November is Fall Prevention Month in Canada so it is a good time to address this important issue, drawing some early attention to what we know and how we, as physiotherapists can help.
Falling is, unfortunately, a common occurrence in the lives of all people. In fact, past research has shown that falls are an important cause of death and disability worldwide. The stats are staggering; the same research indicated that over 16 million years of life were lost due to falls globally and Canadians are no different. In 2018, there were over 400,000 visits to the Emergency Room that could be attributed to falls in people over the age of 65. In fact, for this age group, falls were the leading cause of injury, hospitalization, disability and death. With 20-30% of our seniors falling each year, this is a costly global and national crisis. The consequences of falling will cost our healthcare system in the order of $5.6 billion each year! That’s a lot of money!! No wonder we are giving attention to trying to prevent falls in seniors. Mind you, that is not a simple task. We need to understand why seniors fall (there are many, many reasons), what kind of things could help reduce fall occurrence (there are many contributors), if exercise helps, what types of exercise actually make a difference, how to educate people about the risks and preventions and perhaps most importantly, and the most challenging, how to get buy in and influence people to take action! That is where Fall Prevention Month, fall prevention programs, advanced research, articles like this & our upcoming Facebook Live and your trusty local physiotherapists come in…there is much going on that can help.
As already suggested, there are many factors that contribute to falling. Things like, environment, clothing, cognitive health, the use of mobility/gait aids, activities of choice, strength, balance skills, vision and hearing impairments are some of the main considerations. As physiotherapists we can have our biggest impact on education and training in regards to strength, balance skills and the safe use of mobility aids, so this is where we will focus our attention.
Strength and balance training come in various shapes and sizes. Research has been done on which, if any, of these actually have an impact on fall rate. The good news is that, some things do! We can confidently say that lower extremity and core strength training does decrease fall risk. Including some foot and ankle mobility/stretching exercises also helps to improve risk. Things like structured, group based, Fall Prevention programs, as well as some styles of “exergaming”(video games that gamify strength and balance skills like Wiifit) and Tai Chi have also been shown to have good results when implemented effectively and for the right “target audience”. Another intervention called “stepping training” has been shown to reduce falls in older adults by as much as 50%. This is interesting but it needs to be realized that for the most part, this type of training is lab based and is not generally accessible. A modified version can be incorporated into group or clinic based programs but again is primarily applicable to otherwise healthy adults.
Falls prevention is an important and hot topic in health and wellness considerations. All of us need to keep this kind of information in mind as we move through the journey of life. An ounce of prevention is worth a pound of cure so taking steps to maintain core and lower extremity strength as well as balance skills before you notice you are losing them is the best way to go. Mind you, it is never too late and the older you get the more important preventative and restorative exercise becomes. For more information on this important topic tune into our upcoming Facebook Live event on October 19 and watch for Falls Prevention Month coming in November! You can also call us at ProActive Rehab, 705 788 1480, to ask questions and make appointments.