What are physical therapists doing to prevent falls in older adults in Brazil? - Findings from a nationwide survey

Abstract

Background

Understanding how physical therapists (PTs) approach fall prevention in older adults and factors that may influence their clinical practices is essential for designing knowledge translation strategies.

Objectives

To describe PTs’ clinical practices and barriers to implementing fall prevention best practices in older adults and to identify professional characteristics associated with implementation of fall prevention best practices.

Methods

A cross-sectional online survey was conducted. Registered PTs providing care to older adults were recruited through social media platforms. A pre-tested questionnaire assessed clinical practice patterns, sociodemographic and professional characteristics, and behavioral factors influencing the implementation of fall prevention best practices. Data were analyzed descriptively, and multinomial regression identified associations between PTs’ characteristics and practice frequency. The Theoretical Domains Framework and the Capability, Opportunity, Motivation-Behaviour model guided questionnaire design and interpretation of findings.

Results

Among 454 PTs surveyed, over 65 % reported frequently (often or always) asking patients about falls, identifying and documenting fall risk factors, and implementing fall prevention interventions. Recommended practices such as balance and strength training were commonly implemented. Barriers to fall prevention best practices included patient denial of risk, reluctance to report falls, and adherence challenges. PTs not practicing in geriatrics or those lacking up-to-date fall prevention knowledge were less likely to report consistent use of best practices.

Conclusion

Brazilian PTs frequently integrate fall prevention into older adult care but face patient-related barriers. Addressing the identified barriers through behavior change strategies could enhance the implementation of fall prevention best practices.