National Falls Prevention Awareness Day is observed on the first day of fall (today!) to increase public awareness and promote activities to reduce falls among older adults. This year's awareness day is themed "Standing Together to Prevent Falls," and 46 states are planning to participate. National Falls Prevention Awareness Day is just one example of the tremendous work over 70 professional organizations, including APTA, federal agencies, and 42 state falls prevention coalitions have done through the Falls Free Initiative.

According to the Centers for Disease Control and Prevention (CDC), one-third of older adults fall at least once each year. Falls are the leading cause of fatal injury and nonfatal trauma-related hospital admissions among older adults. Muscle weakness, balance impairments, and walking difficulties are among the leading risk factors for falls among older adults. Fortunately, various types of exercise can lessen the impact of these factors and reduce one's chances of falling.

The US Preventive Services Task Force recently supported exercise or physical therapy and Vitamin D supplementation to prevent falls among community-dwelling older adults. These recommendations are also supportive of those proposed by the American Geriatrics Society, which recommends balance, walking, and strength training to reduce falls risk.

The Physical Activity Guidelines for Americans (PAG) also recommend balance training at least 3 times per week for older adults at increased risk for falls. This is in addition to the general recommendation for a minimum of 150 minutes of moderate-intensity or 75 minutes of vigourous-intensity aerobic exercise per week and 2 days per week of strength training.

Balance training should be challenging and progressive in difficulty (such as reducing base of support and/or increasing movement in multiple directions). Group or individual programs that combine balance and strengthening exercises, such as tai chi, have been proven to effectively reduce falls among older adults.

Evidence-based balance exercise programs can be offered in any number of settings. It is also acknowledged that a variety of other healthy aging programs can be strategically offered within facilities to promote and sustain behavior change, address intermediate risk factors or barriers, or serve as entry programs for referral to more targeted fall prevention programming. Many of these programs are already found within communities supported by the US Administration on Community Living. Research supports a minimum of 50 hours of exercise, over a minumum of 12 weeks (6 months is best) to affect balance and falls, so physical therapists need to partner with agencies that can help to augment or supplement our plans of care.

There are many examples of successful partnerships among community agencies and exercise professionals to offer evidence-based and best-practice programs that deliver the recommended type and amount of exercise. Community agencies are also in a strategic position to offer assistance with marketing, recruiting participants, and providing activity space. Potential partners include senior centers, older adult housing, churches, fitness and wellness centers, and nutrition sites.

APTA provides website resources on falls prevention to its members and promotes the Falls Prevention Awareness Day through its e-newsletter. Other awareness and planning resources are also available from the National Coalition on Aging Center for Healthy Aging. How can your organization and members join together to help your communities' older adults improve balance and reduce falls?

Guest bloggers: Lori Schrodt, PT, PhD, Chair of the Health Promotion & Wellness Special Interest Group, Section of Geriatrics, American Physical Therapy Association; (Bonita) Lynn Beattie, PT, MP, MHA, Vice President, Injury Prevention Lead, Falls Free Initiative; Center for Healthy Aging; National Council on Aging; and physical therapist students from Western Carolina University, Andrea Cahoon, Sherrie Flory, Anna King, Caitlin Laemmle, Kenneth Richards, and Monica Vargas.

Making an Impact through Information  

Consumer tools developed for members to share with their patients are an effective way to promote the benefits of physical activity. Providing members with downloadable and customizable consumer handouts on topics related to physical activity is an efficient, cost-effective way to help members get the word out in their communities. Handouts that we have developed include topics like physical activity tips for families, foot health for runners, physical therapy and diabetes, and how to avoid a variety of sports-related injuries.

Social Media

Because many people rely on the Internet for their health information and millions are on Facebook and Twitter, it can be a good idea to use social media as part of your outreach. Social media can take a variety of forms such as videos, tweets, and Facebook posts. We have developed a library of YouTube videos related to physical activity-related topics, such as ACL Injury Prevention; Activities for Kids of All Abilities; Bike Fit; Exercise Techniques (nine series); Exercise for People with Disabilities; Fitness as You Age; Good Health Tips for Runners: Maintaining Physical Activity Across the Lifespan; and Running Tips and Walking Tips. These and our other social media properties are housed on our consumer website, www.moveforwardpt.com.

Video: "Activities for Kids of All Abilities" (Click to play)

Video: "Strength Training Tips from a Physical Therapist" (Click to play)

Tweeting several times a day on topics relevant to consumers can help you develop a following on a Twitter. Hosting tweet chats where members engage with followers on particular topics can also be an effective way to reach consumers. Our tweet chat topics have included toys for children with disabilities, obesity prevention and management, and foot health for runners. It is also possible to videotape live discussions and stream them via the Internet. This year we hosted our first "livestream" event, "Fit for Life," featuring baby boomer physical therapists discussing how they incorporate physical activity into their lives and the lives of their families.

News releases continue to be an effective way to reach the media. Releases we have issued on the importance of physical activity include "New Dietary Guidelines Highlight Importance of Physical Activity" and "Physical Therapists Help You Get Fit - Safely - in 2011."

Making an Impact through Awareness

An organization's national awareness week or month can be used to deliver a targeted, cohesive message in a way that may not otherwise be possible. Tools may be developed that encourage interaction between members and their patients, or clients and traditional PR strategies may be supplemented by social media during this coordinated effort. In 2010, National Physical Therapy Month was dedicated to the importance of physical activity in preventing obesity, and its consequences. We supported our efforts with social media and developed a downloadable board game for members to use with their patients.

Collaborating with related organizations is another way to extend your impact. For instance, APTA collaborated with the President's Council on Fitness, Sports, and Nutrition on a brochure entitled, Be Active, Be Fit: Beginning and Maintaining a Physical Activity Program. 

What resources and programs have you developed to help your members promote physical activity in their communities?

The American Physical Therapy Association Section on Geriatrics held a 3-day conference in July 2010 on the campus of the University of Indianapolis to promote the application of research on benefits of exercise for older adults into clinical practice. Both the content format and the unique meeting planning create a model that may be useful to other organizations planning an education offering on the value of physical activity.

The conference, Exercise and Physical Activity in Aging Conference (ExPAAC): Blending Research and Practice, was hosted by the University of Indianapolis Center for Aging & Community and Krannert School of Physical Therapy, and drew 350 participants. Presentation topics included the effects of PA and exercise on health and aging, how to affect behavioral change, and evidence-based prescription for older adults. Our goals for the conference were to: 1) make available current research about PA and exercise from middle through older adulthood; 2) translate research into evidence based practice; 3) identify barriers to translation of research into evidence based practice; 4) promote best practices in physical therapist practice; and 5) evaluate public policies that influence the capacity of physical therapists to provide services. Speakers included national and international researchers Jack Guralnik, MD, PhD, MPH; Pamela Duncan, PT, PhD, FAPTA, FAHA; Alexandre Kalache, MSc, MD, PhD, FRCPH; James Rimmer, PhD; Thomas Prochaska, PhD; Barbara Resnik, PhD, RN, CRNP, FAAN, FAANP; and Luigi Ferrucci, MD, PhD.

Session topics included national and international physical activity initiatives, effects of physical activity and exercise on components of health and aging, determinants of behavior change, and evidence based practice exercise for optimizing function. We also held an evening poster presentation session to highlight case reports, research studies, special interest reports, and theory reports. Some participants wished to attend ExPAAC but felt they needed a review in geriatrics, so we offered a one-day pre-conference course that enabled these participants to maximize their experience. The closing keynote speech was delivered by Dr. James Canton, PhD, renowned author and advisor from the Institute for Global Futures.

Holding the conference at the university allowed us to have many great opportunities for networking and discussion - both formal and informal - at mealtimes in the campus cafeteria, during breaks on the outdoor commons, and at several special social events planned for conference attendees. Attendees stayed in the nearby Holiday Inn or in the dormitories on campus, which had the advantages of lower hotel and meeting site costs. An additional benefit was that conference participants were invited to attend exercise classes and to use campus recreational facilities during their free time.

For those who were unable to attend ExPAAC, we made sure that all of the sessions could be purchased through the APTA Learning Center at (click on "Courses" and search for ExPAAC). The PowerPoint presentations and the commentary of the experts during their ExPAAC presentations were included. Each session features multiple choice question examinations for the purposes of CEU credit.

Because of ExPAAC's overwhelming success, the Section on Geriatrics is considering an "ExPAAC II" in the next 5-10 years. We hope that a model such as ours will be as successful for you as it was for us...

Written by guest bloggers: Ellen Milner, PT, PhD; David M. Morris, PT, PhD