FALLS are quite common in the elderly. According to American research, one in three elderly, above the age of 65, is prone to falls.
“Falls are the main cause of the elderly’s fatal and non-fatal injuries, such as fractures and head trauma. A fracture has a big impact on the elderly, as they won’t be able to move much for weeks, resulting in weak muscles and the deterioration of body functions. They seem to struggle to come back up after that. Once someone falls, their health can deteriorate very fast; that’s why it’s very important to prevent falls.
“Hip fractures are even co-related to a higher mortality rate, not just because of the fracture, but also the complications that follow,” says Joseph Chew, chartered physiotherapist at Synapse Physiotherapy.
There are many reasons for falls in the elderly:
Medical condition – Poor vision, blood pressure, Parkinson’s Disease, dizziness, vertigo and even poor management of medication could result in falls.
Muscle weakness – This could be due to ageing and aggravated by inactivity and a lack of exercise.
Poor strength – In general, women are not as strong as men. This is why women are at a higher risk of having falls.
Loss of balance – This is due to the ageing process. As we age, all the systems in the body deteriorate, including the nervous system, so the reaction times become a bit slower, and we would not be able to stabilise ourselves in time to prevent a fall.
Chew says that the elderly should not wait for a fall to happen before taking action. They should keep active and exercise as a form of fall prevention.
“They should concentrate on the lower limb muscles and focus on strengthening exercises as well as balance exercises and endurance,” says Chew.
While all three areas are importance, Chew says balance is a priority.
Here are some exercises that the elderly can do at home for balance and strengthening of the lower limb muscles:
#1: Stand with your feet together. This is not so easy for the elderly as it reduces the base of support. Hold that position for 10 seconds. Rest and repeat.
#2: Tandem standing. Put your foot, one in front of the other and stand like that for 10 seconds. Then put the other foot in front and hold for another 10 seconds. Repeat.
#3: Stand on your toes. Hold for 10 seconds. Then on your heels. Hold for 10 seconds. Rest and repeat.
#4: Stand on one foot (with and without ankle weights). Hold for 10 seconds. This can be quite challenging for the elderly, depending on which leg is weak. Rest, and switch to the other foot. Rest and repeat.
#5: Tandem walking (walking in a straight line, one foot in front of the other). Take 10 steps and rest. Do this four times.
Do tandem walking backwards. Initially do so with support (while holding a railing). Take 10 steps and rest. Do this four times.
#6: Sit on a chair. Make sure your back is supported and it is a hard chair (not the sofa). Practise standing up and sitting down – at first holding the arm rests for support and as you get stronger, without holding anything. Repeat 10 times.
#7: Sit on a chair. Use ankle weights and extend the leg so that it’s straight. Hold for 10 seconds, rest, and do it again.
#8: Walk sideways. Take 10 steps and rest. Do this four times. Rest. Repeat in the other direction.
#9: Tie your legs (just above the knees) with a thick elastic band and walk sideways. Take 10 steps and rest. Do this four times. Rest. Repeat in the other direction.
#10: Walk in a figure of 8. Do this four times. Rest. Repeat in the other direction.
Chew says before attempting these exercises, the elderly should have a doctor assess them to see if they are fit to exercise, and to find out if there are any exercises they should not attempt.
Then, it’s best to see a physiotherapist who can assess again and adapt the exercises to suit their needs. For example, someone with a weak knee or who has had a hip fracture may need to have the exercises adapted for them.
“We can modify it to make it safer and easier for them to start with and as they progress we can make it a bit harder.
“If they are quite fit, they can do the exercises at home, two or three times a week, but if they are quite frail, they may need to be supervised. There are different modifications – they can hold on to something when they are doing the exercises if they are quite frail and when they are stronger, they can slowly try to do it without the support.
“It’s important to be safe rather than try to do the exercises and then injure themselves,” says Chew.
He recommends the elderly doing the exercises at home as well as joining a group exercise class so that they have some social interaction.
While family members often try to be helpful by discouraging the elderly from performing simple tasks around the house, for fear of them overexerting themselves or falling, Chew says this may worsen the elderly’s health as it encourages inactivity.
On the flip side, it is sometimes tough to encourage the elderly to exericse, especially if they have had a fall.
“Once they have had a fall, they have a fear of falling and thus become less active. It is important to have a good rehabilitation after their surgery, then get assessed by a physiotherapist so we can tailor their exercises to suit their needs.
“If their joints are stiff, we can give them different exercises to do. Those who have had injuries would need a bit more support, but they are also the ones who will benefit more from these exercises,” he says.