Monday, August 24, 2020

Falls in Elderly - Why and How to prevent them?

Falls in Elderly

            Falls are one of the leading causes of accidents in the people over the age of 65 years. Before we discuss falls and their causes in detail, it is important to have clear understanding of what a “fall” is. Fall can be defined as “an unplanned, unexpected contact with a supporting surface”. A surface may not necessarily mean a floor, but may also mean a wall or a chair, etc.  They are the main cause of accidental injuries in elderly, which can be non-life threatening or life threatening!

An elderly individual falls in the category of “At-Risk” individuals who are likely to fall. To prevent such an incident, the likely causes of falls should be understood. Let’s have a look at them! 

The causes of falls in elderly individuals:

As we compare this problem of falls with other conditions like diabetes, arthritis, etc. we do realize that we can address 90% of these causes and the incidence of falls can be reduced drastically. Recent study has shown that most individuals are not aware that falls can be prevented by appropriate guidance & physiotherapy.

Why is it important to prevent falls?

Even one incident of a fall or a near- fall leaves us with a fear that our balance will be lost any time and it will lead to a fall. It is a vicious cycle of which the components are interlinked. This fear of falls is physically as well as mentally disabling, because our social engagements are reduced one tends to get isolated.

Balance and anticipatory adjustments to maintain balance are controlled by various systems in the body. Reduced functioning of one or more systems gives rise to fear of falls and loss of balance leading to falls.

Our body and the receptors controlling our balance can be trained by various strategies, let us see them!

Prevention strategies that can be incorporated with the help of exercises:

v  Doing functional exercises which are time based for improving reaction time so that anticipatory balance adjustments are made in time and you don’t lose balance!

v  Balance training by doing exercises on different surfaces such as floor (stable surface), moving platforms, etc.

v  Analyzing what goes wrong and where it goes wrong during walking, and targeting the specific components to improve way of walking

v  Gaze stabilization exercises can improve the vision difficulties and co-ordination of vision with balance

v  Joint proprioception can be improved by giving weight bearing exercises on floor initially and progressing to the Bosu and or vestibular ball

v  Strengthening exercises of the individual muscles which are found to be weak and contributing towards weak balance

v  Proper technique of using a walking aid and knowledge about how it should improve your stability

v  How can you upgrade your surroundings to improve support?


Duration & Frequency:

Exercise programmes that have successfully reduced the number of falls in elderly have required exercise sessions of atleast 3 times/ week for a duration of 30-40 minutes. The exercises are advised to be done under supervision for initial few weeks and then home program can be given, with weekly follow up.

How can we prevent falls?

The management of such a condition, requires a detailed assessment, so as to correctly identify the cause, among of all these potential causes listed above.

All individuals are different and hence, their problems are different, but all the individuals who are at a risk of falls have a common goal: “To prevent falls”. Take a sigh of relief as unlike other accidents in life, these are the accidents that can prevented! We at Rehab Station, offer a complete detailed evaluation with the help of physiotherapeutic skills and also with use of advance technology (Huber 360); a patient tailored exercise protocol; detailed counselling about the condition and coping strategies which are going to be implemented; all under one roof!

- Dr. Sukanya Dandekar (PT)
Neuro physiotherapist at Rehab Station, Pune

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