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Balance Training and Falls Prevention


The baby-boom generation is now cycling and power-walking well into their 60’s, and many of us are also participating in the care of elderly parents and relatives. For their safety as well as our own, it is important to understand the causes of frequent falls and how they can, in many instances, be prevented. Emily Firmin, specialist physiotherapist at Physio2go St. Albans explores this issue and explains why it should be high on our list of health strategies.

Addressing the Cause of Frequent Falls

Did you know that up to 50% of people over the age of 65 fall each year? As we get older falls not only become more of a health issue, but also the consequences of a fall frequently become more serious. Falls often lead to fractures, admission to hospital and in some cases to the need for long term care. Many “frequent fallers“ never return to their previous level of independence.
Underlying medical problems can cause falls in the elderly. Your GP or Pharmacist should review medications regularly. Those taking multiple medications may be more at risk of falls and some medication may increase this risk. It is important to inform your doctor/ nurse of any falls, unsteadiness, weakness or dizziness.
Conditions that affect mobility, balance, co-ordination, and sensation, such as stroke, Parkinson’s disease and arthritis increase the risk of falls. Cardiovascular problems affecting blood pressure may cause problems of dizziness and instability on sudden movements or going from a sitting to standing position.
Elderly people with confusion or dementia may need constant supervision and interventions put in place to keep them safe. A safety gate at the top of the stairs will help to minimise the risks to those that wander at night.
Many people have problems with weakness in upper and lower limbs that makes walking and getting up from a chair or in and out of bed difficult. Balance and co-ordination may be affected. In this case it is important to get a medical assessment. Your doctor may refer you to a Physiotherapist for treatment, advice and ongoing management.
Sight difficulties can affect your balance and mobility. It is essential to have regular eye tests. Bifocal or varifocal lenses can lead to problems with perception e.g. stairs can appear closer than they are. Perception of light and dark is another difficulty, which may result in falls in poorly lit areas or walking on dark floor surfaces.

Walking aids and “safe shoes”

In some instances, either because of a chronic problem or while recovering from an injury or surgery, you may be advised to use a walking aid to help with mobility and to reduce risk of falls. These can help with stability and reduce the load on painful joints. All walking aids need to be properly assessed and adjusted for size and the specific needs of the individual. It is important to wear good footwear as inappropriate and ill-fitting shoes, slippers or mules pose a high risk of trips, slips and falls.

A Safe Home Environment

Safety in the home is of paramount importance. Our homes are full of potential hazards. We may have slippery floors, loose rugs, and raised doorsills, cluttered walking areas, shelves or cupboards that are too high or too low. Even man’s best friend, the cat or dog, can pose a risk of trips or falls.
It is important to make sure that chair, toilet and bed heights are individually assessed. Access to a shower or bath may be difficult, especially for the elderly. Negotiating stairs can be a major hurdle. Fitting of grab rails or banisters can help enormously. There are many pieces of equipment that can help the elderly in and around the home; your GP can refer you to an Occupational therapist if required. Always take your time to answer the door or telephone. Do not be tempted to rush as this puts you at unnecessary risk.

Some general points

It is important to try to keep as active as you can. Regular exercise such as walking, swimming, Tai Chi and Yoga can help with general fitness, mobility of joints, and balance. It is important to drink enough fluids, at least 1500 mls (3 pints) a day, otherwise dehydration may occur which can lead to disorientation and unsteadiness.
Limiting alcohol consumption to the recommended government guidelines for men or women is also recommended. Problems with continence or urinary frequency, which necessitates many trips to the toilet, especially during the night, should be discussed with your GP/nurse. Arrangements can be made for an assessment in order to provide personalised help and advice.

And finally…

Some falls are unavoidable. It is a good idea to plan ahead and think about what you would do if you, or someone in your care, were to fall. Pendant alarms are a valuable way to summon urgent assistance. When these personal alarms are worn at all times, you can be confident that help would be at hand should a fall occur. If you are worried about falling or have had a fall, please speak to your doctor who may advise a referral to a Chartered Physiotherapist.
Physio2go routinely carries out fall risk assessments. Physio2go therapists work with patients in their own homes on individualised programmes of graduated exercise. These programmes are designed to address specific areas of concern, and can focus on balance, muscle power, co-ordination, mobility, endurance and flexibility.

For further information please contact:
Physio2go Ltd.
York Lodge,
St. Peters St,
St. Albans,
AL 1 3HD
Telephone: 01727 850925