Falls among community-dwelling elderly people in selected districts of Umutara province, Republic of Rwanda: the role of the physiotherapist

  • Egide Ntagungira



Falls among elderly people have been identified as a significant and serious medical problem confronting a growing number of older people.


The purpose of the study was to identify the risk factors for falls among the community-dwelling  elders in the Umutara Province of Rwanda.


A cross-sectional convenience survey using a self-administered questionnaire was used, with a sample of 200 elders, both male and female , aged 60 and older. Data was analyzed using SPSS. Chi-squares and Fisher's exact tests were used to test associations between variables.


Nearly a quarter (23.2%) of the community-dwelling  elderly people had multiple falls in the previous year. Risk factors significantly associated with increased falling in the elderly included advanced age, gender, joint stiffness and lower extremity muscle weakness. Loss of balance and coordination, vision deficits , painful joints, multiple drug use and prolonged use of sedatives, and antidepressants were also potential risks of falling. Men fell more often than women. Men tended to suffer outdoor falls, while women were likely to sustain indoor falls.  Injury rates were also high: hip, lower back and ankle injuries were the most prevalent.


Potential  risk  factors  for  falls  include  characteristics  such  as:  physiological  changes (age), chronic  illnesses,  chronic medication and multiple drugs.


Amosun . S. L. (1999). The status of older persons in Africa: Challenges facing physiotherapists. South Afncan Journal of Physiotherapy , 55(3), 1-7.

Chartered Society of Physiotherapy, (1999). Services for older people.Physiotherapy effectiveness Bulletin. 1(2). 1-6.

Daley , M. J. & Spinks, W. L. (2000). Exercise mobility and aging. The Australian j ournal of sports Medicine, 29(1), 1-12.

Elliot, R. (1991).Assistive technology for the elderly: An introduction and overview. U.S Department of Health and Human Services .

Ellyn,V. B. & Miller, P. (2003). Is chronic pain a risk factor for falls among community-dwelling elders. Topics in Geriatric Rehabilitation , 19(2), 145-159

Eisenberg, J. S. (2004). Falls among older patients are a serious public health problem: Can improved vision decrease the risk? The Fifth Annual Presbyopia Report: Your Role in Fall Prevention. 46-48

Fletcher , P.C. (2002). Falls:A n issue among older women. Stride: Ex cellence in Long-term Care, 6-11.

Fuller, G. F.(2000).Falls in the elderly. Problem-oriented diagnosis. The Journal of American Family Physician, 61(7), 2159-2168.

Gallagher, E. M. (1994). Falls and the elderly community. The Centre on Ageing. 1-10.

Gillespie, LD., Gillespie,W.J., Cumming, R., Lamb, S.E., & Rowe,B.H. (2001). Interventions for preventing falls in elderly.Cochrane library Issue 2,oxford: Update software.

Horn, L. B. (2000). Reducing the risk of falls in the elderly. The Interdisciplinary Journal of Rehabilitation , 1-4.

Huang, H, Guan, M., Lin,W. & Kemohan, G. (2003). Assessing risk of falling in older adults. Public Health Nursing, 20(5), 399-405.

Kalasa, B. (2004). Population and ageing in Africa. A policy dilemma. Country report, 84,1-14.

Koski, K., Luukinen, H., Laippala, P & Kivela, S.L. (1998) . Risk factors for major injurious falls among the home-dwelling elderly by functional abilities. Gerontology, 44(4), 232-238.

Langlois, J.A., Smith, G.S., Nelson, D.E., Sattin, R.W., Stevens,

J.A . & DeVito, C.A. (1995). Dependence in activities of daily living as a risk factor for falls. Fails injury events among older people living in the community. The j ournal of American geriatric society, 43,275-278.

Piotrowski, A . B. (1999). Reducing falls in elderly people. Physiotherapy Theory and Practice, 15, 59-68.

Robinson, B.S., Gordon, J.M., Scott, W.W. & Visio, M. (2004). Relationship between lower-ex1remity joint torque and the risk for falls in a group of community dwelling older adults. Physiotherapy Theory and the Practice.20, 155-173.

Shobha, S.R. (2005). Prevention of Falls in Older Patients: Retrived 8 October. 2005,from hhp://www.aa fp.org afg.

Simpson,J. M. (1993). Elderly people at risk of falling: The role of muscle weakness.Physiotherapy, 79(12), 831-83.