Falls among the elderly are prevalent, dangerous, and can diminish their ability to lead an active and independent life. About one in three seniors above age 65, and nearly one in two seniors over age 80, will fall at least once this year, many times with disastrous consequences. I have seen falls result in bruising, fractures to the wrist and arm, hip fracture, and even concussion. The intent of this article is to inform our community on the risks of falls, ideas to stay active, a simple way to test your balance, and treatment options when you find your balance is poor.  I would rather educate and treat preventatively, than see someone fall and hurt them self.


Risk Factors associated with falls:

  • Increasing age
  • Decreased activity levels
  • Difficulty with balance or walking
  • Leg or trunk weakness
  • Poor vision, sensation, proprioception
  • Pre-existing medical conditions, such as Parkinson’s, stroke, or diabetes
  • Taking more than 4 medications at one time
  • Use of an assistive device for walking i.e. cane or walker
  • Past history of falls
  • Tight joints and or decreased flexibility in the lower legs


Maintaining Physical Activity:

            The most critical action seniors can take to help prevent falls is to maintain an active lifestyle. The less active you are the weaker your muscles become and the tighter they become. Also, your joints will become quite stiff, which doesn’t help matters. Physical therapists recommend activities, including walking, gardening, line dancing, pilates, yoga, and gym activities to help improve strength, flexibility, balance, and movement. Please check with your physician before attempting an exercise program, especially if you have pre-existing conditions that are affected by exercise.


Test Your Balance:

Balance may be improved with exercises that strengthen the ankle, knee, and hip muscles and with exercises that improve the function of the vestibular system. A simple assessment of your current balance can be done at home. Do Not Attempt to do this test alone, make sure that you have someone next to you to decrease the potential for risk of falling. If you believe that your balance is poor, seek assistance from your physician or a physical therapist.

  1. Start with feet shoulder width apart and try to stand for 60 seconds.
    1. Fail – Do not attempt the rest of this test. Very poor balance
    2. Pass – Go to the next step.
  2. Stand with one foot forward by about 12 inches for 60 seconds. Test both sides.
    1. Fail – Do not attempt the rest of this test. Very poor balance
    2. Pass – Go to the next step.
  3. Stand with one foot in front of the other, like you are on a tight rope, for 60 seconds. Test both sides.
    1. Fail – Do not attempt the rest of this test. Fair to Poor balance depending on length of time.
    2. Pass – Great balance
  4. Single leg stance – Stand on one foot and hold as long as you can, up to 60 seconds. Test both sides.
    1. Pass – Good to excellent balance. Keep up the good work!


How Physical Therapists Can Help:

Once a physical therapist has reviewed a complete history and thoroughly examined you, he or she will design an individualized program of exercises and activities with an emphasis on strength, flexibility, coordination, balance, and a proper gait pattern. A personalized plan may include a walking regimen that includes balance components such as changes in surfaces/terrains, distance, and elevations, foot positions, and walking in different directions with or without resistance. Equipment used to improve balance can include high tech balance systems i.e. Biodex balance system, which can test and challenge your balance dynamically and statically.  Dynamic is when the platform you stand on can move underneath you and static is when the platform does not move.  We also use the Wii Fit to challenge your balance, (a static platform); there are many programs from these two systems to aid in your recovery and reduce the likelihood for falls. Your physical therapist will also teach you specific strengthening and balance exercises that can be performed at the clinic and at home. If necessary, your physical therapist will refer you to other medical professionals, such as an ophthalmologist, or neurologist to improve your chances of a successful outcome.


If you have any questions on what you have read in this article, don’t hesitate to contact myself or one of our therapists.



Dr. Gary Welch PT, CFCE, CFMT, COMT

Owner – Spectrum Physical Therapy

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