Physical and Occupational Therapist Evaluations for Fall Prevention in the Emergency Department: A Geriatric ED Guidelines 2.0 Systematic Review

Authors

• Lauren T Southerland
• Pedro K Curiati
• Richard D Shih
• Alexander X Lo
• Kristie Harper
• Ian Tarnovsky
• Alexis Brengartner
• Luna Ragsdale
• Neha Raukar
• Suzanne Ryer
• Katherine M Hunold
• Fabrice Mowbray
• Charles L Maddow
• Christopher R Carpenter
• Shan W Liu

Language

English

Publication Date

3-1-2026

Journal

Academic Emergency Medicine

DOI

10.1111/acem.70201

PMID

41354970

PMCID

PMC12937041

PubMedCentral® Posted Date

12-7-2025

PubMedCentral® Full Text Version

Post-print

Abstract

Background: Older adults are at high risk for severe injuries and death from falls. Physical therapist (PT) and occupational therapist (OT) evaluations have been introduced into Emergency Department (ED) care to assist with fall risk evaluation and fall prevention care. An evaluation of current evidence was undertaken to inform the Geriatric ED Guidelines 2.0.

Methods: Systematic review of physical and/or occupational therapy evaluation for fall prevention in the ED. The intervention was evaluation by a rehabilitation therapist (PT, OT, or both) for fall prevention, fall assessment, or mitigation of fall risk factors. Studies that did not perform the evaluation during the ED or ED Observation Unit visit were excluded, such as referrals for home consultation. The published literature was searched using strategies created by a medical librarian and was implemented in Embase and PubMed in March 2025. Covidence was used for article collation and review. Risk of bias was assessed using the Cochrane Risk of Bias v2 and the Ottawa-Newcastle scale.

Results: The search resulted in 387 articles with 52 duplicates, for 335 unique citations. Ten articles on 6 datasets were included (4 abstracts and 6 published manuscripts). One article was at high risk of bias as very few intervention patients received therapist evaluation. The remaining 5 datasets had varied co-interventions in addition to PT and/or OT evaluations. PT or OT evaluation in the ED was associated with reduced ED revisits at 1, 2, and 6 months. Evaluations in the ED were not associated with increased hospital admission rates or ED length of stay. A meta-analysis was infeasible due to varied outcome timeframes.

Conclusions: PT and/or OT evaluations for fall prevention were associated with reduced subsequent ED revisits for older adults. However, the impact of co-interventions and heterogeneity limits strong conclusions.

Published Open-Access

yes

Recommended Citation

Southerland, Lauren T; Curiati, Pedro K; Shih, Richard D; et al., "Physical and Occupational Therapist Evaluations for Fall Prevention in the Emergency Department: A Geriatric ED Guidelines 2.0 Systematic Review" (2026). Faculty, Staff and Student Publications. 3468.
https://digitalcommons.library.tmc.edu/uthmed_docs/3468