Good balance is vital for reducing falls and fracture in osteoporosis. Balance is particularly important for those living with osteoporosis, where the risk of fracture is much higher than for those with good bone density. Fractures in older people can also have a big impact on mobility, independence and quality of life. There are a number of factors that can increase the risk of falls.
FACTORS THAT INCREASE THE RISK OF FALLS:
- Older age
- Poor muscle strength
- Poor balance
- Previous falls
- Reduced ability to walk and move around with ease
- Poor vision
- Trip hazards, particularly at home
(Osteoporosis Australia Medical & Scientific Advisory Committee, 2019)
While of course there is nothing we can do to change our age, there is much that can be done to improve muscle strength and balance. A history of recurrent falls needs to be investigated as the more falls you have had, the more likely you are to have further falls. Medical causes of poor balance, such as low blood pressure, inner ear problems and possible effects of some medications should be investigated by your doctor. A physiotherapist can assess muscles strength and balance. The home should also be assessed for trip hazards. Did you know that 50% of all falls occur around the home? (Osteoporosis Australia Medical & Scientific Advisory Committee, 2019). All these potential factors need to be assessed and addressed when reducing falls and fracture in osteoporosis.
HOW DO WE MINIMISE THE RISK OF FALLS?
There are several ways we can reduce the risk of falls:
- A targeted exercise program
- Optimising nutritional intake
- Addressing medical conditions and medications
- Ensuring a safe home environment
(Osteoporosis Australia Medical & Scientific Advisory Committee, 2019) (Australian Government, 2011)
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Physiotherapists can assist with implementing a falls prevention program. This includes a combination of balance and strength training. We will take a closer look at falls prevention programs below. Physiotherapists can also assist with managing conditions such as hip, knee and foot arthritis which may cause episodes of giving way, increasing risks of falls. Arthritis may also reduce activity levels and muscle strength, again increasing risk of falls.
Osteoarthritis is more common in those with hypermobility, with symptoms often developing earlier in life. Optimising muscle support by training deep muscles with real time ultrasound can be helpful in managing osteoarthritic pain in those with hypermobile joints.
Nutrition is an important factor in falls and fracture prevention. A diet deficient in nutrients such as calcium and Vitamin D can reduce ability to increase bone density. A nutrient rich diet is also important for falls prevention due to its effect on strength, mobility and brain function. Intake of alcohol also has effects on reaction time and steadiness. It is therefore important to eat a well-balanced diet consisting of a variety of foods including fruit, vegetables, dairy and whole grains, and moderate intake of alcohol.
There are many medical conditions that may influence balance. These include medical conditions such as blood pressure issues, arthritis or depression, as well as short term conditions or illnesses, for example the flu, infections, or recent surgery. It is important to check in with your regular doctor to address these conditions. A review of your medications is also a good idea to ensure these medications are not impacting on your balance.
Minimising risk in the home is vital as half of all falls occur at home. A health professional can provide suggestions to help you with this. See some general tips below.
WAYS TO REDUCE THE RISK OF FALLS AT HOME:
- Ensure your rooms are brightly lit, especially near steps or routes you may use at night
- Installing handrails and using non-slip mats
- Removing clutter and trip hazards (e.g. loose cords, maintaining outside pathways)
- Replace carpets with holes or worn areas
EXERCISE FOR REDUCING FALLS AND FRACTURE IN OSTEOPOROSIS
There is mounting evidence that exercise alone can reduce the risk of falls (Sherrington, C et. al, 2011). One recent study looked at a balance training program incorporating strengthening exercises with proprioceptive (body awareness) training (Miko, I et. al., 2017). In other words it used an “inside out” approach to training – people in the study worked on improving function of the deepest muscles around their trunk and pelvis first. They then progressed to the next phase which involved maintaining good control around the trunk and pelvis while using larger, more superficial muscles during arm and leg exercises. The final, functional phase aimed to achieve automatic stabilisation of the body whilst performing higher level dynamic exercises involving greater balance challenges. The study found that there were significant improvements in measures of balance and also a reduction in falls in postmenopausal women with established osteoporosis. You can read more about the importance of osteogenic exercises for the management and prevention of osteoporosis in our previous blog.
Because exercise is so important to bone health, confidence and overall health, Physiotec provides a unique and specialised group program based on the most current research available. It is designed to increase bone health and density through weight training, also incorporating posture and body awareness training along with balance and proprioceptive exercise aimed at reducing the risk of falls, joint overload and injury.
Body – Bones – Balance(Body integration – Bone strength – Balance control) incorporates a group warm up followed by a targeted station-based exercise program that stimulates the whole body, with a special focus on improving health and strength of bones, muscles and tendons and optimising dynamic balance.
Read more information about our class here.
Do you you need help recovering from an injury? Improving your performance? Or just getting back to doing the things that you love? Visit us at PhysioTec, and let one of our physios assess you and provide you with a personalised program to help you get on-top of your condition, and feel at your best.
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Australian Government, D. o. (2011). Don’t fall for it.
Miko, I et. al. (2017). Effectiveness of balance training programme in reducing the frequency of falling in established osteoporotic women: a randomized controlled trial. Clinical Rehabilitation, 31(2), 217-224.
Osteoporosis Australia Medical & Scientific Advisory Committee. (2019). Osteoporosis Australia.
Sherrington, C et. al. (2011). Exercise to prevent falls in older adults: An updated meta-analysis and best practice recommendations. NSW Public Health Bulletin, 22(3-4), 78-83.