29 May 2013

Exercise for balance and to prevent falls

Although a person with osteoporosis is at much greater risk of suffering a bone fracture than someone with normal bone mineral density, studies show it’s often a fall that causes the fracture.

 Although a person with osteoporosis is at much greater risk of suffering a bone fracture than someone with normal bone mineral density, studies show it’s often a fall that causes the fracture.

This also puts elderly people at even greater risk of fracturing a bone because they tend to fall more often. In fact, every year about two out of five (40%) people over 65 fall at least once.  Avoiding falls could go a long way in preventing fractures, particularly hip fractures, most of which are the direct result of a fall.

Teréza Hough, CEO for the National Osteoporosis Foundation of South Africa (NOFSA)gives some tips on how to prevent falls.

How can falls be prevented?

Following treatment for an injurious fall, older people should be offered multidisciplinary assessment to identify and address future risk, and individualised intervention aimed at promoting independence and improving physical and psychological function.

In addition to an assessment of yourself and your living space, it’s essential that strength and balance training are offered. Monitor and adjust the following accordingly to minimise risk of falling:

  • Home hazards: Remove loose rugs, improve lighting, remove loose wires etc.
  • Visual impairment: Changes in vision happen as we age. Have regular eye tests to rule out glaucoma or cataracts.
  • Hearing impairment: Our hearing grows weaker as we age, and certain medications and illnesses can also affect middle-ear function and balance.
  • Medication: Check these as sleeping pills, anti-depressants, blood pressure medication, allergy medications, and anti-epileptic medication can all increase the risk of falls.

Numerous studies have shown that people with better posture, better balance and greater muscle power are much less likely to fall and are therefore less likely to be injured. On the other hand, those with a more sedentary lifestyle are more likely to have a hip fracture than those who are more active.

For example, women who sit for more than nine hours a day are 50 percent more likely to have a hip fracture than those who sit for less than six hours a day. Many research groups have been investigating the benefits of exercise in the elderly as a means to improve their coordination, strength and balance.

Populations tend to become older and we now see many people who reach their nineties and some even get to see a centenary birthday. Studies have shown that in women over 80 years, an individually tailored exercise regimen that incorporates progressive muscle strengthening, training for balance, and a walking plan, can reduce the overall risk of falling by about 20%, and cut serious injury-sustaining falls by just over 30 %.

Testing your balance

Eyes and ears are very important for balance. You can test this by standing close to a table or counter. Stand with your feet close together or try standing on one leg- hold on to the table if you are unsteady- now close your eyes- you’ll see that it is more difficult with your eyes closed. Now open your eyes and shake your head- does this affect your balance?

Individually tailored exercise programs are proven to reduce falls and fall-related injuries.

The balance aspect of this training may be the key. A study has shown, for example, that patients practicing tai chi, an ancient Chinese martial art that focuses on balance, fall only half as much as their peers. This significant improvement was achieved after only 15 weeks, during which the patients received one Tai Chi lesson per week with an instructor and were asked to practice twice daily for 15 minutes on their own.

Strengthening exercises for joints are equally important – especially the ankle joints as they constantly have to make adjustments to spread our body weight over our feet. If they are stiff and weak, they will not be able to make swift adjustments that help us maintain our balance. Toe and heel raises (hold on to the back of a chair at first and then try without the support as you practice more) every day, are good for ankle strengthening.

Ask your physiotherapist to help you with a balance exercise programme to suit your needs.

Some suggestions to improve balance

  • Join a group or class that practices tai chi to help with coordination and balance.
  • Do balance exercises daily – ask a physiotherapist to help you with a programme.
  • Do both weight-bearing and muscle-strengthening exercises to improve muscle strength and to help maintain bone density.
  • Wear glasses or contact lenses if you need them. Practice exercising with bifocal and multifocal lenses.
  • Have regular eye and hearing tests.
  • Learn about the side-effects of your medications and follow the instructions on how to take them.

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Healthy Bones

Tereza is the CEO of the National Osteoporosis Foundation and worked as a Nursing Sister in the field of Osteoporosis for 18 years prior to her appointment with the Foundation. She used to be the Educational Officer for the Foundation and co-wrote the patient brochure on Osteoporosis. Read more

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