PPT Slide
Physical Restraints: Do They Prevent or Promote Falls? Heather Hambly
Purpose: Physical restraints have traditionally been used to protect older persons from being injured, including injuries from falling. The purpose of this review is to examine the recent literature on the relationship between physical restraints and falling. Methods: The literature was collected using an on-line search of the MEDLINE and CINAHL databases. Search terms used were ‘elderly’, ‘restraints’, and ‘falls’. Results were limited to English language articles dating from 1985 or later. References from the retrieved literature were also used. Results: The general consensus of the studies examined is that the use of physical restraints in an elderly population does not prevent falls, and that removing the restraint does not lead to an increased risk of falling. Many variables need to be considered before restraint reduction, such as cognition impairments and ambulatory status. Conclusions: Although our society is already moving towards a restraint-free environment to help decrease falls while promoting independence and quality of life, further studies on specific populations are required to help speed the transition to restraint free care and help set standardized guidelines. Clinical Relevance: Falls are the leading cause of death among elderly persons, and the major reason for restraint use is to prevent falls and injury. However, physical restraints cause loss of muscle tone, pressure sores, and contractures, and psychological problems such as confusion and loss of self-image. All of these effects are important influences on a physiotherapist’s interaction with patients.