Retired but Not Expired: Fall Prevention Strategies By Eduardo Netto, MS Elderly people frequently fall, and this condition is one of the “giants” of geriatric medicine. A fall is frequently described as an incident causing the patient, or part of their body, to unintentionally come to rest on the ground or another surface lower than their body. Medication side effects, osteoarthritis, depression, dizziness, and changes in balance and gait can all contribute to falls. Falls can be caused by a variety of factors, including the use of assistive devices, being older than 80, postural hypotension, poor vision, and chronic illnesses. According to a systematic review by Nader et al., the prevalence of falls among those over 65 is 30% in the USA, 13.7% in Japan, 26.4% in China, and 53% in India. Addi- tionally, studies have indicated that older women experience more falls than older men. An average nursing care patient will experience 1.5 falls yearly. Exercises with many components, such as strength, endurance, and balance training, per- formed in a group setting or at home, have been demonstrated to lower the frequency and risk of falling. It is important to note that the exercises must be intense enough to increase muscle strength. Any fitness program intended to reduce falls should include balance retraining, as it seems crucial. Balance exercises can be part of a movement program like Tai Chi or specific dynamic balance retraining exercises. Exercise should be part of a multifaceted solution that is consistent and long-lasting. Most of the reasons that lead to falls in the elderly are related to the living environment. However, by following simple tips and providing assistive equipment, the risk of falls in the elderly can be significantly reduced. Here are some important tips for the home and the individual: • Proper lighting throughout the house • Grab bars on the wall next to the toilet and shower • Handles for assistance in different parts of the house • Remove rugs from the house • If there are stairs, put non-slip material on the steps • Have a phone easily accessible • Wear appropriate shoes • Do not walk after taking sleeping medication • Have regular eye examinations A multi-factorial program is a set of interventions designed to address multiple elements of fall risk and should consider the combination of two or more best practices. • Individual Risk Assessment • Regular Strength and Balance Exercise • Gait & Assisted Device Training • Medical Review and Management • Management of Chronic Conditions • Vision Correction • Education • Home Safety Improvements RESOURCES Email [email protected] for a listing of article resources. AUTHOR Eduardo Netto is one of AEA’s amazing IAFTC 2023 Presenters. Click here to find out more about Eduardo and the sessions he is offering. practice. It may allow therapists to progress care at a more rapid pace or fitness professionals to immediately enhance ROM in clients. Consider AquaStretch for your next continuing education to grow your business and skill set. REFERENCES 1. MacDonald, G. Z., Penney, M. D., Mullaley, M. E., Cuconato, A. L., Drake, C. D., Behm, D. G., & Button, D. C. 2013. An acute bout of self- myofascial release increases range of motion without a subsequent decrease in muscle activation or force. The Journal of Strength & Con- ditioning Research, 27(3), 812-821 2. Cheatham, S. W., Kolber, M. J., Cain, M., & Lee, M. 2015. The effects of self- myofascial release using a foam roll or roller massager on joint range of motion, muscle recovery, and per- formance: a systematic review. Inter- national journal of sports physical therapy, 10(6), 827. 3. Kochar, R. D. 2011. Effect of Aqua- Stretch on range of motion at knee joint in total knee arthroplasty patients. 4. Alejo, T., Shilhanek, C., McGrath, M., & Heick, J. D. 2018. The Effects of an Aquatic Manual Therapy Tech- nique, AquaStretch™ on Recreational Athletes with Lower Extremity Inju- ries. International journal of sports physical therapy, 13(2), 214. 5. Keane, L. G. 2017. Comparing Aqua- Stretch with supervised land based stretching for chronic lower back pain. Journal of bodywork and move- ment therapies, 21(2), 297-305. 6. Gandomi, F., Soufivand, P., Ezati, M., Salimi, M., Assar, S., Pournazari, M., & Abbasi, H. 2022. The effect of Aqua Stretching exercises and Pilates on pain, function and spine posture in patients with ankylosing spondylitis: a randomized controlled trial. BMC Sports Science, Medicine and Reha- bilitation, 14(1), 1-11. AUTHOR Lori A. Sherlock, EdD, is an associate pro- fessor in the School of Medicine at West Virginia University with over 20 years of experience within the aquatic therapy and exercise industry. She teaches the aquatic therapy curriculum within the division of Exercise Physiology, is an AEA trainer, con- tributes frequently to Akwa magazine, and was the 2015 recipient of the Aquatic Fit- ness Professional Global Award. 14 | Akwa | March / April / May 2023
