Improving Balance and Preventing Falls with Physical Therapy
Maintaining and improving balance is critical as you age as good balance allows you to maintain a stable, upright position when standing, walking, and sitting and avoid injury from a fall. Improving balance has many benefits including body awareness, joint stability, coordination, posture, and a reduced risk of injury and falling. Maintaining good balance is particularly important for seniors as aging contributes to visual, vestibular, and muscular weakness issues that negatively impact balance. Physical therapists can help you improve your balance as you age and prevent falls through a customized exercise and balance training program. Check out our video of physical therapist Jen guiding a senior patient through balance training exercises!
Fall Risk Factors
Falls are a leading cause of injury in older adults with more than 30% of those aged 65 and over and more than 50% of those age 80 and older experiencing a fall in any given year. One out of every five falls cause an injury, such as broken bones or a head injury; at least 300,000 older people in the United States are hospitalized for a hip fracture each year, often due to a fall. Statistically, women fall more often than men and account for three-fourths of all hip fractures. Falls can lead to a fear of falling, which can limit usual activities, lead to loss of independence, and decrease the individual’s overall physical activity. Falls are common in the bathroom when sitting or standing from the toilet or shower or at night in a dark bedroom when getting up to use the bathroom.
There are a number of factors that can heighten an individual’s risk of falling, including:
Balance or walking issues due to vision changes, vestibular problems, altered sensation in your feet, or physical conditions such as Parkinson’s disease, Multiple Sclerosis, stroke, or diabetes
Use of multiple medications (those who take 5 or more medications increase their risk of falls)
Home hazards, such as dim lighting and trip hazards like loose rugs and a cluttered environment
Positional low blood pressure (blood pressure that drops when standing)
Feet and footwear issues
Muscle weakness in legs
Physical Therapy to Improve Balance and Prevent Falls
It is imperative to take steps to minimize the risk of falling and protect seniors from injury. Physical therapists offer a solution through an annual fall risk screening and assessment for seniors. A fall risk screening and assessment is used to determine if you have a low, moderate, or high risk of falling. The fall risk screening involves the physical therapist asking a series of questions about your overall health; if you’ve had previous falls or issues with balance, standing, or walking; a simple vision test; a foot and footwear assessment; and a home safety assessment. The fall risk assessment is a hands-on evaluation in which the therapist has you complete a set of tasks, known as fall assessment tools, that test your strength, balance, and gait. If the fall risk assessment shows an increased risk of falling, the physical therapist then designs a fall prevention program customized to your specific needs and condition.
Physical therapy to improve your balance and minimize your risk of falling can include:
Balance training: Specific static and dynamic exercises that challenge your ability to keep your balance as well as recover from a loss of balance, e.g., single-leg-standing (balancing from a narrow base of support), turning in a circle, or stair-stepping.
Gait and movement training: dynamic movement including figure eights, changes in direction, obstacle courses, and dual-task training.
Multitasking safely: Older adults who have difficulty walking and talking at the same time are at a higher risk of falling. The therapist has you complete a dual-task training program in a safe environment, challenging you to maintain your walking speed while talking or engaging in another task.
Strength training: Targeted strengthening of specific muscle groups, including the core and upper and lower legs, to improve standing balance, balance when walking, and ability to recover from a loss of balance.
Endurance training: Aerobic exercise at low intensity and a longer duration to help improve your overall fitness, involving walking or aquatic therapy.
Patient education and fear management: education regarding safety in the home, removing home fall hazards, and creating techniques to manage a fear of falling in various scenarios.
Mangiarelli Rehabilitation physical therapist, Jen Story, is working with Ann, an amazing patient in her 90s, who is working on her balance. In the video, Jen progresses Ann from a single leg standing exercise to various exercises through an obstacle course, alternating between moving from a wide base of support to a narrow base of support and side-stepping.
A video involving Mangiarelli Rehabilitation patients is posted with the verbal and written permission of the patient.
Give Mangiarelli Rehabilitation a call for your free, complementary fall risk screening with our physical therapists.
