Exercise as it relates to Disease/Exercise to prevent falls in the elderly

Exercise to Prevent Falls in the Elderly

Background
A part of growing old is that our muscle mass decreases, visual adaption to darkness decreases and our proprioception deteriorates. These and many other factors increase the risk of falling in later life. Add in osteoporosis and there is increased risk of breaking bones. There have been many studies on why elderly people fall and also how to prevent this. These studies have shown that physical exercise can be used to reduce the risk of falling. With 30% of people over 60 years of age falling annually and falls costing in Australia $498 million, it is an issue worth fixing.

Why the Elderly Fall
The major physiological reasons for the aged falling are:
 * Decreased vision
 * Vertigo
 * Difficulty in regaining balance
 * Drop attack
 * Proprioceptive problems

How does exercise help?
Exercise is beneficial for the human body in lots of different ways. Some of the ways that exercise helps to prevent falls are:
 * Increased muscle mass will improve the person's strength and balance
 * Increased flexibility
 * Increased bone mass; stronger bones have a lower risk of breaking
 * Improves/maintains gait

Recommendations
When conducting an exercise program, factors to take into account include age, weight, fitness level and ability. The program's aims are to increase strength, balance and flexibility. Popular activities are walking and swimming. Exercise programs should always be individualised and overseen by a professional.

Given that elderly people are more fragile and have more limitations then middle-aged people, the intensity of the program should be lower; however, the frequency can be increased. The elderly should avoid high-impact activities and increases should be more gradual. The prescribed heart rate for the elderly is 40% to 80% of their heart rate reserve. 30 minutes of low intensity exercise every other day is a good guide.

Other considerations
Other things to consider are to undertake daily activities in a safe manner, such as reaching and bending properly, taking time to recover balance when rising from a chair or bed, learning the proper way to fall, and learning how to recover after a fall.

A good change to make is to be fitted with the appropriate shoe size and fit.

Tai Chi
Tai Chi has been proven to help prevent falls. Its focus on flexibility, balance and core strength makes it perfect for reducing falls. A study showed 47% less falls in a group of seniors participating Tai Chi, to those who dont (Wolf Jags 1996).

=Further reading=
 * http://www.homecareatyourservice.com/Documnets/Spring2009.pdf
 * http://journals.lww.com/ajnonline/Citation/1979/11000/Why_The_Elderly_Fall.15.aspx
 * http://www.nia.nih.gov/
 * http://www.ncoa.org/

=References=
 * Pollock, M. Graves, J. Swart, D. LOWENTHAL, D. (1994) Exercise Training and Prescription for the Elderly. Retrieved October 26, 2011, from http://journals.lww.com/smajournalonline/Abstract/1994/05000/Exercise_Training_and_Prescription_for_the_Elderly.17.aspx
 * Preventing Fall in the Elderly (2009) Retrieved October 26, 2011, from http://www.homecareatyourservice.com/Documnets/Spring2009.pdf
 * Randomised controlled trial of a general practice programme of home based exercise to prevent falls in elderly women, Retrieved October 25, 2011. from http://www.bmj.com/content/315/7115/1065.abstract
 * Smee, D.J. (2011) Falls in the Elderly, Retrieved from Moodle database
 * Slocumb, N. (1979) Why the Elderly Fall. Retrieved October 26, 2011, from http://journals.lww.com/ajnonline/Citation/1979/11000/Why_The_Elderly_Fall.15.aspx
 * The Effects of Exercise on Falls in Elderly Patients, Retrieved October 25, 2011. From http://jama.ama-assn.org/content/273/17/1341.short
 * Wolf, S.L. Barnhart, H.X. Kutter, N.G. et. al (1996) Reducing Frailty and Falls in Older Persons: An Investigation of Tai Chi and Computerized Balance Training, the American Geriatrics Society