Physiotherapy

Strength and Balance Training

Falls Prevention and Reduction

With falls being one of the largest causes of preventable deaths in the Australian elderly population there is a massive potential for change.

Countless studies have suggested strengthening and balance exercise programs for this population significantly decrease not only the rate of falls but also the severity of injury after a fall. It’s even worse for people living in aged care with research showing that they are three times more likely to fall than people living at home.

Having said this, one of the main reasons for people going into aged care facilities is decreased mobility which is caused by lack of strength and poor balance. This means their risk of falling is already increased before they go into aged care. The lack of activity is the main problem as the less active you are, the more your strength and balance will decrease, the less confident you will feel to safely move around the house and community, the more likely you are to be even less active. It’s a downward spiral.

Evidence of the benefits of exercise programs has shown that individually prescribed strength training and balance exercises can dramatically decrease the risk of falls with one particular recent Australian study showing a 55% reduction in falls and a similar reduction in injury in those who did have a fall. The main factor in this research was that the person was not just given an exercise sheet or video to watch, they were individually supervised and each program was progressed depending on how well they performed each exercise.

The key to improvement is the exercises have to be challenging, but at the same time safe. This is why with supervision and constant exercise progression and increasing difficulty there is such a dramatic improvement as the programs are constantly being made more challenging but are safe and use correct technique due to the supervision.

Another Australian study has shown that group based exercise is very effective in the prevention of falls especially when combined with home hazard and reduced vision management. This is particularly the case with those living at home, aged 70-84 and rate their health as good. This is likely due to the supervision provided and with exercise and the environment improving compliance with exercise.

Physiotherapists have extensive training and knowledge on strengthening and balance training, particularly in the elderly population where there is the potential for a fall to occur. Supervision is important and correct exercise prescription to ensure the person is performing the required exercises safely is a necessity.

References:

Jennifer Hewitt, Kathryn M Refshauge, Stephen Goodall, Timothy Henwood and Lindy Clemson (2014), Does progressive resistance and balance exercise reduce falls in residential aged care? Randomized controlled trial protocol for the SUNBEAM program, Clin Interv Aging. 2014; 9: 369–376.

Lesley Day, Brian Fildes, Ian Gordon, Michael Fitzharris, Harold Flamer and Stephen Lord (2002), Randomised factorial trial of falls prevention among older people living in their own homes, BMJ 2002;325:128.