Republished with permission. Click here to explore KERA's THE BROKEN HIP — A KERA News Breakthrough Series.
Nine years ago, Joyce Powell was in a hospital, on her way to the bathroom, when she fell and broke her hip. She recovered. But there’s something she hasn’t gotten over: A fear of falling.
“It stays with you,” Powell says. “You’re aware that you can’t function like you once did.”
It might sound silly, but it turns out that people who are afraid of falling are actually more likely to fall.
That’s why Powell attends a fall prevention class at the University of Texas at Arlington: not just to get stronger, but to face her demons.
At one recent session, an instructor tells participants: “All right, so now what we’re going to do is a toe touch with the right foot, if you feel comfortable."
Participants are in their 70s, 80s and 90s, and their workouts involve everything from balance balls to playing Wii games.
“The greatest predictor of a future fall is a previous fall,” says Chris Ray, the kinesiologist who’s leading the efforts at UT-Arlington’s Center for Healthy Living and Longevity.
Improving Balance Is Key
The greatest risk for older people who’ve fallen? They’ll simply stop exercising, Ray said.
But exercise is key: Studies show exercise can prevent falls in older people.
“We start to restrict the activities we perform,” he says. “As we age, if we were walking on an icy sidewalk, we decide we’re not going to walk on icy sidewalks anymore. And that's a very appropriate selection. But if we don’t replace that, then we see a decline of strength, neurological, eventually cardiovascular, pulmonary, skeletal, all these systems start to decline. Eventually, that has a very compounding effect.”
One of the keys to preventing falls is improving balance. As we age, natural changes occur in hearing, vision and proprioperception — what you feel in your toes and hands. It makes it harder to stay upright and oriented. If seniors can learn to better use those senses, then they’ll be less likely to fall.
To do that, Ray tests them using something that looks like an open photo booth you would expect to find at an amusement park. The machine assesses how well someone can use the senses to maintain balance. The walls shift, the screen changes and the floor tilts.
“In daily life, when we see seniors that fall, it’s usually during multitasking,” Ray explains. “So what we’ll do is we have the opportunity to recreate that. We pipe in loud noises, city sound or music, pipe in visual distractors on the screen, or a test on the screen as they’re trying to maintain their postural control while the walls are moving in concert.”
This isn’t just for amusement. The goal, Ray explains, is to identify the best intervention for each individual. For some, a regimen of tai chi might be enough. For others, it might be weightlifting or even practicing walking with their eyes closed.
"The greatest predictor of a future fall is a previous fall," says Chris Ray, the kinesiologist leading the efforts at UT-Arlington
'I want to be be free'
Powell says she’s felt more confident getting around and traveling since she began classes at UT-Arlington. Still, she’s cautious.
“When I walk, I look to see where I am, particularly if I’m on uneven ground,” she says. “But I look at my feet and I’m constantly looking to see what I’m stepping on, to see if there’s something there that would create a problem.”
Freedom from falls is never guaranteed. But dedication to an exercise program can help seniors keep their balance without giving up the activities they love.
“It’s one of the things I’ve learned you just have to do in order to protect yourself to remain upright,” Powell says. “I guess I could use a walker to do it but I don’t want to. I want to be free.”
The vast majority of hip fractures are the result of a fall, and more than half of all falls happen at home. Many of these falls could be prevented by making simple changes to the lighting and arrangement of furniture. How can you make your bedroom fall-proof?
Also, explore the results of a study that determines that exercise can prevent falls in older people.