Greatest Risk Factor Associated With Falls In Older Adults- Balance

One of the greatest risk factors for falling in older adults is a loss of balance. Balance relies on the synchronization of several systems in an ongoing cycle: the ability to detect position and direction of movement, hearing, vision, and muscle strength. The three most important contributors to balance control are:

1. Ability to detect position and direction of movement- related to both standing still and balance whilst moving

2. Muscle Strength-related to balance whilst moving only.

3. Skin sensation- weakly related to balance whilst standing still.

One’s ability to detect position and direction of movement as well as skin sensation accounts for approximately 60-70% of balance when standing still, whilst sight and hearing contribute the rest. Muscular strength is also important for maintaining balance when moving. One’s ability to detect position and direction of movement is important for smooth and coordinated movements as well as maintaining and regulating balance control. Some studies have shown that the ability to control the body whilst standing still is more dependent upon one’s ability to detect position and direction of movement than upon vision.

Studies have shown that with increasing age and lower physical fitness levels certain individuals demonstrate reduced balance performance. This is due to the fact that with normal aging there is a loss of bone and muscle mass as well as strength, resulting in impaired ability to perform activities of daily living, a reduction in quality of life and an increased risk of falling.

An individual’s risk of impaired balance control can be assessed through the relationship of their ability to detect position and direction of movement, and muscle strength, both whilst moving and standing still. Understanding such relationships assists in selecting targeted exercises to improve balance control by developing and implementing a personalised fall-prevention plan for each individual.

Since the majority of falls occur when the body is moving rather than standing still, improving the detection of position and direction of movement as well as muscle strength should be prioritised when looking at reducing the risk of falling. Improving all of these senses is achieved through a progressive programme of strengthening and balance exercises. The specific exercises will differ for each individual depending on their own specific deficits. Evidence suggests that, with programmes based on aerobic and resistance exercises, functional independence in older adults can be restored or maintained, whilst also preventing, delaying, or reversing frailty.

Exercises to improve one's ability to detect position and direction of movement and muscle strength to reduce the risk of falling will be discussed in my next blog...

References:

• SONG, Q., ZHANG, X., MAO, M., SUN, W., ZHANG, C., CHEN, Y. AND LI, L. Relationship of proprioception, cutaneous sensitivity, and muscle strength with the balance control among older adults In-text: (Song et al., 2021) Your Bibliography: Song, Q., Zhang, X., Mao, M., Sun, W., Zhang, C., Chen, Y. and Li, L., 2021. Relationship of proprioception, cutaneous sensitivity, and muscle strength with the balance control among older adults. Journal of Sport and Health Science, 10(5), pp.585-593. Copy bibliography citation Copy in-text citation Check for grammar
  

• Journal ZHANG, C., TALABER, A., TRUONG, M. AND VARGAS, B. B. K-D Balance: An objective measure of balance in tandem and double leg stances In-text: (Zhang, Talaber, Truong and Vargas, 2019) Your Bibliography: Zhang, C., Talaber, A., Truong, M. and Vargas, B., 2019. K-D Balance: An objective measure of balance in tandem and double leg stances. DIGITAL HEALTH, 5, p.205520761988557.