As we begin to get older, keeping our balance can become harder. We may even find that we are more prone to falling. Falls are a serious concern for older people; not only can they cause bodily harm but they are costly as well. There are specific parts of the body that help regulate balance, thus preventing falls. Physical therapy can aid in detecting issues with the balance centers in our body and can strengthen those centers.
Falling is a serious and costly issue for older people. Based on CDC statistics 1 out of 5 falls can cause serious injury such as broken bones or head injury. Each year, 3 million older people are treated in emergency departments for injuries related to falling. In 2015, the total medical cost for falls totaled more than 50 billion dollars. Medicare shouldered 75% of these costs.
Falling is an issue that is fairly common and there are many factors that contribute to falls. The following are examples of what may cause and/or contribute to a person falling:
- Lower body weakness
- Vitamin D deficiency (not having enough vitamin D in your system)
- Difficulties with walking and balance
- Use of medicines, such as tranquilizers, sedatives, or antidepressants. Even some over-the-counter medicines can affect balance and how steady you are on your feet.
- Vision problems
- Foot pain or poor footwear
- Home hazards or dangers such as:
- broken or uneven steps
- throw rugs or clutter that can be tripped over
There are specific centers in our body that regulate balance. In total, we have three such “balance centers” that help us to maintain our balance and prevent us from falling. They are as follows: vision, proprioceptive, and vestibular. The vision center, otherwise known as the eyes, communicate information about horizontal/vertical to the brain. This information helps our body maintain a normal horizon. The proprioceptive center consists of a small group of proprioceptive nerves. These nerves are located in our joints and relay information concerning our bodies position in space to the brain. The brain can react accordingly in order to maintain balance. The vestibular system is located in our inner ear. This system reacts to head movement, communicating to the brain that we are balanced because our head “feels” centered. The visual system is the strongest of the three balance centers. However, a disruption in any of these three control centers could cause an individual to have difficulty balancing. This may, in turn, lead to a risk of falling.
Physical therapy is one option that can help people who are having trouble balancing and/or are at risk of falling. During a physical therapy evaluation, a physical therapist will assess a person’s lower body strength and flexibility. They will also administer balance tests. One of the quickest and easiest tests to perform in the clinic to determine if a person is a fall risk is the “Timed Get up and Go” test. In this test, the patient is timed as they get up out of a chair, walk straight for 10 feet, turn around, walk back to the chair, and sit down. If a patient is unable to complete the “Get Up and Go test in under 14 seconds, they are considered to be at risk of falling. Physical therapists can also perform tests to tease out exactly which balance center(s) may be dysfunctional. This may be done by challenging a patient’s balance with their eyes closed to assess proprioceptive nerves or testing head and eye tracking to assess vestibular function.
Physical therapists provide several types of treatment in order to reduce/prevent a patient’s risk of falling. For example, education, prescribing exercise and measuring patients for assistive devices. Educating patients may include instructing them on how to better arrange their living environment. For example, installing a night light so that a patient can see better when getting up out of bed to use the bathroom, picking up loose throw rugs, installing a grab bar in the shower, etc. Prescribed exercises include those that can be performed in the clinic or at home. These exercises are designed to specifically target and strengthen one or all of the three balance control centers. Physical therapists can also help measure patients for appropriate assistive devices. These devices can include a cane, a walker, or a rollator.
In conclusion, falls are a serious issue for older patients. Physical therapy can help individuals who have fallen or have difficulty balancing. If you think you might be a risk of falling or just have trouble balancing, visit your doctor and ask them to provide you with a prescription to see a physical therapist.