Shelly Denes & Karen Pryor – “Fall is Not a Good Season for Patients” – Improving Hip, Rib and Compression Fracture Dangers and Mortality Rates” – Part One

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Speaker: Shelly Denes, PT, C/NDT, CFPS, CGCP |  Karen Pryor, PhD, PT, DPT, CH, CFPS

Duration: 2 Hours 01 Minutes

Format: Audio and Video

Copyright: Jun 30, 2023  

Media Type: Digital Seminar

Description

Many elderly patients face mortality after a hip, rib, or compression fracture.  You hold the key to reducing mortality and cause of the fracture which may have been from a fall and/or loss of balance.  Your clients need a robust head-to-toe assessment to address these issues.  With this in-depth evaluation, you’ll be able to tailor your program and goal setting to better address: reducing fracture risk, fear of falling, poor balance, nutritional issues, strength deficits and MORE! 

Speaker

Shelly Denes, PT, C/NDT, CFPS, CGCP

Shelly Denes, PT, C/NDT, CFPS, CGCP, is an expert in fall prevention and neuro-rehab with more than 30 years of experience treating patients with hemiplegia, neurological diseases, neuromuscular disorders, TBI, and SCI. She has a special interest in Long COVID, autoimmunity and the impact of chronic inflammation and sleep deprivation in rehab. She has been involved extensively with neuroprosthetic devices, lower extremity orthotics, and exoskeleton devices at the Rehab Institute of Michigan. Mrs. Denes travels nationally to present seminars on fall prevention, Long COVID and geriatric rehabilitation. Additionally, her expertise has been presented through expert witness work and consulting both nationally and locally. She also sits on the State of Michigan Fall Prevention Coalition committee. Shelly Denes is a graduate of University of Michigan’s PT program, and she earned her certification in Neurodevelopmental Treatment for Adult Hemiplegia (NDT) at the Rehab Institute of Chicago. She helped create the certifications for ‘Fall Prevention Specialist’ and ‘Geriatric Care Professional’ with Evergreen Certifications, holds these two certifications and sits on their advisory board.

Speaker Disclosures:
Financial: Michel Janet (Shelly) Denes is the owner of Denes Physical Therapy Consulting LLC. She is a consultant with Experts in Therapy LLC and previously with NewGait™. She receives a speaking honorarium from Motivations, Inc. Michel Janet (Shelly) Denes receives a speaking honorarium and recording royalties from PESI, Inc. She has no relevant financial relationships with ineligible organizations.
Non-financial: Michel Janet (Shelly) Denes is an advisory board member for Evergreen Certifications.

Karen Pryor, PhD, PT, DPT, CH, CFPS
Health Sphere Wellness Center

Karen Pryor, PhD, PT, DPT, CH, CFPS, has a doctorate in physical therapy and has practiced for 40 years in the field. Dr. Pryor is the owner of Health Sphere Wellness Center, an integrative therapy clinic in Nashville, Tennessee. Involved with early intervention in the birth-three population for over 30 years, she has developed neuroplasticity techniques that are used in a wide variety of settings, including homes, childcare centers, and school systems, to advanced pediatric therapy programs.

Dr. Pryor serves on several boards, including the Leadership Interagency Council for Early Intervention (2014-2019), a position to which she was appointed by Tennessee Governor Bill Haslam. In 2010, she received the President’s Volunteer Service Award for her contributions to the advanced treatment of children from President Barack Obama. In addition to her work with children, Dr. Pryor has served as an adjunct professor at the Tennessee State University Occupational Therapy Assistant program. She is a clinical instructor for several universities and colleges. With her years of experience and passion for complete wellness, Dr. Pryor advances a more expansive view of how to integrate therapy throughout the lifespan by using neuroplasticity techniques.

Speaker Disclosures:
Financial: Karen Pryor is the owner of Health Sphere Wellness Center, LLC and is a field examiner for PDMS-3. She has employment relationships with Tennessee State University, the University of Tennessee at Chattanooga Physical Therapy School, the Daymar Physical Therapy Assistant School and the Volunteer State Community College. She is a paid consultant for Evergreen Certifications. Karen Pryor receives a speaking honorarium and recording royalties from PESI, Inc. She has no relevant financial relationships with ineligible organizations.
Non-financial: Karen Pryor is a reviewer with Tennessee Physical Therapy Association and American Physical Therapy Association. She is an Ambassador for National Down Syndrome Society.

Objectives

1. Build a solid understanding of the impact of these fractures on mortality and how we can improve outcomes for these individuals.
2. Determine a connection between fall risk, screening to prevent the falls and possibly the fracture.
3. Develop an understanding of inflammation, sleep deprivation, visual issues, and their impact on mortality in these circumstances.

Outline

Prevention of Falls from a global perspective 

• Evaluation – Top Down 
• Causal Agents of Descent 
• Nutritional Access 
• Preventive Screening
  • Bone Scans 
  • Activity Levels 
  • Balance Impairment and Assessment 
• Balance Impairment Post Cancer 

Hip Fractures & Mortality 

• Mortality Factors 
• Can hip fractures be prevented? 
• Differential Diagnosis with hip fractures     
• Factors associated with poor outcomes after hip fractures 
• Reducing mortality after hip fractures
  • No delay if surgery is needed 
  • Consider risk of major surgery with elderly patients? 
  • Early mobilization with or without surgery  
• The burden of hip fractures – why aren’t we better at prevention ? 
• Barriers to the implementation of osteoporosis screening  

Addressing Orthogeriatric Comanagement / Rehab 

• Well-coordinated teamwork with all disciplines
  • PT -early mobilization and gait  
  • OT – early ADL training 
  • Nutrition, Dehydration and Anemia 
  • Social Work 
  • Psychology -dealing with fear 
  • Physicians 
  • Review of medications 
  • Vitamin D deficiency 
  • Appropriate activity and exercise programming 
  • Good coverage once they are discharged and providing services immediately 
  • Good follow up 
  • Adding an ER physician to the HIP FRACTURE team ? 
• Rehab after a hip fracture
  • Dealing with fear 
  • Early ambulation and mobility 
  • Appropriate exercise programming  
  • Early ADL instruction 
  • Hip Fracture Case Studies 

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