Falls Prevention – Part 1
Falls are a common occurrence for people aged over 65 with a third of the elderly having a fall each year [1]. Approximately 1 in 10 falls result in fractures, soft tissue & serious head injuries, reduced quality of life, a lack of confidence and a fear of falling again [1, 5].
The most common causes of falls are frailty, poor balance, and a lack of strength. This can occur due to a multitude of conditions or scenarios that affects each individual differently [3]. For example, a person with Parkinson’s Disease is at a higher risk of falls due to spasticity, freezing of gait and impaired mobility [4]. However, an elderly woman with osteoporosis may be frailer and more prone to fractures upon falling.
All these conditions should be consulted with a health professional to provide a safe and effective falls prevention program for the patient. The risk of falling increases with the number of predisposing factors and conditions [5]. For example, in a cohort of elderly persons in the community, the risk of falling rose from 8% with no risk factors to 78% with greater than four risk factors [5].
“Exercise is one of the largest evidence-based practices in falls prevention.
The most effective type of exercise has been shown to be strength, balance, gait training and functional activities to reduce falls risk [2].”
Exercises should target both strength and balance training to reduce the risk of falls. These exercises should be supervised in a safe environment to always ensure patient safety. Incorporating a home-based exercise programme can additionally encourage patients to perform daily tasks at home throughout the day. A study showed that walking and other activities are effective however should not be the only exercise for falls risk, therefore, the multidimensional approach is vital [3].
By conducting a comprehensive program of balance, strength, and endurance training, you should see an improvement in overall function, increased independence and decreased all-cause mortality risk.
Written by Hannah Boardman
References
- Pinheiro M, Oliveira J, Bauman A, Fairhall N, Kwok W, Sherrington C. Evidence on physical activity and osteoporosis prevention for people aged 65+ years: a systematic review to inform the WHO guidelines on physical activity and sedentary behaviour. International Journal of Behavioral Nutrition and Physical Activity. 2020;17(1).
- Lee S, Kim H. Exercise Interventions for Preventing Falls Among Older People in Care Facilities: A Meta-Analysis. Worldviews on Evidence-Based Nursing. 2016;14(1):74-80.
- Gardner M. Practical implementation of an exercise-based falls prevention programme. Age and Ageing. 2001;30(1):77-83.
- Allen N, Schwarzel A, Canning C. Recurrent Falls in Parkinson’s Disease: A Systematic Review. Parkinson’s Disease. 2013;2013:1-16.
- Tinetti M. Preventing Falls in Elderly Persons. New England Journal of Medicine. 2003;348(1):42-49.