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
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
- 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
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.