalk
Anna Spiteri @spiteri_anna
RT @physiotalk: Q In your place of work, whose responsibility does it tend to be to ask about falls? #physiotalk
Ian Tyrrell @IanTyrrell5
@physiotalk Ian slightly late from stoke #Physiotalk
Joe Middleton @_JoeMiddleton
Everyone's. Nurses will include in their admission paper work. Doctors will ask, but usually only if that is a feature of the presentation (Geriatricians are an exception to this). However, nobody asks as frequently or as in depth as physiotherapists (imho!). #physiotalk
Emily Daymond @physio_edaymond
@physiotalk From my experience of previous placements the responsibility of the therapist completing the initial assessment if nursing staff have not already asked #physiotalk
Janet Thomas @JanetThomas47
I think this is an interesting question. In my setting (Day Hospital) we all ask (not all at the same time!) , but with differing reasons and questions. Hopefully not too repetitive though! #physiotalk
Ian Tyrrell @IanTyrrell5
@physiotalk Everyone asks about falls in ed but I like to think the devil is in the detail #physiotalk
Joe Middleton @_JoeMiddleton
RT @IanTyrrell5: @physiotalk Everyone asks about falls in ed but I like to think the devil is in the detail #physiotalk
Jo Lockyear @Jolockyear1
@physiotalk Everyone’s, the medic clerking the patient in starts the process but the PT and OT are the main people #physiotalk
Janet Thomas @JanetThomas47
@_JoeMiddleton Cant disagree in my opinion as well! Although the rest of the MDT in my workplace are very thorough :) #physiotalk
Suzanne Smith @suzsmu_tbh_phys
@physiotalk Working with Rheumatology outpatients, I would say it is either physio or OT - however, our systems aren't set up to easily record falls. #physiotalk
Velocity Physio @_velocityphysio
@physiotalk Drs & consultants during clerking and post taking patient. Then the physiotherapists with their CGA of the patient #physiotalk
Farida Lingard @FaridaLingard
Everyone's in Mental Health Services for Older People @NottsHealthcare #physiotalk
Catherine Bowdler @clbowdler
@physiotalk Physio, OT and Community Matron will all routinely ask ask as part of initial assessment. #physiotalk
Christopher Tuckett @HealthPhysio
@physiotalk Whoever the admitting clinician is should do the asking, but in reality it often gets left to the nursing staff admitting the patient to the inpatient area. If they don't get admitted then either the clinican in ED or the frailty unit. #physiotalk
Helen Caldwell @caldwell_pt
@IanTyrrell5 @physiotalk Agreed! #physiotalk
physiotalk @physiotalk
@IanTyrrell5 So - Ian and @_JoeMiddleton Tell us the detail and why physios are the best! #physiotalk
Alice Kilby @AliceKilbyPT
@physiotalk In theory it’s everyone’s! However is therapists are pretty good at it so we should play to our strengths. #physiotalk
physiotalk @physiotalk
Wondering if (for clarity) we need to be clear if we are talking about a falls assessment on presentation or falls in an inpatient setting? #physiotalk
James Armstrong @PhysioArmstrong
@physiotalk Whilst on placement and working as a Physio Assistant during the summer it was very much a MDT responsibility mainly OT and Physio though. It was interesting to see both professions approach #physiotalk
Farida Lingard @FaridaLingard
@physiotalk Sorry new to this. Think I'm posting in the wrong place! Everyone's responsibility in Mental Health Services for Older People @NottsHealthcare #physiotalk
physiotalk @physiotalk
@PhysioArmstrong How did they differ in your opinion? #physiotalk
Joe Middleton @_JoeMiddleton
@IanTyrrell5 @physiotalk A doctor asks because they want to know why you fell. A nurse asks because they want to keep you safe in hospital. We ask because we want to know why you fell, how we can minimise the risk, how we can get you home, and how we can keep you living the life you want #physiotalk
Louise Brennan @Louise_Brennan_
@caldwell_pt @IanTyrrell5 @physiotalk So true, a falls ax is really a case of 'if you're going to do something, do it right'! #physiotalk
Helen Caldwell @caldwell_pt
@physiotalk I saw a quote saying ‘it takes a village to prevent a fall’ – I agree with this, but the only trouble with it becoming everyone’s business is that there becomes the danger of it being nobody’s business #physiotalk How do we prevent this?
physiotalk @physiotalk
@FaridaLingard @NottsHealthcare You are fine! All you need to do is include the hashtag in your tweets and we can all 'see' your tweets #physiotalk
physiotalk @physiotalk
RT @_JoeMiddleton: @IanTyrrell5 @physiotalk A doctor asks because they want to know why you fell. A nurse asks because they want to keep yo…
Joe Middleton @_JoeMiddleton
@physiotalk @IanTyrrell5 Physiotherapists can approach falls from multiple perspectives, encompassing the bio, the pyscho, and the social. #physiotalk
Ian Tyrrell @IanTyrrell5
@physiotalk @_JoeMiddleton “Controversial tweet” doesn’t have to just be a physio(I know this is physio talk but bear with me) but I think as therapist we can explore more about in intrinsic and extrinsic factors regarding to falls rather than just the cardiac/neurological causes #physiotalk
Alice Kilby @AliceKilbyPT
@physiotalk However therapists are only around for part of the day that’s why it’s important to have a system for recording falls and events preceding the fall to establish patterns. #physiotalk
James Armstrong @PhysioArmstrong
@physiotalk Often I felt OT's would have a more functional approach and very empathetic and the Physio's more goals based and structured. Not sure if I'm explaining it that well. Both were good in there own way. As a student it was fascinating to observe. #physiotalk
suzanne avington @avington_suzann
Lots of staff ask the question its what steps are taken and onward referrals made...? #physiotalk #falls
hannah young @hmlyoungphysio
Following the chat along in leicester #physiotalk
physiotalk @physiotalk
@IanTyrrell5 @_JoeMiddleton Controversial is good (Well as long as not too controversial) ! We want a discussion rather than all be in full agreement... #physiotalk
Joe Middleton @_JoeMiddleton
RT @Louise_Brennan_: @caldwell_pt @IanTyrrell5 @physiotalk So true, a falls ax is really a case of 'if you're going to do something, do it…
Fran Hallam @FranHallam_PT
@_JoeMiddleton @IanTyrrell5 @physiotalk Agree, one of our strengths as physios is to see the whole holistic picture and put all the pieces of the jigsaw together #physiotalk
Farida Lingard @FaridaLingard
@avington_suzann Agree @avington_suzann it's about what happens next. #physiotalk
Pamela Hansford @PamKHphysio
@physiotalk #physiotalk Pam Hansford from CT SA, a 75 yr-old neurophysio now also recovering quadriplegic (biggest challenge: mild L hemi-athetosis) who wonders why therapists still want to focus on the problem first (falls)?Lets make #healthyaging & #Wellbeing our goaldirected startingpoint
physiotalk @physiotalk
So - we've made a start talking about #Falls Heading towards question two next... #physiotalk
Joe Middleton @_JoeMiddleton
RT @FranHallam_PT: @_JoeMiddleton @IanTyrrell5 @physiotalk Agree, one of our strengths as physios is to see the whole holistic picture and…
Jessica Metcalfe @JLMPhysio
RT @_JoeMiddleton: @IanTyrrell5 @physiotalk A doctor asks because they want to know why you fell. A nurse asks because they want to keep yo…
Helen Caldwell @caldwell_pt
@physiotalk Blimey this is flying by! #physiotalk
physiotalk @physiotalk
So … Q How would you ask about falls, without using ‘the f word (fall)’?! #physiotalk
Joe Middleton @_JoeMiddleton
Great point. As with most assessments, it is what is done with the findings that matters. #physiotalk
physiotalk @physiotalk
And if you are not sure why this is important then see https://t.co/V04gxua2BS #physiotalk
Joe Middleton @_JoeMiddleton
I assume we're not allowed to replace 'fall' with a mime? #physiotalk
Ian Tyrrell @IanTyrrell5
@_JoeMiddleton Almost like an interrogation at times, exact time, exact place, who was there, what were you wearing, what was on the television, anything distracting you....#physiotalk
Helen Caldwell @caldwell_pt
@PamKHphysio @physiotalk Thanks for joining us Pam - goo dto have you here. Goal specific to the patient is always key, but useful to get a background on their falls to see if any risk factors can be removed/modified to prevent further falls #physiotalk
Mari @mariand84
@physiotalk I try to always ask about falls when I meet patients over the age of 65 in clinic (outpatient) #physiotalk
Louise Brennan @Louise_Brennan_
@caldwell_pt @physiotalk I was thinking this too - when everyone is responsible, sometimes people think someone else will do it. Does the buck have to stop somewhere? #physiotalk
Opeyemi @opewalker
@physiotalk Usually the physiotherapist #physiotalk
physiotalk @physiotalk
@_JoeMiddleton Now this is where I wish we could swap and have a video based chat... #physiotalk
Claire O' Connell @ClaireOCPhysio
@physiotalk Nursing staff do initial falls assessment. Physio/Ot go into more detail aboit falls and action any plans. Gps also ask patients. #physiotalk
Alice Kilby @AliceKilbyPT
@_JoeMiddleton @IanTyrrell5 @physiotalk With so many people’s asking similar questions, we need to make sure we communicate the info we have gathered effectively #physiotalk
Helen Caldwell @caldwell_pt
@IanTyrrell5 @_JoeMiddleton Yes and difficult then if you're asked the same sort of questions by the next person/at the next place #physiotalk
Joe Middleton @_JoeMiddleton
RT @physiotalk: @_JoeMiddleton Now this is where I wish we could swap and have a video based chat... #physiotalk
francis rogan-physio @francisrogan
@IanTyrrell5 @physiotalk Agree devil is in the detail. From physio point of view I ask about activity, do strength test. However I think physician who sees patient should be looking at medication etc. it needs to be a team approach #physiotalk
Charlotte Deller @physio_cdeller
@physiotalk Always us as a physio! Pts often get referred on the ward for falls but we will be the first people to talk about them with the patient, even if that’s why they were admitted #physiotalk
James Armstrong @PhysioArmstrong
@physiotalk Any difficulty with your balance? #physiotalk
Mari @mariand84
@physiotalk How is your balance? #physiotalk
Janet Thomas @JanetThomas47
@AliceKilbyPT @_JoeMiddleton @IanTyrrell5 @physiotalk It is worrying though how often when we met after our MDT assessment how often we have all been told different things. Why? Is it linked to how we ask? #physiotalk
Farida Lingard @FaridaLingard
@physiotalk It can be difficult. I often talk ask about balance ... #physiotalk
hannah young @hmlyoungphysio
I think it also matters how often you ask (depending on the setting you work in) it can’t just be a one off and then a box is ticked and never returned to #physiotalk
Helen Caldwell @caldwell_pt
@_JoeMiddleton All to often when looking back at incidents the risks are asked & documented, but the action taken is not. This is imperative #physiotalk
Ian Tyrrell @IanTyrrell5
@caldwell_pt @_JoeMiddleton Yes but I think documentation around falls/causes and accuracy of said documentation would be a whole other can of worms. Dare I mention #MechanicalFall hehe #physiotalk
Joe Middleton @_JoeMiddleton
Ask re: balance (whether patient has ever loses balance or whether they feel balance is poor). Ask whether able to get up from the floor? #physiotalk
James Armstrong @PhysioArmstrong
@mariand84 @physiotalk Is that regardless of what they are presenting with? #physiotalk
Claire O' Connell @ClaireOCPhysio
@caldwell_pt @physiotalk We have it set that the nursing staff have to do the initial falls assessment on admission to avoid this happening. #physiotalk
Alice Kilby @AliceKilbyPT
Get involved with #falls chat- the pace is fast and the answers already brilliant #physiotalk @physiotalk we are only in question 1!
Leah Palmer @Leahphysio577
@physiotalk Ask about mobility in the house/outdoors? Then move towards how they perceive their balance as this usually sparks the conversation about previous falls #physiotalk
Janet Thomas @JanetThomas47
@_JoeMiddleton I'm often told at the start of an assessment that they feel their balance is poor and they struggle with STS or stairs People know their own bodies! #physiotalk
Ian Tyrrell @IanTyrrell5
@francisrogan @physiotalk I think gait is massive! Countless referrals via gp to orthotics for even the slightest of foot drops can stop regular falls #physiotalk
Joe Middleton @_JoeMiddleton
@IanTyrrell5 @caldwell_pt Blasphemy!!! #physiotalk https://t.co/Q8imJISMqs
physiotalk @physiotalk
@mariand84 Why specifically over the age of 65 @mariand84? #physiotalk
Helen Caldwell @caldwell_pt
@IanTyrrell5 @_JoeMiddleton Argh #mechanical fall #physiotalk
Joe Middleton @_JoeMiddleton
RT @JanetThomas47: @_JoeMiddleton I'm often told at the start of an assessment that they feel their balance is poor and they struggle with…
IPTOP WCPT @iptopwcpt
@IanTyrrell5 @caldwell_pt @_JoeMiddleton NOOOOOOOOOOOO #physiotalk
Joe Middleton @_JoeMiddleton
RT @IanTyrrell5: @francisrogan @physiotalk I think gait is massive! Countless referrals via gp to orthotics for even the slightest of foot…
Ian Tyrrell @IanTyrrell5
@_JoeMiddleton @caldwell_pt Someone had to do it @_JoeMiddleton #physiotalk
physiotalk @physiotalk
RT @AliceKilbyPT: Get involved with #falls chat- the pace is fast and the answers already brilliant #physiotalk @physiotalk we are only in…
suzanne avington @avington_suzann
Its a challenge isn't it balancing #falls as everyone's responsibility with targeted interventions? Ideas at #physiotalk @caldwell_pt
Alice Kilby @AliceKilbyPT
@JanetThomas47 @_JoeMiddleton @IanTyrrell5 @physiotalk Do we as Physio’s have a different emphasis? Are we, ‘cause we are interested in falls more likely to probe deeper? -yes! That’s no bad thing #physiotalk
Louise Brennan @Louise_Brennan_
@francisrogan @IanTyrrell5 @physiotalk team approach works well, key thing will then be for each person to report back clearly to the team through notes or face to face so a full picture can be formed #physiotalk
James Armstrong @PhysioArmstrong
@Louise_Brennan_ @francisrogan @IanTyrrell5 @physiotalk Reporting back exactly what the pt says is really important and perhaps how the said it? #physiotalk
IPTOP WCPT @iptopwcpt
@PhysioArmstrong @mariand84 @physiotalk It probably should be Lots of evidence behind frailty screening in MSK outpatients #physiotalk
physiotalk @physiotalk
RT @physiotalk: So … Q How would you ask about falls, without using ‘the f word (fall)’?! #physiotalk
Ian Tyrrell @IanTyrrell5
@AliceKilbyPT @JanetThomas47 @_JoeMiddleton @physiotalk From working in ed massively. Medics are concerned if there is something that needs treating urgently. In my role it’s about prevention as best we can in a hyper acute situation. #physiotalk
francis rogan-physio @francisrogan
@Louise_Brennan_ @IanTyrrell5 @physiotalk Agree. And the from there to feedback to the patient too. I think patients are lost in the follow up ( working in a private setting) #physiotalk
Helen Caldwell @caldwell_pt
@avington_suzann Its that individualised Ax that leads to the individualised interventions and then whomever is documenting an intervention to ensure it either takes place or is passed onto the relevant person #physiotalk
Mari @mariand84
@PhysioArmstrong @physiotalk Yes. #physiotalk
Joe Middleton @_JoeMiddleton
This is so, so vital. e.g. the patient said 'oh, I don't know... I must have tripped' vs. the patient said she 'tripped' #physiotalk
physiotalk @physiotalk
#physiotalk
Claire O' Connell @ClaireOCPhysio
@physiotalk Start off with... how do you manage at home? Is there anything that you find difficult? How is your mobility at home? That usually starts off a conversation about poor balance.. #physiotalk
Mari @mariand84
@physiotalk Because falls are more common among older ppl. 65 is a good age to draw the line. #physiotalk
physiotalk @physiotalk
Just about half way through Some great hashtagging going on Keep it up! #physiotalk #physiotalk #physiotalk #physiotalk #physiotalk
Helen Caldwell @caldwell_pt
@clbowdler @physiotalk I tend to ask directly about falls first and then judge the response as to whether I need to try a different tact #physiotalk
physiotalk @physiotalk
So - we need to keep going with the next question... A little more specific this time... #physiotalk
physiotalk @physiotalk
Q How do you assess falls? What sort of things are you asking about? #physiotalk
Ian Tyrrell @IanTyrrell5
@physiotalk I tend to see a lot of patients with facial injuries following a fall in ed and my usual opening gambit (original I know) is what does the other bloke look like? I tend to try and encourage people to be honest, helps me troubleshoot #physiotalk
Claire O' Connell @ClaireOCPhysio
@physiotalk I will ask directly too..it depends on the patient! #physiotalk
Helen Caldwell @caldwell_pt
@physiotalk Here’s the NICE guidelines for falls in older people as a reference if you need it after the tweetchat https://t.co/cKus6FWDrk #physiotalk
Louise Brennan @Louise_Brennan_
@PhysioArmstrong @francisrogan @IanTyrrell5 @physiotalk good point, people often use euphemisms or figures of speak when discussing difficult topics like falls - the words, tone, context, non-verbal cues all need to be listened to! #physiotalk
James Armstrong @PhysioArmstrong
@physiotalk What were they doing at the time of the fall? #physiotalk
Anna Spiteri @spiteri_anna
@physiotalk Great to see so many students in the conversation tonight #physiotalk #falls
IPTOP WCPT @iptopwcpt
@IanTyrrell5 @physiotalk And does the type of injury help you assess - falls forwards onto face, ability to get saving arm out etc etc #physiotalk
Leah Palmer @Leahphysio577
@physiotalk We don't just ask, we observe too. As many of the things that can contribute to a fall can stem from age, past medical history, mobility, medication, eye sight... #physiotalk
KB @KBNeuroinfo
RT @caldwell_pt: @physiotalk Here’s the NICE guidelines for falls in older people as a reference if you need it after the tweetchat https:/…
Zoe Merchant OT @ZoeJRichardson
RT @physiotalk: So … Q How would you ask about falls, without using ‘the f word (fall)’?! #physiotalk
hannah young @hmlyoungphysio
@physiotalk I’d like to ask what everyone uses for a short sharp assessment tool? Any recommendations and pros and cons? Thanks #physiotalk
RWT Nurse Ed @RWT_NurseEd
RT @physiotalk: Q In your place of work, whose responsibility does it tend to be to ask about falls? #physiotalk
Mari @mariand84
@physiotalk And in Sweden we have an in-patient register called senior alert. The nurses must ask everyone over 65 of falls in history #physiotalk
ACPOPC @ACPOPC
RT @physiotalk: And if you are not sure why this is important then see https://t.co/V04gxua2BS #physiotalk
Alice Kilby @AliceKilbyPT
@physiotalk A tip I picked up from a geriatrician when working is a falls clinic was to explain to the patient and or carer what I consider a fall and then ask from there #physiotalk
Leah Palmer @Leahphysio577
RT @caldwell_pt: @physiotalk Here’s the NICE guidelines for falls in older people as a reference if you need it after the tweetchat https:/…
James Armstrong @PhysioArmstrong
RT @caldwell_pt: @physiotalk Here’s the NICE guidelines for falls in older people as a reference if you need it after the tweetchat https:/…
Helen Caldwell @caldwell_pt
@Leahphysio577 @physiotalk Observation is a really important skill/tool #physiotalk
Claire O' Connell @ClaireOCPhysio
@physiotalk Our assessment inc: mobility/balance/vision/continence/fear of falling/falls history/osteoporosis risk/cognition/ability to use call bell(in patient)/ meds/environment/ any neuro conditions/infection risk.... #physiotalk
IPTOP WCPT @iptopwcpt
@hmlyoungphysio @physiotalk To assess …. Or to screen for risk? (Spoiler - do they work?) #physiotalk
Christopher Tuckett @HealthPhysio
@physiotalk I like to treat it as a functional assessment like I used to with my other MSK patients. Combined with constant subtle questioning which allows you to then decide on suitable more specific tests/assessments e.g. BP ax #physiotalk
Mari @mariand84
@PhysioArmstrong @physiotalk I would ask this one too #physiotalk
Helen Harte @Hartey_PainPT
@physiotalk Time of day / night it happened. Context i.e. rushing to the bathroom. IMHO Urinary urge often overlooked as another normal part of ageing.... #physiotalk
Janet Thomas @JanetThomas47
@AliceKilbyPT @physiotalk It wouldn't be the first time I've defined a fall (in laymans terms) first! #physiotalk
Ian Tyrrell @IanTyrrell5
@physiotalk Being honest in ed I look for the obvious, wish I had more time to do a complete falls assessment, I look for abnormalities, gait, time of falls, classic going to toilet at night and trouble shoot from there. Ensure onward referral if meet communit criteria #physiotalk
Joe Middleton @_JoeMiddleton
- Number in past 12/12 - Frequency - Nature & Pattern (inc. location & time) - Prev. injury - Preceding symptoms - Ability to summon help/get off the floor - Fear of falling - Self-reported balance problems - Mobility - Function - PMH & DH of note - Recall of events #physiotalk
Alex Fisher @alex_fisher1969
@IanTyrrell5 @_JoeMiddleton Oops #physiotalk
Christopher Tuckett @HealthPhysio
@physiotalk STS, TUG, walking speed etc all can show you a lot about a patients physical and cognitive abilities I find. #physiotalk
Helen Caldwell @caldwell_pt
@iptopwcpt @hmlyoungphysio @physiotalk If you work in in-patient setting, the National Audit of Inpatient Falls 2017 is a useful document to compare your setting to. Also recommends not to use falls risk prediction tools! https://t.co/EaavmtxIO8 #physiotalk
Joe Middleton @_JoeMiddleton
As a starter for 10. #physiotalk
James Armstrong @PhysioArmstrong
RT @Louise_Brennan_: @PhysioArmstrong @francisrogan @IanTyrrell5 @physiotalk good point, people often use euphemisms or figures of speak wh…
physiotalk @physiotalk
RT @_JoeMiddleton: - Number in past 12/12 - Frequency - Nature & Pattern (inc. location & time) - Prev. injury - Preceding symptoms - Abili…
Jo Lockyear @Jolockyear1
@physiotalk I always like to ask about a patients feelings towards falling. Are they feeling anxious or developed a fear of falling. This can give you a real insight into how your intervention should/will go #physiotalk
Anna Spiteri @spiteri_anna
RT @physiotalk: Just about half way through Some great hashtagging going on Keep it up! #physiotalk #physiotalk #physiotalk #physi
Farida Lingard @FaridaLingard
@AliceKilbyPT @physiotalk Same @AliceKilbyPT. It depends on the person you are asking. And then you need to probe further, time of day, what they were doing, how often, environment etc etc #physiotalk
Claire O' Connell @ClaireOCPhysio
@physiotalk Always ask what would they do if they had a fall.... not always able to prevent them, so educate on how to manage if it happens is key! #physiotalk
Leah Palmer @Leahphysio577
RT @_JoeMiddleton: - Number in past 12/12 - Frequency - Nature & Pattern (inc. location & time) - Prev. injury - Preceding symptoms - Abili…
Anna Spiteri @spiteri_anna
RT @physiotalk: So - we need to keep going with the next question... A little more specific this time... #physiotalk
KB @KBNeuroinfo
RT @_JoeMiddleton: - Number in past 12/12 - Frequency - Nature & Pattern (inc. location & time) - Prev. injury - Preceding symptoms - Abili…
Anna Spiteri @spiteri_anna
RT @physiotalk: Q How do you assess falls? What sort of things are you asking about? #physiotalk
Anna Spiteri @spiteri_anna
RT @caldwell_pt: @physiotalk Here’s the NICE guidelines for falls in older people as a reference if you need it after the tweetchat https:/…
Helen Caldwell @caldwell_pt
@Hartey_PainPT @physiotalk I agree - continence can be one of the main reasons for rushing to go to the bathroom #physiotalk
KB @KBNeuroinfo
RT @caldwell_pt: @iptopwcpt @hmlyoungphysio @physiotalk If you work in in-patient setting, the National Audit of Inpatient Falls 2017 is a…
Emily Daymond @physio_edaymond
@physiotalk I find that asking patients about their balance tends to trigger them to mention any near misses or falls that thy have had #physiotalk
Mari @mariand84
@francisrogan @physiotalk So if poor TUG-score they will get more physio and wait for surgery? #physiotalk
James Armstrong @PhysioArmstrong
@Jolockyear1 @physiotalk Really great point! Fear of falling can be so important in establishing approach to reducing falls #physiotalk
Alice Kilby @AliceKilbyPT
@HealthPhysio @physiotalk With some patients subtly is key! In the community a chat while walking round the property can be enlightening. And then you’re assessing dual tasking too! #walkingandtalking #physiotalk
Louise Brennan @Louise_Brennan_
@AliceKilbyPT @physiotalk I like this idea, do you include near-misses in this definition, out of curiosity? #physiotalk
Joe Middleton @_JoeMiddleton
- Continence - Vision - Hearing - Bowel habit - Footwear - Environment (e.g. lighting, flooring etc.) #physiotalk
Helen Harte @Hartey_PainPT
RT @physiotalk: Q How do you assess falls? What sort of things are you asking about? #physiotalk
Anna Spiteri @spiteri_anna
RT @caldwell_pt: @iptopwcpt @hmlyoungphysio @physiotalk If you work in in-patient setting, the National Audit of Inpatient Falls 2017 is a…
Helen Caldwell @caldwell_pt
@Hartey_PainPT @physiotalk I mean for falling when rushing! Clearly it is one of the main reasons for rushing to the bathroom! #physiotalk #typingtoofast
Sheila White @Sheila_I_White
@physiotalk Occupational therapist here eavesdropping 😁 #physiotalk
Janet Thomas @JanetThomas47
@_JoeMiddleton Are all your falls the same... Any common factors? Strength (not just functional strength although that's vital!) Gait speed as well as gait (if you know what I mean!) #physiotalk
Joe Middleton @_JoeMiddleton
#physiotalk
Alice Kilby @AliceKilbyPT
@Louise_Brennan_ @physiotalk Yes I would, but record it as such #physiotalk
Zoe Merchant OT @ZoeJRichardson
RT @_JoeMiddleton: - Number in past 12/12 - Frequency - Nature & Pattern (inc. location & time) - Prev. injury - Preceding symptoms - Abili…
Joe Middleton @_JoeMiddleton
@JanetThomas47 Do you ask about gait speed or just assess it? #physiotalk
physiotalk @physiotalk
@Sheila_I_White Don't stick at eavesdropping - join in! (Well you have done...) #physiotalk
Helen Caldwell @caldwell_pt
@HealthPhysio @physiotalk You're right - we're aiming to minimise, rather than prevent. Minimise the risk of falling and minimise the risk of injury from a fall #physiotalk
suzanne avington @avington_suzann
@_JoeMiddleton @physiotalk Any preference for fear of #falls assessment tool... a recent debate with colleagues #physiotalk
Helen Caldwell @caldwell_pt
@ClaireOCPhysio @physiotalk The contingency plan is so important #physiotalk
Louise Brennan @Louise_Brennan_
@caldwell_pt @iptopwcpt @hmlyoungphysio @physiotalk oh that's so interesting re the prediction tools! It always seemed a strange notion to tell someone they were at risk of a fall.. Do they discourage their use in hospital settings too e.g. for risk ax purposes? #physiotalk
Alice Kilby @AliceKilbyPT
@PhysioArmstrong @Louise_Brennan_ @francisrogan @IanTyrrell5 @physiotalk Yes! Let’s use plain language that everyone can understand #physiotalk
Janet Thomas @JanetThomas47
@_JoeMiddleton Timed walk but also ask about community mobility, can they get to toilet in time etc Also distance - whats the furthest you've walked in the past week / month #physiotalk
francis rogan-physio @francisrogan
@hmlyoungphysio @physiotalk In screening we have used TUG, and now introducing hand grip strength. This helps us to decide if patient discharged with walker/ crutches. It also has helped us manage expectations of patients, and to help them plan. We use in combination with RAPT score to plan d/c #physiotalk
Helen Caldwell @caldwell_pt
@avington_suzann @_JoeMiddleton @physiotalk Ooh yes lovely question! #physiotalk
Axelle Mokry @axelle_mokry
RT @physiotalk: Q How do you assess falls? What sort of things are you asking about? #physiotalk
Catherine Bowdler @clbowdler
@ClaireOCPhysio @physiotalk Yes, absolutely, all of these. Culprit drugs too and any symptoms of postural hypotension #physiotalk
physiotalk @physiotalk
Any help / comments here... #physiotalk
M-J Sharp @hipsterlife85
Great tweetchat going on tonight with @physiotalk about falls, v. insightful & lots of useful tips! #physiotalk
Christopher Tuckett @HealthPhysio
@caldwell_pt @physiotalk Yep, I think the term 'prevention' is misleading at best and harmful at worst as it can lead patients to believe they should not happen. When in fact they are a very normal part of life. #physiotalk
Alice Kilby @AliceKilbyPT
RT @caldwell_pt: @iptopwcpt @hmlyoungphysio @physiotalk If you work in in-patient setting, the National Audit of Inpatient Falls 2017 is a…
Ian Tyrrell @IanTyrrell5
@_JoeMiddleton @JanetThomas47 But how many patients do you see that walk perfectly for you and their family say bolt around the house at high speed. There is a little bit of #WhiteCoatSyndrome when it comes to risk taking/aversion when it comes to being seen by a professional #physiotalk
Joe Middleton @_JoeMiddleton
All patients in hospital, aged 65 or older, are to be considered at risk of falling #physiotalk
Janet Thomas @JanetThomas47
@HealthPhysio @caldwell_pt @physiotalk I fell last weekend.... Now I know I have grey hair but.... #physiotalk #overwhelmingextrinsicfactors #segway
physiotalk @physiotalk
#physiotalk
francis rogan-physio @francisrogan
@mariand84 @physiotalk Ideally yes. But often depends on the funder and patients means (in private setting) #physiotalk
Christopher Tuckett @HealthPhysio
@caldwell_pt @physiotalk Stigmatising 'falls' as a never event for older people is a trap we would do best to strongly avoid otherwise they may not admit to having one at all. #physiotalk
Anna Spiteri @spiteri_anna
@physiotalk MDT working so important and working with Pharmacists and Medics about medication induced falls. Side effects of meds can’t be ignored. #Physiotalk #falls
Emily Daymond @physio_edaymond
RT @_JoeMiddleton: - Number in past 12/12 - Frequency - Nature & Pattern (inc. location & time) - Prev. injury - Preceding symptoms - Abili…
physiotalk @physiotalk
Onto the next question - some great tweeting but we won't get to all the questions otherwise! #physiotalk
Joe Middleton @_JoeMiddleton
@IanTyrrell5 @JanetThomas47 Frequently get that look of bewilderment and annoyance on a relative's face. 'He was worse than this this morning. Honest!!!' #physiotalk
Jo Lockyear @Jolockyear1
@physiotalk Also getting a patient to describe there fall. So many people may not recognise a fall, particularly if they haven’t ended up on the floor. #physiotalk
Fran Hallam @FranHallam_PT
@physiotalk Before asking anything I start assessing as soon as I arrive at the person's house, looking at the access, how long they take to answer the door, use of mobility aid, footwear, signs of injury….#physiotalk
physiotalk @physiotalk
Q What type of exercise do you feel is most effective for frequent fallers #physiotalk
Helen Caldwell @caldwell_pt
@Louise_Brennan_ @iptopwcpt @hmlyoungphysio @physiotalk Certainly for falls they are not recommended according to NICE. IMHO if you're telling someone they're at risk of falls, you're automatically increasing their fear & thus probably reducing their activity #physiotalk
Joe Middleton @_JoeMiddleton
RT @avington_suzann: @_JoeMiddleton @physiotalk Any preference for fear of #falls assessment tool... a recent debate with colleagues #physi
Alice Kilby @AliceKilbyPT
@HealthPhysio @caldwell_pt @physiotalk Interesting stuff about the idea of prevention, very useful to remember when working with people who present again and again to falls services #physiotalk
physiotalk @physiotalk
RT @caldwell_pt: @Louise_Brennan_ @iptopwcpt @hmlyoungphysio @physiotalk Certainly for falls they are not recommended according to NICE. IM…
Leah Palmer @Leahphysio577
@physiotalk Chair based exercise to start to build confidence and them move to strength, balance and propripception exercise #physiotalk
James Armstrong @PhysioArmstrong
@physiotalk One that they can enjoy and understand how it will help? #physiotalk
Pamela Hansford @PamKHphysio
@physiotalk #physiotalk need to ask about medication - @Atul_Gawande Atul Gawande in his fascinating book Being Mortal points out that people taking more than 4 prescription medications are at risk of falling! Only 4? Also: #Deprescribing & @TheIHI are promoting understanding of this aspect
Alice Kilby @AliceKilbyPT
@HealthPhysio @caldwell_pt @physiotalk And when assessing if interventions have been successful #physiotalk
Ian Tyrrell @IanTyrrell5
@_JoeMiddleton @JanetThomas47 Yup! I have had countless nicknames for making people walk perfectly that aren’t able to! #physiotalk but often it’s understanding the psychological issues behind it! But I’m a deep thinker #physiotalk
Helen Caldwell @caldwell_pt
@spiteri_anna @physiotalk Yes. This. Completely. Polypharmacy can't be understated in increasing falls risk #physiotalk
physiotalk @physiotalk
RT @caldwell_pt: @spiteri_anna @physiotalk Yes. This. Completely. Polypharmacy can't be understated in increasing falls risk #physiotalk
Joe Middleton @_JoeMiddleton
Must take the opportunity to plug the @MDTea_podcast episode on 'Fear of falling' https://t.co/FFW3QPa5VL #physiotalk https://t.co/Mzzj8BibJT
Helen Caldwell @caldwell_pt
Ooh I listened to this. It is good. Worth a listen #physiotalk
Ian Tyrrell @IanTyrrell5
@physiotalk Again I work in ed, so I don’t have shed loads of time but I always say for some older patients that walking, even if they fear that the most is the best exercise! #physiotalk
Louise Brennan @Louise_Brennan_
@caldwell_pt @iptopwcpt @hmlyoungphysio @physiotalk It's so counter-productive, isn't it! And to be fair, they probably know they're unsteady on their feet anyway... #physiotalk
Janet Thomas @JanetThomas47
@Leahphysio577 @physiotalk Would you always start with chair based? I'm wondering why? #physiotalk
Anna Spiteri @spiteri_anna
RT @caldwell_pt: @spiteri_anna @physiotalk Yes. This. Completely. Polypharmacy can't be understated in increasing falls risk #physiotalk
Joe Middleton @_JoeMiddleton
Must take the opportunity to plug the @MDTea_podcast episode on 'Acute management of falls' https://t.co/i7FZ78Pcz6 #physiotalk
IPTOP WCPT @iptopwcpt
@caldwell_pt I totally recommend the @MDTea_podcast A great listen on all types of subjects #physiotalk
Christopher Tuckett @HealthPhysio
@physiotalk Any exercise that utilises strength and balance work, that is also progressive, and dosed strongly enough and most importantly engaging enough to sustain long term commitment. #physiotalk
francis rogan-physio @francisrogan
@physiotalk Depends on setting, but I often ask them if I can test there balance and time their stride standing balance. I use this as opener for them to say “oh my balance is good/bad” and the I can ask “why?” #physiotalk
Helen Caldwell @caldwell_pt
@Leahphysio577 @physiotalk In an ideal evidence based falls prevention exercise continuum, chair based exercise should aim to prepare and progress people to standing balance challenging exercise #physiotalk
Mari @mariand84
@physiotalk A simple sitting to standing exercise to begin with #physiotalk
Alex Fisher @alex_fisher1969
@physiotalk #physiotalk embedding 'exercise' into meaningful activity. Again alot if the folk I work with are cog impaired & have neuro apathy. They may not have insight into 'needing' exercise
Joe Middleton @_JoeMiddleton
Must take the opportunity to plug the @MDTea_podcast episode on 'Falls prevention' https://t.co/aUYUJkzT0p #physiotalk https://t.co/vC0kxrvNax
physiotalk @physiotalk
RT @_JoeMiddleton: Must take the opportunity to plug the @MDTea_podcast episode on 'Falls prevention' https://t.co/aUYUJkzT0p #physiotalk
Christopher Tuckett @HealthPhysio
@physiotalk As a general rule we seem to set the bar way too low for most older people, and then wonder why they get bored or don't progress. We need to challenge them! #physiotalk
Helen Harte @Hartey_PainPT
@IanTyrrell5 @physiotalk Yes! My biggest bugbear is that we may unwittingly perpetuate fear of falling by instilling a fear of mobility #physiotalk
suzanne avington @avington_suzann
@_JoeMiddleton @MDTea_podcast Thank you.. will check out #falls #physiotalk
IPTOP WCPT @iptopwcpt
Here's a few that I saw during #FPAD2018 promotions #physiotalk https://t.co/0LVMjmY9Gp
Alice Kilby @AliceKilbyPT
@physiotalk Has to be challenging, has to make them wobble, has to include strengthening exercises and has to be progressive #physiotalk
Leah Palmer @Leahphysio577
@JanetThomas47 @physiotalk Not always. Depending on the individual patient. I tailor each program individually as everyone is different and some more confident than others #physiotalk
Fran Hallam @FranHallam_PT
@HealthPhysio @physiotalk Sustainment is a really good point and often difficult to achieve #physiotalk
Janet Thomas @JanetThomas47
@HealthPhysio @physiotalk Agree! Challenge, tailoring and progressions are vital #physiotalk
Simon Everett @sdephysio
@physiotalk Standing at their sink whilst washing pots doing mini dips quays dancing to their favourite songs on the radio. Do what they like and make it fun! #physiotalk
Louise Brennan @Louise_Brennan_
@physiotalk Balance retraining, reaction skills, real-world situations... Also, there's a really great app called @clock_yourself that I think lots of patients would benefit from! (I recommended it to a family member after an ankle op!) #physiotalk
Helen Caldwell @caldwell_pt
@Leahphysio577 @JanetThomas47 @physiotalk Tailoring to your patient is great. If they can go straight to standing strengthening/balance work, evidence shows its best to bypass the chair based exercises completely #physiotalk
hannah young @hmlyoungphysio
@HealthPhysio @physiotalk Too much prevention focus can lead to patients avoiding things and healthcare profs being v risk averse, which can have its own consequences. Interesting discussion #physiotalk
Suzanne Smith @suzsmu_tbh_phys
@physiotalk Calf raises - simple and easy to do safely without equipment. I also encourage movement to music to help reduce anxiety and improve rhythm.#physiotalk
suzanne avington @avington_suzann
We perhaps don't dissuade this enough...how many referrals to therapy "at risk of falls" #physiotalk
Janet Thomas @JanetThomas47
@Louise_Brennan_ @physiotalk @clock_yourself Promotional tweet alert! We have @MegLowryPT from @clock_yourself speaking at #AGILE18 on 10th Nov #physiotalk
Helen Caldwell @caldwell_pt
@FranHallam_PT @HealthPhysio @physiotalk That understanding of why it is beneficial, and the patient seeing the value is so important #physiotalk
Joe Middleton @_JoeMiddleton
@physiotalk Working in the very acute setting (ED/AMU), I don't get to do much in the way of exercise with my patients. However, I believe resistance exercises and tai chi are both pretty good. Otherwise, what ever the patient will continue to do, and challenges them! #physiotalk
Catherine Bowdler @clbowdler
@physiotalk Working alongside OT colleagues to create patient centred functional strength and balance exercises. Recent example of wheeling a laden wheelbarrow round the garden. #physiotalk
Anna Spiteri @spiteri_anna
@caldwell_pt @physiotalk https://t.co/E9Fxk1vQfg Look this up! Bohemian Polyphamacy. If you’re a Queen fan you will love this. #physiotalk #falls
Farida Lingard @FaridaLingard
@physiotalk Individually tailored to improve strength and balance as well as walking. As challenging as a person can do safely. This is where outcome measures can be valuable to show progress to an individual. #physiotalk
James Armstrong @PhysioArmstrong
@caldwell_pt @FranHallam_PT @HealthPhysio @physiotalk Absolutely, getting them to then really buy into their own treatment plan #physiotalk
physiotalk @physiotalk
#physiotalk *facepalm*
Janet Thomas @JanetThomas47
At a risk of being too promotional - recommend the training from @LaterLifeTrain (Yes, I do tutor on their courses :) ) #physiotalk
Alex Fisher @alex_fisher1969
@physiotalk #physiotalk Consideration should also take into account carer burden. Their time in managing compliance with what we px and advise
Joe Middleton @_JoeMiddleton
https://t.co/NZg2rfxqyb @LaterLifeTrain #physiotalk
Alice Kilby @AliceKilbyPT
@physiotalk Given current nhs pressures, do we as Physio’s need to build better relationships with our exercise professional colleagues to ensure we are providing evidence based interventions? #physiotalk
Emily Daymond @physio_edaymond
RT @_JoeMiddleton: Must take the opportunity to plug the @MDTea_podcast episode on 'Falls prevention' https://t.co/aUYUJkzT0p #physiotalk
physiotalk @physiotalk
Less than 10 mins to go - so onto our last question #physiotalk
NNUH Physiotherapy Team @NNUHphysio
Check out #physiotalk to see what people are saying about falls. Some interesting discussions
physiotalk @physiotalk
RT @NNUHphysio: Check out #physiotalk to see what people are saying about falls. Some interesting discussions
Owen O'Neil @OwenONeil_UK
RT @physiotalk: Q What type of exercise do you feel is most effective for frequent fallers #physiotalk
Helen Caldwell @caldwell_pt
@PhysioArmstrong @FranHallam_PT @HealthPhysio @physiotalk Motivational interviewing. Getting them to tell you what would make them less likely to fall. Empowers ownership of treatment plan #physiotalk
physiotalk @physiotalk
Q What other ways do you help to prevent falls? Any new technologies helping? #physiotalk
Alice Kilby @AliceKilbyPT
@caldwell_pt @Leahphysio577 @JanetThomas47 @physiotalk Agreed! Get them up, get them moving! #physiotalk
suzanne avington @avington_suzann
Absolutely...and something that we know they'll engage in...mirroring an activity that they know or better still that they love #physiotalk
Helen Harte @Hartey_PainPT
@HealthPhysio @physiotalk YES!!!!! and i wonder if this is part of the reason that the older people speciality remains unattractive for some physios? #physiotalk
Joe Middleton @_JoeMiddleton
@IanTyrrell5 @JanetThomas47 I find that validating patients fear is a big step. Telling them that it is okay to be scared of falling, but together we canm bit-by-bit, get on top of this. #physiotalk
IPTOP WCPT @iptopwcpt
@_JoeMiddleton @physiotalk The best exercise is the one the person will do! On the other hand, we do need to motivate them to do the evidence based exercises - otherwise no good for falls! #physiotalk
Helen Caldwell @caldwell_pt
@alex_fisher1969 @physiotalk Meaningful exercise - yes. My chance to promote #OHPF4YO next Monday channel 4 at 9pm! #physiotalk
Alex Fisher @alex_fisher1969
#physiotalk I am v much enjoying hanging out with u lovely lot
physiotalk @physiotalk
#physiotalk
Christopher Tuckett @HealthPhysio
RT @JanetThomas47: @Louise_Brennan_ @physiotalk @clock_yourself Promotional tweet alert! We have @MegLowryPT from @clock_yourself speaking…
Ian Tyrrell @IanTyrrell5
@physiotalk For me one of the biggest bugbears its not having an orthotics department as part of our trust. I see so many foot drops that could benefit from splints but not direct access so have to access through go so just wastes time! #physiotalk
Helen Caldwell @caldwell_pt
@clbowdler @physiotalk OTs and physios can be a really great team when it comes to functional activities for high risk fallers #physiotalk
Louise Brennan @Louise_Brennan_
@clbowdler @physiotalk Taking the patient outdoors is so important! (if they usually go outdoors, that is..) curbs, grass, uneven steps, weather changes.. Simply showing a patient that they can do these things again can help reduce falls risk #physiotalk
francis rogan-physio @francisrogan
@mariand84 @physiotalk One of my favorites for patients. Often introduce it early and do sit-stand test as there are norms. Patients quite like the challenge and to see an improvement #physiotalk
Helen Caldwell @caldwell_pt
@IanTyrrell5 @physiotalk My biggest bugbear is having to go via the GP for an orthotics referral rather than direct! #physiotalk
Pamela Hansford @PamKHphysio
@physiotalk #physiotalk start with a,b,c, (not #Strengthening!) #Alignment to gain #Balance to work on #Control and create #DynamicStabilisation through #Education & #EnergisingThroughExercise in meaningful #FUNctionalActivity in #DailyLife
Natasha Goswell RN @NatashaGoswell
RT @_JoeMiddleton: Must take the opportunity to plug the @MDTea_podcast episode on 'Falls prevention' https://t.co/aUYUJkzT0p #physiotalk
physiotalk @physiotalk
A must watch! But hope its not on weekly as otherwise you would miss half of #physiotalk
Alex Fisher @alex_fisher1969
@IanTyrrell5 @physiotalk #physiotalk get friendly with yr local CNRTs. If u're discharging folk their way, they may order off the peg
Farida Lingard @FaridaLingard
@caldwell_pt @IanTyrrell5 @physiotalk Its probably a bugbear for the GPs too! #physiotalk
Ian Tyrrell @IanTyrrell5
@_JoeMiddleton @JanetThomas47 Exactly, often by saying “I’m not going to let you fall, it’s too much paperwork” can alleviate those fears and that confidence. I only see hyperacute so it’s difficult to comment on anything else #physiotalk (paperwork comment is a poor gag)
Joe Middleton @_JoeMiddleton
I'm still waiting to see my first patient that has summoned assistance via Alexa #physiotalk
Helen Caldwell @caldwell_pt
@physiotalk Only for 5 weeks! #physiotalk
suzanne avington @avington_suzann
@physiotalk Would love to know of any success with technology as a falls education medium? #physiotalk. interactive too?
Christopher Tuckett @HealthPhysio
@Hartey_PainPT @physiotalk Massively, and until it moves away from being seen as simply walking older people up and down a ward and instead towards active, goal led rehab that takes into account motivation and sustainability then it will continue to suffer a bad rep. #physiotalk
physiotalk @physiotalk
So - 2 minutes remaining of the #physiotalk chat. What is your top tip for #Falls
Pamela Hansford @PamKHphysio
@physiotalk #physiotalk Also #Dancing for People with PD would be appropriate for all people whose balance is challenged
Fran Hallam @FranHallam_PT
@caldwell_pt @PhysioArmstrong @HealthPhysio @physiotalk Get to know the person, what motivates them, their interests, their lifestyle. And if this fits with an evidence-based activity for improving muscle, bone strength and balance even better! https://t.co/yDcYxj38YQ #physiotalk
francis rogan-physio @francisrogan
@physiotalk Have been using Otago exercises. Easy, standardized and patient can do with a family member. Need to think of ways to decrease costs etc #physiotalk - using family members helps get extra sessions in.
Helen Caldwell @caldwell_pt
@avington_suzann @physiotalk Has anyone any experience of Oxehealth digital care assistant? We were talking about potentially trialling one at @LingsBar #physiotalk
physiotalk @physiotalk
@caldwell_pt Watch it on catch up it is then.... #physiotalk
physiotalk @physiotalk
RT @caldwell_pt: @avington_suzann @physiotalk Has anyone any experience of Oxehealth digital care assistant? We were talking about potentia…
physiotalk @physiotalk
@caldwell_pt @avington_suzann @LingsBar A what?! #physiotalk
suzanne avington @avington_suzann
@AliceKilbyPT @physiotalk Agree this will be essential ...and still an area we can have lots of impact #falls @thecsp #physiotalk
Alex Fisher @alex_fisher1969
@physiotalk #physiotalk Emerging tech is great. Sadly it's the funding which is the bug bear in the era of austerity & folk being turned down for PIP. I get slightly aerated when I think of the cost savings. End of rant!
physiotalk @physiotalk
Wow - that is the hour up! Its been a fast one tonight #physiotalk
Helen Harte @Hartey_PainPT
#physiotalk
Leah Palmer @Leahphysio577
@physiotalk We've got access to the OTAGO program that we can refer via the local leisure centre which has been really popular and recommended by lots of patients #physiotalk
physiotalk @physiotalk
But please keep chatting - we won't gather the transcript for a while! #physiotalk
Pamela Hansford @PamKHphysio
@physiotalk correction #physiotalk Also #DancingForPeopleWithPD would be appropriate for all #peoplewhosebalanceischallenged
Ian Tyrrell @IanTyrrell5
@_JoeMiddleton Had a patient who said she had this system! But Alexa wasn’t in every room so she could only fall in certain spots! I was so intrigued (technophobe so don’t know how Alexa works) but how many people have pendant alarms but don’t wear them! #physiotalk
Alex Fisher @alex_fisher1969
@caldwell_pt @physiotalk #physiotalk Can u tell I'm an OT? Honestly can't do my job without u all
Helen Caldwell @caldwell_pt
@avington_suzann @physiotalk Oh sorry you were talking about education medium. CareFall, produced by RCP and funded by NHS England is a national e-learning package and is fairly good. I believe there's a care home and medic version #physiotalk
Catherine Bowdler @clbowdler
@Louise_Brennan_ @physiotalk I agree. Makes a big impact on fear of falling. Also (weather depending) patients really enjoy it when we go outside. #physiotalk
James Armstrong @PhysioArmstrong
@francisrogan @physiotalk Do you feel that Otago challenges strength enough? #physiotalk
Janet Thomas @JanetThomas47
@IanTyrrell5 @_JoeMiddleton Don't forget the new Apple watch as well! #physiotalk
Joe Middleton @_JoeMiddleton
I think @IanTyrrell5 summed it up at the start. The devil is in the detail. Go full on #Sherlock or #Poirot #physiotalk
Helen Caldwell @caldwell_pt
@physiotalk @avington_suzann @LingsBar It's supposedly an optical sensor which detects movement - the Trust it was piloted with apparently described it like their 'sixth extra night staff'! #physiotalk
Lewis Lovegrove @_lewadam
@physiotalk Apple have released the falls detection sensory app, unsure on how successful that will be though #physiotalk
Leah Devlin @Leahdevlin1989
RT @physiotalk: And if you are not sure why this is important then see https://t.co/V04gxua2BS #physiotalk
Alex Fisher @alex_fisher1969
@physiotalk #physiotalk thank you
Janet Thomas @JanetThomas47
@PhysioArmstrong @francisrogan @physiotalk Lots of strength exercises - just make sure you use an appropriate leg weight #physiotalk
francis rogan-physio @francisrogan
@physiotalk Prevention is better. Test patients, encourage strengthening and physical activity in every patient. #physiotalk
suzanne avington @avington_suzann
@caldwell_pt @physiotalk Not in the community though for patients? - you might have to enlighten me another time 😉#physiotalk
Christopher Tuckett @HealthPhysio
@physiotalk I love tech, but falls tech has often concentrated on the 'alerting' as opposed to rehab, and as such has often worsened the fear of falls (e.g. alarms). If it can be used more for rehab or exercise adherence in the future then great #physiotalk
James Armstrong @PhysioArmstrong
@JanetThomas47 @IanTyrrell5 @_JoeMiddleton 92% false positive reported for Atrial Fibrilation 😬 #physiotalk
Helen Caldwell @caldwell_pt
@avington_suzann @physiotalk Ah no not for patients. Recap?! ;) #physiotalk
Joe Middleton @_JoeMiddleton
@JanetThomas47 @IanTyrrell5 Probably still face the issue of these amazing people not wanting to 'cause a fuss' or not wanting to 'bother anyone'. Having said that, I assume there is some sort of accelerometer in an apple watch? So it could detect the fall itself? #physiotalk
Alice Kilby @AliceKilbyPT
@caldwell_pt @avington_suzann @physiotalk @LingsBar Great question! We would all do well@to remember that just because someone is older they automatically can’t use technology. Comes back to tailoring interventions that you talked about earlier #physiotalk
Sheila White @Sheila_I_White
@caldwell_pt @physiotalk @avington_suzann @LingsBar Have heard about this but not seen any hard evidence for effectiveness. #physiotalk
gemma weatherby @gemmaweatherby
Very interesting tweetchat tonight about falls! #physiotalk
Helen Caldwell @caldwell_pt
@physiotalk Thanks so much for having me. I've had a lovely time and possibly the quickest hour of my life!! #physiotalk
Janet Thomas @JanetThomas47
@HealthPhysio @physiotalk Some interesting apps discussed at the last @LaterLifeTrain conference for exercises and adherence. Just can't quite remember what they were called... #looksforconferencetweets #LLTconf #physiotalk
Louise Brennan @Louise_Brennan_
@clbowdler @physiotalk Haha yes, there's so much to be said for it...and you often find the pt is first in line for physio the next day if it means they can get out for some air! #tricksofthetrade #physiotalk
Alice Kilby @AliceKilbyPT
Brilliant stuff @caldwell_pt could barely keep up! #fatfingers #physiotalk
Joe Middleton @_JoeMiddleton
Great chat @physiotalk. Thanks for hosting @caldwell_pt #physiotalk
suzanne avington @avington_suzann
@caldwell_pt @physiotalk Mmm...not sure...wish there was something more interactive?#physiotalk
Christopher Tuckett @HealthPhysio
@physiotalk They are normal and to be expected if you are remaining active. A fall does not have to signal the start of old age, far from it. Healthcare needs to get on board with this too. #WeAllFall #physiotalk
Helen Caldwell @caldwell_pt
@Sheila_I_White @physiotalk @avington_suzann @LingsBar No I hadn't either #physiotalk
physiotalk @physiotalk
@caldwell_pt I think you are right! Thanks so much for the suggestion #physiotalk
francis rogan-physio @francisrogan
@PhysioArmstrong @physiotalk In the very weak Patient it is a great start. I have started using hand grip strength in every older patient. Some are surprisingly week, and then others surprisingly strong. #physiotalk In the very week, Otago is good.
Suzanne Smith @suzsmu_tbh_phys
@physiotalk @caldwell_pt Thanks for my first #physiotalk ! Its made me think about the chain of assessments - I'm way down the line after ED, # clinic etc but I shall be going in tomorrow and finding out about where I find the falls assessment and how to ensure that it has been done.
Mari @mariand84
@physiotalk Dare to ask, encourage balance- and strengthening training. At my clinic we have a balance group 4 training #physiotalk
gemma weatherby @gemmaweatherby
RT @_JoeMiddleton: Must take the opportunity to plug the @MDTea_podcast episode on 'Fear of falling' https://t.co/FFW3QPa5VL #physiotalk
Ian Tyrrell @IanTyrrell5
@_JoeMiddleton @JanetThomas47 That category of patients who don’t want to cause a fuss fill me with joy but also infuriate me! What’s the best approach to address this? General advice? “Telling off” “coaching and inspiring” “gentle sarcasm” intrigued by what approach people use. #physiotalk
physiotalk @physiotalk
Like this... Well join us again in 15th Oct for our next chat on Medical devices hosted by @IanTyrrell5 #physiotalk
Pamela Hansford @PamKHphysio
@HealthPhysio @physiotalk #physiotalk Lets start by asking them #WhatareyourStrengths? Working in water can be amazing for those who enjoy swimming
Meg Lowry @MegLowryPT
@physiotalk Otago if resourced. Otherwise HEP w 3-4 tailored exercises 1) LL strength exercise (sit-stand, single leg calf raise, stairs, lunge or floor transfer) 2) static balance narrow BOS 3) multidirectional stepping eg @clock_yourself 4) one w head & body turns when safe #physiotalk
Lewis Lovegrove @_lewadam
RT @physiotalk: Like this... Well join us again in 15th Oct for our next chat on Medical devices hosted by @IanTyrrell5 #physiotalk
Helen Harte @Hartey_PainPT
RT @physiotalk: Like this... Well join us again in 15th Oct for our next chat on Medical devices hosted by @IanTyrrell5 #physiotalk
Helen Caldwell @caldwell_pt
@suzsmu_tbh_phys @physiotalk Like that it makes people think. These #physiotalk 's are really good for that
Janet Thomas @JanetThomas47
@IanTyrrell5 @_JoeMiddleton I think you could describe my approach as gentle sarcasm in general. But depends on individual #physiotalk
Ian Tyrrell @IanTyrrell5
@physiotalk Got quite a bit to live up to after tonight *gulp* #physiotalk
Joe Middleton @_JoeMiddleton
@HealthPhysio @physiotalk I remember a big @thecsp campaign about falling not be an inevitable part of ageing. My thought was; but it is an inevitable part of bipedal ambulation? #physiotalk
Janet Thomas @JanetThomas47
@_JoeMiddleton @IanTyrrell5 That's what I understand. But you can switch it off..... #physiotalk
suzanne avington @avington_suzann
Thank you @caldwell_pt and @AliceKilbyPT #physiotalk I definitely still have my L plates on. Well done Helen 👏
Janet Thomas @JanetThomas47
@_JoeMiddleton @HealthPhysio @physiotalk @thecsp I don't think you can count my Segway fall as bipedal ambulation! But it was probably inevitable... #physiotalk
Claire O' Connell @ClaireOCPhysio
@physiotalk We run a general strength and balance/falls prevention talk using the "get up and go guide" from the @thecsp the following day we see patients on a 1.1 basis to try and make the exercises more individualised. #physiotalk
Joe Middleton @_JoeMiddleton
I'm ready. #physiotalk
Roy Lilley @RoyLilley
RT @physiotalk: Like this... Well join us again in 15th Oct for our next chat on Medical devices hosted by @IanTyrrell5 #physiotalk
Helen Caldwell @caldwell_pt
To spread the word, there’s a handy guide for colleagues, patients or families. The Get Up & Go Guide is free to download from @theCSP https://t.co/Cougf0qbYY #physiotalk #olderpeoplesday
physiotalk @physiotalk
@avington_suzann @caldwell_pt @AliceKilbyPT If its fast paced then Tweetdeck usually the best way to keep up However there were some issues in parts of the #physiotalk team with Tweetdeck tonight :(
Claire O' Connell @ClaireOCPhysio
@physiotalk Depending on ability/fear of falling I try to encourage a static unsupported stand to make them feel more comfortable/confident when they are not gripping their zimmers! Once able progress to dynamic movemebts unsupported #physiotalk
Meg Lowry @MegLowryPT
@physiotalk @clock_yourself A safe HEP is different to what can be done w standby assistance from physio. During Rx I go with goal oriented training + Outdoor mobility, reaching, asymmetrical farmers carries, step downs, kneeling & standing balance on BOSU, dual task games, timed challenges. #physiotalk
Alice Kilby @AliceKilbyPT
RT @caldwell_pt: To spread the word, there’s a handy guide for colleagues, patients or families. The Get Up & Go Guide is free to download…
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