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Fall Prevention: Proper Exercise Greatly Reduces Risk

Each year, millions of Americans are injured in some type of fall. For those over the age of 65, one in three individuals falls each year, leading to around a quarter of a million hips fractures and approximately 25,000 deaths each year.

Research and experience have shown us that regular exercise can reduce fall risks, but improving strength, coordination, and – most of all – balance.

The simplest way to exercise for fall prevention is to maintain a regular walking regimen. This exercise improves lower-body strength and has the added bonus of providing aerobic activity.

Balance exercises can be as simple as bouncing on a small indoor trampoline (they even have balance bars to hold) or standing on one leg for an extended period. For the more adventuresome, stand-up paddling on a paddle board strengthens both core and foot muscles and improves the body’s interior balance feedback system.

However, some of the latest research, outlined in a recent New York Times article, indicates that a combination of exercises is best for improving balance and reducing falls. Exercises that focus on the combined gross motor skills of coordination, agility, and balance appear to rewire the brain in unexpected ways. While strength training and aerobic exercise both trigger brain chemicals that improve neuron growth, balance and coordination exercises all upon higher level processes that actually seem to increase the total number of synapses that connect these neurons.

Evidence also suggests that simple balance exercises alone don’t accomplish quite enough. Rather than relying solely on repetition, the best exercises call upon unpredictability to challenge us. A recent European study compared one group of endurance athletes; e.g., cross-country skiers and runners, with another group of more skill-trained athletes; e.g., figure skaters, dancers, and gymnasts.

The researchers were hoping to assess the athletes’ motor cortex plasticity. This plasticity shows a brain’s ability to rewire itself in response to different stimuli. While both groups of athletes were well trained, endurance athletes tended to use certain muscles repetitively, so that the brain, in essence, went on autopilot. However, skaters, dancers, and gymnasts, who do not rely on autopilot, demonstrated significantly higher plasticity in the parts of their brains that controlled calf muscles. Their brains were more primed to learn new motor tasks and respond to changes in the environment.

Another recent study found that a particular exercise regiment greatly reduced serious falls in senior women. A group of women in their 70s had supervised workouts three times per week for a year. The workouts included balance and strength training activities.

A follow-up to the study revealed that, even five years later, women in the exercise group were 51% less likely to suffer fall-related injuries, and they were also 74% less likely to have fractures, as compared to a control group. Doing only strength or balance training didn’t seem to reduce women’s risk but a combination of balance-jumping and resistance training improved bone strength and physical functioning; e.g., balance.

Lessons learned?

  • Exercise can play a major role in reducing falls or their most serious effects.

  • A combination of activities; e.g., strength training, walking, and balance exercises, has the greatest impact on fall prevention.

  • Learning new skills and avoiding too much routine in an exercise program can improve the brain’s plasticity and cognitive function.

If we as caregivers invest a fraction of the time that we spend in cautioning loved ones and care recipients to “be careful” into promoting physical fitness and regular exercise, the overall results can be much more positive.

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