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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