EXERCISE AS AN IMPORTANT CONTRIBUTOR FOR FALL PREVENTION

DOES EXERCISE HELP PREVENT FALLS IN OLDER ADULTS?

Someone asking “does exercise prevent/treat conditions associated with old age?” is synonymous to asking “does medication prevent/treat diseases associated with aging?” The answer only makes sense when exercise is described as a modality, with dosage, how long you are exposed to it, complying with the prescription, and tailored exercise for each condition, in this case being falls (Singh, 2002).

• Exercises improve your strength so you can stay independent
• You have more energy to do the things you want to do and reduce fatigue
• It improves your balance and lower risk of falls and injuries from falls
• Physical activity helps manage and prevent some diseases like arthritis, heart disease, stroke, type 2 diabetes, osteoporosis, and 8 types of cancer, including breast and colon cancer
• You sleep better at home
• Reduced levels of stress and anxiety
• You reach or maintain a healthy weight and reduce risk of excessive weight gain
• Exercise controls your blood pressure
• Possibly improve or maintain some aspects of cognitive function, such as your ability to react quickly between uneven surfaces; like over a rock or slippery surface
• Physical activity perks up your mood and reduce feelings of depression

 

WHAT CAUSES FALLS IN OLDER ADULTS?

Falls are defined as accidental events in which a person’s center of gravity is lost and his/her effort to restore balance is ineffective eventually dropping to the ground (Ungar et al, 2013)

; The cause could be a related to visual impairment(partial or total blindness), syncope (dizziness), cognitive impairment, heightened brain activity(seizures), a stroke, a loss of consciousness, muscle loss/weakness(from aging, disuse atrophy), or non-contestable forces. The pathogenesis of falls is often from different factors, due to physiological age-related changes or more properly pathological factors, or due to the environment. The identification of risk factors is essential in the planning of preventive measures.

Many older people have a variety of adverse psychosocial difficulties related to falling, including fear, anxiety, loss of confidence, and impaired perception of ability to walk safely without falling. The umbrella term for these problems is “fear of falling,” and this is found in around half of community dwelling older people who fall and in up to half of those who have never fallen. Consequences include avoidance of activity, social isolation, and increasing frailty and risk of further falls independent of physical impairment.

 

 

DO PREVIOUS FALL PREVENT YOU FROM EXERCISE AND PHYSICAL ACTIVITY?

Although fear of falling is common and affects many older people who have had a history of fall, understanding of its management is limited. Some research support the use of physical activity to manage the fear of falling, and recent studies supports the use of psychological therapies as well.

When it comes to exercises, many older people who have fallen before have a variety of psychosocial difficulties related to falling, including fear, anxiety, lack of confidence, and impaired perception of ability to walk safely without falling.  However these does not prevent one from engaging in physical activity. Avoidance of physical activity can lead to and increasing frailty and risk of further falls independent of physical impairment.

A history of falling have a visible impact on how older people walk. An experiment of older people undergoing gait and balance studies on elevated walkways show disproportionately slow walking speeds and other dysfunctional gait adjustments, alongside abnormalities in postural balance compared with younger subjects. Such experimental data and the observation of higher risk of falls and increasing physical frailty in fear of falling suggest that physical therapy is important in managing fall.

 

 

 

REFERENCES   

Maria Antoinette Fiatarone Singh, Exercise Comes of Age: Rationale and Recommendations for a Geriatric Exercise Prescription, The Journals of Gerontology: Series A, Volume 57, Issue 5, 1 May 2002, Pages M262–M282, https://doi.org/10.1093/gerona/57.5.M262

Ungar A, Rafanelli M, Iacomelli I, Brunetti MA, Ceccofiglio A, Tesi F, Marchionni N, Fall prevention in the elderly. Clinical cases in mineral and bone metabolism: The Official Journal of the Italian Society of Osteoporosis, Mineral Metabolism, and Skeletal Diseases, 10 May 2013.

Parry Steve W, Finch T, Deary V. How should we manage fear of falling in older adults living in the community? British Medical Journal  2013; 346 :f293