Get Balanced!

The Centers for Disease Control and Prevention predict that every 18 seconds, an older adult is treated in an emergency department for a fall.  Among adults age 65 and older, one-third will fall each year. The most common injury suffered by this demographic after a fall is a fractured hip. Consequences of hip fractures due to falls include loss of independence, costly hospital bills, and can ultimately lead to death.  One recent study showed that 24% of people aged 65 and older who suffered a hip fracture died within 1 year of their fall.

 Once someone suffers a fall, even if they are not injured, they can develop a fear of falling again. This fear will cause them to limit their activity level, leading to reduced mobility and a decrease in overall fitness. This chain of events will actually increase their risk of falling again as their bodies can no longer react properly to a loss of balance.

WHAT INFLUENCES BALANCE?

There are three main factors that play a role in maintaining balance: Vision, the vestibular system, and the neuromuscular system.  We assess eyesight on a regular basis and ask questions about how often eyeglasses are updated. If you cannot see clearly, then there will be a problem in identifying a potential hazard such as a throw rug that is not flat or a toy left in the middle of the hallway. The vestibular system refers to the fluid in our inner ear and influences our ability to maintain the body’s upright position. A problem in the vestibular system can cause someone to feel like they are constantly dizzy, thereby causing them to lose their balance. Vestibular problems can often be treated with physical therapy, which in turn will decrease the risk of a fall. Dr. Paul Lanza, a primary care physician notes, “Balance problems and falls in the elderly make up a significant number of injuries which may be preventable if treated early and correctly.” The problem that we can have the most direct influence on is the neuromuscular system. As we get older, our muscles become smaller, weaker, and slower to react.  Furthermore, the ability to detect the body’s position in space is greatly reduced in the aging body. The combination of these deficits can certainly predispose someone to a higher risk of falling. Fortunately, the neuromuscular component can be treated.  

Your physical therapist will review your medical history (including medications as these can also affect balance), and determine your general physical condition. Most importantly, a variety of tests specifically designed to measure balance and gait will be performed and he/she will be able to determine whether you are at risk for a fall. Based on the results of this testing, your physical therapist will set up a program that emphasizes strength, flexibility, coordination, and proper gait. The neuromuscular system is adaptable and will respond to the stress that is placed on it - meaning it will learn balance if it is placed in situations where balance is challenged.

In addition to physical therapy, Tai Chi and yoga have also been shown to improve balance and stability. Both disciplines help to develop an increased awareness of body position and weight distribution, in addition to improving strength and flexibility. Yoga and Tai Chi now have research outcomes that prove their effectiveness in helping people with balance issues.

The statistics show that as we age, there are many factors that contribute to an increased risk of falling and sustaining a debilitating injury. Fortunately, there are proven ways to combat this and prevent falls from happening in the first place. If you or someone you know has recently suffered a fall or may be at risk for a fall, take a proactive approach and contact a local physical therapy clinic so a thorough assessment can be performed by a qualified professional.

*This article can be found in the February, 2009 issue of The Central Record in the Health highlights section*