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EXERCISE INTERVENTION TO PREVENT FALLS IN THE ELDERLY By: Sandeeep Kumar Rajavelu Balachander, RPT

A previous meta-analysis with meta-regression, which included 44 trials in 2008 and 54 trials in 2011, found greater fall prevention effects in trials where exercise programs included balance training, were undertaken more frequently (i.e., exceeded 2 hours a week over the study period) and did not involve walking exercise. Another report published online in BMJ outlined how French researchers tested the impact of fall prevention exercises. They concluded that exercise programs reduced falls that caused injuries by 37 percent and falls, leading to severe injuries by 43 percent. Precaution While Performing Balance Exercises: Some exercises for seniors, including balancing exercises, can be challenging and may lead to falls. If you are thinking of performing such exercises, do so slowly and carefully. You should only do the movements that are safe for you. Being physically fit is not just about living longer. If you are fit and can minimize the risk of falling or the risk of age-related problems, your need for medications and hospital visits will be translated into cost savings for yourself and the healthcare system. Working with a physical therapist is the best way to get started on an exercise routine and ensure safety. While you do need to challenge your balance,youalsowant tomakesureyoudon’t fall. References: 1) The epidemiology of falls and syncope. Rubenstein LZ, Josephson KR Clin Geriatr Med. 2002 May; 18(2):141-58. 2) Clinical practice. Preventing falls in elderly persons.TinettiMENEnglJMed.2003Jan2;348(1):42-9. -The costs of fatal and non-fatal falls among older adults. StevensJA,CorsoPS,FinkelsteinEA,MillerTR InjPrev.2006 Oct;12(5):290-5. 3) CentersforDiseaseControlandPrevention. Falls among older adults: an overview. 2016 [Available from: http://www.cdc.gov/homeandrecreationalsafety/falls/ adultfalls.html. Accessed March 2016. 4) Alfonso J. Cruz- Jentoft, Francesco Landi, Stéphane M. Schneider, Clemente Zúñiga,HidenoriArai,YvesBoirie,Liang-KungChen,RogerA. Fielding, Finbarr C. Martin, Jean-Pierre Michel, Cornel Sieber, Jeffrey R. Stout, Stephanie A. Studenski, Bruno Vellas, Jean Woo, Mauro Zamboni, Tommy Cederholm. Age and Ageing, Volume43, Issue6,November2014,Pages748–759,https:// doi.org/10.1093/ageing/afu115 5) K. Aleisha Fetters, MS, CSCS, isa freelanceHealth&Wellness reporteratU.S.News. As a certified strength and conditioning specialist with a graduatedegree inhealthandscience reporting.

Commonhealthconditionssuchasheartdisease and Type 2 diabetes can also impact your risk of falling by contributing to nerve damage in the legs and feet. And, when your legs and feet go numb, staying upright is next to impossible. And while a diet rich in vitamin D, calcium, and protein can boost fall prevention, as can staying mentally engaged with brain games, exercise is critical in preventing fall-related hazards, too. Simply adding the right exercises to your routine can make an enormous impact on your safety by strengthening the body, boosting blood flow to the lower extremities, improving neurological function, and even helping to enhance your body’s proprioceptive powers. A 2016 comprehensive British Journal of Sports Medicine meta-analysis found that exercise alone reduces the risk of falls in older adults by an average of 21 percent . What’s more, working out for more than three hours per week was linked to a 39 percent reduction in falls. It’s best to focus on your body’s largest, most powerful muscle groups, such as your glutes, quads, and hamstrings while also performing single-leg and balancing exercises. Balance exercises for seniors are a vital component of any exercise program as we age. Research shows that those who are physically active tend to live longer, and balance exercises can improve muscle mass as well as prevent life-ending falls. When you think about it, it is remarkable that a simple lifestyle change, such as a balance exercise for the elderly, can make a big difference when it comes to overall good health. Sadly, a report by the United Health Foundation back in 2015 showed that 33.3 percent of seniors are not physically active. For instance, one study showed that physically active individuals at 78 years old were more likely to live an independent lifestyle at the age of 85. Exercises have also been linked to improved cognitive function, weight control, and decreased disease, such as hypertension, heart disease, diabetes, and some types of cancers. Reduced anxiety is another benefit to regular physical activity. The benefits of exercises to improve balance in seniors has been pointed out in many studies.

FALLS HAPPEN, NO MATTER your age. Falls are a leading cause of morbidity and mortality in older adults. Approximately one in three community-dwelling people aged 65 years or older will fall at least once per year, and the risk of falling increases with age. Falls impose a significant social and economic burden on individuals, their families, community health services, and the economy. As the proportion of older people is rising globally, the costs associated with falls will increase. The prevention of falls is, therefore, an urgent public health challenge. Public health bodies and international guidelines are promoting the implementation of appropriately designed intervention programs that are known to prevent falls in older people. There is strong evidence that appropriately designed intervention programs can prevent falls in older people. A Cochrane systematic review established that exercise interventions reducetherateoffalls(numberoffallsperperson) and riskof falling (proportionofpeoplehavingone or more falls) in community-dwelling older people. Furthermore, exercise as a single intervention has a fall prevention effect similar to multifaceted interventions, suggesting the implementation of exercise as a stand-alone intervention may be the optimal and potentially most cost-effective approach to fall prevention at a population level. Lack of exercise causes a decline in muscle mass. According to one Age and Ageing review, 1 in 3 adults age 60 and older suffer from severe muscle loss, called sarcopenia. Sarcopenia drastically affects the strength of the legs, hips, and core, all of which are critical to mobility and maintaining independence. The loss ofmusclemassandstrength inthearmscanmake itdifficult tocatchyourself ifyoudo trip.Andsince themusclesof thebodyactasasortofprotection for the bones, if you fall because of inadequate muscle mass, you may be more likely to suffer a bone break. Meanwhile, your proprioception – or your ability to sense where your body is relative to other things and control your body’s positioning – can naturally decline through the decades. As a result, balance and stability suffer.

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