The Dangers of Falling

by Scott Sonnon

 

The Center for Disease Control and Prevention recently reported that the leading cause of injury related deaths in aging adults (65+) is due to falling.

Circular Strength Training® provides a safe, effective and quickly learned way to reduce the number of falls and the severity of falling injuries.

Just the Facts:

  • Every year one-third to one-half of the population age 65 and over experience falls.1-5
  • About one third of the population age 65 and over reports some difficulty with balance or ambulation; incidences increase in frequency and severity in the population over age 75.5
  • Falls are a leading cause of fatal and nonfatal injuries in older adults.2, 6-9
  • In 2000, 1.6 million seniors were treated in emergency departments for fall-related injuries and 353,000 were hospitalized.10
  • The medical expense related to falls amounts to more than $20 billion annually in the US, and is projected to climb to $32 billion annually by 2020.2, 9,11
  • The elderly represent more than one third of all hospital injury admissions, and more than 80% of these injuries are caused by unintentional falls.12
  • Many of the hip fractures sustained by elderly Americans as a result of falls are related to balance disorders.15
  • Fear of falling may negatively impact postural control, thereby completing a vicious loop.11
  • Nearly 20% of Americans between the ages of 65 and 75 suffer from balance disorders; by age 75, that figure rises to 25%.16

Causes and Prevention

The causes of falls are referred to as "risk factors." No single risk factor can be blamed for all falls. However, the more risk factors present the more likely it is that a fall will occur, and the greater the severity and number of injuries that may result. Most risk factors can be prevented. To prevent and lessen the severity of these falls we must increase our knowledge of the risk factors, beginning with the fact that: "falling is not a normal part of aging!"

At least one-third of all falls involve environmental hazards in the home. The most common danger comes from trips over objects lying on the floor. Other factors include poor lighting, loose rugs, lack of or poorly located/mounted grab bars, and unsteady furniture. With some environmental control, many of these issues can be prevented. Nurses with a concentration in geriatrics often conduct home safety assessments. Aged readers may want to consider this option.

When you do begin to trip, it's the ability to recover from mid-fall and minimize damage once you do fall that will prevent major calamities. It is simply not the case that you must accept that if you trip, you will fall, and that if you fall, it will be severe.

Dynamic Mobility as Prevention

Failure to exercise regularly results in poor muscle tone, decreased strength, loss of bone mass, loss of flexibility and most importantly loss of agility to recover when movements deviate from the expected. This last point is crucial.

Most therapeutic models attempt to apply traditional strengthening exercises in the belief that increasing joint stabilization will help one to avoid falls. This is a very shallow perspective on falling. Recovering from a trip doesn't merely involve resisting destabilization. To recover from a trip a joint must move from an unfamiliar range of motion back to a normal range. Falling occurs when the joint has been suddenly moved beyond familiar boundaries, and injuries result from resisting the impact rather than relaxing downwards. Recovery from trips and minimizing damage from falls are both easily learned skills.

Loss of kinesthesia (or movement sense) and loss of joint position sense can result from recurrent trauma, from thickening of connective tissue, and even from fear. Though many therapeutic methods exist for resolving this loss of movement and position sense (which is a major leading cause of falling and collision in aging adults), the real test is whether or not the individual will stick with the program. By the time that we reach a particular age we have invested decades developing routines that are familiar and comfortable. Although a traumatic event may make it somewhat easier to change routines, most people would prefer to prevent that trauma in the first place. This is what we mean in CST® when we say "Prehab Now - Or Rehab Later!"

Intu-Flow® in particular (but the entire CST® System as a whole, in general) offers a 10-15 minute, easy to follow, simple to understand movement program which will not only increase kinesthesia and joint position sense, it can be quickly inserted into any adult's daily routine.

TOP 10 BENEFITS of Intu-Flow®:

  1. Increased normal fitness attributes: strength, stamina, endurance and flexibility.
  2. Increased energy resulting from sending nutrition to the joints.
  3. Decreased accelerated aging of connective tissue, since the exercises lubricate and feed starving, dry, brittle joints.
  4. Decreased pain from compressed joints.
  5. Increased kinesthesia (movement sense) and joint position sense, critical for recovering from trips and minimizing damage from falls and collisions.
  6. Increased joint mobility, intramuscular coordination, and reactive agility to prevent trips and collisions from happening through early detection.
  7. Decreased onset of osteoarthritis, which contributes to decreased mobility and joint pain.
  8. Decreased onset of osteoporosis, which contributes to severity of injury from falls and collisions.
  9. Increased reaction speed, decreased recovery time and increased movement speed to prevent trips, collisions and falls.
  10. A feeling of reclaimed independence due to decreased emotional fear of falling and increased confidence in mobile safety and security.

Additional Preventative Measures

Beyond having a solid mobile safety fitness program in place, here are some other factors that will help to prevent injuries from falling, tripping and collisions.

  • Eat or drink sufficient calcium; get sufficient vitamin D in order to enhance the absorption of calcium.
  • Schedule an eye appointment. Age-related vision diseases can increase the risk of falling. Cataracts and glaucoma alter older people's depth perception, visual acuity, peripheral vision and susceptibility to glare. Use color contrasts to define grab-bars, keep eye glasses clean, and keep eyes wet with regular tear-drops.
  • Certain medications can increase falls by diminishing attention, negatively impacting coordination and dropping blood pressure when standing. Combined medications can have multiple effects. Check the dates on your medication, limit your dosage to the minimum, and have your doctor check all medications.
  • Check all outdoor and indoor high travel areas. Have cracks or weak boards fixed or replaced. Check all grab-bars for sturdiness, and use color contrast to denote them. Remove all clutter from travel paths. Keep at least one phone in each room, and an emergency response system if possible. Install motion-activated lights and non-skid rugs and mats, indoors and out.

Relevant Web Sites of Interest

References:

  1. Coogler, CE. Falls and imbalance. Rehab Management, April/May 1992.
  2. American Academy of Orthopedic Surgeons. Fact Sheet: Don't let a fall be your last trip. http://orthoinfo.aaos.org/fact/thr_report.cfm?Thread_ID=74&topcategory=Prevent%20 Falls&all=all. Accessed March 2003.
  3. Hausdorff JM, Rios DA, Edelber HK. Gait variability and fall risk in community-living older adults: a 1-year prospective study. Archives of Physical Medicine and Rehabilitation 2001;82(8):1050-6.
  4. Hornbrook MC, Stevens VJ, Wingfield DJ, Hollis JF, Greenlick MR, Ory MG. Preventing falls among community-dwelling older persons: Results from a randomized trial. The Gerontologist 1994; 34(1):16-23.
  5. Rubenstein LZ. Falls and Balance Problems. Patient Education Forum, American Geriatrics Society. http://www.americangeriatrics.org/education/forum/falling.shtml. Accessed March 2003.
  6. Murphy SL. Deaths: Final data for 1998. National Vital Statistics Reports, vol. 48, no. 11. Hyattsville (MD): National Center for Health Statistics; 2000.
  7. Alexander BH, Rivara FP, Wolf ME. The cost and frequency of hospitalization for fall-related injuries in older adults. American Journal of Public Health 1992; 82(7):1020-3.
  8. Klein K, and Ritzel DO. Falls Pose a Serious Threat to the Elderly. National Safety Council - Falls in the Home. http://www.nsc.org/issues/ifalls/falthreat.htm. Accessed March 2003.
  9. Centers for Disease Control. Falls Among Older Adults. Injury Fact Book 2001-2002. www.cdc.gov/ncipc/fact_book/15_Falls_Among_Older_Adults.htm. Accessed March 2003.
  10. Centers for Disease Control. Web-based Injury Statistics Query and Reporting System (WISQARS) [database online]. National Center for Injury Prevention and Control, Centers for Disease Control and Prevention (producer). www.cdc.gov/ncipc/wisqars (2001).
  11. Bloem, et al. An Update on Falls: Curr Opin Neurol, 2003; Vol 16(1):15-26.
  12. Greenwald BD, et al (2003). Congenital and Acquired Brain Injury. 1. Brain Injury: Epidemiology and Pathophysiology. Arch Phys Med Rehabil Vol 84, Suppl 1, March 2003, S3-S7.
  13. University of Pittsburgh. http://www.pitt.edu/~kaf24/table.html. Accessed July 2003.
  14. Braithwiate RS, et al. Estimating Hip Fracture Morbidity, Mortality and Costs. JAGS 51:364-370, 2003.
  15. National Institute on Deafness and Other Communication Disorders, March 1997.
  16. Biology Seminar presented to NASA headquarters by Dr. James F. Battey, Director, National Institute on Deafness; June 1998.

 

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