Falls are one of the most common injuries amongst individuals with disabilities and the elderly population, where 1 in 4 people who are aged 65 and over have at least 1 fall per year (HealthDirect, 2023).
Falls are a debilitating condition that can cause serious physical injuries such as bone fractures and head injuries, which can often lead to the person being unable to walk for a some time.
However, it can also severely affect one’s confidence with walking, leading to avoidance of physical activity, which in turn leads to further physical decline, thus putting them more at risk of falling.
Luckily there is a clinically proven way to reduce one’s risk of falling, which physiotherapists can help with.
Physiotherapy plays a big role in helping high-falls-risk individuals by setting out a balance and strength exercise regime that improves one’s balance and confidence in walking, significantly enhancing their quality of life.
Definition of balance
The definition of balance is the act of controlling the position of the centre of mass (CoM) relative to the base of support (BoS). Typically, “balance” occurs when the CoM is directly over the BoS as seen in the picture below.
The centre of mass is a point in an object where mass is concentrated. In the human body, it’s inside and slightly below the belly button.
The base of support is the area of the body that is in contact with the support surface. When we’re standing on a flat surface, it’s located in the midfoot.
If you have no issues with your balance, try this:
- While standing lean forward onto your toes. This brings your centre of mass forward and you may notice that you will bring your arms back to maintain the verticality of the CoM over the BoS.
- On the other hand, when you lean back, you will most likely bring your arms out in front instead, as the CoM has now moved posteriorly.
Body Structures associated with balance
There are three systems in the body that contribute to our balance.
- Somatosensory system:
- This system provides information about the position of our body in space, also known as proprioception. Knowing the position of our limbs in relation to other body parts allows us to co-ordinate movements to maintain balance.
- Visual system:
- This system uses sight to provide feedback on movement and direction which helps us to navigate our environment and identify obstacles to prevent falls.
- Vestibular system:
- This system provides information about the position of the head in relation to gravity. It helps us to detect changes in head position and movement, allowing us to maintain balance when turning our head to look towards either side.
All three systems work in conjunction, providing information to the brain which integrates this information to coordinate the appropriate motor responses in maintaining our balance.
However, when we age or have a disability these systems or others like the musculoskeletal system can be impaired, leading to reduced balance.
Role of Physiotherapy
So, how do physiotherapists help with poor balance and fall prevention?
Firstly, we assess the function and functional limitations of the patient. Through a variety of assessments, we determine what impairments are contributing to the poor balance.
These can include reduced muscle strength, reduced co-ordination or proprioceptive, vision or vestibular related impairments.
From the information gathered from the assessment, a balance and strengthening exercise program will be provided that includes task-specific training, individualised for the patient.
These have been clinically proven to improve balance, lower body strength and mobility to reduce the risk of falls and falls-related injuries. (Sadaqa et. Al. 2023)
For high falls risk individuals, it is not uncommon for them to be anxious about participating in exercises due to fear of falling.
At Optimum Health Solutions, our in-clinic exercise gym has access to the appropriate equipment that will ensure every individual feels safe when practising their exercise, while sufficiently challenging their balance.
By feeling safe and confident, individuals will be more motivated to adhere to their program, helping them to achieve their personal goals of walking safely and confidently
Falls from poor balance are a leading cause of injuries to the elderly and the disabled, however, it can be managed and treated.
Physiotherapy has been clinically proven to effectively improve balance and lower limb strength, reducing one’s risk of falling.
If you have had a recent fall, visiting an Optimum Health Solutions physiotherapist can help you regain your independence, enabling you to take every step with confidence.
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References:
Health Direct. (2023). Older People and Falls https://www.healthdirect.gov.au/falls
Kuperman, Roxanna. (2019). Static Postural Stability https://scalar.usc.edu/works/edkp-3/static-postural-stability-4
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