Written By Anna Ziemer, Physiotherapist and Champion for Balance.
A fall is a debilitating experience which will happen to third of over 65s ever year. Falls have various risk factors like deconditioning, poor posture and balance or taking many medications. However, current research studies suggest that the fear of falling might be a greater contributing factor to falls than some other reasons.
Two thirds of older adults experience and express fear of falling which steals their attention away from planning or completing complex movements like walking or regaining balance.
Being preoccupied with anxiety about falling or needing to adapt your movements to the environment causes the body to behave awkwardly, i.e.: to stiffen or visually disengage with obstacles causing trips and slips and loss of natural balance reactions. Consequently, people experiencing a fear of falling may unnecessarily withdraw from physical and social activities. This will result in further deconditioning and loss of confidence and self-efficacy.
Recent multidisciplinary research projects are helping us to increase our understanding how fear of falling contributes to falls and we now know that exercise-based activities with a cognitive element of movement execution help to improve balance confidence and self-efficacy which both reduce the fear of falling and the risk of falls.
Some research has suggested that even allowing people to experience near falls and analyse how it feels just before having a fall, as well as after, might help with falls reduction by building the confidence that one can avoid a fall or in case of an actual fall an individual would know how to react and would be able to get off the floor with no or minimal help.
At SP Therapy Services we run a Falls Prevention Course for those who have suffered falls, or suffer from a fear of falling.
Friedman S.M., Munoz B., West S.K., et.al. Falls and Fear of Falling: Which Comes First? A Longitudinal Prediction Model Suggests Strategies for Primary and Secondary Prevention. Journal of the American Geriatric Society 2002; 50:1329-1335.
Gusi N., Adsuar J.C., Corzo H., et al. Balance training reduces fear of falling and improves dynamic balance and isometric strength in institutionalised older people: a randomised trial. Journal of Physiotherapy 2012; 58: 97-10.
Kumar A., Delbaere K., Zijlstra G.A., et al. Exercise for reducing fear of falling in older people living in the community: Cochrane systematic review and meta-analysis. Age and Ageing 2016; 45:345–352.
Young W.R, Williams A.M. How fear of falling can increase fall-risk in older adults: Applying psychological theory to practical observations. Gait & Posture 2015; 41: 7–12.
Sturnieks DL, Menant J, Valenzuela M, et al Effect of cognitive-only and cognitive-motor training on preventing falls in community-dwelling older people: protocol for the smart±step randomised controlled trial. BMJ Open 2019;9:e029409. doi: 10.1136/bmjopen-2019-029409
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