FALLS PREVENTION
Globally, falls are a major public health problem and are the second leading cause of accidental or unintentional injury deaths worldwide. A fall is defined as any event which results in a person coming to rest inadvertently on the ground, floor or lower level. Each year an estimated 646,000 individuals die from falls globally, with 37.3 million falls severe enough to require medical attention occur each year. Death rates are highest among adults over the age of 60 years and it is estimated that at least one-third of people aged 65 years and over fall one or more times a year.
In older adults, up to 30% of falls can result in moderate to severe injury, including head trauma, hip fractures and dislocations, resulting in an increased early death. In Australia, falls are the leading cause of hospitalised injury, with one in five causing serious injury and 93% of hip fractures are the result of a fall-related injury. One in three adults aged over 50 and over die within 12 months of suffering a hip fracture, and this increased risk of death remains for almost ten years.
WHERE DO FALLS OCCUR
Most falls occur on flat ground, with falls on stairs or in the bathroom relatively rare. Of those who fall and lie on the floor for hours, half will die within six months, hence it is important to know what to do if you do have a fall and how to get up.
RISK FACTORS
- Age
Older people have the highest risk of death or serious injury arising from a fall and the risk increases with age.
Children are also at a high risk of falls largely as a result of their evolving developmental stages, innate curiosity in their surroundings, and increasing levels of ‘risk taking’.
- Gender
Across all age groups and regions, both genders are at risk of falls.
Older women and younger children are especially prone to falls and increased injury severity.
Worldwide, males consistently sustain higher death rates.
- Occupation
Working at elevated heights or other hazardous working conditions
- Underlying medical conditions
- Alcohol or substance use
- Medication
- Physical inactivity
- Unsafe or cluttered environments
- Visual impairment
- Dementia
WHAT TO DO IF YOU FALL
- Stay still and slow your breathing
- Check if you have any injuries
- Look for hazards such as broken glass or electrical cords before you move, or before you allow anyone to help you up
- Decide if you will try to get up If you can get up: Think about how you will get up off the floor. If you do not manage the first time, rest before trying again.
- Seek medical attention if you are hurt.
HOW TO GET UP AFTER A FALL
- Roll over onto your stomach and try to get into a crawling position.
- Crawl to a stable piece of furniture, like a lounge chair.
- Try to get up onto your knees to hold onto the furniture.
- Push up, using your strongest leg and arms, still firmly holding onto the furniture.
- Pivot around to sit down on the furniture.
- Sit for a few minutes and assess how you feel before attempting to move again.
HOW TO REDUCE THE RISK OF A FALL
- Use non-slip mats in the bathroom
- Mop up spills to avoid wet floors
- Get help lifting or moving items that are heavy or difficult to lift
- Remove clutter and ensuring that all areas of the home are properly lit
- Have your eyes checked
- Ask your doctor for a medication review and see if any might make you dizzy or sleepy
FALL PREVENTION STRATEGIES
Contrary to popular belief, falls are not inevitable and many falls can be prevented. Some risk factors for falls are relatively easy to change and, where falls occur, the severity of injuries can be reduced. Prevention strategies should emphasise education, training, creating safer environments, prioritising fall-related research and establishing effective policies to reduce risk.
Research has shown that older people who take part in regular strength and balance training are less likely to have a fall. Regular exercise improves muscles and makes you stronger. It also helps keep your joints, tendons, and ligaments flexible. Exercise programmes involving balance and functional exercises have been proven to reduce the rate of falls and the number of people experiencing falls in older people living in the community. Try to get at least 150 minutes per week of physical activity!
EXERCISES
Here are a couple of our favourite exercises to strengthen your core and lower-limbs to help improve your balance! All exercises should be somewhat challenging, but not so difficult that you are unable to complete them. If they are too difficult, try lightly holding on to a stable support for balance until you are able to complete them without holding on.
If you avoid physical activity because you’re afraid it will make you more likely to fall, please inform your doctor or physiotherapist.
- Tandem Walk Start in a clear space free of obstacles. Begin this exercise by putting one foot in front of the other, so that your heel touches to the toes of the opposite foot. Repeat bringing your rear foot in front and continue the walking motion, ensuring you take your time to place heel to toe. Walk like this for 20 steps.
- Standing Leg Extensions Start by standing behind a chair or table. Standing tall and keeping your knees straight, slowly lift your right leg straight backwards then return to the starting position. Repeat on the left leg. We recommend trying 15 slow repetitions on each leg.
- Side Leg Raise Start by standing behind a chair or table. Standing tall and keeping your knees straight, slowly lift your right leg out to the side then return to the starting position. Make sure you keep your head and toes facing forwards and avoid bending at the hips. Repeat on the left leg. Try for 15 slow repetitions on each leg.
- Squat to Chair Start by standing in front of a chair with your legs shoulder width apart. Slowly lower your hips back and down whilst bending at the knees, to slowly lower onto the chair then stand up again. For an extra challenge, try pausing at the bottom to hover above the chair before pushing through your feet to stand up again. Repeat this exercise up to 15 times.
- Calf Raises Start by standing up right with your feet hip width apart. Slowly lift both of your heels of the ground to balance on the balls of your feet. Slowly and gently lower yourself back to the ground. Try for at least 20 repetitions.
We also offer balance and falls prevention classes at the clinic for people who feel like their balance is deteriorating or that they are at an increased risk of falling over. We incorporate a variety of gentle exercises targeting lower body strength and endurance to improve balance and confidence.
Alternatively, come in for a visit and we will be able to conduct a full assessment and create a custom exercise program aimed at improving your balance, flexibility, muscle strength and gait.
Give us a call on 9875 3760.
REFERENCES
https://www.cochrane.org/CD012424/MUSKINJ_exercise-preventing-falls-older-people-living-community
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