Backward-chaining

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Introduction

Older adults are at risk of falls and subsequent significant injuries. After a fall, the older adult is at risk of experiencing a long lie. As part of falls management, physiotherapists can teach older adults to get up from the floor in the instance of a fall. Backward-chaining is one useful method to do this.

Description

Backward-chaining involves breaking a particular task down into steps. Then, the whole task is taught starting with the last task and working your way backwards to the first task. If one step proves challenging, it can be broken down into smaller steps. Progress from one step to the next is only made when the individual can successfully complete all prior steps.

In the case of falls, this means you start with the older adult on the floor and then teach them to work their way back up into standing or sitting on a chair. Getting up from the floor using backward-chaining means the older adult starts in the most stable position and only progresses to more unstable positions (on knees, sitting or lying on floor) as they are able.

Sequence of steps

See here for photos.

The following is from Reece and Simpson.

1. Start by having the older adult sitting on a chair or plinth, slightly turned to one side. Or stride standing next to a plinth or chair. The older adult then kneels one knee down onto a foam wedge or similar. 2.