The Role of Physical Activity in Reducing Falls

1. The Role of Physical Activity in Reducing Falls Debra J. Rose, PhD Co-Director Center for Successful Aging California State University, Fullerton and Fall Prevention Center of Excellence University of Southern California

2. Why is Physical Activity Important? • Important risk factor for falls • Reduced mobility increases fall risk in older adults with chronic medical conditions due to limited physiological reserves and fragility. • More physically active older adults fall less!

3. What We Know! • Stand-alone exercise interventions that target fall-related risk factors, lower fall risk as much as 50%. • Different settings (community, home) • Varied durations, intensity, frequency, and type of exercise • Different levels of risk • Group versus individually tailored home exercise programs

4. What We Know! • Multifactorial intervention strategies, with exercise as a core component, are particularly effective in lowering fall rates in high risk groups. • Additional factors targeted: • Gait training and assistive device use • Review and modification of medication • Treatment of postural hypotension • Modification of environmental hazards • Treatment of cardiovasculardisorders

5. Effective Exercise Interventions • Include activities that specifically target balance and gait • Also target other associated risk factors (e.g., muscle weakness, aerobic endurance) • Exercise is performed at a moderate intensity or progresses from low to moderate intensity • Introduce progressively more challenging practice environments

6. Alternative Forms of Exercise: Tai Chi • Effective intervention strategy for lowering fall incidence rates in sedentary and “at-risk” groups. • Less effective as stand-alone strategy in more frail groups. • Well-suited for large-scale community-based fall prevention initiatives.

7. Practical Implications • Form of tai chi selected is important. • Important that instructor understands impact of age-associated changes on movement patterns • Should emphasize movement components that become limited with age: • Multi-directional weight-shifting • Multi-segmental coordinative movements • Body alignment • Synchronized breathing

8. “There is NO One-Size-Fits-All Physical Activity Program”

9. “Walking with nordic poles promotes stability and increased energy Expenditure”

14. Best Type of Physical Activity? • Low risk • Any type of dynamic weight-bearing activity that elevates the heart rate for a sustained period of time, lubricates the joints, builds muscle, AND challenges balance. • Moderate Risk • Weight-bearing activities (with and without support) that build muscle AND progressively challenge balance. • High Risk • Seated activities that build muscle strength –to-standing activities that progressively challenge balance, build muscular endurance. Must be individualized based on specific impairments.