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In This Episode:
Dr. K interviews Tiffany Shubert, PhD MPT, a practicing physical therapist on faculty at the University of North Carolina, and a leading expert on exercise programs for fall prevention. They discuss:
- What types of exercise work best for fall prevention, and why
- Why strength and balance exercises are so important for aging adults
- Why walking is not enough, when it comes to fall prevention
- Easy tests you can do at home, to check an older person’s leg strength and balance
- What’s involved in the Otago Exercise Program, an exciting new physical therapy program proven to reduce falls in older adults and endorsed by the Center for Disease Control (CDC)
- How to find Otago near you
- Why any exercise or physical therapy program for fall prevention should involve exercises done in standing, that are challenging, that get more challenging over time, and that involve at least two hours/week of exercises
- Other proven programs to reduce falls in older adults
- Tips on doing fall prevention exercises in people with Alzheimers or other dementias
Related Episodes:
052 – Maintaining Mobility & Preventing Falls in Aging: Myths & Truths
004 – What to Do if You’re Worried About Falls
Related Resources:
- Carolina Geriatric Education Center: Otago Resources
- Otago Implementation Guide (designed for use by physical therapists)
- Otago Exercise Guide (for older adults)
- Videos Demonstrating All Exercises Used in Otago
- How to do the 30 Second Chair Rise Test (to check is score is ok for age, see here)
- How to do the 4 Stage Balance Test
- Information on other fall prevention programs:
- Stepping On
- A Matter of Balance
- National Council on Aging (NCOA): Evidence-Based Fall Prevention Programs
- FallProof Program
- iStandFit (online program for Otago exercises)
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Liz Lutz says
I am 90 years old retired Registered Nurse and very active. I had a fall yesterday. Thank goodness I was not hurt. I have worn transition glasses for years and the glasses also transition to dark glasses when I go in the sun outside. Yesterday I walked from my car to where my son works. The glasses transitioned to dark when I left the car and were slow to transition back to light when I entered his building. I was going down two flights of stairs and did not see the second stair. OOPS That is when I fell. I am taking physical therapy for strength and balance and am constantly aware of my glasses. Maybe they need changing? Eyesight is so important for prevention of falls and this fact has not been mentioned by my Doctor, by my physical therapist or the agency caretaker for my husband. Hearing is also important! Who should advise seniors about this!
Nicole Didyk, MD says
I’m glad you weren’t injured in that fall, Liz!
Yes, vision and hearing impairments are risk factors for falls, and usually best assessed by optometrists and audiologists respectively. You might be interested in this article about hearing loss: Age-Related Hearing Loss (Presbycusis): What to Know & What to Do
Andie says
what about someone with vestibular neuritis and Cervicogenic dizziness? Hip is out of alignment so some leg exercises cannot be performed (leg out to side, etc). Thank you! Great info.
Nicole Didyk, MD says
Vestibular neuritis is caused by inflammation of the vestibular nerve, usually caused by a virus and usually temporary, but it can cause significant problems with balance. The symptoms can include vertigo, a spinning sensatin.
Cervicogenic dizziness is associated with some neck conditions like arthritis or injury to the cervical spine.
In both of those conditions, exercises of the neck and head might be helpful. Before starting a program, I would recommend checking in with your health provider to make sure all of the exercises are appropriate for you.
I’m glad you enjoyed the article!
Davida R says
Thanks for the podcast, it is very interesting. I’m currently mostly working with patients with multiple sclerosis, do you perhaps have any recommendations for preventing the risk of falls for these people as well?
Leslie Kernisan, MD MPH says
I don’t know much about preventing falls in multiple sclerosis (MS). Presumably the same core concepts apply, but there are also probably certain specific things to try that are likely to help.
I would recommend you search on Google and Pubmed. Here’s some of what turned up when I did:
Conference Explores Why Some People with MS Fall Down and How to Prevent It
Preventing Falls in MS: An International Approach
Linda Meneken PT says
Our local Fall Prevention Program is through Meals on Wheels and Senior Outreach Services, Walnut Creek, CA (925) 891-4761, mowsos.org.
Leslie Kernisan, MD MPH says
Great that you are part of a local Fall Prevention Program. Is the Otago program being offered by PT providers near you?
Jen says
I was just wondering about my client. She is blind and has fallen the first time and split her leg open. Then she fell backwards without realizing it. She has fallen again. How can I help her if she is blind?
Leslie Kernisan, MD MPH says
If she is having falls, then the first step is to get her evaluated to identify what’s causing the falls and what additional problems are increasing her risk for falls. I have links to resources on this topic in the related episode, What to Do If You’re Worried About Falls. Also see 8 Things to Have the Doctor Check After an Aging Person Falls.
Otherwise, if you are asking how to implement Otago if a person is blind, then I would recommend you try to get help from the client’s doctor and also from local physical therapists. There is probably a way to do the program with an older person who is blind, but you should work in person with experts to figure out a safe and effective way to move forward. Good luck!
Linda Meneken says
Yes, Dr. Kernisan, some physical therapists are teaching the Otago Exercise program (originating from New Zealand and endorsed by CDC). There is an online training program to become certified.