Falls at any age are a high risk for injury but are even more detrimental for the older population. For the elderly, falls greatly impacts health and quality of life. Falls can be reduced and even prevented through proper balance training and lower extremity strengthening. The balance system is made of three components – visual, vestibular and proprioception. When one component is at a deficit, this will increase the risk of falls. Lower extremity strength provides stability and symmetry while walking or going up and down the steps. Without the stability from the hip muscles, there is a shift in posture that could cause more falls. Fear of falling also presents as a factor to fall risk. As a person is more fearful, the level of activity and mobility reduces. This in turn reduces functional strength and balance, increasing the likelihood of a fall. Fall awareness and preventions is beneficial for better health and quality of life.
When at home, it is important to be aware of any hazardous items around the living quarters. Loose rugs are one of the most common items that people trip over that could cause a fall. Secure corners of rugs with tape, slip-resistance backs, or remove the rug if it cannot be changed. This is also true for bathmats around the bathroom and bathtub or shower. Use nonslip mats on the floors to prevent any slips. When in the bathtub or shower, it could be beneficial to use a shower chair to reduce chances of slipping in the tub or shower. Other hazardous items are boxes, books/newspapers or electrical cords that are on the ground. When hallways or spaces are blocked by these items, the probability of tripping will increase. Store such items away properly and tape/hook the electrical cords in corners or against the wall. Lastly at home, keep the living quarters bright. Use night lights or lamps in the middle of the night and be sure to turn on the light when going up or down the stairs to be more aware of your surroundings. For home and community ambulation, use an assistive device based on your health care providers recommendation. It could be helpful to have grab bars placed in and outside the tub or armrest beside the toilet seat. Use the handrails whenever on the stairs and when walking if necessary. All of these will help to reduce fall risk, but when discussing fall prevention, it is important to stay physically active.
Physical activity and function will prevent muscle atrophy and maintain bone integrity. With longer durations of sedentary posture and living, there is a higher risk of chronic medical diseases and disability. As previously described, balance and strength training are two evidence-based methods for fall prevention. Balance training can be done either statically or dynamically, with a variety of factors to train the person for full home and community function. General progressions of balance training involve interventions with eyes open vs. eye closed, standing vs. walking with upper body motions, or obstacles with walking. These interventions are tailored to the persons needs by their healthcare provider, based on the person’s level of function. The best balance training exercises are completed for endurance and are individualized to fit the person’s lifestyle. Strength training for fall prevention can be isolated to the hip and core muscles. Hip strength consists of your gluteal muscles or hip rotators, these are the stabilizing muscles that keep the posture upright. Strength training involves non-weight bearing and weight bearing interventions. Weight bearing exercises are completed in standing or walking motions to simulate the movements while functioning during activities of daily living. The strength program is most effective when it is individualized to the person, based on the recommendations from the physical therapist or healthcare provider. Physical activity has many benefits with short term and long-term effects. Most of all continued physical activity will reduce the probability of falls when recommended correctly by a healthcare professional.
Fall awareness and prevention is necessary at any age, but perhaps more indicative for the elderly population. Those who are fearful of falling or have history of falls are at highest risk of injury and more falls. Accommodations and arrangements for a save living space to prevent falls can be done by anyone on their own. For further prevention, it is best to consult a physical therapist or healthcare professional to receive strength and balance training to reduce probability of falling and fear of falling. Physical function and activity is necessary to maintain a healthy and quality life.
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Costa JNA, Ribeiro ALA, Ribeiro DBG, et al. Balance Exercise Circuit for fall prevention in older adults: a randomized controlled crossover trial. J Frailty Sarcopenia Falls. 2022;7(2):60-71. Published 2022 Jun 1. doi:10.22540/JFSF-07-060
Toyoda H, Hayashi C, Okano T. Associations between physical function, falls, and the fear of falling among older adults participating in a community-based physical exercise program: A longitudinal multilevel modeling study. Arch Gerontol Geriatr. 2022;102:104752. doi:10.1016/j.archger.2022.104752