Each year, more than one-third of American adults 65 and older suffer a fall. According to the Centers for Disease Control and Prevention, falls are responsible for an estimated 40 percent of hospital admissions and are the number one cause of death and injury in this age group. The good news is that scientists have found that fall-prevention exercise programs can help reduce fall incidence.
In a large review of studies on fall-prevention exercise programs, researchers found that, com-pared to non-exercising controls, participants who took part in programs focusing on balance, gait, and daily functioning were 37 percent less likely to suffer an injurious fall. They were also less likely to experience falls resulting in severe injuries, fractures, or a need for medical care, the researchers reported in a paper published online Oct. 29, 2013 in the British Medical Journal (BMJ).
A mind-body program with goals similar to those of the program in the BMJ study is taught at MGH by Renee LeVerrier, RYT, a certified yoga instructor and author of the book “Yoga for Movement Disorders.”
“I focus on the basic elements that contribute to an individual’s ability to maintain balance,” she says. “These types of exercise programs not only improve participants’ strength, flexibility, and balance in everyday tasks, they also help to build confidence and free individuals from the fear of falling, which can lead to inactivity that increases stiffness and decreases stamina. I teach from the philosophy that the more we move, the better we move. My participants learn how to be active in a safe way.”
Balance and age
Aging is associated with a number of possible changes in the body and brain that can increase the risk for falls. The list of potential triggers of balance problems is long and varied. It includes problems with vision, low blood pressure, arthritis, heart disease, muscle weakness, loss of agility, changes in spinal alignment, head injury, infection, and abnormalities in the inner-ear balance system. Chronic neurological conditions or impairment of neurologic function that affects a person’s ability to stand or walk normally, such as Parkinson’s disease or Alzheimer’s disease, can also increase the risk for falls, as can certain medications and even mood disorders such as depression or anxiety.
While muscles and tendons may be the support structures that stabilize the body, the brain is the primary regulator of balance. The brain coordinates three distinct components of the balance process: the visual system, which relays information from the eyes to the brain; the proprioceptive system, which uses sensory inputs from throughout the body to relay information about body position and the relationship of various body parts to one another; and the vestibular system, which relays information from organs in the inner ear about movements of the head. Because the latter system is apt to deteriorate with age, older people tend to become more dependent on vision, with its slower processing speed, to establish balance.
“Exercises that incorporate all three systems have the greatest impact on improving balance,” Ms. LeVerrier says. “I concentrate on the underlying physical factors by working to strengthen muscles that provide stability, lengthen those that are chronically tight, and flex and extend joints such as ankles, knees, and hips to increase fluidity. In addition, we move through poses that improve the sense of balance in the inner ear, foster awareness of posture and body positioning, and consciously increase the use of vision to gauge direction and movement. Bringing awareness to how we move is crucial to changing the way we move so that we don’t throw ourselves off balance.”
Although it is difficult to avoid many of the disorders or age-related changes that can negatively affect balance, fall-prevention exercises can reduce their effects in many cases. It’s advisable to check with your medical care provider before initiating any new exercise program. Adopt a gradual approach to your exercises, and make sure that there is physical support such as a wall or sturdy chair on a non-slip surface nearby. Begin with one or more of the exercises described on page 4. It’s essential to proceed slowly and with caution and use support to protect yourself from falling.
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