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Exercise to Prevent Falls in the Elderly

Background
Apart of growing old is that our muscle mass decrease, visual adaption to darkness decrease and our proprioception deteriorates. These and many other factors increase the risk of falling in later life. Add in osteoporosis and there is another increase risk of breaking bones. There has been many studies on why elderly fall and also how to prevent them. 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 a 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;
 * Increasing muscle mass; will improve the persons strength, and balance
 * Increase flexibility
 * Increase bone mass; stronger bones create a decrease risk of them breaking
 * Improves/maintains gait

Recommendations
When conducting an exercise program there needs to be considerations taking in to account including; age, weight, fitness level and ability. The programs 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 the elderly person is more fragile and has more limitations then middle-aged people, the intensity of the program is 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. 30mins of low intensity exercise every other day is a good guide.

Other considerations
Other things to consider are 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/

=Refrence= in Older Persons: An Investigation of Tai Chi and Computerized Balance Training'', the American Geriatrics Society
 * Pollock, M. Graves, J. Swart, D. LOWENTHAL, D. (1994) Exercise Training and Prescription for the Elderly. Retrived 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) Retrived 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, Retrived October 25, 2011. from http://www.bmj.com/content/315/7115/1065.abstract
 * Smee, D.J. (2011) Falls in the Elderly, Retrived from Moodle database
 * Slocumb, N. (1979) Why the Elderly Fall. Retrived 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, Retrived 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