While having a fall as you grow older is often viewed as needing to “be more careful next time”, the reality is that the natural ageing process brings with it a wide range of changes to the body that make older adults more likely to have a fall.
In Hong Kong, a 2018 survey showed that a fall was the most common type of unintentional injury, accounting for 39.4% of all injury episodes that occurred over a 12-month period. Other countries have similar statistics, with falls accounting for 40% of all of Australia’s injury-related deaths as well as 42% of their hospitalised injuries, with one in three adults aged over 65 years having at least one fall each year.
Given that one out of five falls causes a serious injury like a broken bone or head injury, and that more than 95% of all hip fractures are caused by a fall, paying close attention to a person’s falls risk and supporting them in preventing falls is very crucial in supporting a person’s health, mobility, independence and quality of life.
This is where physiotherapy comes in, having been shown through the years to significantly reduce the risk of falls in older adults through their work in supporting a person’s balance, mobility and strength., Here’s a closer look into what causes falls, how a physiotherapist can help you prevent a fall, and what new research published in mid-2022 is saying about how strength, mobility and balance training can support a longer lifespan.
What Causes A Fall?
There are two ‘types’ of contributors to a fall in any person: intrinsic and extrinsic.
- Intrinsic factors are those occurring within a person’s body, often related to the ageing process. This includes changes in balance, coordination and walking, vision changes, muscle weakness, reduced reflexes, other existing injuries or problems, and medical conditions or diseases that may alter proprioception (the body’s ability to perceive its own position in space). As an example, muscle weakness in your feet and legs can increase your likelihood of having a fall by over four times.
- Extrinsic factors are environmental factors that contribute to falls. This ranges from the lighting in your home to rugs that are tripping hazards to taking certain medications or multiple medications. For example, taking benzodiazepines is associated with an increase of as much as 44% in the risk of hip fracture and night falls in older adults.
It is often the combination of both intrinsic and extrinsic factors that lead to a fall – like tripping over that rug as you couldn’t see it well because of vision changes paired with lower lighting, and then didn’t have the reflexes or strength to be able to catch yourself before falling.
Preventing Falls
The good news is that it is very much possible to prevent a percentage of falls, or at least lower the risk of falling significantly. Going back to the intrinsic and extrinsic factors we talked about, many of these can be improved with the right care, attention, training and modifications. Strength, gait and balance can be improved and supported, and confidence on your feet can be somewhat restored. Tripping hazards can be removed, better lights installed, extra handlebars fitted, and better shoes purchased.
The interventions offered by physiotherapists have been shown to reduce falls risk by up to 25% through specific strength and balance retraining exercises. When paired with a multidisciplinary team, this may increase to up to 40%.
Studies have concluded that effective falls prevention in older adults needs three key elements: exercise, education and home or environmental modifications. Here at Bend + Mend, our physiotherapists work with those worried about falls, or that have had a previous fall, to reduce their falls risk by:
- Identifying muscle weakness, tightness, gait and balance problems as well as other musculoskeletal issues, then creating exercise and rehab plans to address these factors to help you regain functionality and optimise gait
- Helping you make the right footwear selections for both inside and outside of the home to minimise falls risk
- Suggesting wearable supports, like splints or braces, to support your stability and function. These may be general braces that are already in stock, or may be custom-made for you if you have problems like drop foot where a custom device may yield the best results
- Gait retraining
- Education programmes
- Helping you recover from other causes of musculoskeletal pain or injury that may be interfering with your ability to stay active and complete your daily recommended exercise requirements
- Referring you to other health professionals, from occupational therapists for a home assessment to optometrists to assess any new vision changes
