23 Feb Exercise can prevent falls
Falls are the leading cause of injury-related hospitalisation in persons aged 65yrs+
Falls threaten the health, wellbeing and independence of older people. But, falling is not an inevitable part of ageing.
New research confirming the benefits of exercise for the elderly puts the onus on doctors to encourage older patients to get moving.
A systematic review of 54 randomised controlled trials, published in the NSW Public Health Bulletin in a special issue on falls prevention, found that exercise reduces the rate of falls by
Key risk factors for Falls:
- Poor Balance & Mobility
- Muscle Weakness
- Poor Eyesight
- Decreased reaction time
- History of Falls
- Use of Sleeping tablets
It is common for people who feel unsteady on their feet to do less walking. Over time this actually increases the risk of falling because muscles get weaker, joints get stiffer, and balance gets worse.
People who have experienced a fall increase the likelihood of falling again unless they undertake an appropriate exercise programme.
Falls whether they result in physical injury or not, impact on psycho-social health. Older people who have fallen often show increased anxiety, loss of confidence, decreased activity and increased
dependence due to a fear of falling again.
- About one in three people over the age of 65 fall each year.
- Between 22-60% of older people suffer injuries from falls.
- Each fall increases the risk of serious injury
- About 10 -15% of falls cause a major injury.
- Fractured bones are the most common major injury.
- The most common injuries that require hospitalisation comprise femoral neck fractures, fractures of radius, ulna and other bones fractures of the neck and trunk.
- Falls are the leading cause of injury-related hospitalisation in persons aged 65yrs+ in Australia.
- For older people living in Victoria, falls are now the leading cause of injury related deaths.
- In NSW each year, falls lead to approximately 30,000 hospitalisations and at least 300 deaths in people aged 65 years.
- Falls account for 40% of injury-related deaths and one percent of total deaths in this age group.
In terms of morbidity and mortality, the most serious of these fall-related injuries is fracture of the hip.
Elderly people recover slowly from hip fractures and are vulnerable to post-operative and bed rest complications.
In some cases, hip fractures result in death and of those who survive, many never regain complete mobility.
Another consequence of falling is the “long lie” – remaining on the ground or floor for more than an hour after a fall.
The long lie is a marker of weakness, illness and social isolation and is associated with high mortality rates among the elderly. Time spent on the floor is associated with fear of falling,
muscle damage, pneumonia, pressure sores, dehydration and hypothermia.
Falls can also result in restriction of activity and fear of falling, reduced quality of life and independence. Even falls that do not result in physical injuries can result in the “post-fall
syndrome” – a loss of confidence, hesitancy, and tentativeness with resultant loss of mobility and independence. It has been found that after falling, 48% of older people report a fear of falling and 25% report curtailing activities.
Finally, falls can also lead to disability, decreased mobility which often results in increased dependency on others and hence an increased probability of being admitted to an institution. Falls are commonly cited as a contributing reason for an older person requiring admission to a nursing home.
Staying Active the Best Prescription:
There is no doubt that the most important thing that older people can do to prevent falls is to maintain physical activity. Studies have shown that exercise significantly reduces the risk of falling.
People with better posture, better balance and stronger muscles are much less likely to fall and therefore less likely to be injured.
Individually tailored programmes including weight bearing exercise and balance retraining with progressive muscle strengthening are most effective.
Special exercise programmes prescribed by physiotherapists, can reduce the risk of falling by about 20% and can also decrease serious injury from falls.
Ongoing supervised exercise programmes targeting balance and performed up to three times a week can reduce falls by 40%. Physiotherapists are best suited to designing an exercise programme incorporating, endurance, strength, balance and flexibility tailored to the needs of the individual.
Other Benefits of Physical Activity & Exercise:
- Improves flexibility
- Improves joint range of movement
- Strengthens muscles
- Strengthen bones
- Improves circulation & function of heart and lungs
- Improves balance and coordination
- Increases energy and stamina
- Improves quality of sleep and promotes feeling of wellbeing
It is never too early or too late to intervene with an exercise programme. Balance and muscle strength starts to decline after the age of 40, and more dramatically in women.
Other Factors to Consider in Falls Prevention:
- Review of medication
- Check lying and standing blood pressure
- Eyesight review
- Supplementary Vit D & calcium
- Nutrition & diet
- Adequate hydration
- Use of hip protectors
- Choice of proper footwear
- Safety evaluation of the home
All HNA physiotherapists are highly skilled in prescribing individual home-based programmes of strength and balance retraining exercises for the aged population.
We also offer classes of small groups of supervised, circuit based, weight bearing exercise and balance retraining in a fun and safe environment in our clinic. Please contact Noosa Sports & Spinal Physiotherapy Centre for further information on our services.
Information compiled by HNA Physiotherapist Kelly J Woosnam.
References available on Request.