Falls have become a serious problem that older adults are facing at home and in the community. Falls are the leading cause of fatal injuries and nonfatal emergency room admissions in older adults. Unfortunately, the risk of falls is very high and increases with age. For adults over the age of 80, half can expect a fall annually and about 50% can expect multiple falls. Falls can result in broken bones, muscle strains, brain injuries and can limit ones independence. The good news is that falling is not inevitable! There are various ways to assess your risk and methods to decrease your chances of falling.
What are some risk factors that could cause a fall?
There are numerous risk factors for falls including poor balance, poor lower extremity strength and range of motion, decreased vision, improper footwear, medication side effects, fear of falling and slow walking speed just to name a few. I am going to take a few of those risk factors and break them down a little further for you.
After a fall many people become fearful of another fall so they stop doing activities that they feel are risky. While some activities are good to delegate to others, such as climbing on ladders or going into the attic, you should be able to complete other activities with no fear or anxiety, such as changing the bed sheets and light cooking. Avoiding certain behaviors and activities and decreased confidence in your balance have been known to be great predictors in falls. Typically, when a person begins avoiding activities due to fear of falling they slowly become less mobile, which in turn decrease strength and range of motion therefore increasing the risk of a fall, not to mention decreasing the quality of life.
As we age, we lose about 1% of our strength every year. Core and leg strength are very important for being able to prevent and/or recover from a fall. If you are not performing a structured exercise routine you may be overlooking important muscles and therefore they are becoming weaker. Weak muscles will not be able to clear obstacles, stabilize on uneven ground, or keep upright posture as well as strong muscles leading to increases chances of falling. In the event of a fall, strong muscles will better support and protect your bones and make it easier to stand back up from the floor.
Many people are not aware of the fact that walking speed is a good way to measure fall risk. Slower gait speeds are typical of higher fall risk. While it is fine to walk at a comfortable speed during your average day, there are times when a quick, but safe, walking speed is important, such as in an emergency situation or when rushing to use the restroom. In those times when a person is walking at an increased rate the chances of a fall is higher. Due to the lack of practice, a change in a person’s average walking speed will also increase the chances of a fall. A person should be able to walk at varying speeds without compromising safety.
How can physical therapy help me?
A physical therapist can help assess your fall risk by assisting you through some basic physical tests and having you fill out some questionnaires regarding your balance and confidence. Once you have been evaluated the PT can create a program that is tailored to your needs, most likely a combination of static and dynamic balance activities and strengthening exercises. Performing these activities in the clinic will allow the therapist to correct any mistakes they notice and you will feel more confident with the supportive staff at your side.
The therapist can also work to simulate activities that you may have been avoiding, such as climbing steps, walking on uneven surfaces and performing housework. There is always a way to progress the balance activities as you improve such as adding an unstable surface, removing arm support, or taking away the visual component. The therapist may recommend the use of an assistive device (walker or cane) to increase your safety. If they believe that is the safest situation they are able to correctly adjust the height for maximum support and instruct you in the proper way to use the device. The therapist will continue to reassess your progress to help you reach your goals and decrease your risk of falling!
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