How to Improve Balance and Prevent falls Presented by Maria Sarah Anson, BSPT, tdpt Certified Vestibular Therapist/Concussion Rehabilitation Certified Tai Chi Instructor Don Cao, PTA Vestibular Therapist
Introduction According to Centers for Disease Control (CDC) 1 in 4 older adults reported of fall in 2014. The concern is every second an older American falls; threaten the health and independence of older adults.
Who is at risk? Falls happens and increases with age. According to CDC 2014 the falls happens at the age of 65 and older and the falls varies by race and ethnicity.
What can be done? Falls are not just a normal part of aging they are preventable. Having the tools such as screening and effective strategies can save lives and money. According to CDC falls is a preventable problem that health providers, older adults and their caretakers can work together to decrease these incidents of falls that causes devastating injuries.
According to CDC the Screening tool is being used by simply asking 3 Questions to Older Adults: The population of 65 and older, we can make these three questions a routine part of personal or caregiver pre-screening. 1. Have you fallen in the past year? 2. Do you feel unsteady when standing or walking? 3. Do you worry about falling? If the answers yes to any of these key screening questions, there is high possibility that you are at risk of falling. It s significant to consider consulting your Primary Physician/Nurse for further assessment and recommendations.
The Physical Therapy Role: 1) Evaluate patients who are at risk of falling. 2) Assessing modifiable risk factors. Reviewing and managing prescriptions, medications, over the counter and supplements which a side effect causes dizziness, sleepiness and high risk for falls. Review adherence/compliance to medications to avoid withdrawals that may cause or linked to falls. 3) Education for older adult and caregivers of environment/home safety measures to reduce the risk of falling and keeping their independence longer..
4) Educate about Vitamin D supplements for improvement of bone, muscles and nerve health. 5) Offer effective fall strategies such as promoting physical activities and mobility in keeping flexibility, strength and healthy balance.
Older Adults and Caregivers must do: 1. Speak up. Talk to your doctors/nurse/physical therapist about fall risk prevention. Tell your health provider if you have fallen, or you are fearful that you might fall or feeling unsteady. 2. Check your eyes. Encourage to have vision screening once a year and update glasses as needed. 3. Check your feet. Have your healthcare provider check your feet once a year and discuss proper footwear, and ask whether seeing a foot specialist is necessary.
4. Check Home Safety. Most common falls happen at home. Consider the following modification: Keep floors clutter free. Remove small rugs or tape down or secure them. Add grab bars in the bathroom Have handrails and lights installed on all staircases. Make sure there is plenty of light in the house. Using proper assistive device/equipment for transferring and walking if indicated. Addendum: keep your phone in the lower location that can easily reach or have life alert. 5. Keep moving. Physical activities that strengthen arms and legs helps your balance.
Presentation of Tai Chi a comprehensive exercise which help improve flexibility, strength, coordination, and balance which shown evidence base results in prevention of falls with older adults. Tai Chi exercises is a traditional Chinese martial arts and a sport consist of a series of sequential, graceful, and balanced movements that are executed in a slow, meditative, and relaxed manner.
History of Tai Chi Origin from China Chen Wangting, a 16 th century Royal Guard of the Chenjiangou village in Wenxian County, Henan Province. After retired from the army, he was drawn to the teachings of Taoism, which led him to a simple life of farming, studying and teaching martial arts. Some reports date Tai Chi to the Ming Dynasty in 1368. It was modified and brought to Beijing and called the yang Style The name Tai Chi means supreme ultimate.
Taoism philosophy: everything is composed of two opposite, but entirely complementary, elements of yin and yang Tai Chi consists of exercises equally balanced between yin and yang. Some Tai Chi uses weapons: Sword, Staff, Spear, and Push hands Push Hands is a form of Tai Chi uses a partner and focuses on self-defense. 5 major styles of tai Chi: Chen, Yang (most widely taught), Wu, Sun (Adopted by the Arthritis Foundation), Hao (Woo) There are two Chinese Martial arts systems, the Internal and the External systems The Internal system includes Tai Chi, Sheng-I and Pa-Qua styles The External system includes Shao Lin, Long Fist, Southern Fist, and other styles.
References: Centers for Disease Control (2017). Older adult fall prevention. Retrieved from https://www.cdc.gov/steadi/patient.html Yuan, Z., & Wang, Y. (2015). Tai chi as an intervention to reduce falls and improve balance function in the elderly: A metaanalysis of randomized controlled trials. Chinese Nursing Research, 3(1), 28-33. doi: 10.1016/j.cnre.2015.10.003
Lam, P. (2006). History of Tai Chi. Retrieved from https://taichiforhealthinstitute,org/history Goodman, C. C., & Fuller, K. S. (2015). Pathology implications for the physical therapist. St. Louis, MO: Elsevier Saunders