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Use of physical activity to decrease fall-injury risk

A quick look at demographic trends shows a growing population of older adults in our society. In 2016, Americans aged 65 and older made up 13% of our population. This percentage has only grown since and is expected to increase to 19% over the next decade. That equates to more than 72 million individuals over 65 years of age by the year 2030. Due to this trend, much thought and preparation moving forward will be devoted to helping our aging population maintain functional ability and physical independence. Considering one in four individuals in this age range experience a fall each year, alarm bells should be ringing. The implications of a projected 18 million older adults with a fall incident each year by 2030 are substantial and will greatly affect our public health landscape.

Recently, the American College of Sports Medicine published official pronouncements on a range of physical activity-related topics. One such pronouncement was “Physical Activity, Injurious Falls, and Physical Function in Aging, An Umbrella Review.” In this review, the Aging Subcommittee of the Physical Activity Guidelines Advisory Committee, convened by an office of the United States Department of Health and Human Services, focused on the effects of physical activity on fall-related injuries and functional ability. Through an extensive analysis, the PAGAC identified evidence to support the many benefits of physical activity.

The PAGAC examined the relationship between physical activity and risk of injury due to a fall. The evidence concludes that multicomponent physical activity significantly reduced the risk of fall-related injuries by 32 – 40%. Also, the risk of fall-related bone fractures decreased by 40-60% among older adults participating in multicomponent activity within their community or home settings.

A multicomponent physical activity routine includes a combination of various activity types such as aerobic, muscular strengthening, balance and flexibility. Just as common diet recommendations revolve around a balanced selection of healthy choices, it comes as no surprise that a healthy activity profile includes a balanced mix of activity types. The more diverse the activity types are that you participate in, the better prepared you will be for the many movements daily life requires.

The most convincing evidence discovered in the review relates to the greater benefits of multi-component activity in comparison to single-component activity. Furthermore, some research suggested the use of low-intensity walking as a primary activity may not be enough to reduce the risk of fall-related injury or bone fracture in older age. While this does not mean that low-intensity walking is a poor activity choice, it is safe to infer that walking should not be your only activity choice. Some programs, such as the Lifestyle-Integrated Functional Exercise intervention, have been created to encourage incorporation of different activities during your daily tasks to help prevent falls. One example the LiFE program recommends is to attempt a one-leg stand while you heat food in the microwave or brush your teeth to improve balance. Another is to put the heel of one foot directly in front of the toe of the other while waiting for the kettle to boil for more balance work. These activities can be assisted by using support from the hands on the counter when needed. Others include bending your knees instead of your back to pull clothes out of drawers and using slightly less hand support on rails when climbing stairs to increase strength. Participants in the LiFE program significantly improved balance, strength and functional performance, according to the review.

Falls are already the most common cause of nonfatal trauma-related admissions to the hospital for older adults. Despite the overwhelming evidence that physical activity can greatly decrease fall risks and improve physical function capabilities, only 27% of older adults meet aerobic activity recommendations.

If nothing else, try expanding the number of activities you participate in by at least one type. Dance. Cycle. Garden. Participate in sports. Turn part of your daily walk into a high knee march or side-stepping balance challenge, if you can safely do so. The possibilities are endless. Increase your activity choices to decrease your fall-related injury chances!

Travis Rogerson, is a supervisor in exercise programming at Vidant Wellness Center in Washington. He can be reached at 252-975-4136.