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

 

  1. 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).
  2. 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.
  3. Gardner M. Practical implementation of an exercise-based falls prevention programme. Age and Ageing. 2001;30(1):77-83.
  4. Allen N, Schwarzel A, Canning C. Recurrent Falls in Parkinson’s Disease: A Systematic Review. Parkinson’s Disease. 2013;2013:1-16.
  5. Tinetti M. Preventing Falls in Elderly Persons. New England Journal of Medicine. 2003;348(1):42-49.