Falls are a common cause of mortality in older adults worldwide. A fall is when someone inadvertently comes to rest on the ground or a lower surface. There are 11 million adults aged 65+ in a single country independently living, and 30% to 40% of them fall each year. The risk for a fall is 53% more likely for individuals who experienced a previous fall when compared to persons with no prior history of falling. Falls and environmental hazards are correlated, especially in living areas. Common environmental hazards include poor stairway design and disrepair; inadequate lighting; clutter; slippery floors; unsecured mats; and the lack of nonskid surfaces in bathtubs (1).
Fall prevention programs provided at Back to You Osteopractic Physical Therapy & Rehabilitation in Royal Oak, Canton, and Grosse Pointe Woods, MI give people a tool to continue their everyday activities with a reduced fear of falling. The four integral P’s to implement into a fall prevention program include pain, position, placement, and personal needs. By implementing the four P’s, the fall prevention program centers on a mindset to address needs at varying times of the day (2). Common questions to ask about the four P’s include:
- Pain: “Are you in pain?” “Do you have any discomfort?”
- Position: “Do you want me to help you move into a better position?”
- Placement: “Do you need anything to be placed within easy reach?”
- Personal needs: “Do you need anything to drink or eat?” “Do you want to go to the washroom?” (2)
When someone has a fear of falling, an increase in the likelihood of falling, depression, and a decrease in everyday activities occurs. On the other hand, physical exercise provided at Back to You Osteopractic Physical Therapy & Rehabilitation in Royal Oak, Canton, and Grosse Pointe Woods, MI is a method to reduce the chance of experiencing a fall (3). According to research, engaging in integrated training (resistance training, core training, and balance training); physical training (walking and various weightlifting); and fitness training (Pilates, yoga, and Tai Chi) all demonstrate a reduction in falls. The most effective method to prevent falls consists of implementing integrated training into a weekly routine for at least 32 weeks. Completing the exercises three to five times a week will decrease the possible occurrence of a fall, but five or more times a week reduces the chance even more (6).
Sit-to-stand exercise is an integrated training technique utilized to reduce the potential for a fall. The sit-to-stand exercise centers on strengthening the lower extremity and improving body mechanics. The equipment needed for this exercise includes a sturdy chair and a surface at about hip height in front of the chair to grab if needed. The individual performs the sit-to-stand motion while using their hands for support when necessary. To progress the exercise, the person will not use their hands and can hold weights while completing this exercise to provide even more advancement. The individual repeats this exercise for ten repetitions, and their endurance determines the number of times the ten repetitions are repeated (5).
The addition of another integrated training technique of a balance exercise focuses on improving the person’s balance abilities to increase the chance of the individual catching him or herself before falling. The equipment needed for this exercise includes a sturdy surface to lean on for support at about hip height. The person begins by altering their base of support from a wide stance to a narrow stance while removing their hands from the surface when narrowing the base of support. To advance the exercise, maintain the narrow base of support and lift one leg and then the other leg while removing the hands from the base of support. The individual challenges their balance for 10-30 seconds with the goal of reaching 30 seconds with no swaying (5).
Yoga is a fitness training technique utilized to reduce the potential for a fall by improving a person’s balance. A study focused on a 12-week yoga program for individuals to determine if any changes occurred in the outcome measures of the Mini Balance Evaluation Systems Test for balance and the Canadian Occupational Performance Measure for the satisfaction of engagement in everyday activities centering on physical activity, balance, and self-care. According to research, improvement was shown in both outcome measures, indicating yoga enhanced a person’s balance and satisfaction with engagement in activities (4). Yoga positions utilized to improve balance include mountain pose, crescent lunge, and tree pose. A chair or sturdy surface provides more stability for the individual if needed (7). Many falls are preventable with the use of a fall prevention program provided by Back to You Osteopractic Physical Therapy & Rehabilitation in Royal Oak, Canton, and Grosse Pointe Woods, MI following simple steps and exercises to enable people to engage in the everyday activities of their choosing without a fear of falling.
Author: Lauren Pressler, S/OT
REFERENCES:
1. Alshammari, S. A., Alhassan, A. M., Aldawsari, M. A., Bazuhair, F. O., Alotaibi, F. K., Aldahil, A. A., & Abdulfattah, F. W. (2018, April). Falls among elderly and its relation with their health problems and surrounding environmental factors in Riyadh. Journal of Family and Community Medicine, 25(1), 29-34. doi: 10.4103/jfcm.JFCM_48_17
2. Centre for Effective Practice. (July 2016). Falls prevention supplement for care staff. CEP.health. https://cep.health/media/uploaded/CEP_Falls_SupCareStaff_2016.pdf
3. Layne, K., Collins, K., & Cremer, K. (2020, August 18). Fitness in the parks: A community-based falls prevention program for older adults. American Occupational Therapy Association. https://www.aota.org/publications/ot-practice/ot-practice-issues/2020/fitness-in-parks
4. Oestreich, A., et al. (2021, April 5). Yoga intervention for fall prevention in rural-dwelling seniors. American Journal of Occupational Therapy, 75(2), 1. doi:10.5014/ajot.2021.75S2-PO307
5. Stutzman, L. (n.d.). Fall prevention: Balance and strength exercises for older adults. John Hopkins Medicine. https://www.hopkinsmedicine.org/health/wellness-and-prevention/fall-prevention-exercises
6. Sun, M., Min, L., Xu, N., Huang, I. L., & Li1, X. (2021, December). The effect of exercise intervention on reducing the fall risk in older adults: A meta-analysis of randomized controlled trials. International Journal of Environmental Research and Public Health, 18(23). doi:10.3390/ijerph182312562
7. Swason, A. (2016, June 3). Yoga therapy for balance and fall prevention. [Video]. YouTube. https://www.youtube.com/watch?v=ql69k_9EUdg