Senior Fall Risk Reduction
Let’s review some of the more common reasons that cause seniors to suffer a fall, as well as several senior fall prevention tips and exercises that can effectively improve balance.
Falls remain one of the most detrimental factors to the independence and overall functionality of the older population. The damage sustained when a senior falls includes fractures and physical injury, which are obviously the most imminent concern.
However, the delayed rate of healing brought about by the natural aging process, as well as increased fear of being physically inactive after a fall can actually be much more harmful to an individual’s quality of life.
Despite various age-related changes that place a person at a higher risk for falling, most of these risk factors can be reduced or eliminated entirely. Furthermore, there are other issues that can cause falls that are completely avoidable.
Elderly Fall Risk Factors
As we address the question of what actually causes a person to fall, this will pertain to specific problems experienced more often by the older population. Furthermore, we will not get into the literal scenarios that may result in a fall, instead focusing on various age-related changes and discrepancies that increase a person’s risk.
Aging Loss Of Muscle Mass
One of the biggest factors influencing the increased fall risks in the older population is a significant decrease in overall lean muscle mass and strength. This loss of muscle is especially harmful when it occurs in the muscle groups composing the legs and trunk.
These muscles, which are the largest and most powerful in the body, are responsible for properly moving through the active gait cycle. Furthermore, these large muscle groups are important for the usually automatic, self-corrective actions that naturally occur during a loss of balance.
Throughout the aging process, if a senior individual does not maintain a viable amount of lean muscle mass, there are several movement-based changes likely to occur.
One issue is that decreased leg strength usually leads to a lower foot swing during walking, resulting in a much higher chance of tripping on something. Also, when a loss of balance does occur, the body is not able to right itself through the firing of postural muscles.
Inner Ear And Balance Problems
Another factor playing a role in the increased fall risk amongst older individuals is changes that take place in the inner ear. This portion of the anatomy is one of the main components of the vestibular system. The vestibular system is responsible for making the brain and body aware of where we are in space.
This system allows us to maintain our balance during dynamic movements that include rapid head movement, quick shifting of the eyes and tracking a moving object (such as reading a sign while driving in a car).
As a person ages, the vestibular system becomes less responsive to changes in position and does not react as quickly or efficiently to maintain balance in a rapid fashion. While people of every age are known to experience relatively short-term issues with the vestibular system such as vertigo, seniors sustain an actual structural change in this system that does not tend to improve without specific interventions.
Seniors And Medications
In general, older individuals tend to have a more extensive medication regimen than the younger population. Given that age is one of the biggest risk factors for most chronic illnesses, it would make sense that a person utilizes more medication to prevent or treat these conditions.
It is common knowledge that any form of medication comes with the risk of adverse side effects. Dizziness and fainting are usually somewhere on this list of side effects pertaining to most medications.
Furthermore, an individual taking a fairly large combination of medications is more likely to experience similar issues. This is the reason that dizziness and loss of balance due to pharmacological reactions is not an unusual thing regarding seniors.
Senior Blood Pressure Fluctuations
While there are certainly exceptions to this risk, as with each one that we have and will discuss, older individuals tend to experience more significant changes in blood pressure than their younger counterparts.
One of more severe examples of these fluctuations that affect seniors more frequently is known as orthostatic hypertension. This issue is marked by a significant drop in blood pressure when changing positions, such as lying down or sitting to standing. As a result, a person experiencing orthostatic hypertension is much more likely to sustain a fall.
Sensory Loss In Older Adults
Older individuals are known to experience a decrease in most of the senses. Sensations such as taste, smell, vision, and pain are usually experience at least some reduction over the course of the aging process.
While any loss of sensory information can increase the risk of falling, one of the main sensory deficits that predispose a person to a fall occurs in the legs and feet.
The amount of sensory loss experienced varies widely from person to person, as some individuals develop chronic conditions such as diabetes and other circulatory disorders that severely limit the feeling in the lower extremities while others may lose a marginal amount of sensation as they age. However, most older individuals will lose some of their sense of feeling in the extremities.
This deficit can obviously result in a fall, as the feet and legs are unable to relay important information about surface texture and height to the brain, therefore limiting the amount of postural adjustments that are made to remain upright.
How To Prevent Falls In The Elderly
These age-related factors contributing to falls are amongst the most common causes among seniors, however, this is not an exhaustive list. It is extremely important to mitigate these risk factors, as the secondary problems and impairments experienced by the older population after sustaining a fall far too commonly result in decreased quality and quantity of life afterwards.
The primary goal of any intervention designed for seniors should always be to maximize overall function and mobility so that an individual can continue to take part in the activities that they enjoy.
Preventing falls is undoubtedly the most important aspect of this overarching goal.
How To Reduce Fall Risk
Before we discuss any specific exercises that are effective at improving balance in the older population in order to reduce the risk of falling, it is important to outline a couple of environmental changes that should be implemented in the home. Preventing a fall is a two-fold approach that involves both improving balance from a physical standpoint as well as creating a safer environment.
- The first household tip is to ensure there is adequate lighting throughout the home. Unfortunately, a large percentage of falls happen at home, especially at night. Attempting to navigate stairs or get up to use the bathroom in poorly lit conditions is a perilous tasks for anyone with balance deficiencies.
There are many lighting fixtures available that are intended to illuminate problem areas, such as stairway lights and motion detecting night-lights that can be plugged in to an outlet near the bed and/or bathroom.
These readily available and relatively inexpensive modifications can go a long way in preventing a fall. Furthermore, the cost of implementing these items pails in comparison to the medical costs and significant loss of mobility associated with fractures and other serious injuries.
- The second risk factor reduction that seniors should be aware of is the removal of rugs and areas of loose carpet that can easily cause tripping. For the individual with moderate balance deficits, even a slightly elevated surface causing the smallest loss of balance can spell disaster.
On a similar note, the floor area of the home should remain free from clutter. While this may not seem like a relevant risk factor, things like pillows, shoes and items of clothing certainly have the ability to result in a fall. This becomes especially true in a dimly lit environment, making both of these home modification tips equally important.
Senior Fall Prevention Exercises
Now that we have outlined two changes in the home environment that are conducive at creating a safe walking space, we will describe various exercises that should be regularly performed by any older individual seeking to reduce their risk of falling.
While the risks associated with these exercises is fairly low, having a competent individual supervising the person completing these exercises is recommended.
There is no point in a person placing themselves in a risky situation for the sake of improving balance and strength. Listed below are specific exercises aimed at improving balance. Included are instructions on how to perform these movements as well as the reasoning behind them.
Sit To Stand Without Hands
This is an extremely beneficial exercise for seniors, as it is an effective way to improve strength and endurance in the lower extremities as well as overall balance. To perform this movement, all that is required is a standard chair.
- Start this exercise from a normal sitting position.
- Without using any armrests or pushing off from the seat of the chair, use only the legs and forward momentum created by leaning forward at the hips to come to a standing position.
- Once standing, maintain this position for a moment to gather balance and feel the weight of the body equally distributed through both feet.
- Finally, slowly lower the body back to the seated position, emphasizing the use of the leg muscles to control the descent.
Watch This Sit To Stand No Hands Video
It is a good idea to start with a manageable number of repetitions, slowly increasing the number as tolerated.
Seated Hip Adduction
When considering the necessary muscles involved with moving the leg through space and maintaining balance, the hip adductors play an integral role. These are the muscles located on the inside of the thigh. Seated hip adductions are an effective way to maintain strength in this muscle group.
- To perform, assume a seated position, placing a relatively soft item such as a pillow or foam padding between the knees.
- Next, squeeze this item as hard as possible, attempting to bring the inside of both knees and inner thighs together.
- Maintain this squeeze for a count of 5.
- Upon relaxing, secure the pillow or padding with your hands so that it does not fall to the ground.
Watch This Seated Hip Adduction Exercise Video
When beginning this exercise, perform two sets of ten repetitions.
Supine Hip Flexor
Another extremely important muscle group involved in walking and balance are the hip flexors. These muscles are responsible for raising the upper leg when taking a step.
Often times, weak hip flexors result in the inability to lift the legs high enough to clear obstacles or stairs when walking, which can easily lead to a fall.
- Begin this exercise by lying face up on a firm but comfortable surface, both legs straight.
- While maintaining a completely straightened leg, slowly raise the leg as high as possible without having to bend the knee.
- The final step is to slowly lower the leg back to the starting position. It is important to be in complete control of the lowering portion of this exercise.
- Repeat for each leg – 10 times per leg.
Watch This Supine Hip Extension Exercise Video
A good first step to beginning this movement is to complete two sets of ten repetitions on each leg, remembering to only exercise one leg at a time.
Side Lying Straight Leg Hip Abduction
As we have already discussed the importance of hip strength as it pertains to walking and balance. This exercise will target what are known as the hip abductors, which include the muscles of the outer thigh as well as portions of the buttocks.
Having adequate strength in these muscles is important for keeping the pelvis stable when walking and being able to control leg swing.
- To perform the side lying hip abduction, begin by lying on either the right or left side.
- As with supine hip flexion, make sure the leg closest to the ceiling is as straight as possible.
- While maintaining this straightened position, slowly raise the top leg, imagining touching the ceiling with the outside of the ankle.
- In a controlled motion, lower the leg back to the starting position.
Watch This Isometric Side Lying Hip Abduction Video
Complete two sets of ten repetitions on each side, remembering to exercise the leg on your right and left sides.
Standing Heel Raises Exercise
The standing heel raise is a fantastic exercise as it relates to balance and leg strength for seniors.
First and foremost, the shifting of body weight back and forth on the feet allows an individual to sense their center of gravity moving from the ankles to the toes.
Also, this exercise strengthens the calf muscles, which are the muscle group responsible for pointing the toes downward.
- To perform this exercise, stand with the feet shoulder with apart. It is important to have something to hold onto during this exercise, such as a table or countertop.
- Using the balls of the feet, raise both heels off of the ground, feeling the calf muscles contracting.
- As slowly as possible, lower the heels back onto the ground.
Watch This Standing Heel Raises Exercise Video
Given that the calves are a muscle group that is very active throughout the day, they tend to require a bit more exercise to increase in strength. For this reason, it may be beneficial to begin this exercise with a relatively high amount of repetitions.
Single Leg Stand
While this exercise does include some benefit in terms of building strength, it is primarily suited for balance improvement. This movement also allows a large degree of progression, meaning there are many ways to make it more challenging in order to continue improving.
- For beginners, assume the same position as the previous exercise, making sure there is something sturdy to hold on to.
- Next, simply bend one knee, bringing the foot slightly off of the ground. Using only the other leg, maintain the weight of the body using one leg.
- Although keeping both hands on a sturdy surface is recommended for safety reasons, most of the weight should be placed on the foot on the ground.
- Attempt to stand on one leg for thirty seconds before repeating the exercise on the other leg.
Watch This Single Leg Stand Video
2 Variations Of Single Leg Stands
We will also discuss two variations of this exercise to increase the difficulty. Given that both of these variations come with a higher risk of falling, it is important to have someone directly behind the individual, ready to intervene if they begin to sway too much or lose their balance.
- The first variation involves performing the exercise in exactly the same manner as described above, but with both eyes closed. By taking eyesight out of the equation, there is an increased emphasis on using the muscles of the legs and feet to control balance.
- The second way to modify this movement is to stand on a soft surface, such as a pillow or exercise mat. By doing so, the muscles and structures around the ankle must work even harder to constantly adjust to changes in the individual’s center of gravity.
Low Box Step Ups
Step-ups are a great exercise for seniors in that they both increase strength in the legs and hips, but also directly carry over into everyday life. All that is required to perform this exercise in a step. This can be a stairway, aerobics step or even a firm box. For safety reasons, this step should not be any higher than those typical found on the average staircase.
- To begin this exercise, bring one foot up onto the step, followed by the other, just like walking up a flight of steps.
- When both feet are on the step, pause for a moment to ensure a balanced and steady posture.
- Next, bring the foot that was first placed on the step back to the ground, then the other.
- For individuals with significantly decreased balance, it is important to make use of a handrail and/or supervisor when performing this exercise.
Start with ten step-ups on each leg.
Watch This Low Box Step Ups Video
Benefits Of Wall Pushups
Although this exercise does not specifically target the muscle groups in the legs, it is an effective way to improve balance and allow an individual to gain control of their center of gravity.
- To begin, stand facing a wall, placing both hands on the wall with a slight bend in the elbows.
- Next, slowly bring youre nose to the wall while simultaneously increasing the bend in each elbow. This should resemble a standard push-up.
- Finally, straighten each arm all the way back to the starting position.
To increase the difficulty of this exercise, simply stand further away from the wall. This will increase the range of motion and place more of the bodyweight through the hands, resulting in more force required to move back to the starting position.
Watch This Wall Pushups Video
Can Seniors Exercise Too Much
When considering the intended purpose these exercises, it is important to remember that safety should remain the priority. Although most of these movements are relatively low level, an individual with decreased leg strength and balance can easily fall and injure themselves without the necessary precautions in place. That being said, it is always a good idea to avoid performing them alone.
Furthermore, any form of exercise may cause a significant amount of soreness in the days following. This usually only persists for one or two days afterwards. It is important to distinguish general soreness due to exercise from an actual injury.
If you experience severe pain, numbness, tingling, swelling, and/or bruising after completing any of these exercises, they should be discontinued, and your primary care physician should be contacted.
Although muscle soreness is a relatively common occurrence, especially for an individual without an adequate fitness level, it is critical to allow enough time for recovery between exercise sessions.
A general rule of thumb would be to allow one day of rest between sessions, however, if more time is required due to prolonged soreness, it is a good idea to postpone the next exercise session until this subsides.
When performed safely and with appropriate frequency, seniors can enjoy a challenging workout that increases their strength and balance in the comfort of their own homes. All of the movements discussed in this article do not require anything that is not usually present in most homes.
It is perfectly okay to start out very slow with each exercise, progressing only when strength and balance has improved enough to allow the difficulty to be increased without jeopardizing technique and safety.
Whether performing the exercise described or any other effective workout routine, seniors can greatly benefit from performing an adequate amount of physical activity on a consistent basis.