Falls prevention!

• There is clear evidence that exercise can prevent falls.
• Randomised trials and systematic reviews provide clear evidence that falls in older people can be prevented with well designed intervention programs.

Although many different risk factors for falls have been identified, intervention trials have found that the effects of exercise on falls prevention are as large as those from multi-faceted interventions.

Therefore, widespread implementation of exercise seems to be the best approach to falls prevention at a population level. Physiotherapists have a lot to offer in this area.

The evidence

A meta-analysis published in the Journal of American Geriatrics Society in 2008 found that up to 42% of falls can be prevented by well designed exercise programs.

The exercises that had the biggest effect on fall rates involved challenging balance abilities and they were undertaken frequently (e.g. more than two hours a week over a six month period).

Practical implications

Exercises that challenge balance involving:

• Controlled movement of the body’s centre mass (e.g. Tai Chi, or leaning/reaching while standing)
• Decreasing the base of support (e.g. standing with feet close together or on one leg)
• Lessening arm support (e.g. exercises that progress from holding a chair or rail to unsupported exercise)

Similar effects have been found from group and home based programs, as long as they are individually prescribed and functionally relevant exercises.

To be effective the exercises must be performed safely, otherwise they may cause the falls they are designed to prevent.

What about other forms of exercise?

Like everybody, older people will also benefit from exercises that enhance muscle strength and fitness (e.g. seated exercises, upper body resistance training etc). However, they may not be effective in falls prevention.

References

1. Sherrington, C (2010). “Standing Tall”, InMotion, p.31. Australian Physiotherapy Association: Camberwell, VIC
2. Sherrington et al (2008): Effective exercise for the prevention of falls: a systematic review and meta-analysis. Journal or American Geriatrics Society.
3. Australia and New Zealand Falls Prevention Society http://www.anzfallsprevention.org
4. Cochrane review on falls prevention http://preview.tinyurl.com/yj8yj5g

Wellness & Lifestyles has seen great results preventing falls at some of our facilities. We have a number of therapists that can design exercise programs and classes to suit all residents. Contact us on 08 8331 3000 for more information.