Importance of Exercise and the Role of Physiotherapy in Fall Prevention and Reversing of Frailty in Older Adults

It is well-known that risk of falling is a very serious issue especially among the elderly. As we age our muscle strength and balance have a tendency to gradually deteriorate making falls more likely to occur. To make matters worse bone density or bone strength reduces with increased age meaning that the chances of a fall resulting in a bone fracture are also increased. One of the most common fractures that can result from a fall in the older adults are hip fractures which can take many months to recover from and may have a significant impact of the person’s function and independence.
There are a number of factors that can increase the likelihood of falling such as poor general health, male gender, perceived insufficient sleep, health problems requiring assistive devices, alcohol consumption, being over-weight and history of stroke. (1) Other medical problems including seizures, cataracts, postural hypotension, cognitive impairment, Parkinson’s and depression can can also have an adverse effect on the risk of sustaining an injury as a result of a fall. (2)

It has been shown in a number of studies that structured physical exercise can increase muscle strength, reduce frailty and ultimately diminish the risk of falling. For instance, in a study done in 2002 on 115 older men and women it was shown that 9-month supervised progressive exercise training that focused on flexibility, strength and balance resulted in significant improvement in physical function, strength, balance and cardiovascular fitness. (3) These types of exercises are often used by physiotherapists and other health professionals to address this issue.
Interestingly, Tai Chi has been found to be a beneficial tool to improve balance and hence reduce the risk of falling in the elderly.(4) Generally, exercise programmes designed to prevent falls should “provide a moderate or high challenge to balance and be undertaken for at least 2 hours per week on an ongoing basis”. Also individuals at high risk of falling should not be prescribed brisk walking programs. (5) There may often be a need to see your doctor to address some of the possible medical risk factors involved.
For a individually-tailored falls prevention programme see your physiotherapist. Here, at BodyFit Physiotherapy we can help to build a custom made programme for you that will address your needs, in particularly managing and reducing the risk of falling and its associated consequences on your well-being. As a physiotherapy professionals we know that injury prevention is extremely important and usually more successful than dealing with consequences of an injury after it already occurred.

References:

1. Grundstrom ACGuse CELayde PM. (2011) Risk factors for falls and fall-related injuries in adults 85 years of age and older. Archives of Gerontology and Geriatrics, 53(1), Published Electronically.

2. Al-Aama T. (2011) Falls in the elderly: spectrum and prevention. Canadian Family Physician, 57(7), 771-6.

3. Binder EF, Schechtman KB, Ehsani AA, et al. (2002) Effects of exercise training on frailty in community-dwelling older adults: results of a randomized, controlled trial. Journal of the American Geriatrics Society, 50(12), 1921

4. Rand DMiller WCYiu JEng JJ. (2011) Interventions for addressing low balance confidence in older adults: a systematic review and meta-analysis. Age and Ageing, 40(3), 297-306.

5. Sherrington CTiedemann AFairhall NClose JCLord SR. (2011) Exercise to prevent falls in older adults: an updated meta-analysis and best practice recommendations. ,New South Wales Public Health Bulletin, 22(3-4), 78-83.

 

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