As we age, it becomes increasingly important to have good balance to assist in fall prevention. The CDC reports that 1 in every 3 people over the age of 65 years old will fall one time each year. This statistic increases to 1/2 population over the age of 80 years old. Those are some pretty staggering numbers! These falls can result in minor bruises or bumps but also often result in fractures or head injuries. To prevent injury, we suggest assessing yourself to determine if you are likely to be one of those who might be at risk of a fall.
There are several contributing factors to falls and poor balance, some are as follows:
- Age: Age is a component of many of the following risk factors. You are more likely to have vision issues, underlying medical conditions or medications that may play a part in imbalance.
- Leg Weakness: the less active you become the more weakness you will notice. This often becomes a downward spiral as you do less you become weaker and more fearful of falls so you do even less.
- Poor Standing Posture: due to tightness of muscles, changes in bony structures and weakness in certain muscles our posture changes and this effects our balance points.
- Vision: if we can’t see the fall hazard or where we are putting our feet then we are more likely to trip.
- Medical Conditions (such as diabetes, peripheral neuropathy, stroke, Parkinson’s disease, vertigo): may also be contributors due to loss of sensation, movement or other issues.
- Low Blood Pressure
- Home Hazards
Leg strength and flexibility is important in balance. The muscles in your hips, knees and feet all assist with controlling your body so that it remains balanced. If these muscles are weak then it is more difficult for you to have control over your body as it reacts to position changes and walking. In addition to strength, flexibility is also important in keeping your body moving the way it is supposed to.
Poor balance can be a combination of the above mentioned factors. It is important to determine why you are experiencing poor balance so that you can help yourself prevent future falls. If you are experiencing dizziness, especially when you lay down, or with change positions, or when you sit or stand up too quickly, it can be due to an issue with vertigo or low blood pressure. The tests and exercises below likely will not help in this case. You should always consult your doctor if you experience this type of balance issue to get appropriate treatments, medication adjustments or other assessments as needed.
What you can do to help yourself:
One of the easiest to modify from the list of risk factors is home hazards. This includes throw rugs (kitchen mat, bathroom mat, hallway rug) or power and telephone cords. These obstacles are easy to trip over or to catch on a cane or walker. Removing these and adding night lights to well traveled areas can assist in reducing the risk of falling.
First Test your Balance:
When performing the following exercises/tests it is important that you remain safe and have someone that is aware of what you’re doing and is close by for assistance.
First, test your abilities. Stand facing the kitchen counter and hold on with both hands. Have a chair behind you as a safety measure! Lift one of your legs up so that you are standing only on one leg. Try to let go slowly and count, in seconds, how long you are able to remain steady without having to touch down. Repeat with this test with the opposite leg. If you are unable remain steady for 15 seconds, you should be working on your balance.
Below are some suggested progressions of balance exercises that you should work on daily to improve and maintain your balance. Remember your safety instructions!
- Tandem: Exercises performed with one foot in front of the other.
- Standing: place on foot in front of the other while facing the counter and holding on. Balance like this beginning by using two hands for support. Progress as you improve to using one hand, then fingertips, then no hands at all. If this is too difficult try to just stand with both your feet close together instead of one in front of the other.
- Walking: using the kitchen counter (or the walls in a hallway) to hold on to at first. Place one foot in front of the other, following the counter then turn and repeat. After you become steady using your hand, try without holding on.
- Standing on One Leg:
Like in the test mentioned above, stand at the kitchen counter using both hands and stand on one leg. Remove one hand, use finger tips then no hands. Progress yourself only if you feel steady at each stage. To make this more difficult after you are able to stand on one leg steadily, try performing the same exercise on a pillow or with your eyes closed.
Exercises can be done seated or standing at the kitchen counter based on your level of comfort. Some examples of exercises are: marching, kicking to the side with a straight leg, kicking to the back with a straight leg, bending and straightening your knee (while seated). Try for 10-15 repetitions on each leg. As you get stronger you can purchase adjustable weights to challenge yourself further.
Stretch your calf muscles by putting one leg behind you keeping the knee straight and lean toward the wall bending the front knee. Or using a strap while seated pulling your foot up toward your knee keeping the knee straight. Hamstrings can be stretched while laying down using a strap, lifting your straight leg up until you feel a stretch in the back of your thigh.
Improving your flexibility and strength will make great strides in helping your balance.
Again, it is important that you feel safe walking and moving. Be sure you are safe while performing these exercises and do not perform them without someone else close by if assistance is needed. If you do not feel safe, consult your physical therapist or your physician. Balance issues are treatable and can improve your safety and confidence in a short period of time! Visit RI Limb Prosthetics, Orthotics And Physical Therapy for more information.
Post Contributed by Mellissa Walters, DPT.
Vertigo can be caused by many things including head trauma, stroke, neurological issues or tumors. This post will focus on a very easily treated form of vertigo -- BPPV (Benign paroxysmal positional vertigo). This type of vertigo is related to changes in position of the crystals that are a component of the inner ear.
Symptoms include brief bursts of dizziness, spinning sensations, nausea and or lightheadedness. Some complain of a vague sense of not being "grounded" and being off balance. Symptoms are often intermittent being present for a few days or weeks, stopping and recurring again.
The symptoms are usually noted with positional changes like:
- rolling in bed,
- moving the head from looking down to looking up
- quickly twisting or turning the head
- bending over
Activities that bring on symptoms will vary from person to person but symptoms are almost always precipitated by a change of position of the head with respect to gravity. Getting out of bed or rolling over in bed are the most common problem motions.
What causes the onset of BPPV? Commonly reported causes are hitting your head, whiplash, infection or other disorders of the inner ear and degenerative changes of the structures of the inner ear as we age. Determining BPPV is usually completed with a history and physical exam. Additional testing can include MRI (if neurological problems are suspected) or rotary chair testing (for difficult to diagnose cases).
During the exam if the therapist or physician can reproduce symptoms with various testing movements and can see a jumping of the eyes (called nystagmus) that is associated with BPPV they will be able to treat the vertigo in the office and instruct in management at home.
The treatment of the Epley maneuver is performed by moving a client through 4 distinct positions to move the loose crystals through the ear canal to a point where they no longer will stimulate the symptom onset. Home exercises are usually given along with instructions to avoid extremes of head motions, sleeping in a reclined position and not sleeping on the involved side. This procedure is effective in about 80% of the population.
As always we hope the information is helpful in your daily pursuit of good health and improvements in mobility. If you would like more information you can call or contact us at RI Limb Prosthetics, Orthotics And Physical Therapy -- (401) 884-9541