The Role of Exercise

Literature suggests that the most beneficial intervention for preventing or reducing falls is a multifactorial approach that involves reducing environmental hazards, behavioural education, medication adjustment, and exercise (Campbell et.al, 1997; Robertson et.al., 2001).  Multifaceted interventions can prevent falls in the general community for those at higher risk of falling as well as in residential care facilities (NICE, 2013; Gillespie et al., 2003).

Of these components, exercise was proven to be the most important factor to prevent and reduce someone’s risk of falling.  Evidence suggests that exercise contributes an overall reduction in falls risk of 17% based on a number of studies assessing exercise programs and rate of falls in older populations. The most effective exercise treatment was a combination of individually prescribed lower body strengthening exercise, balance retraining exercises, walking and Tai chi. 

Strength-based program and falls

  • Poor muscle strength is a risk factor for falls
  • There is evidence to suggest an effect of strength training on the proportion of fallers, but not the rate of falls
  • Strength training increases functional strength and maintenance of activities of daily living.

Balance program and falls

  • The inclusion of balance training in exercise programs has been shown to reduce falls risk by approximately 17% (Province et al., 1995)
  • Group-based and home programs are effective
  • Prescription needs to be challenging (supervised sessions for safety)
  • Walking programs are only effective if included with appropriate balance program

Exercise and preventing injuries associated with falls

Exercise interventions not only reduce the rate of falls, but also prevent injuries associated with falling in older community-dwelling people. Evidence suggests that multi-component exercise can improve reaction time, gait, muscle strength, coordination and overall physical and cognitive functioning, which aid in the reduction of injurious falls (El-Khoury et al., 2003).

In conjunction with improving balance and decreasing risk of falling, exercise has been proven to improve cognitive functioning and the speed and effectiveness of protective reflexes or the energy absorbing capacity of soft tissues (muscles). This in turn can reduce the force of impact a fall may have on the body and reduce associated trauma (El-Khoury et al., 2003).

Not all falls are physically injurious, however can have a significant psychological impact on the individual. Depression, fear of falling and other psychological problems – post-fall syndrome – are common effects of repeated falls. Loss of self-confidence as well as social withdrawal, confusion and loneliness can occur, even when there has been no injuries. (Rubenstein, 2006)

 

For further information about this topic please contact Healthy Connections P 3624 2185