Preventing Falls Through Better Balance

Did you know?• By the year 2030 the Center for Disease Control

(CDC) estimates the older adult population will rise to 20%? That is about 71.5 million people!

• Falls are the leading cause of accidental death in older adults, with ½ of falls occurring in the home. Most of these could be prevented!

• More than 1/3 of older adults (65+) fall each year, with 20-30% suffering moderate to severe injuries?

In fact, in 2010, 21,700 people age 65 or older died from unintentional fall injuries. (CDC)

More fun facts

• Up to 60% of fallers express a “fear of falling” with 33% of them indicating they restrict activities due to this fear

• One half of older adults hospitalized for a fall related injury are discharged to a nursing home

Body Changes As We Age

• Strength, flexibility, balance and endurance decline with age

• Changes occur in cardiovascular and musculoskeletal function, as well as in our sensorimotor system and in our connective tissue

Strength• A decline in muscle strength occurs due to

loss in muscle fibers and size.• Can be improved with exercise – you

know the old “ you don’t use it you lose it” saying – well if you use it more, it WILL get better!

• Progressive exercises with bands or weights not only increases strength but assists in fall prevention by “catching self” easier with step strategies

Muscle Stiffness

• As we age, the ligaments and tendons increase in stiffness making movements more difficult

Slowing Reaction Time

• One of the biggest changes is the decreased reaction time of the sensors needed to initiate a movement following a stimulus, such as tripping over the dog!

• 3 sensors of the sensorimotor system• In muscles and joints of foot and leg• Visual sensors• Vestibular apparatus in the inner ear

Sensorimotor Changes• It takes longer to complete the information loop

between the body sensors, brain and muscles resulting in decreased coordination and increased reflex response time

– Brain cells are dying as we age– The sheath coverings around the nerves are

deteriorating– The speed of transmission slows down

• We don’t see as well

Direct Results of Changes

• Gait becoming slower, with shorter step, wider base of support

• Balance decreases

• Fall risk increases

Why focus on better balance?

• To maintain the ability to walk comfortably and not with short shuffling steps

• To reduce the chance of falling through greater mobility and better reaction time

• Maximize independence!

Fall Factors

• Intrinsic - things we have difficulty controlling

• Extrinsic – things we can control

Intrinsic fall factors

• Decreased vision• Decreased strength• Decreased balance• Increased medications (4+)• Lack of sleep• Possible decline in mental status• Chronic disease• Alcohol use• Poor posture

Extrinsic Fall Factors

StairsClutterWet surfacesLoose rugs/carpetsCordsPoor lightingHurrying/rushingNot wearing shoes

What can you do to prevent falls?

• Begin a regular exercise program• Review your medications with your health

care provider or pharmacist• Make your home more safe• Have your vision checked

Physical Activity for Balance

Social Balance

Strengthening

Endurance

Stretching

Finding the time

• Mixing up various types of exercises during television commercials makes it easy to get fit and not miss favorite shows.

• Achieving better balance makes it all worth while – much more fun to play with the grandkids than have them visit you in the hospital or nursing home

So What Can I Do?

Watch for signs of blood pressure drop with standing

Be fully upright before begin to move ( often falls occur within first 3 steps from chair!)

Wear proper footwear (we call them “slippers” for a reason)

Been falling? Talk to physician / family about it.Begin a regular exercise program, including

strengthening, stretching, balance and cardio, going at your own pace and ability and have fun!

Opportunities for you to improve your balance!

• Matter of Balance• EnhanceFitness• Spectrum Health offerings• Local fitness / exercise classes

Why Evidence Based Programs?

Why these programs? Because we know…

But the bottom line is…..get moving!

What is A Matter of Balance?

A Matter of Balance is a program: Designed to reduce the fear of falling and

increase the activity levels of older adults who have concerns about falls

Lead by volunteer lay leaders What makes the program unique is the

focus on the way we think about falls and getting rid of that “stinkin’ thinkin’!”

A Matter of Balance: Managing Concerns About FallsDuring 8 two-hour classes, participants learn: To view falls and fear of falling as controllable

To set realistic goals for increasing activity

To change their environment to reduce fall risk factors

The important role of exercise to increase strength and improve balance

Kitchen table talk

A Matter of Balance: Managing Concerns About Falls

What Happens During Class? Participants share strategies and fears Participants learn ways to stay safer and prevent

falls at home and in the community. Participants learn the connection between

assertiveness and fall prevention The importance of exercise in relation to fall

prevention is discussed and exercise begin in the 3rd week and done each week thereafter.

Participants are empowered with skills and knowledge

Who could benefit from A Matter of Balance?

Anyone who:• is concerned about falls• has been experiencing falls• has given up things that are important to them

due to a fear of falling. • is interested in improving flexibility, balance and

strength• is age 60 or older, and able to problem -solve

A Matter of BalanceParticipant outcomes:

Class Evaluation Results: 97% - more comfortable talking about fear of falling 97% - feel comfortable increasing activity 99%- plan to continue exercising 98% - would recommend A Matter of Balance

“I am already noticing a difference in my physical being. I am sure I am a little more mobile than I had been and plan to continue these exercises. Hopefully I will be jumping over the moon soon”

“ I seem to be more aware of every situation for my safety. I now ‘stop, look and listen’ to my surroundings.”

You could be a participant, a provider, or a coach!

•If you are looking to add more balance to your life, A Matter of Balance has many opportunities!•Classes throughout the area•Additional providers needed•Coach’s training at AAAWM March 19 and 20!

What is EnhanceFitness?

EnhanceFitness is an evidenced based group exercise program specifically for older adults

Developed by the University of Washington Health Promotion Research Center and Seattle Senior Services

Taught by a certified fitness instructor to ensure quality assurance and safety

EnhanceFitness

What happens during three 1-hour weekly classes: Focus on strength, stretching, flexibility, 20

minutes of cardio. Participants learn to gradually increase their

activity and work out at their own pace Socialize with others Become stronger, healthier, and build

friendships.

EnhanceFitness Outcomes

Participant Outcomes after 6 months: Improvement in:

Upper and lower body strength Balance and mobility 93% reported their physical abilities had maintained

or improved as a result of participating in EnhanceFitness

Decrease in: Depressive symptoms Health care costs

Final Resources

• A fall prevention resource guide is available that includes programs offered through Spectrum Health, Grand Rapids Community College and many other local resources. Many are appropriate for people with osteoporosis.

• Remember the most important thing to do is keep moving!

Questions?? Nancy Mason MM PT

Spectrum Health Lemmen-Holton Cancer Pavilion - 486-5055

nancy.mason@spectrumhealth.org

Julie Lake

Senior Neighbors - 233-0283

jlake@seniorneighbors.org

Thank You