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A Matter of Balance: Managing Concerns About Falls

A Matter of BalanceFalls are one of the most serious health risks for older adults. They are not only the leading cause of injury-related deaths in this population, but they are also a significant cause of disability. In fact, falls cause ten percent of all emergency department visits and more than half of injury-related hospitalizations.

Approximately one in three older adults fall each year. As the number of older adults increases rapidly over the next decade, the annual cost for fall-related injuries is expected to skyrocket, reaching $44 billion by 2020. Although most falls don’t result in severe physical injuries, a fall or near-fall often produces a psychological fear of falling. This contributes to a self-imposed decrease in activity, followed by functional declines and a greater risk for falls.

Falls in older adults are often viewed as unpredictable and unavoidable accidents. However, identification of the factors linked to falls combined with appropriate interventions to correct these conditions can dramatically lessen the risk of a fall. In many cases, falls are caused by a loss of balance or the inability to maintain the body’s center of gravity over its base of support. There are two types of balance:

Static balance, which is the ability to control postural sway during quiet standing; and Dynamic balance, which is the ability to react to changes in balance and to anticipate changes as the body moves. Dynamic balance includes maintaining balance while walking and stepping over or around objects.

The ability to balance depends in large part on sensory, muscular and motor systems. The three most influential sensory systems are the visual, vestibular and somatosensory systems. However, with advancing age, sensory function decreases, which negatively affects balance. Understanding these systems is essential to providing exercise programs that target balance for older adults.

The visual system is a major contributor to balance, providing information about the environment, the location of the person and the direction and speed of the person’s movement in the environment. Visual acuity, depth perception, peripheral field and sensitivity to low spatial frequencies (requiring more contrast to detect spatial differences) decrease with age. As a result, older adults tend to have a reduced ability to use visual cues to control balance.

The vestibular system, located in the ears, provides information about movement of the head, independent of visual cues. One component, the otoliths, detects head movement in relation to gravity, such as degree and direction of head tilt. The other component, the semicircular canals, are fluid-filled canals composed of three half circles positioned in three different planes. As the head moves, fluid in the canals triggers receptors and information is sent to the brain where it provides input about head orientation. At approximately age 40, vestibular neurons start to decrease in number and size, resulting in various impairments including dizziness.

The somatosensory system provides information about the body’s position and contact from the skin through pressure, vibration and tactile sensors, as well as joint and muscle proprioceptors. Skin sensation via tactile, vibration and pressure sensors is important in all activities of daily living, especially those involving movement. Skin sensitivity is reduced with increasing age. Lack of input from tactile, pressure and vibration receptors makes it difficult to stand or walk and detect changes in heel-to-toe body weight shifts, which are important in maintaining balance.

Muscle Strength and Exercise are Important for Proper Balance
In addition to the three sensory systems, muscle strength plays a role in balance and mobility. Muscles are particularly important in stability, since they work to keep the center of gravity within the base of support.

Balance exercises involve maintaining standing and postural stability under a variety of static and dynamic conditions. Activities in a balance-training program can include standing with one foot in front of the other to alter the base of support, shifting the body weight in different directions and lifting the feet from the floor. Exercises can also be performed with the eyes closed, while moving the head and/or while standing on foam to target the visual, vestibular and somatosensory systems respectively. A variety of activities are used to increase strength using body weight or equipment such as cuff weights or elastic resistance bands. Exercises which simulate activities of daily living, such as reaching forward to put something on a shelf, can then incorporate resistance and dynamic balance to challenge balance further. However, when performing these exercises it is important to have a chair or other sturdy surface within reach in case it becomes necessary to steady one’s self.

Even if exercise improves balance, accidents still happen and knowing that help is available with the push of a button is relieving for individuals and their loved ones.

PAL Button offers independence and peace of mind.
Living life to the fullest as we age is everyone’s desire. Living at home as we age is the desire of most seniors but may be worrisome for family members. PAL Button takes the worry out for seniors on their own and for family members near and far. Instant communication at the touch of a tiny waterproof button is the key. No batteries to charge, no codes to remember. Just wear PAL Button, push it and speak into the air. In trouble but can’t speak? No problem, PAL Buttons are continually monitored and once pushed help is dispatched to the scene immediately. From medical emergencies to the simple comfort of knowing that someone is always there, secure their independence and your peace of mind by calling PALButton today!

1-800-881-8746 | www.palbutton.com

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