1. Falls : Going down, Getting up, and Staying up By Janice Sallitt, PT

2. Table of Contents How to get up from a fall How to fall How to prevent a fall

3. How to get up from a fall Step 1 - Take a minute to calm yourself and breathe deeply to relax your muscles. Step 2 – If you are in pain, do not move and call for help/call 911 if possible. Step 3 – Think about how you want to move before you do it (visualize your movement) Step 4 – Check to see if a chair/table/stable piece of furniture is close by to grab to assist you to get up.

4. Continued Step 5 – If you fell out of a wheelchair, put the brakes on and use it get up Step 6 – Roll onto your side ( get off your back) Step 7 – Try to bend your knees or pull them up by pulling on your pant legs Step 8 – Get the arm that you’ve rolled on out from under you

5. Continued Step 9 – Grab furniture or crawl to a chair Step 10 – Get up on one knee, then the other Step 11 – Get up on one foot and pull up to a standing position How you can prepare – 1. Practice rolling from your back to your side (left and right) 2. Scan your living areas : large open areas of floor space should have chairs or tables to assist in getting up 3. Carry phone or lifeline button on you (not in a drawer)

6. How to fall Gradual Descent Immediately let go of any assistive device to free the arms to cushion the fall Bend your knees to lower your center of gravity

7. How to prevent a fall Avoid looking at your feet while walking on level surfaces (practice looking about 10-15 feet ahead of you on the floor – this allows you to scan the area just ahead for obstacles – giving your body time to react) Having a Physical Therapist knowledgeable in multiple sclerosis evaluate your balance, gait/walking, strength, sensation, environment, fatigue factors, etc., to determine your fall risk

8. Continued Have a health professional perform a home safety assessment for suggested modifications to your particular home environment (your local county office on aging may have a home safety check list available) Realize that difficulties in walking may predispose you to falls (For example – If you are unable to clear your foot, you are more likely to trip) Also realize that carrying objects may impair your ability to stay balanced and increase your fall risk