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Balancing Act: Preventing Falls in Older Adults

I’ve Fallen and I Can’t Get Up
As the human body ages, physiological changes are inevitable. Once you pass your reproductive prime, chemical changes occur that lead to decreased muscle mass, diminished bone density and reduced joint range of motion. Cumulatively, these changes can greatly increase your risk of falling. According to the Centers for Disease Control and Prevention, or CDC, falls are the leading cause of both fatal and nonfatal injuries in older adults. However, a well designed exercise program can slow physical decline and mitigate the risk of falls. For fitness professionals working with older adults, understanding the underlying components that contribute to postural instability is essential.

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Standing Tall
A primary contributor to unstable balance is poor posture. Typically, your standing posture is the cumulative result of years of bad habits and unbalanced activity. A golfer or tennis player may develop scoliosis over time due to repeatedly using one side of the body differently than the other side. Individuals who spend long hours at a desk may develop kyphosis, where the shoulders become hunched forward. Any misalignment of the spine shifts your center of gravity, making it harder to maintain stability, and increasing your risk of falling. A 2012 study of older adults published in “Gait and Posture” associated the ability to control balance while standing on a compliant surface with a high degree of reduced fall risk.

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Strong and Supple
Imbalanced muscular tension at the joints is the underlying cause of postural misalignment. Weak muscles combined with inelastic muscle and connective tissue cause the skeleton to deviate from its neutral anatomical position, creating instability. Once an older adult has fallen, especially if injury has occurred, fear of falling can greatly increase the risk of a recurrent episode. According to researchers at Brunel University’s Centre for Sports Medicine and Human Performance, heightened anxiety can cause “stiffening” behaviors when an individual senses a falling threat. This in turn can lead to reduced movement efficiency in performing functional tasks, with the result of reduced stability and increased risk of injury.

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Slow and Steady
Fitness professionals should adopt a three-pronged approach to programming for older adults. According the the American College of Sports Medicine, or ACSM, your exercise regimen should include two to three sessions of resistance training on non-consecutive days of the week, performing one to three sets of 10 to 15 repetitions of exercises for all major muscle groups. Flexibility training for all the joints should be performed on at least five days per week, and balance training that focuses on functional movement and performance should be an intrinsic part of your training protocol. You will have to make allowances for structurally altered posture in some individuals. You may not be able to fully restore stability, but you can do a great deal to improve it.

Resources
Understanding the needs and physical limitations of older adults is important for trainers who wish to tap into this lucrative and growing market. As always, W.I.T.S. is on the cutting edge, providing quality education to help you grow as a fitness professional. To learn more about training older adults, explore our Older Adult Fitness Specialist, Older Adult Fitness Foundations, and Able Bodies courses, all available online.
References and Credits
American College of Sports Medicine: Exercise and the Older Adult
https://www.acsm.org/docs/current-comments/exerciseandtheolderadult.pdf

Centers for Disease Control and Prevention: Falls Among Older Adults: An Overview
http://www.cdc.gov/HomeandRecreationalSafety/Falls/adultfalls.html

Gait and Posture: How fear of falling can increase fall-risk in older adults: Applying psychological theory to practical observations.
http://www.gaitposture.com/article/S0966-6362(14)00705-X/abstract?cc=y=

Gait and Posture: Postural stability and history of falls in cognitively able older adults: the Canton Ticino study.
http://www.ncbi.nlm.nih.gov/pubmed/22832469

*Images courtesy of freedigitalphotos.net.

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