Fall PreventionFalls occur in roughly 30% of adults over age 65, and many treatment approaches have been investigated to determine which are most effective at reducing fall rates. Stubbs et al2 recently published an extensive survey of the literature to assess what really works. Comparing dozens of studies at once can only provide a bird’s-eye view on the subject, but this is very useful for pointing us in the right direction.

What they learned is that “exercise” (the myriad studies included various types, such as balance exercise, tai chi, group exercises, home exercises, etc.) has consistently been shown to significantly reduce the incidence of falls. They found that Vitamin D supplementation or environmental modifications may or may not help. They reported that heart surgery and cataract surgery or patient education show minimal evidence in favor of fall reduction. And finally, they found that “multi-factorial” interventions (combining several treatments) are highly effective, but much less so if they aren’t tailored to each individual.

Bottom line, the strongest evidence was in favor of exercise. Since this umbrella study was, by necessity, vague in its details of what “exercise” means, let’s look at another study that investigated what type of exercises are best.

In 2008, Sherrington et al1 found that the most effective exercises to reduce falls are challenging balance exercises. These involve keeping the feet close together, trying not to hold on, and practicing “controlled movements of the center of mass”. Those who did more hours of exercise had greater results. They also noted that a walking program, while beneficial in many other ways, was not helpful for improving fall risk.

Balance exercises must be done carefully, and ideally in a supervised environment. Physical therapists are trained in both assessing fall risk and guiding patients through individualized balance programs. If you’re concerned that you or a loved one may be at risk for falls, come on into Impact and have your fall risk assessed by a physical therapist!

References

1 Sherrington C, Whitney JC, Lord SR, et al. Effective exercise for the prevention of falls: a systematic review and meta-analysis. JAGS. 2008;56:2234—2243.

2 Stubbs, B, Brefka S, Denkinger MD. What works to prevent falls in community-dwelling older adults? Umbrella review of meta-analyses of randomized controlled trials. Phys Ther. 2015;95:1095—1110.