Fall Prevention

Thirty-three percent of adults over 65 fall each year. The biomechanics of falling involves balance, foot and postural collapse, limb length inequality, neuro-muscular integrity, reaction time, and muscle strength and aging and other factors reduce balance, increase sway, and dampen our reaction time and ability to perform.

The fear of falling forces us to take shorter and slower steps as a compensatory mechanism known as “Senile Walking.” We walk slower at eighty than at forty.

Preventing a first fall may be more important than preventing future falls after the first research has demonstrated that foot and ankle sensation is critical to fall prevention and programs work better with added postural control. Also, devices that diminish unwanted motion provide for healthier, more injury free quality of life.

There are three basic mechanisms to maintain balance and posture:

• Visual cues from our eyes make us aware of potential dangers and obstacles which can prevent falls
• Our brain's spatial orientation tells us where our arms, legs, and torso are positioned
• The inner ear balance mechanism gives important information on the position of our head and its movement in space

These systems working together with our musculoskeletal system maintains balance and allows us to resist falling. Training that combines improving overall upper and lower body strength while challenging our balance mechanisms with activities have been proven most successful. Gait training upgrades one’s walking equilibrium in order to walk with more balance, power, and endurance. Patients are examined while walking or using treadmills and then trained to have a healthier, better-balanced gait. These become habit when repeated. Finally, as we age, strengthening exercises of the feet and lower extremity are essential because many seniors have muscle atrophy due to reduced lifestyles. Hint: It is important when selecting trainers and therapists to seek those committed to improving balance, performance, and quality of life. Look for a location that has smiling, active patients.

Lifestyle Adjustments

Adding a program of exercises that improve strength, balance, agility, and timing decrease the risk of falling as well as the risk of associated injury. Monitored training programs can increase stability, balance, reaction time, strength, and endurance while decreasing postural sway.

Changing the way we live life can have a positive effect on balance, muscle strength, and performance. For example, if a person’s balance weakens after walking four blocks and they are taking a twelve-block walk, the last eight blocks of this walk will eventually lead to slips and falls. It is better to use Interval Walking, which actually improves balance by dividing the twelve-block walk into three four-block walks separating each with a one-minute pause. Hint: Dividing any task or job into intervals can be very helpful as well.

Falls can never be totally prevented but a multifactor approach seems to be the best way to prevent both a first fall and future falls. One study of elderly people involving a detailed assessment and a multiple approach with a control group found that after twelve months the intervention group reported 183 falls and the control group 510.

It is important when selecting, health coaches, trainers, and therapists to seek practitioners committed to improving balance, performance, and quality of life proactively. Avoid practitioners whose Fall Prevention Programs begin after the first fall. This reactionary paradigm engages patients when they are less likely to be rehabilitated.

By reducing the likelihood and the fear of falls, Fall Prevention Programs improve the function and quality of life for those treated whether they fall or not.