October 31, 2013
News Review From Harvard Medical School -- Exercisers Less Likely to Get Hurt in Falls
Research has shown that some kinds of exercise programs can help to keep older adults from falling. A new analysis finds that they also reduce injuries when people do fall. Researchers put together results from 17 studies of fall-prevention programs. More than 4,000 people were involved in the studies. Their average age was 77, and 3 out of 4 were women. Tai Chi was the exercise in two of the studies. Most of the programs used balance, gait and strength training. Many also used functional training, which helps people do normal activities. Overall, people in the exercise programs were about 37% less likely to be injured if they fell than people who did not get this training. They were 61% less likely to have broken bones after a fall. They also were 43% less likely to require a hospital stay. Researchers said the bodies of people who exercised may have been better able to absorb an impact without injury. The journal BMJ published the study online October 29 HealthDay News and Reuters Health News Service wrote about it.
By Howard LeWine, M.D.
Harvard Medical School
What Is the Doctor's Reaction?
More than 30% of people ages 65 and older fall every year. And the injuries can be severe, even with seemingly minor falls. Hip fractures are especially serious. About 25% of older adults who suffer a hip fracture die within a year.
With people living longer, the number of hip fractures continues to rise. By 2050, some experts predict there will be more than 6 million hip fractures per year worldwide. Even today, the costs of medical care after a hip fracture are well over $10 billion a year in the United States alone.
It's well established that structured exercise with balance training reduces falls in the elderly. It's been assumed that such programs also would reduce the degree of injury if someone does fall. This study provides the evidence. It found that fall-prevention exercise programs can reduce all fall-related injuries by 37%. Severe injuries were reduced 43%.
What is most important, these programs overall reduce fractures from falls by an estimated 61%.
Balance training has been the mainstay of fall-prevention programs. But exercises that improve endurance, muscle strength and flexibility are also important components of a program to prevent falls and injuries from falls.
Beyond better balance, the other benefits of such a program include:
- Faster reaction time to help keep yourself upright if you start to fall by putting out an arm quickly to grab something stable
- Improved coordination, again to help prevent falls, but also to help you roll rather than crash as you go down
- Stronger and larger muscles that can buffer the impact of a fall, providing some protection to bones and joints
- Stronger bones, which are less likely to break, as a result of resistance exercises
Regular exercise also is proven to help maintain brain function as we age. And with clearer thinking, you just might avoid situations that would increase your fall risk.
What Changes Can I Make Now?
If you are at risk for fall, no matter what your age, you should be engaged in fall-prevention activities. You can start this at home.
For balance, here is a simple way to begin:
- See how long you can stand on one leg. You will need a stable structure to hold on to before you even try to lift the leg. A doorway is a good choice. Practice lifting one leg a few times while holding on.
- Once you are comfortable, lift one leg slowly. Then slowly release your hands while keeping the leg lifted off the ground. Repeat with the other leg.
- Measure the number of seconds you are able to keep the leg lifted without needing to grab the doorway or put the leg down. Balancing on one foot is an excellent exercise. By measuring how long you can hold each leg up, you also can keep track of your progress.
- Once you are very comfortable with balancing on one foot, you can advance to the next stage. Balance on one foot, and hold the lifted foot in front of you before lowering it to the ground. Always stay in control by holding on with your hands as you need to.
- You can then add aerobic exercise, resistance training and stretching for flexibility.
- You are never too old or too frail to exercise. There are always routines that can fit your needs.
What Can I Expect Looking to the Future?
Fall prevention should actually start when we are young. The key is to maintain physical fitness, combining aerobic exercise and strength training. Start now and stick with it.