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Thursday, August 06, 2009

10 WAYS TO PROTECT YOURSELF FROM DANGEROUS FALLS

A friend told me recently about a neighbor who had broken her arm twice in just two years. Because this woman was in her late 60s, she was checked for osteoporosis, but it turned out her problem wasn't weak bones -- rather, it was staying upright. The doctor referred her to a physical therapist, where she learned balancing exercises specifically to help her resist falls. This proactive approach is gaining popularity around the country in the hope of preventing or at least reducing the myriad serious health-related problems that may be triggered when an aging person falls. In 2005 alone, about 1.8 million Americans over age 65 were injured in falls resulting in an emergency room visit and nearly 500,000 of them were hospitalized for treatment.

As we age, our ability to remain upright may be compromised by numerous factors. According to Marilyn Moffat, PT, DPT, PhD, professor of physical therapy at New York University and author of Age-Defying Fitness, a person's ability to avoid falling depends, among other things, upon balance -- both while stationary and when moving. Maintaining balance, in turn, requires the ability to adjust to changes (particularly sudden and unexpected) in body positions... adequate flexibility in one's joints, muscles and ligaments... and appropriate muscle strength, especially in those muscles that support the ankles and the knees, says Dr. Moffat. (While most of us don't give much thought to our ankles, she says that about 50% of balance problems that occur in aging result from weakness in the muscles controlling ankle movement and stability.) The inner ear, brain and joint receptors are also involved in balance, since they are responsible for "proprioception," the ability to sense correctly where your head and body are in space, both with your eyes open or closed.

AGING AND BALANCE

With all of these systems contributing to the ability to stay upright, problems in just one area can make people vulnerable to falls, says Dr. Moffat. For instance, loss of vision with age makes people fearful of falling -- that anxiety itself actually increases the likelihood they'll fall. In addition, the brain and nervous system decline in function with age, which can lead to problems with depth perception and coordination and timing of movement. As a consequence of these and other changes, aging adults may move tentatively and slowly, taking smaller, shuffling steps and often keeping their eyes focused on the ground -- all of which set them upfor a fall.

However, the news is not all bad. Dr. Moffat says that with commitment, practice and time, fall-resistance training can absolutely turn the situation around. For people who are unfit or have serious problems maintaining their balance, like my friend's neighbor, Dr. Moffat strongly advises having a physical therapist do an initial examination to determine where weaknesses lie and how extensive the problem is, in order to develop an individualized exercise program to do at home or at a fitness club.

AT-HOME TECHNIQUES

If you are reasonably fit, though, you can start your balance fitness training right now in your own home. Here are some ideas on how to get going...


  1. Walk on tip-toes. How long has it been since you walked on your tip-toes? Probably years, but this childhood diversion is excellent for strengthening your ankle and calf muscles and for improving balance. Dr. Moffat suggests going up and down on your toes as often as possible, including as you brush your teeth each day and while you walk around the house.
  2. Walk in all directions and different ways. Since staying upright requires adapting to different types of movements, a good workout should include movement in different directions and ways. Try walking backward, both on your feet and your toes. Also try walking on your heels... tandem walking (one foot directly in front of the other)... side-stepping... and doing grapevines (walking sideways alternating front and back with the feet).
  3. Look around. Switch your gaze around, from side to side as well as up and down as you stroll. Be careful to avoid tripping -- for instance, keep one hand on a hallway wall.
  4. Balance yourself. Soon you should be able to multitask while practicing balancing -- several classic techniques are to cross your arms, then stand on one foot, then the other... another is to stand on one foot while holding onto a counter, then close your eyes. (For more on basic balance exercises,
    see Daily Health News, July 3, 2008.)
  5. Vary your gait. Change it up, from long strides to short steps, suggests Dr. Moffat, who considers methodical gait training a very important motor skill.
  6. Speed up, slow down. Walk at a normal pace, accelerate, slow down, speed up... and do it again and again.
  7. Exaggerate. Deliberately exaggerate your typical heel-to-toe pattern... then try it with a high-step gait.
  8. Vary your footwear. Go barefoot, wear a variety of shoes.
  9. Change the surface. Switch from stable to unstable surfaces -- walk on tile floors, carpeted floors, the beach, gravel... these are good ways to reinforce your ability to sense where your foot is on the ground.
  10. Heads up. It's crucial to break the habit of gazing at the ground while you walk. Dr. Moffat points out that looking down throws off your postural alignment, which makes correct body responses more difficult. After a short time, you will find that walking with your head held high feels good, and it is not at all scary. Extra benefit: It may help you avoid neck/back problems.

Dr. Moffat advocates practicing balance activities every day of the week, incorporating a variety of techniques into your usual routine. This should require no more than 10 to 15 minutes of your day and in about eight week's time, she says you should see a big difference in your balance, your gait and your confidence.

Source(s):

Marilyn Moffat, PT, DPT, PhD, professor of physical therapy at New York University, author of Age-Defying Fitness (Peachtree).

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