Physical Therapist Intervention For Balance Impairments May Help Reduce Risk Of Falling
Physical therapists will answer questions about the risk factors of falling, how the body maintains its balance, and how older adults can help to improve their balance and reduce the risk of falling during a toll-free national hotline on Friday, February 8, from 9:00 am until 5:00 pm, EST. The hotline is offered as a public service of the American Physical Therapy Association (APTA) and is not a substitute for a visit to a physical therapist or other health care professional.
The toll-free number is 1-877-NEED-A-PT (633-3278).
"Falling and fear of falling among seniors is a public health problem and should not be accepted simply as a normal condition of aging," says physical therapist Leslie Allison, PT, PhD, assistant professor in the Department of Physical Therapy, College of Health Sciences, at East Carolina University in Greenville, NC.
Allison notes that there are several risk factors associated with falls, including: being older; being female; impairment of balance or walking; poor vision; leg or trunk weakness; reduced cognitive status (dementia); pre-existing medical conditions, such as Parkinson disease, stroke, or diabetes; being on more than four medications simultaneously; use of an assistive walking device; and a past history of falls.
Maintaining physical activity as one ages is one of the most critical things that seniors can do to help prevent falls, observes Roberta Newton, PT, PhD, a professor at Temple University's Department of Physical Therapy. "Fifty percent of older adults think that if they decrease their physical activity level, they will have less chance of falling. But, in reality, the exact opposite is true," says Newton. Many of her patients view exercise as a chore more than as pleasure, so Newton often recommends activities such as gardening, line dancing, and yoga to help improve balance and movement. "We see significant improvement not only in patients' balance, but also with their confidence levels, an awareness of body alignment, and a reduced fear of falling," she says.
"Physical therapists play an important role in screening patients for potential balance problems," notes Susan Whitney, PT, PhD, NCS, ATC, of the University of Pittsburgh. "Once a physical therapist has thoroughly examined a patient and has a comprehensive medical history in hand, he or she will design an individualized program of exercises and activities with an emphasis on strength, flexibility, and proper gait." If necessary, the physical therapist will refer the patient to other medical professionals, such as an ophthalmologist or neurologist.
Physical therapists Marilyn Moffat, PT, PhD, professor of physical therapy at New York University, and Carole Lewis, PT, PhD, GCS, professor in the department of geriatrics at George Washington University, authors of Age-Defying Fitness, say that you have to train your balance in the same way you have to train your muscles for strength and your heart for aerobic capacity.
According to Moffat and Lewis, balance may be improved with exercises that strengthen the ankle, knee, and hip muscles and with exercises that improve the function of the vestibular (balance) system. Moffat and Lewis suggest starting with a simple assessment of your current ability to maintain good balance. With a counter or sturdy furniture near enough to steady you if necessary, perform this test:
1. Stand straight, wearing flat, closed shoes, with your arms folded across your chest. Raise one leg, bending the knee about 45 degrees, start a stopwatch, and close your eyes.
2. Remain on one leg, stopping the watch immediately if you uncross your arms, tilt sideways more than 45 degrees, move the leg you are standing on, or touch the raised leg to the floor.
3. Repeat this test with the other leg.
4. Compare your performance to the norms for various ages: 20 to 49 years old (24 to 28 seconds); 50 to 59 years (21 seconds); 60 to 69 years (10 seconds); 70 to 79 years (4 seconds); 80 and older (most cannot do this test).
To improve balance and reduce falls risk, physical therapists may recommend stability and strengthening exercises; a formal exercise program; a walking regimen that includes balance components such as changes in surfaces/terrains, distance, and elevations; Tai Chi (which emphasizes balance, weight shifting, coordination, and postural training); and aquatics classes geared toward balance and coordination.
Physical therapists are health care professionals who diagnose and manage individuals of all ages who have medical problems or other health-related conditions that limit their abilities to move and perform functional activities in their daily lives. Physical therapists examine each individual and develop a plan of care using treatment techniques to promote the ability to move, reduce pain, restore function, and prevent disability. Physical therapists also work with individuals to prevent the loss of mobility by developing fitness- and wellness-oriented programs for healthier and more active lifestyles.
The American Physical Therapy Association is a national organization representing almost 72,000 physical therapists, physical therapist assistants, and students nationwide. Its goal is to foster advancements in physical therapist education, practice, and research. Consumers can access "Find a PT" to find a physical therapist in their area, as well as physical therapy news and information at http://www.apta.org/consumer.
* National Council on Aging
American Physical Therapy Association
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