The link between balance and falling
Good balance is key to preventing falls as we age. Our balance gradually worsens as we get older and we aren’t always aware of its decline. Balance can often be improved with exercises and proprioceptive training.
One of the leading causes of falls in the elderly is balance disorders. Research shows that there is a direct link between balance and injury prevention.
In a report published online in the BMJ, researchers did an analysis of the results of 17 trials that tested the effect of fall-prevention exercises on seniors’ risk of falls and fall-related injuries. Exercise programmes designed for this purpose managed to reduce falls that caused injuries by 37% and falls that lead to serious injuries by 43%. Broken bones were reduced by 61%.
Studies show that 1 in 3 adults aged 50 and over, dies within 3 months of suffering a hip fracture and hip fractures are most commonly the result of a fall. Over 30% of people aged 65 or older experience an average of 1 fall a year. This is a major reason why it is important to reduce the risk of falling as much as possible in the senior population.
Fear of falling can result from poor balance and leads to functional decline, reduced mobility and anxiety and depression. Balance and strength training can greatly reduce the risk of fear of falling.
How can we assess balance and fall risk?
The ‘Timed Up and Go Test’ has been proven in research to be a sensitive and specific measure of the likelihood of falling in older adults. A study done in 2022 also found that the test is a strong predictor of mortality. The 4-Stage Balance test and 30-Second Chair Stand test are other objective examinations used to assess balance and the risk of falling. Subjective questionnaires are also utilised to determine previous fall history and medications which may increase the risk of falling. If you are concerned about your balance, ask one of the team to run one of these tests next time you are in the clinic.
How can we improve our balance?
The good news is that there are many activities and exercises that we can do to improve our balance, and the key is a little and often! A few exercises daily can make a great difference in the long run.
Studies show that resistance training, aerobic exercise, balance training, and wobble board training, are all effective ways to increase the ability to balance in the elderly. Also, did you know the world health organisation recommends 150 minutes of moderate-intensity aerobic activity a week, 2 to 3 days performing muscle strengthening exercises and 3 or more days practising balance exercises as a minimum exercise prescription to reduce physical decline in people over 65!
Here are some balance exercises you can try at home:
Make sure that you have a sturdy surface nearby to hold on to if you need support.
1: Stand with your feet as close together as possible and cross your arms over your chest. If this is too easy you can modify it by standing on an uneven surface such as a cushion. You can make it even more difficult by closing your eyes. Hold this position for 15 seconds.
2: Stand on one leg. Make this exercise more difficult by crossing your arms over your chest, closing your eyes or looking side to side while holding the position. Hold for 15 seconds.
3. Tandem stance: Stand with one foot in front of the other, one heel touching the toes of the foot behind. Hold this position for 15 seconds. This exercise is more difficult with your weaker leg at the back, so try it on both sides!
4. Heel-raises: Stand with your feet about hip width apart, push-up onto your toes, raising your heels off the ground. Try to hold on with as little support as possible. Repeat 10 times.
5. Bird Dog: Go onto your hands and knees in a four-point kneeling position. Extend one leg and the opposite arm. Hold this position for 10 seconds. Switch and alternate sides. Repeat 10 times on each side.
Please note, these exercises may not be suitable for everyone and do not constitute bespoke exercise prescription. Only do what you feel comfortable and safe to do. If you require more assistance or guidance please contact a member of the team who will be happy to assess your needs and advise on a more bespoke exercise program.
References
- Fabienne El-Khoury, et al, (2013), The effect of fall prevention exercise programmes on fall induced injuries in community dwelling older adults: systematic review and meta-analysis of randomised controlled trials, BMJ, 347: f6234. DOI 10.1136/bmj.f6234
- M Katsoulis, et al, (2017), Excess mortality after hip fracture in elderly persons from Europe and the USA: the CHANCES project, J Intern Med, Mar;281(3):300-310. DOI 10.1111/joim.12586
- Edson J. Ascencio, et al, (2022), Timed up and go test predicts mortality in older adults in Peru: a population-based cohort study, Timed up and go test predicts mortality in older adults in Peru: a population-based cohort study, BMC Geriatr. 22: 61, doi: 10.1186/s12877-022-02749-6
- Ewan Thomas, et al, (2019) Physical activity programs for balance and fall prevention in elderly, Medicine (Baltimore), Jul; 98(27): e16218, doi: 10.1097/MD.0000000000016218
- World Health Organization, (2022), Physical Activity, 24th July 2023, https://www.who.int/news-room/fact-sheets/detail/physical-activity
