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November 6, 1996

An 85-Year-Old Women With a History of Falls

Author Affiliations

Spaulding Rehabilitation Hospital Boston, Mass

JAMA. 1996;276(17):1383. doi:10.1001/jama.1996.03540170027015

To the Editor.  —In his article on falls in the geriatric population, Dr Lipsitz1 presents a comprehensive approach for diagnosis and management except for 1 important aspect: since everybody ages, some falls may be prevented, but many are inevitable. Thus, critical adjunctive treatment should include 2 more issues.Minimization of injury during falls may reduce morbidity and mortality. For example, martial arts such as judo and aikido teach techniques for falling into a roll, preventing injury, and allowing resumption of an upright stance. Some cultures even teach techniques for falling that can minimize injury from great heights. Unfortunately, most physical therapists are not aware of such methods, much less how to adapt them for the elderly.In addition, proper mobility strategies after a fall may minimize complications. Although resumption of upright stance for ambulation is optimal, even crawling or change of positions on the ground is usually preferable to lying stationary to