Balance -Don’t Fall for Bad Advice!
Anatomy of balance
Our balance is controlled by the vestibular system, which provides information about the body's position and enables rapid compensatory movements in response to self-induced and externally generated forces. The peripheral portion of the vestibular system is a part of the inner ear that continually reports information about the motions and position of the head and body to parts of the brain, including the brainstem and cerebellum. This information is then sent to other organs, such as our eyes, joints or muscles, allowing us to keep our balance and know our body's position. Although we are not consciously aware of its function, the vestibular system is essential for postural reflexes, and when damaged, our sense of orientation and balance is adversely affected. Additionally, in situations such as being on a ship or aeroplane, different sensory organs send contradictory messages to the brain, making us feel unwell, dizzy or nauseous.
Falls - how do they occur?
Everyone has experienced falling over; however, our risk of falling increases as we get older, which can become a significant health concern. Falls are the leading cause of unintentional injury for older adults, with 1 in 3 older Australian adults having experienced a fall in the past 12 months, with 1 in 5 requiring hospitalisation. Older adults are at an increased risk of falls due to the physical, sensory, and cognitive changes associated with ageing and inadequate environments that are not adapted for an ageing population. Therefore, understanding how the body changes as we age and the common risk factors associated with falls is beneficial for reducing fall risk.
Modifiable Risk Factors
Balance problems
Muscle weakness/Loss of muscle mass
Poor eyesight
Hazards: e.g. poor lighting, poor footwear, trip hazards and steps
Blood pressure
Physical inactivity
Non-modifiable Risk Factors
Previous history of falls
Health conditions: e.g. diabetes, Parkinson's, stroke, incontinence, dementia
Age
Medication side effects
Although some health conditions are out of our control and considered non-modifiable risk factors, you can still implement strategies such as assistive devices, standing up slowly and balance training to help reduce your risk of falls.
Common injuries
Although falls are not always fatal, they can be severe enough to require medical attention, and for Australians, over half of all fall injuries involve a fracture. When analysing falls that require hospitalisation, the most common body parts injured are the Head & Neck (29%), Shoulder and Arm (23%), Hip and Leg (26%), Trunk (15%), Wrist and Hand (3.6%) and Ankle and Foot (2.6%).
Other problems that may arise from falls:
Broken bones - commonly wrists, arms, ankles and hips
Head injuries
Fear of falls - this in turn reduces confidence in normal activities
Financial costs - increased care and hospital costs
How do you prevent falls?
Physical activity and exercise are crucial for preventing falls and reducing the risk of reoccurrence. Conducting exercise programs in a safe, hazard-free environment and incorporating balance and functional exercises typically results in a 42% reduction in falls. This is because physical activity decreases the risk factors associated with falls by improving muscular strength, balance, confidence with movement, physical function, walking speed, mental ability and mood. Research has shown that incorporating lifestyle-specific, balance-demanding exercises that vary in complexity can benefit older adults considerably. For example, depending on your current level, you can perform static or dynamic balance activities while sitting, standing or walking.
Examples of exercises that assist with fall prevention are:
Yoga/Pilates
Tai chi
resistance training
heel-toe walking
single-leg stance.
For safety, try completing exercises near a bench, rail or wall. Additionally, adolescents and youths will also see improvements in static, dynamic and proactive balance when exposed to high- and low-level balance training.
