What we know about the effect that exercise and balance training has on living a long, active life.
We don’t need a research report to tell us that the older we get, the more dangerous it is to fall. As we age, a variety of physical conditions can cause us to feel an increased sense of instability. As the sense of instability grows, so does the fear of falling.
And, one of the most natural things to do in response to that fear is avoid activities that cause us to feel unstable.
This pattern of responding to instability by decreasing our activity level sets us down a dangerous path. We avoid certain activities, and as we do, also become increasingly sedentary. With inactivity comes muscle loss, less flexibility, joint stiffness, and a shrinking range of motion. All of these lead to an even greater sense of instability. In response, we lower our activity level further, and so on and so on.
Before we know it, we’re caught in a dangerous Cycle of Frailty that’s difficult to get out of.
For Senior Living Communities, preventing the cycle of frailty is a primary driver behind health and wellness programs. But, what do we know about what works and what doesn’t? What strategies are most effective when it comes to helping Seniors not only remain strong and stable, but feel strong and stable so that they remain active for as long as possible?
There are three important strategies for an effective fall prevention program:
- Fear prevention
- Physical exercise that includes strength training, flexibility and balance training, and functional exercises
- Cognitive training that focuses on improved executive functioning
Let’s look at all three and how they work together to create an effective fall prevention program.
#1. Fear prevention strategies are an essential part of fall prevention programs.
The fear of falling has a direct impact on balance whenever seniors find themselves in a situation in which they feel unstable. For example, when walking on an uneven path or on a sidewalk with patches of ice, the body’s natural reaction is to stiffen, tightening the leg muscles and causing us to take stiffer, smaller, slower steps. While this constricted movement might feel safer, it has the opposite effect and can actually lead to a fall.
One way to reduce the fear of falling is to address it head on. Encourage seniors to be aware of how their body is reacting to situations that feel unstable and equip them with knowledge about how to move through the situation without increasing their risk of falling.
Another way of decreasing the fear of falling is to teach seniors a handful of simple balance training activities that can be incorporated into daily life. Empowerment is an effective antidote to fear. As such, engaging in effective, yet simple, balance training exercises throughout the day can have a significant effect on physical AND mental wellbeing by helping seniors feel more in control.
It’s also important to understand why someone is afraid of falling. Fear is one of the ways our body alerts us to a problem and sometimes a fear of falling is derived from an internal sense that something is wrong. Understanding the root causes of their fear can uncover both internal and external factors that are in fact putting them at a greater risk for falling.
#2. Strength Training, Stretching, and Functional Training should work together.
Functional training, stretching, and strength training are most effective in preventing falls when they work together.
As we age, muscles become shorter and less elastic, joints weaken, and our range of motion narrows. All of these factors can contribute to an increased risk of falling. The good news is that there is a huge body of research showing that age-related muscle loss can be minimized by resistance training, as can the effects of bone-related disorders, such as osteoarthritis and osteoporosis.
Of particular importance is the core. As the central linking point between the lower and upper body, core muscle strength affects how we lift, reach, turn, and bend. Nearly every activity we engage in throughout the day requires some level of core strength.
Weak core strength can lead to a forward flexed posture, a condition that’s been linked to poor balance and an increased risk of falls. If core muscles are allowed to further deteriorate and weaken, just standing up straight becomes a challenge, and a fall becomes almost inevitable.
Strength training is important, but it’s not enough.
Along with strength training, research shows that maintaining flexibility and range of motion are also critical to fall prevention. Of particular importance is maintaining flexibility and range of motion in the quadriceps, hamstrings, and hip joints because these muscles and joints directly affect static AND dynamic balance - our ability to balance when standing still, and our ability to balance while in motion.
Stretching is especially effective when it’s part of a holistic training plan that also includes balance training, strength training, and cardio exercises designed to support the actions required for daily life. After all, fall prevention strategies aren’t useful unless they have a direct impact on what we do outside the gym, in our daily lives.
This wholistic approach includes at least two days a week of strength training along with exercises that promote flexibility, balance, and cardio health such as tai chi, Pilates, water therapy, yoga, walking, and biking.
#3. Executive Functioning is the missing link in many fall prevention programs.
A fascinating study published in 2014 involved 182 subjects who were randomly assigned to one of two fall prevention programs. The first program included progressive strength training in combination with balance training. The second program was the same as the first except that it included the addition of cognitive training using a computerized virtual learning system. After participating in the training groups for 12 weeks, the participants were assessed for changes in their fall risk and the results were staggering.
Both groups showed a reduced risk of falling, but the participants in the training group that included cognitive training reduced their risk of falling by 80%!
As we age, most of us experience changes in the prefrontal cortex that are associated with executive functioning and attention. Compounding the problem, are age related declines in our ability to take in sensory information. This double whammy of executive function and sensory declines has a serious impact on our risk of falling.
When combined with a loss of muscle mass, limited range of motion, and environmental hazards, the cause of falls becomes multifactorial. So, the intervention should be too.
The HUR Senso was created on the principle that learning is most effective when exercises closely resemble the actual environment in which that new skill will be performed. We know that in order to learn or improve a skill, it's vital to practice performing that exact skill. If many daily tasks involve simultaneous performance in both cognitive and motor areas, then we need to challenge both of those systems during practice sessions.
The Senso includes a wide assortment of games that challenge both the cognitive and motor systems. The games were designed to improve sustained attention, working memory, divided attention, reaction time, inhibition, cognitive flexibility, and visuo-spatial skills.