4 tips to prevent dangerous falls

One-third of those over the age of 65 fall every year . Whether someone actually falls has more to do with behavior than disease, and the fear of falling by itself contributes to fall risk. There are some ways that individuals, friends and family can prevent falls. Here are a few tips:

1.  Move more

Elderly people who move more are less likely to fall than those who do not move as much. Even education about fall reduction does not decrease fall risk. Only taking action to change behavior and increase physical activity can do that.

2.  Trust and use your body

As a physical therapist working with patients with balance problems, this is usually one of my first interventions beginning the very first day of treatment.

For most people, young and old, a simple sway of the body, bump or loss of balance should cause a person to shift their weight or take a step.

With a fear of falling often comes changes in the way people move around. Using hands on walls and countertops, walking slower and staying in the home are behaviors which change the way people move and balance themselves.

To someone who no longer trusts their body, external devices (countertops, walls, people) are clung to, and slow rigid walking is used as a choice for balance. These changes in behavior further decrease the person’s trust with their own body to balance, and the cycle continues. Removing these behaviors and allowing the body to react is the best way to stay out of this cycle.

3.  Walk faster

Walking slow creates changes in the way we walk, which increases the risk of falls8,1. These specific changes in walking go away when a person chooses to walk faster5.

4.  Allow your head to move, thereby using your inner-ear balance system

We know from our own experience that people use their eyes more for balance as they age. This overuse of vision, reduced movement and lack of use of our inner ear balance system (vestibular system), makes our balance worse.

Reducing how much we move, or no longer using or trusting our vestibular system, can make us dizzy, even if there is not a disease in the vestibular system. When this happens, normal movement of the body, or movement as seen by the eyes, can result in our brain telling us we are dizzy. Increasing movement of the body, the head and the eyes along with the head (regular everyday movement), can help resolve these problems, even if there actually is a disease of the vestibular system.

This blog post was contributed by Jeffrey Guild, a strength coach turned neurological and vestibular physical therapist on the staff at the Baylor Tom Landry Fitness Center.

Sources: 

1. Dargent-Molina, P., Favier, F., Grandjean, H., et al. (1996). Fall-related factors and risk of hip fracture: the EPIDOS prospective study. Lancet, 348, 145-149

2. Friedman, S.M., Munoz, B., West, S.K., Rubin, G.S., Fried, L.P. (2002). Falls and Fear of Falling: Which Comes First? A Longitudinal Prediction Model Suggests Strategies for Primary and Secondary Prevention. Journal of the American Geriatrics Society, 50, 1329-1335.

3. Gillespie, L.D., Robertson, M.C., Gillespie W.J., Sherrington, C., Gates, S., Clemson, L.M., Lamb, S.E. (2012). Interventions for preventing falls in older people living in the community. Cochrane Database of Systematic Reviews, Issue 9.

4. Herdman, S.J. (2007). Vestibular Rehabilitation, 3rd Edition. F.A. Davis Company, Philadelphia, PA

5. Kirkwood, R.N., Souza, Moreira, B., Vallone, M.L.D.C., et al. (2011). Step length appears to be a strong discriminate gait parameter for elderly females highly concerned about falls: a cross-sectional observational study. Physiotherapy, 97, 126-131.

6. Perracini, M.R., Teixeira, L.F., Ramos, J.L., Pires, R.S., Najas, M.S. (2012). Fall-related factors among less and more active older outpatients. Rev Bras Fisioter, pii: S1413-35552012005000009

7.  Staab, J.P. (2011). Behavioral aspects of vestibular rehabilitation. NeuroRehabilitation, 29, 179-183

8. Verghese, J., Holtzer, R., Lipton, R.B., Wang, C. (2009). Quantitative Gait Markers and Incident Fall Risk in Older Adults. J Gerontol A BiolSci Med Sci, 64A, 896-901.

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4 tips to prevent dangerous falls