Systematic reviews show that older people who exercise have 21% fewer falls than controls – and in some clinical groups exercise programmes can halve fall rates.
In a seminar on bone health and fall prevention, Catherine Sherrington from the University of Sydney, Australia, said that falls in older people are common – around one in three community dwellers over 65 fall each year.
They result from an interaction of physiological, behavioural and environmental factors, she said. Exercise has a clear impact on preventing falls. But it is not clear that, as a single intervention, exercise can prevent falls in settings such as care homes, where environmental factors might be more important.
An update of systematic reviews in 2016 indicated that exercise programmes challenging balance, and involving more than three hours of exercise a week, work best. But getting older people to take part in exercise can be a problem, said Catherine Sherrington, who is Professorial Research Fellow at the George Institute for Global Health.
“We wanted to understand what factors affect participation in exercise programmes,” she said. “Themes identified as important include social influences and interaction with peers, physical limitations, competing priorities, access difficulties – both environmental and financial – and motivations and beliefs.”
Jennifer Bottomley from the United States, who is currently President of the International Association of Physical Therapists working with Older People, emphasised that fall prevention involves managing frailty as a long-term condition. However, fraility is not routinely identified and physical therapists have a role in improving its profile.
To keep people in their own homes, physiotherapists need to make sure they maximise functional capabilities, and that their homes are safe.
Attending to posture, joint mobility and functional activities are all important, she said.
“There are remarkable benefits from exercise in all conditions contributing to long-term fraility,” she said. “And if anyone asks you how much activity is needed, anything above rest works.”
Source: World Confederation for Physical Therapy July 2017