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Falls are becoming an increasing concern in the older population.  As a person ages, bone and muscle integrity begins to change. The risk of falling makes individuals further susceptible to significant injuries, such as broken bones.  More than one third of older adults fall each year and this rate continues to advance as age increases. According to the Center for Disease Control and Prevention, falls continue to be the leading cause of injury related deaths in older adults, as well as the most common reason for hospitalization.  Falls are a growing epidemic in the elderly population.  

    There are multiple factors that make an individual an increased risk for falling.  These factors include muscle weakness, previous fall history, gait and/or balance deficit, assistive device uses (ex. walker, cane, rollator), visual impairment, neurological deficits (impaired sensation in legs/feet, Parkinson's, etc.), arthritis, difficulty completing daily living tasks, depression, cognitive impairments, age (often 80 or older), taking four or more medications, and cardiovascular deficits (blood pressure changes due to posture/positioning).  A person having at least four to five of these factors is at a higher risk of falling.

   The Center for Disease Control recommends steps to following in order to decrease the risk of falling. First, begin organizing a safe home environment.  Remove items from a walking path that that can become obstacles, such as removing small throw rugs. Keep items that are often used in lower cabinets to improve accessibility. Install grab bars near tub and toilet areas, including nonslip mats. Also, improve lighting, install staircase handrails, and wear supportive shoes inside and outside the home.  Second, perform exercises to improve your balance and strength.  Exercises like Tai Chi have been proven to show balance improvements.  Contact a physical therapist for further balance and strength exercise instruction and for education on appropriate home exercises.   Third, have a doctor or pharmacist review all medications.  Certain medications can cause light headedness, dizziness, and/or changes in blood pressure.  Be sure the doctor is aware of all medications, both prescribed and over- the-counter. Most adults see multiple doctors; therefore assigned prescriptions should be shared.  Fourth, have a regular vision screening conducted by an eye doctor. Vision is necessary for balance and difficulties with vision can change how the surrounding environment is perceived.

What are the expectations when meeting a physical therapist for exercise and balance training?  Physical therapists take a multi-factorial approach to balance.  Since there are a variety of aspects that increase an individual's risk of falls, a full evaluation is completed, including medical history, discussion of past falls, and strength/balance testing to determine an individualized program for each patient.  Exercises focus on leg strengthening (hips, knees, ankles), core and abdominal control, balance retraining (dynamic and static), vestibular (inner ear) and proprioceptive training (joint receptors), gait training, and education on home safety.  A personal exercise program will be established for each individual to complete at home.

Taking steps toward preventing falls can lower the risk of sustaining a significant injury in the future.  If you have any questions regarding preventing a potential risk of falling or would benefit from balance training, contact Progressive Physical Therapy 301-729-3485 and ask to talk to a balance and fall specialist today or visit us on our website at!

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