The Balancing Act of Fall Prevention
Aug 26, 2021 Cedars-Sinai Staff
More than a quarter of seniors fall each year, causing more injuries in this age group than any other accident, according to the Centers for Disease Control and Prevention (CDC).
Falls are responsible for most hip fractures and traumatic brain injuries and lead to more than 3 million emergency department visits annually, CDC figures show. And while 20% of falls seriously injure seniors, the likelihood of falling again doubles after a first occurrence.
Seniors who walk away unharmed also often develop a fear of falling that can backfire: Avoiding activities that might lead you to trip can weaken your body and actually worsen your risk. Instead, experts say standing up and moving can help keep you safe.
"Balance is like any skill: You can get better at it if you practice."
Get on the right footing
The Department of Health and Human Services recommends at least 150 minutes per week of moderate-intensity exercise for older adults, including balance training as part of a multicomponent fitness plan. Your exercise should also focus on strengthening lower-body muscles in the back, abdomen and legs, which further improves stability.
Geriatricians suggest that all patients should be encouraged to exercise, if they can.
Exercise programs for seniors that highly challenge balance and include more than three hours of exercise per week have been found to reduce falls by 39%. And seniors engaged in preventive balance-boosting exercise who end up falling are much less likely to hurt themselves.
An Rx of balance challenges
Cedars-Sinai geriatrician Dr. Allison Mays recommends a basic at-home strength and balance routine:
- Stand up from a chair without using your arms. Using a sturdy chair (without wheels), cross your arms over your chest and attempt to stand up from the chair. If you're able to, try 10 chair stands in a row—three times a day. If you need to use your arms to support you in standing, that's OK, too. The goal is to strengthen your legs so you don't need support from your arms in the future.
This will "strengthen quadriceps and buttocks muscles and help with mobility," she says.
- Try holding different standing positions. Keeping the chair nearby to hold onto as needed, stand with your feet together. See if you can hold that position for at least 10 seconds.
Space one foot slightly in front of the other into a "semi-tandem stance" and try holding for the same amount of time.
Repeat this holding pattern with one foot in front of the other, as if you are standing on a straight line.
"If any of those positions are difficult for you, then keep working on that one until it gets easier," Dr. Mays suggests.
- Stand on one foot. Normal balance is considered being able to stand on one foot for 10 seconds.
Look for opportunities to build balance into your daily routine, so you're consistently reinforcing your training.
"Balance is like any skill: You can get better at it if you practice," Dr. Mays says.
Consult with your doctor any time you start a new exercise program or regimen, or if you're unsure about exercise safety, Dr. Rosen says. This is especially important if you have a chronic health condition and don't know its effects on your exercise abilities.
When exercising at home, always make sure you're wearing appropriate athletic footwear with strong ankle support, because going barefoot or wearing just socks or slippers makes you more likely to trip. Anyone with preexisting balance issues should wear a structured sneaker around the house.
Dr. Mays adds that having the support of a family member or caregiver to spot you while working out can help ease anxiety.
Group exercise can supplement your training
Balance-oriented physical activities such as yoga and tai chi also are beneficial. These disciplines can be done individually or with others, can help with motivation and can make exercise more fun, Dr. Mays says.
Early results from Cedars-Sinai's recently completed Leveraging Exercise to Age in Place (LEAP) study reinforce the value of group-based exercise for seniors. The trial offered three classes—Enhanced Fitness, Tai Chi for Arthritis and Arthritis Exercise—to older adults in an effort to stave off falls, as well as social isolation.
While the study is no longer active, interested participants can still sign up for the virtual arthritis exercise class by emailing community health lead Katrina Rosales at firstname.lastname@example.org. Cedars-Sinai is also launching a new pilot program pairing seniors with online exercise buddies, says Dr. Mays. Other virtual exercise classes are available through the L.A. County Department of Parks and Recreation.
You don't have to fall just because you're no longer young, geriatricians stress. Fitness and balance training strengthen your body's arsenal against the internal and external forces that can trigger a fall.
"Falls are a common occurrence with aging, but they are not a normal part of aging," Dr. Rosen says.