With September being National Falls Prevention Awareness Month, this is a good opportunity to assess risks of falls and to take steps to prevent falls from happening to you or others. About 3 million older adults are treated in the ER for injuries from falls every year, and approximately 20 percent of falls result in serious injuries, says the CDC.

In fact, falls are among the leading causes of serious injury (e.g., fractures) and death for seniors in the US. And, while falls are more common in older adults, they can happen to people of all ages. There are a number of factors that play a role in an individual's ability to maintain good balance, such as ear and visual health, core muscle strength, and nervous system function, among others.

Balance problems may develop due to an injury or illness that negatively affects one of these regions. For older individuals, balance problems are often linked to vertigo, ear infections, hearing loss, heart problems, posture changes, arthritis, certain medications, loss of strength, and conditions that affect the nervous system (e.g., Alzheimer's disease, Multiple sclerosis, Parkinson's disease).

When older individuals fall, they may experience, soft tissue damage, fractures, persistent pain, loss of self-confidence, a reduced quality of life due to functional impairments, heightened health-care costs, and an increased risk of death. Falls are among the leading causes of serious injury (e.g., fractures) and death for seniors in the United States.

As falls are particularly common among seniors, this age group is often described as a high-risk population that requires tailored approaches to fall prevention. Beneficial approaches include risk factor assessment, multicomponent exercise, Physical Therapy, dietary supplementation, and safety improvements for the home or other settings where seniors frequently gather. Exercise and strength are of the most important of these preventive measures. 

Research shows that there are a number of useful exercises for older individuals that help prevent falls by improving muscle strength and balance.

These include:

• Walking heel to toe
• Standing on one foot
• Standing on one foot with arm movements
• Standing on one foot and tracing half the clock face with the free foot
• Side leg raise
• Back leg raise
• Core strengthening i.e. squats

Walking heel to toe is an exercise that makes the legs stronger and in doing so, helps older individuals to walk without falling. In order to perform this exercise, place the right foot in front of the left foot so that the right foot's heel is touching the tips of the toes on the left foot. Next, move the left foot in front of the right one, place the weight on the heel, and then shift the weight to the toes. Repeat this motion with the right foot and then walk heel to toe for at least 20 steps. It’s great to practice this in a hallway where there are nearby walls for support if needed.

When practicing exercises standing on one leg (single limb stance), the individual should stand behind a steady chair that does not have wheels and hold on to the back of it with the least amount of grip needed to resist falling. Next, lift the right foot while balancing on the left and hold this position for as long as possible before switching to the other foot. The long-term goal is to be able to balance on one foot for up to one minute without having to hold on to the chair. These types of exercises promote optimal balance by increasing the strength of core muscles as well as those in the limbs. Please note that although this exercise is easy to do, guidance may be necessary especially if the exercise is performed during a recovery period.

If you would like to learn how to prevent falls, consider working with a physical therapist who can demonstrate techniques such as balance and strength training, as well as stretching exercises that can build strong muscles, restore good posture, encourage proper bodily movement, and help prevent falls. In addition, if you were seriously injured due to a fall, the physical therapists at Therafit Physical Therapy can develop an individualized plan, which may include home modifications or assistive devices (e.g., cane, walker) that will help restore your mobility, provide pain management, and improve overall health. Personal training and pool therapy can also help individuals to build a strong, flexible core.

In addition to talking with your physical therapist and/or doctor to assess your risk of falls, the CDC also recommends:

• Considering exercises, such as a yoga class or Tai Chi, that improve balance and strength, and personal training and pool therapy that can help to build a strong, flexible core which can help with balance and stability.
• Having eyes and feet examined, with poor vision, walking issues and poor footwear having the potential to increase chances of falls.
• Cleaning up items from floors and stairs that can be tripped over.
• Removing small throw rugs or using double-sided tape to keep them in place.
• Using non-slip mats in the bathtub and shower floors and grab bars next to and inside the tub, and the toilet, for older individuals.

You can also secure cords inside and outside of the home, ensure pathways and doorways are well-lit, and repair raised cracks in sidewalks.

Take steps this month to prevent falls.

Call us at 978-452-9252 to set up an appointment with one of our Physical Therapists to see how you can personally prevent falls.

References

1. Røyset B,et al. Effects of a fall prevention program in elderly: a pragmatic observational study in two orthopedic departments. Clin Interv Aging. 2019;14:145-154.

2. Johnston M, Magnan MA. Using a Fall Prevention Checklist to Reduce Hospital Falls: Results of a Quality Improvement Project. Am J Nurs. 2019;119(3):43-49. 

3. Karinkanta S, Piirtola M, et al. Physical therapy approaches to reduce fall and fracture risk among older adults. Nat Rev Endocrinol. 2010;6(7):396-407. 

4. Petridou T, Manti G, et al. What works better for community‑dwelling older people at risk to fall?: a meta‑analysis of multifactorial versus physical exercise‑alone interventions. J. Aging Health. 2009;21(5):713-729.

5. Frieson CW, et al. Editorial: Evidence-Based Practices to Reduce Falls and Fall-Related Injuries Among Older Adults. Front Public Health. 2018;6:222.