Importance of Exercise and the Role of Physiotherapy in Fall Prevention and Reversing of Frailty in Older Adults

09/09/2011 15:26:00

It is well-known that risk of falling is a very serious issue especially among the elderly. As we age our muscle strength and balance have a tendency to gradually deteriorate making falls more likely to occur. To make matters worse bone density or bone strength reduces with increased age meaning that the chances of a fall resulting in a bone fracture are also increased. One of the most common fractures that can result from a fall in the older adults are hip fractures which can take many months to recover from and may have a significant impact of the person’s function and independence.
There are a number of factors that can increase the likelihood of falling such as poor general health, male gender, perceived insufficient sleep, health problems requiring assistive devices, alcohol consumption, being over-weight and history of stroke. (1) Other medical problems including seizures, cataracts, postural hypotension, cognitive impairment, Parkinson’s and depression can can also have an adverse effect on the risk of sustaining an injury as a result of a fall. (2)

It has been shown in a number of studies that structured physical exercise can increase muscle strength, reduce frailty and ultimately diminish the risk of falling. For instance, in a study done in 2002 on 115 older men and women it was shown that 9-month supervised progressive exercise training that focused on flexibility, strength and balance resulted in significant improvement in physical function, strength, balance and cardiovascular fitness. (3) These types of exercises are often used by physiotherapists and other health professionals to address this issue.
Interestingly, Tai Chi has been found to be a beneficial tool to improve balance and hence reduce the risk of falling in the elderly.(4) Generally, exercise programmes designed to prevent falls should “provide a moderate or high challenge to balance and be undertaken for at least 2 hours per week on an ongoing basis”. Also individuals at high risk of falling should not be prescribed brisk walking programs. (5) There may often be a need to see your doctor to address some of the possible medical risk factors involved.
For a individually-tailored falls prevention programme see your physiotherapist. Here, at BodyFit Physiotherapy we can help to build a custom made programme for you that will address your needs, in particularly managing and reducing the risk of falling and its associated consequences on your well-being. As a physiotherapy professionals we know that injury prevention is extremely important and usually more successful than dealing with consequences of an injury after it already occurred.

Are you wearing the right footwear for your sport?

02/23/2011 18:52:00

We are right at the start of another winter sports season and it’s time to think what we can do to prevent those nasty injuries from interrupting your game. One of the easiest ways to minimize the risk of injury is to make sure you have the right footwear for the conditions. It is still summer and the ground is reasonably dry. Most people will think that this makes playing sport safer as it prevents slipping and falling. However, it might not always be the case. When the playing surface is too dry and hard it makes the foot stick harder to the ground. This is known as “shoe-surface friction”. As you know, many team sports such as rugby, soccer, league, netball, basketball and others, often require the athletes to suddenly change direction while running at a high speed. This is when your shoe’s ability to get unstuck from the ground becomes vitally important. Many knee injuries occur when a player makes a sudden directional change with a foot being fixed to the ground and not being able to be freed from the surface at the right time. This causes excessive torsional (or twisting) forces in the knee often resulting in severe ligament tears. Some of these knee ligament injuries can take months to rehab and may often require surgery. Choosing the right footwear design will help you reduce the risk of these injuries and avoid lengthy time off the field required for full rehabilitation.

Generally, the higher the tread on the shoes the less ‘give’ there is and the more stress is generated on the ankle and knee joints. When applied to football boots, this means that larger and longer cleats will give you more friction which may be a positive thing when you are playing on a wet surface such as often seen in winter. However, in dry conditions this may not allow enough ‘give’ and therefore result in a serious injury. Therefore, it would be fair to say that there is no universally ideal footwear design suitable for all sports and surface conditions. Instead, it is wise to choose the type of footwear taking into consideration the current conditions on the day. In summary, the boots with larger and longer cleats are recommended to be worn in wet weather to provide adequate friction between the shoe and the ground to prevent slipping, and shorter cleat footwear with reduced grip are to be used on dry surfaces.

Another factor to consider is playing on artificial turf which is being used more and more these days. A study by Villwock et al, 2009 has shown that wearing special turf footwear which has a dense pattern of short elastomeric cleats may reduce the stress on your joints while participating in sports on artificial surfaces.

And last but not least a firm mid-sole will help to prevent excessive rear-foot movement and avoid associated problems. It is really easy to check for this when purchasing your new pair of football or rugby boots just by bending and twisting the boot through the middle. There should be a reasonable amount of resistance felt when doing this.

In addition to the above I would like to say that the footwear you play sport in should also simply feel comfortable. That means picking the right size as well. The last thing you want to do when you are participating in a sport is worry about pain and discomfort associated with footwear being too tight and those annoying blisters.

I would also recommend consulting with a health professional knowledgeable in the area such as a physiotherapist or podiatrist before purchasing your next pair of sports shoes/boots if you are not sure exactly what to look for when buying sports footwear.

1. Mark R. Villwock, Eric G. Meyer, John W. Powell, Amy J. Fouty and Roger C. Haut. (2009) Football Playing Surface and Shoe Design Affect Rotational Traction. American Journal of Sports Medicine, 37: 518.

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Importance of Exercise and the Role of Physiotherapy in Fall Prevention and Reversing of Frailty in Older Adults

Are you wearing the right footwear for your sport?