אפידמיולוגיה ומניעת נפילות

Understanding the causes of noninfectious diseases initiated a second epidemiologic revolution, which is described, among other things, as a diagnosis of primary risk factors that cause significant morbidity. (Bodenheimer, T. S., Grumbach, 2020)

In physiotherapy, we can find great examples for this statement: identifying risk factors and preventing falls among the elderly.

It can be seen that by adopting a healthy lifestyle, physical activity, and proper nutrition, it is possible to prevent the morbidity of serious diseases. (Nicklett & Taylor, 2014)

The sedentary Western lifestyle and the lack of engaging in physical activity, together with an increase in life expectancy, led the professionals in physiotherapy to make physical activity adapted to the different populations' part of the profession's treatment methods.

 Today, the concept of health policy in physiotherapy organizations worldwide holds that physiotherapists are leading professionals in health promotion programs. (Ambrose et al., 2013)

 Falls are one of the leading causes of morbidity and mortality in the elderly and may cause functional decline, decreased quality of life, and depression. Preventing falls and their different accompanying injuries among old-aged people is an urgent goal of the public health system. It was found that arthritis in the lower body is a significant risk factor for falls due to the deficiencies characteristic of this pathology: pain, decreased balance, and weakness of lower body muscles. (Nicklett & Taylor, 2014)

Physiotherapy should include targeted treatment in regards to each of the three risk factors that characterize this population. 

The therapeutic guidelines regarding physical activity, which have been shown to prevent falls in the elderly (such as working on balance and stability), are also admissible in patients with lower-limb arthritis. Thus, personal practice programs should be built/designed for patients with arthritis, according to the patient's symptomatic state, the severity of the disease, and the patient's needs.

Will this method of health disease prevention continue? I guess it will.

Whether Coronavirus and its ways of coping with it characterize the transition to the Third Revolution? This question may also have a positive answer.

The original epidemiological revolution idea describes the transition from acute infectious diseases to death through chronic, non-infectious, degenerative diseases. (Harper & Armelagos, 2010)

 This change occurred because of a higher standard of living and the introduction of medical and public health practices in high-income countries undergoing industrialization.

We are now entering a third epidemiological transition, characterized by a reappearance of infectious diseases, which were once considered controllable at the same time as the rapid appearance of several new diseases.

 In addition, the existence of antibiotic-resistant pathogens all heralds the possibility that we are living at the end of the age of antibiotics. (Harper & Armelagos, 2010)

These dramatic changes are driven by a fast global transportation system that turns the disease contagion process with the transmission of pathogens, being so quick and wide.

Considering all the facts and risk factors described previously, we shall expect to continue and face many challenges in the world of medicine and physiotherapy, with increased chronic diseases and rising morbidity.

 

References:

Ambrose, A. F., Paul, G., & Hausdorff, J. M. (2013). Risk factors for falls among older adults: a review of the literature. Maturitas, 75(1), 51–61. https://doi.org/10.1016/j.maturitas.2013.02.009

Bodenheimer, T. S., Grumbach, K. (2020). Understanding Health Policy: A Clinical Approach, Eighth Edition, 8th Edition.

Harper, K., & Armelagos, G. (2010). The changing disease-scape in the third epidemiological transition. International Journal of Environmental Research and Public Health, 7(2), 675–697. https://doi.org/10.3390/ijerph7020675

Nicklett, E. J., & Taylor, R. J. (2014). Racial/Ethnic predictors of falls among older adults: the health and retirement study. Journal of Aging and Health, 26(6), 1060–1075. https://doi.org/10.1177/0898264314541698