There’s truth in numbers, and the sad truth is that nearly 3 million older adults in this country go to the emergency room each year for fall-related injuries — this according to the Centers for Disease Control.

Among seniors, falls have the dubious distinction of being the No. 1 cause of fractures, hospital admissions for trauma, and loss of independence.

As we age, we may develop more risk factors that can lead to a fall. During the normal aging process, individuals have decreased muscle strength and a slowing of reflexes and balance reactions, and they can develop fear of falling.

Balance and gait are also affected by neurological conditions, such as Parkinson’s disease or stroke, in addition to complications related to visual disturbances, diabetes, and unstable blood pressure.

And with aging, we also tend to take more prescription medications; in fact, the National Institutes of Health indicates that those taking four or more prescriptions have an increased risk of falling.

According to the CDC, 1 in 5 falls causes a serious injury, such as a broken bone or head trauma. The severity of such an injury can be compounded if the injured takes certain medications, such as blood thinners.

So, how can we mitigate the fear and the actual act of falling? Balance and gait training can be beneficial and accomplished by performing exercises on level or uneven surfaces.

A basic balance exercise can be done by positioning the body to the side of a chair, placing one hand on the chair for support, and standing with feet shoulder width apart.

Weight is then shifted to the left foot while the right foot is slowly lifted; the position should be held for 30 seconds to maintain balance.

The process is then repeated with the left side, and, as it becomes easier, the exercise can be done without the additional support of the chair.

Movement can also be added to the raised foot, such as writing your name or a portion of the alphabet with the toe of the right foot while balancing on the left.

Balance discs, foam pads and rollers, balance boards, and stability balls are tools that can add variety and challenge to balance-training programs.

Improvement in balance can also be realized with resistance training and stretching programs. While these and other “traditional” physical therapy exercises can help improve balance and prevent falls, there exists meaningful evidence that the discipline of tai chi may reduce the risk of falling in older adults.

In brief, the ancient Chinese practice of tai chi is a soft martial art whose name translates approximately as “supreme, ultimate harmony.”

With the ultimate purpose to enhance life and balance, tai chi is based on the principles of yin and yang, with yin representing the parasympathetic nervous system (rest and digest) and yang the sympathetic nervous system (fight or flight).

Tai chi involves soft, slow movements in opposite directions (yin and yang) to increase strength and improve flexibility and concentration. It can also restore self-confidence in those who have fallen in the past and fear a repeat performance.

To achieve balance, tai chi employs principles of upright posture, coordinated breathing, weight shifting, and slow, fluid movements. The slow, smooth, and continuous movements of tai chi help strengthen internal muscles that support and strengthen the spine.

In addition to its physical benefits, this form of gentle resistance can calm the mind, helping reduce falls resulting from sudden movements that lead to significant blood pressure drop, particularly in those who take medication that can cause blood pressure variations.

Tai chi practitioners are mindful of the importance of transferring weight with each step; this assists mobility, coordination, and balance and places emphasis on upright and supple posture to further strengthen muscles.

That said, tai chi — which can best be described as a moving form of meditation — is extremely low impact, placing minimal stress on joints and muscles.

Regular vision examinations, good lighting, and fall-proofing measures throughout the home are certainly part of the fall-prevention mix.

Remove unnecessary obstacles, such as throw rugs and electrical and phone cords, from walkways; repair loose floorboards or carpeting; store clothing and food items within easy reach; use nonslip mats in tub/shower; place nightlights in bedrooms and bathrooms; and immediately clean spilled liquids/food.

Don’t be a statistic — by practicing basic balance, resistance training, stretching programs, or tai chi in concert with taking simple fall-prevention measures throughout the home, you have a much better chance of not becoming one of this year’s 3 million to visit the ER for a fall-related injury.


Eric Edelman, PT, is the owner of Peak Physical Therapy & Sports Performance with locations in Scituate, Norwell, Quincy, and Hanover, Mass.

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