Functioning, not falling
Functioning, not Falling
This article provides you with some basic background facts on the issue of falls prevention. There will be further and more specific articles on conditions and body parts to assist you with your health and fitness activities in future newsletters including specific exercise to improve strength and balance to reduce the risk of falls and related injuries.
A fall results in a person inadvertently coming to rest on the ground, the floor or other lower level. This can be, for example, from standing, from a bed or a chair.
Approximately 1 in 3 people aged 65 + will experience one or more falls and related injuries per year and 1 in 12 require medical attention.”
(Fisher + Kettle 2005; Stevens, Mack, Paulozzi + Ballestreos 2008)
Falls and their related injuries are a major concern for people who become less able and so less active, the consequences of which can be quite profound. Personal independence and quality of life can become compromised. Commonly associated with reduced activity, falls may result from a specific health condition and/ or ageing itself. Falls and their related injuries create major health and functional fitness problems. Increased falls risks and injuries tend to occur later in life (reduced physical activity and chronic condition association) as the body and mind reduces in ability and capacity.If an older person has had a fall, there is an increased risk of falling again and with a history of falls 66% of people who fall will experience another fall within six months (Recurrent falls of 1 – 4 this increases risk by 10 – 69%). Falls can often lead to loss of confidence and reduction in activity which can have the spiraling effect of reduced activity and weakness leading to more falls. Injury from a fall puts an older person more at risk – particularly of fractures.Falls risk factors are associated with intrinsic or internal issues that are particular to the person such as poor balance, a chronic condition, poor vision etc. and the issues that relate to the environment (hazards both in and outside) known as extrinsic or external factors.
Functioning Well – Mobility and the Link to Fall Related Injuries
Fitness and health declines with age and may eventually fall below the level required to undertake everyday activities easily and safely. The level of body control and the ability to move efficiently and effectively diminishes with age whether a person is stationary or when moving. The physical factors include lack of fitness, strength and suppleness. Strength and balance in fact decline gradually from 30 onwards with greater increases becoming more noticeable later in life. These subtle changes in movement and balance increase the risk of falls and can affect functional abilities. Physiological changes, along with many health conditions, can also affect balance and body control. Good mental processing is necessary for a person to respond and react quickly to any disturbances in movement. It is therefore important for people to stay alert and always be aware of their environment to avoid or manage the different hazards which can occur throughout the day. Optimal capacity is required to perform many daily tasks to achieve purposeful, good and safe results. Functionality can involve many tasks done together; these activities involve a combination of muscular strength (power), endurance, flexibility, balance, co-ordination and cognition. Physical and cognitive dysfunction are the major factors contributing to reduced function.
Why do people fall? – Major Fall Risk Factors
- Underlying medical/chronic conditions and muscle weakness with associated factors e.g. pain resulting in joint stiffness, reduced activity, balance problems, dizziness and associated fear of falling
- Reduced physical activity and disturbances in gait patterns can cause unsafe mobility problems and transfers. Walking becomes slower and more cautious
- Reduced mental abilities can result in a reduction in alertness which reduces the ability to react quickly to unexpected situations
- Foot problems and inappropriate/ inadequate shoe wear.
- Eyesight changes and visibility involving issues such as changes in depth perception, acuity and adaptations to changes in lighting
- Poor or inadequate medication management and use as well as their side effects e.g. use of psycho-active medications which may cause light headedness and dizziness
- Environmental hazards inside the home and outside
* Plus many more related issues such as a previous fall, increasing age and frailty, use of a walking aid etc.Chronic condition examples that can increase the risk
- Musculo-skeletal conditions such as arthritis, osteoporosis and medical conditions such diabetes can reduce the ability to be active and strong.
* Neurological conditions such as stroke and Parkinson’s disease in particular increase risk
- Cardiovascular conditions such as uncontrolled blood pressure and arrhythmias may cause light headedness and dizziness
NB. The risk of a fracture following a fall greatly increases with people diagnosed with osteoporosis but osteoporosis itself is not a risk factor. Exercise has an important role to play in the “big picture” in relation to reducing falls risks and injuries as a result from a fall..
“The public health importance of physical activity may relate not just to its role in preventing decline, but also to its role in enhancing physical function”
“Emphasis should be placed on factors that result in permanent lifestyle change to encourage a lifetime of physical activity.”
Pollock M., Gaesser G
There will be further and more specific articles on conditions and body parts to assist you with your health and fitness activities in future newsletters including specific exercise to improve strength and balance to reduce the risk of falls and related injuries.