Falls are the number one cause of traumatic brain injury and fractures in older adults. 30% of people aged over 65 and 50% of people aged over 80 will have one or more falls within a year. If the fall causes a hip fracture the statistics are alarming; Over 10% of previously independent people will be discharged to a nursing home and 25% will die within a year of the fracture, as stated by the Australian and New Zealand Hip Fracture Registry 2017.
There are many factors that can contribute to falls, some are changeable others are not. Some of the main factors associated with falls are; previous falls, poor balance, fear of falling, home hazards (dim lights, clutter, slippery mats), blood pressure, poor vision, bladder issues, medications, muscle strength in legs and numbness or pain in feet.
It has been shown that by changing these factors the risk of falling can be significantly reduced. An analysis of 88 trials comprising 19478 participants found that exercise reduced the rate of falls in community dwelling older adults by 21%. The greatest effect was with exercise programs that challenged balance and involved more than 3 hours per week of exercise.
There are 3 systems outside the brain that help us balance; the visual system, the vestibular system and the mechanism of proprioception.
The visual system I’m sure you can appreciate is what we can see, close your eyes and it’s much harder to balance, hence the reason why poor vision is a risk factor in falls.The vestibular system is a system of small fluid filled canals located in the inner ear, when we move our head the fluid moves, this helps to tell the brain where we are in space. An example of this is if you spin around quickly several times the fluid in your ear continues to flow, this confuses your brain, causing you to feel unsteady on your feet, this is the vestibular system.
Proprioception is a feedback mechanism from the lower extremity; skin, ligaments, tendons and muscles. This system sends messages to the brain so that it knows what’s going on down below. This can be challenged by changing the floor surface. For example, it’s harder to balance on a soft surface than it is on a hard surface, this is why home environment, and footwear is so important in falls risk management.
The brain is the final piece of the puzzle. The brain controls everything we do so if you’re having issues with your ability to process information than you’re at greater risk of falling.
As previously mentioned balance programs have been shown to decrease the risk of falls. Programs such as Falls and Balance at our Worongary Clinic, aim to improve your balance by challenging the 3 balance systems and by educating you on ways to reduce your risk of falls at home.
Before you finish reading go back to the risk factors highlighted above. If you have any of these risk factors, you should seriously consider having a falls risk assessment with your doctor and attending a falls and balance class.
Like all things in life practice makes perfect, the more you practice your balance the better you’ll be, when you need it most. Get the balance right!
Read More information in regards to falls prevention developed by the Australian Government
Article written by Simon Callahan , Physio at Worongary Clinic.