Increasing Balance. Decreasing Falls.
By: Julie Hancox, DPT, Claremore Clinic
With National Fall Prevention Awareness Day, presented by the National Council on Aging, around the corner I thought this would be a fitting topic for this month’s blog.
Have you or anyone close to you ever said:
- “Falls just happen when you get old.”
- “Falling is bad luck. I slipped and that could happen to anyone.”
- “It was an accident. I will be more careful next time.”
- “I already walk for exercise, why do I need to work on my balance?”
As we age, many people are in denial of their risk of falling, and I can understand why. Who wants to admit their balance is becoming worse, let alone be put in a situation of potential embarrassment after a fall? While I understand pride, I also have read the statistics, researched the factors behind falls, and know the medical costs associated with falling; this is why I believe prevention of falling is key!
The statistics are quite astonishing. 33% of people 65 years and older will fall this year. Less than half of the Medicare beneficiaries who fell in the previous year talked to their healthcare provider about it. Every 29 minutes an older adult dies from a fall. 1 out of 5 falls causes a serious injury such as a head trauma or fracture. Over 2 million older adults are treated in emergency departments for nonfatal fall injuries each year. Direct medical costs for fall injuries total over $28 billion annually. Hospital costs account for two-thirds of the total.
While the statistic are daunting, there are risk factors that may be changed, as well as ones that cannot be changed (sorry, none of us are immortal, so aging just has to be accepted). Not only are there risk factors we can and cannot change, but there are risk factors that are intrinsic (inside our bodies) as well as extrinsic (outside our bodies).
So what are these risk factors, you ask?
|INTRINSIC FACTORS||EXTRINSIC FACTORS|
|Advanced age||Lack of handrails on stairs|
|Previous fall(s)||Poor stair design|
|Muscle weakness||Lack of bathroom grab bars|
|Gait (walking) and balance disturbance||Dim or low lighting|
|Poor Vision||Obstacles and trip hazards|
|Postural hypotension||Slippery or uneven surfaces|
|Chronic conditions including arthritis, diabetes, stroke, Parkinson’s, incontinence, dementia||Psychoactive medications (e.g. benzodiazapines, medications with the side effects of drowsiness/sedation)|
|Fear of falling||Improper use of assistive device|
The more risk factors you have, the higher your risk of falling. The highlighted boxes are factors that physical therapy is able to help with! I’ll explain more below.
Next great question, what are some things you can do to prevent falls?
- Begin an exercise program to improve your leg strength and balance
- See your doctor for a referral to physical therapy
- Participate in Tai Chi: Movement for Better Balance classes offered locally at Summit Physical Therapy and First United Methodist Church
- Go to your local gym and begin an aerobics class or use the weight room/machines (make sure you are aware of how the machines work so you do not injure yourself)
- Ask your doctor or pharmacist to review your medications
- 4 or more medications puts your at risk for balance issues or falls
- Get annual eye check ups and update your eyeglasses
- Make sure the depth perception and acuity are correct
- Make your home safer!
- Lighting in all rooms
- Area rugs removed and electrical cords out of the path of traffic
- Most likely to fall in the living room, followed by the bedroom, kitchen, and bathroom
Now, to answer how physical therapy may help?
As our muscles become weaker, they are not able to react as quickly as stronger muscles. With weaker muscles comes slower gait speeds and shorter step length. By increasing muscle strength of the leg muscles, gait speed and step length will also begin to improve. Fear is a self-limiting factor that has the capacity to limit, and potentially debilitate, anyone. The only way to conquer this fear is to practice working on your balance and strength in a safe environment with a trained professional, which all physical therapists fit the criteria. Assistive devices like canes and walkers can be confusing when you approach a curb, step or other uneven surfaces; a physical therapist is trained in the teaching of proper use of assistive devices in varying situations.
Now that you know a little more about the statistics, factors playing a part into falls, and things you can do to prevent falls, let me give you a few of my favorite exercises to help improve leg strength.
- Begin lying on your back with your arms resting at your sides, your legs bent at the knees and your feet flat on the ground.
- Tighten your abdominals and slowly lift your hips off the floor into a bridge position, keeping your back straight.
- Make sure to keep your trunk stiff throughout the exercise and your arms flat on the floor.
- Begin by lying on your side with your knees bent 90 degrees and your hips and shoulders stacked.
- Raise your top knee away from the bottom one, then slowly return to the starting position.
- Make sure not to roll your hips forward or backward during the exercise.
- Sit to Stand from chair (with hands on knees or without hands)
- Begin by sitting upright on a chair with your feet slightly wider than shoulder width apart.
- Reach out with your arms and lean forward at your hips until your bottom starts to lift off the chair. Move your body into a standing upright position, then reverse the order of your movements to return to the starting position.
- Make sure not to let your knees collapse inward during the exercise.
- Tandem Stance
- Begin in a standing upright position with your arms resting at your sides.
- Place one foot directly in front of the other, so you are standing in a heel-to-toe position. Maintain your balance in this stance.
- Try not to move your arms away from your body and make sure to keep your back straight.
Improving your balance will not happen overnight. Research recommends doing resistance and aerobic training 3 days/week, for 10-20minutes, for at least 10 weeks to see improvement with your balance. Devotion, consistency, and perseverance will help you improve your balance. If you do not know where to start, or have concerns about beginning an exercise program, I would recommend contacting your doctor.. Once you have been cleared to participate, consider taking a tai chi class or other balance and fall prevention class. We are here to be a resource for you!