HEALTH BEAT: Most falls can be prevented with trainingPublished 6:19pm Saturday, September 7, 2013
By MARIA STALLS
Vidant Beaufort Hospital
If you have ever fallen, you can most likely look back and identify what caused the fall. The truth is that most falls can be prevented. With proper training, balance can be improved and falls risk can be greatly reduced.
Much of the training that is associated with balance and coordination is focused on challenging proprioception. Basically, this is your body’s way of knowing where you are in space. Without consciously thinking, your feet and legs are communicating with your eyes and your inner ear, coordinating information and sending signals to your brain. That information is then sent back out to your muscles to adjust for balance. These systems work together to make fine adjustments in where you place your feet and what changes you are feeling in the surface you are standing on. Your eyes are validating that the information makes sense according to what you are seeing. If one of the three gives wrong information, your body relies on the other two to agree and make a decision on how to react. Have you ever been sitting at a stoplight, with your foot on the brake, and the car next to you moves? You feel like you are moving too, and you reflexively press harder on the brake, only to realize you were never moving in the first place. This is an example of how your eyes could give you wrong information.
Just as a disclaimer: please do not read this article and perform exercises that are outside of your ability. If you are not sure that you can safely do something, don’t try it when you are home by yourself. You should be in a safe environment, with help if needed. Balance training is not difficult, you can take the normal exercises and activities that you do every day and modify them to challenge your balance. There are three ways to challenge balance: decrease the base of support, change the surface and close your eyes. Some of you just read the last challenge and said to yourself, “Well, I would never be able to do that.” Remember that everyone reading this is at a different level and some may not reach such a high level of training. Just because you cannot complete all of the tasks does not mean that you are not improving your balance. You have to find the activity that challenges you and start there.
Decreasing your base of support can be simply working towards bringing your feet together. But it can be more than that. Many of my patients cannot even stand without holding on for support, so we begin basically with four points of support (two feet on floor, two hands on counter/holding on to kitchen sink). We start with all four points in contact, then decrease to standing with one hand support, then standing with no support from upper body. Then we work on standing on one leg, but resort back to two hand supports, then one leg and one hand support. During this activity, you activate your core muscles helping to stabilize and support your body.
After we decrease the base of support, we change the surface you are standing/sitting on. Think of how much easier it is to walk on a flat, level surface compared with your grassy, unlevel backyard. We train for the more difficult so that normal day to day challenges do not pose a threat for falls.
After we change the surface, then we close our eyes and perform the same activity. Remember our eyes play a key role in validating our position. This is one reason I recommend nightlights throughout the home. If you walk into a dark room, you put yourself at a disadvantage when you don’t have your vision to help your balance.
If some of these suggestions seem too confusing or if you have such balance issues that you feel that you cannot try training on your own, talk with your doctor. This is possibly the time for a physical therapy assessment. Let us help you in developing a plan that is right for you, that addresses your specific needs.
Maria Stalls has been with Vidant Beaufort Hospital since 1997. She is manager of physical-therapy services.