Falls remain the leading cause of injury and death for older Americans. As we age, a variety of factors can affect our balance. In addition to the overall decline in flexibility and strength, impairments in our vision, hearing and inner ear, reflexes, and position sense (or proprioception) can cause us to be at greater risk for falls.
There are many other reasons older people fall. They may lose their footing when stepping off a street curb. Or they may fall after getting dizzy from taking medicines. Some studies have shown that chronic pain can increase a senior’s risk of falling, as can carrying too much weight on your frame. Many falls may be related to the results of a stroke or other medical conditions, like diabetes — research shows that complications from diabetes greatly increase the risk of falling. According to the Centers for Disease Control and Prevention, or the CDC, over 76% of older adults are diabetic or pre-diabetic, and when a diabetic or pre-diabetic falls, a fracture is 12 times more likely.
In addition to pain and suffering, falls with or without injury also carry a heavy quality-of-life impact. A growing number of older adults fear falling and, as a result, often self-limit activities and social engagements. The resulting limitations can lead to further physical decline, depression, social isolation and feelings of helplessness.
The CDC's Physical Activity Guidelines for Americans recommend two types of physical activity each week to improve health — aerobic and muscle-strengthening. Experts recommend that older adults engage in moderate physical activity for at least 30 minutes five days a week, and muscle-strengthening activities on two or more days a week that work all major muscle groups. Unfortunately, statistics show that less than one-third of Americans over the age of 65 meet these levels.
Here are 3 recommended programs to improve balance and reduce the risk of falls. You can learn more about these and other programs at the National Coalition On Aging website.
Otago is an individually-tailored program of muscle-strengthening and balance-retraining exercises of increasing difficulty, combined with a walking program. This extensively tested fall prevention program is now used worldwide. The program is delivered by either a physical therapist experienced in prescribing exercises for older adults, or a nurse who is given special training and receiving ongoing supervision from a PT.
Stepping On is a multifaceted falls-prevention program for community-residing elderly. About 30% of older people who fall lose their self-confidence and start to go out less often; such inactivity leads to social isolation and loss of muscle strength and balance, increasing the risk of falling. Stepping On aims to break that cycle, engaging people in a range of relevant fall preventive strategies.
Tai chiTai Chi: Moving for Better Balance
The program includes 24 tai chi forms that emphasize weight shifting, postural alignment and coordinated movements, and also integrates synchronized breathing aligned with the tai chi movements. The program aims to improve balance, strength and physical performance for older adults.
A few last thoughts to keep in mind for reducing the risk of falls:
Learn to do a few exercises EVERY DAY for strength and balance. Practicing these each day can help you stay active and independent.
Wear low-heeled shoes that fit well and give your feet good support. Use footwear with nonskid soles. Repair or replace worn heels and soles.
If you use a walker or cane, make sure it is fitted to you. Put rubber tips on it.
If you have pets, keep them in one place at night. Train your pets not to jump or get underfoot. Think about buying a collar with a bell for your pet so you will know when your pet is nearby.
Written by: Michael Beauvais, PT, is a physical therapist and the clinical director and co-owner of East Metro Physical Therapy, a Physiquality network member in Clinton Township, Michigan
For more information on a physical therapy program for aging and balance issues please call Northville Physical Rehabilitation for a complimentary consultation:
Tel. (248) 349-9339 or (248) 349-9336