FALLS IN THE ELDERLY CONTINUE TO RISE. IT IS DEVASTATING. The implications of falls have long been brought to light by researchers and statisticians alike. The economic impact upon the government is staggering.
Every 11 seconds, an older adult is treated in the emergency room for a fall; every 19 minutes, an older adult dies from a fall.
Falls are the leading cause of fatal injury and the most common cause of nonfatal trauma-related hospital admissions among older adults.
Falls result in more than 2.8 million injuries treated in emergency departments annually, including over 800,000 hospitalizations and more than 27,000 deaths.
The enormity of the problem has prompted diverse programs involving over 70 national organizations involved in Fall prevention, The Falls Free National Action Plan by the NCOA.
The plan includes action steps of reducing the impact of medications as a risk factor, promoting physical mobility, and improving home safety. Fall risk assessment and screenings, promoting evidence-based programs also is a major component of this national initiative.
More Fall Prevention Programs have surfaced and a majority of these promote exercise programs designed to reduce falls in the elderly. Tai Chi has been widely recognized as an effective exercise program for fall prevention.
Tai Chi Principles for Falls Prevention in Older People
The following notes are suggestions for incorporation into a Tai Chi program specifically targeting fall prevention in older people.
The key element in preventing a fall. Balance has been shown to decrease with age; however, some aspects of balance can be enhanced through training.
Key elements to incorporate into a Tai Chi program:
> relaxes muscles > lowers the center of gravity Lowered center of gravity > increases load on lower limbs > over time increases sensation and awareness of lower limb movement.
• Transfer of Weight:
Shifting body weight from leg to leg through incremental movements. Start with a small range of movement and gradually build up to a wide, square base stance.
• Muscle strength
Muscle bulk and therefore strength decrease with age. A bent-knee stance and movement work to strengthen lower limb muscle (particularly the quadriceps muscles) (however, always work to an individual’s limitations. If a bent knee stance is too difficult, then do the movement without bent knees).
This involves issues such as increased body sway, low mobility, and postural instability. Increasing age is also associated with reduced sensation in lower limbs and is consequently associated with a loss of righting reflexes and an increase in body sway, which can lead to falls.
Decreased stepping height and decreased stride length. Women tend to have a narrow walking and standing base, closer foot placement, erect posture > difficulty stepping down from stools/benches. Men tend to have a small-stepped gait, wider walking and standing base, and stooped posture.
Tai Chi addresses gait problems by teaching the “correct” movement of lower limbs. This is done by lifting lower limbs from the knee rather than the foot; lifting lower limbs without misaligning the pelvis, and teaching to place heel down first when moving forward (toes first when moving back). Also, teaching movement with appropriate weight transfer, posture, and slightly bent knees improves stride length
Tai Chi also teaches participants to maintain a relaxed posture with an elongated spine.
Tai Chi consists of moving from one stance to another in a slow, coordinated, and smooth way. This trains students in improved mobility and increased body awareness.