Preventing falls and fractures in children with muscle conditions information sheet

Information about preventing falls and fractures in children with muscle conditions. 

Falls can be prevented

The goal is to maintain safe walking and active participation. Preparation of the environment is key to this. Contact your local physiotherapist and occupational therapist for specific help. Discuss the below strategies with school to ensure your child stays safe.

This information has been adapted from the clinical guideline for management of Duchenne muscular dystrophy.

 Your occupational therapist or physiotherapist can provide a home or school visit to assess and advise on:

•  Walking surfaces (flooring, paths that are even and level, non-slip)
• Terrain (a predictable path of travel that is level or gradual rise will be much easier than steps, uphill grass path or sand for example)
• Obstacles (identifying trip hazards) • Fatigue management (by pacing daily routines or using a wheelchair for long distances) • Wheelchair safety - falls from wheelchairs are a common cause of injury 
• Safe transfers to and from wheelchairs • Appropriate footwear to avoid slips and trips

• Remove obstacles such as rugs, toys, cords, and clutter
• Provide a chair or stool in key locations in the home, such as at kitchen bench, so your child doesn’t have to stand for long periods which might over-fatigue.
• Place a chair in the garden or on transit paths so your child can rest to prevent over-fatigue.
• Supervise your child on stairs and provide a handrail for support.
• Allow plenty of time for using stairs. Encourage your child to put both feet on each step, before going up to the next step
• Use non-slip mats in shower or bath • Install grab bars for shower or bath, or toilet.
• Use a bath seat or other adaptive equipment for bathing
• Install non-slip treads for steps
• Consider installing handrails on both sides of stairs.

• Take special care when outdoors because of uneven surfaces, obstacles, or slippery paths after rain
• Ensure your child wears ‘pool shoes’ for protection against falls when walking on slippery surfaces around water. 
• Avoid loose footwear.
• Ensure the shower or toilet floors are dry before your child walking or transfers.

Avoiding falls from wheelchair or mobility device

• Use seatbelt at all times
• Use anti-tippers on wheelchairs 
• Practice safe best-transfer technique with your therapist.

Safe transfer in and out of wheelchair

• Consider hoist or sling seat systems for home and school to provide assistance to recover from falls. This reduces manual handling injuries of carers and parents.
• Consider adaptive equipment to minimise falls or injury risks during transfers (e.g. toileting, bathing or showering equipment).