Strength and Balance Exercises Can Help with Fall Prevention

April 26, 2017 | Blogs

It can happen at any time, during normal tasks-walking to the mailbox or bathroom, carrying groceries to the car, crossing the street.

Falls are the leading cause of injuries and deaths from injury among older Americans, according to the Centers for Disease Control and Prevention (CDC). Each year, one in four adults age 65 and older falls, and about three million of them require emergency treatment. Falls are a common cause of head injuries (especially traumatic brain injuries); broken wrists, arms and ankles; and hip fractures.

Though common, falling isn't an inevitable consequence of aging and is very much preventable. Consulting with a primary care physician and using assistive devices like a four-wheel walker and travel cane are just some of the things older adults can do to avoid falls. Among the most important preventive measures is maintaining good strength and balance, says Lauren H. Smith, trauma program coordinator at Sinai Hospital of Baltimore.

"We can't guarantee you're not going to fall. We also can't always affect our environment. But issues with strength and balance have been most proven to cause falls," Smith said.

The other risk factors include:

Vitamin D deficiency
Lower body weakness
Vision problems
Improper footwear
Home hazards
Side effects of some medications

Smith conducts the seven-week "Stepping On" falls prevention program at LifeBridge Health & Fitness. It teaches fun strength and balance exercises, and offers tips for medication management, home safety, and proper footwear. A big focus of the program, Smith says, is helping participants build their confidence and open up.

"Part of the program is getting them to talk to other people about the same challenges, so they realize they're not the only ones having those problems," Smith said. "We see it all the time in our classes where someone says, "˜Well, that happens to me, too, and this is what I do.' And sometimes, it's just that person who would never have said anything about it if two other people didn't say it before them to get them to consider it."

Some older adults are hesitant to discuss falling even with their doctors. Although one out of four older Americans falls each year, less than half tell their doctor, the CDC says. But seeing a doctor is an important first step. Your doctor can assess whether you're getting enough vitamin D and look for other physical deficiencies that can elevate your fall risk.

Your doctor can also review your current medications, especially those that make you dizzy or sleepy, and adjust your doses accordingly. People who take five or more mediations, or a similar combination of prescription drugs and over-the-counter supplements, are at a greater risk of falling, Smith says. Taking more than five mediations is linked to frailty, which increases the risk for falls, disability and death, according to the Health in Aging Foundation.

"If you see multiple doctors, as in your primary care doctor and another specialist for a specific condition, you want to make sure that at appointments with at least one of those doctors, if not every doctor, you always have your list of medications on you and all those medications are reviewed," Smith said. "There are just so many drug interactions out there. And it's not always our prescribed drugs. Some of us don't realize that there are supplements that will enhance some medications. And there are some medications you shouldn't take with certain foods. Those are all things you should be educated on."

For medical appointments, older adults should be prepared to discuss if they've fallen in the past year, feel unsteady or often worry about falling, the CDC says.

Here are some other pointers to consider:

Stay active, and perform strength and balance exercises. The CDC says falling once doubles your chances of falling again. In addition, many older adults who fall, even if they weren't seriously injured, become fearful of falling again and may become less active. That can contribute to body weakness, which is why you should keep moving and engage in regular exercise, with an emphasis on activities that can improve your balance and strengthen your legs. Tai Chi can help, as can knee curls and extensions, leg raises, heel-toe raises (you can do these while holding onto the back of a chair), heel-toe walking, and hip bridges. Sideways walking exercises, Smith says, also are pivotal. "People tend to fall if they're trying to get around something quickly, and this exercise helps improve the muscle memory so that if you do have to step around something quickly, you'll be able to keep your balance," she said. Ideally, older adults should strive to do balance exercises every day and strength exercises at least three times a week, Smith says.

Have your vision checked. The CDC recommends having your eyes checked at least once a year (The Krieger Eye Institute offers routine exams) and upgrading your eyeglasses if needed. Those who wear glasses with bifocal or progressive lenses should ask their eye doctor about switching to single-vision glasses at least for certain activities, as bifocals can sometimes make things seem closer or farther away than they really are. "When you're walking, that's not good, because bifocals are constantly adjusting," Smith said. "You definitely don't want to use bifocals when walking up or down the stairs."

Identify and eliminate safety hazards at home. According to the National Institutes of Health (NIH), six out of every 10 falls happen at home. The usual causes? Loose carpets and floorboards, dark stairways, slick floors, and cluttered walkways, to name a few. For starters, you should properly arrange or remove things you could easily trip over, such as boxes, cords, and small items like toys and pet bowls. Make sure carpets are secured to the floor and stairs, and put down some anti-slip tape or rubber mats where possible. If necessary, move some furniture around to give yourself more room to walk freely. Also, think about putting grab bars near your tub/shower and toilet, and railings on both sides of the stairs. Good lighting is especially important. The NIH says there should be sufficient lighting in each room, at entrances, and on outdoor walkways. "If you're fumbling for your keys in the dark, and then you drop your keys, and you have to reach down for your keys, those are all things that are going to lead to a fall," Smith said. Having light switches at the top and bottom of stairways is ideal. You should also place a lamp near your bed, install nightlights around the house, and keep a flashlight handy in case of an outage. In addition, when it's icy and snowy out, spread sand or salt on your porch and sidewalks, or ask someone to do it for you. In general, avoid icy or slippery surfaces.

Choose safer footwear. For older adults, the NIH recommends shoes with low heels and non-slip soles. Your shoes should fit well and completely surround each foot. Keep your laces tied and avoid wearing only socks or floppy, backless slippers. When you have to go out in the snow, wear boots with good traction, the NIH says.

Be observant, and take your time. Be on the lookout for obstacles that could cause you to fall. And don't be in such a hurry-take your time, especially when walking up and down the stairs. When you're out at night, give your eyes time to adjust to the darkness. (It's also a good idea to wear bright or reflective clothing so you'll be visible to drivers.)

Stay hydrated. Drink plenty of water, as dehydration can cause low blood pressure (hypotension), fatigue, dizziness, and loss of balance, all things that can lead to a fall. Avoid alcoholic beverages.

LifeBridge Health offers advanced, comprehensive physical medicine and rehabilitation services at each of its hospitals (including Carroll Hospital) and various community locations throughout the region. From initial consultation to hospital stays and follow-up rehabilitation, our dedicated specialists strive to restore patients to maximum physical function and help them resume normal activities.

To schedule an appointment with one of our highly trained physicians and find out why LifeBridge Health is Baltimore's premier health care organization, fill out our online appointment request form, or call 410-601-WELL.