Balance and Falls Prevention

Balance and Preventing Falls
Everyone can be at risk of having a fall, but falls can be more serious in older adults because they are more likely to be injured.

Falls Facts1

• One in four people over the age of 60 and one in three people over the age of 65 will fall each year.
• The most common injuries from a fall are fractures to the hip and thigh (38%), followed by injuries to the head (20%).
• Slipping, tripping and stumbling are the most common causes of falls leading to hospitalisation.
• Patients will spend on average, 7 days in hospital, following an accidental fall and related injury.
• Falls lead to 38% of hospital admissions in people over the age of 65 compared to only 13% for transport related injuries.
• Falls cause more injury-related deaths in Australia than transport crash fatalities.

Falls are common in older people and are a leading reason for admission to hospital or nursing homes. Falls can lead to older people losing confidence or becoming withdrawn and many feel as if they have lost their independence.
There are simple, everyday measures around the home that an older person can take to help prevent a fall. They include:

• using non-slip mats in the bathroom
• mopping up spills to avoid wet floors
• getting help lifting or moving items that are heavy or difficult to lift
• removing clutter and ensuring that all areas of the home are properly lit

You may ask a professional to review the medications that you are taking to see if they cause side effects, such as dizziness, which will increase your risk of having a fall. A sight test may also be beneficial if you are having problems with your vision.

Balance
Balance is the ability to move, stand, walk, climb stairs, play sports of dance without falling over. We often take good balance for granted. Simple activities such as walking across a gravel driveway, stepping from a footpath onto grass of getting out of bed in the middle of the night without stumbling can be difficult for those with impaired balance. Without good balance, these activities can be fatiguing and sometimes dangerous.

Balance is achieved and maintained by a complex system which includes:

• sensory input from your vision, proprioception (joint and body position sense which comes from stretch receptors in muscles and joints), and the vestibular system (inner ear);
• integration of sensory input in the brain (particularly the cerebellum);
• motor output to the eyes and body muscles to enable appropriate postural adjustments and clear vision when we are moving.

Injury, disease, certain drugs or the aging process can affect one or more of these components.

Is there any way to prevent falls?
Research has shown that older people who take part in regular strength and balance training are less likely to have a fall2.

How can I build my balance?
Moving your body will improve your balance and posture, strengthen your muscles and bones and improve your overall fitness and general wellbeing.

• Your physiotherapist can design an individualised program to help train and improve your balance.
• Exercises which build your balance include walking heel to toe, stepping over objects and safely standing on one leg.
• Activities which involve leaning and moving in different directions can help build your balance. These include tai chi, tennis or lawn bowls.
• NSW Health Active and Healthy website enables you to find a local exercise program.
• "Stepping On" is a community-based falls prevention program for seniors. It is designed to build knowledge, strength and confidence to prevent falls and stay active and independent

How can I strengthen my legs?
Maintaining strong muscles, bones and joints in your legs will help you avoid slips, trips and falls and allow you to maintain your movement and flexibility.

• Your physiotherapist can show you simple exercises to work and strengthen your muscles.
• Exercises like standing up from a chair without hands or using light weights can help to make your leg muscles and bones stronger.
• Activities such as gardening and cleaning can help keep you active.

Useful contacts

• NSW Health Active and Healthy www.activeandhealthy.nsw.gov.au
• Australian Physiotherapy Association: www.physiotherapy.asn.au
• Stepping On: www.steppingon.com
• Arthritis and Osteoporosis NSW: www.arthritisnsw.org.au
• Taoist Tai Chi Society of Australia: www.taoist.org.au

1.  AIHW: Bradley, C. (2013) Trends in Hospitalisations due to falls by older people, Australia 1999-00 to 2010-11, Injury Research and Statistics no. 84. cat. no. INJCAT 160. Canberra: AIHW. Retrieved from http://www.aihw.gov.au/WorkArea/DownloadAsset.aspx?id=60129543591
2.  Sherrington, C., Michaleff, Z.A., Fairhall, N., Paul, S.S., Tiedemann, A., Whitney, J., Cumming, RG, Herbert, RD, Close, CTC, Lord SR. Exercise to prevent falls in older adults: an updated systematic review and meta-analysis.  Br J Sports Med (2017) 51:17491757