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April 3, 2005
Fall prevention in the elderly

I have seen many elderly folks in the office in the past few weeks, some of them getting around with canes, others with walkers, and then the lucky few who could still rely on their own two feet alone.  Some of them have fallen in the past and are very concerned about doing it again.  My grandmother always says, once you break a hip it's all down hill from there.  While that's not entirely true, many elderly people don't recover completely from fall injuries.  The other day my preceptor was explaining to a patient a few exercises she could do to improve her balance and decrease her risk of falling.  So, I was wondering, what's the evidence behind this?

 
One randomized, controlled study had the intervention group do weight-bearing group exercises and the control group did flexibility and relaxation exercises over a 12 month period.  There were 22% fewer falls in the intervention group.  The weight-bearing group exercise included "aerobic exercises, specific strengthening exercises, and activities for balance, hand-eye and foot-eye coordination, and flexibility".  For more details of the exercises you can link to the full text article if you are on the intranet.  I also looked at a review article, which found that the most effective way to prevent falls was with a multifactorial risk assessment and management program.

Posted At : 11:35 AM. | Link | Rotation 4 04-05 | Comments (6)

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I saw an elderly patient who was unsteady on his feet and my preceptor showed him some excercises to do and even told him to get back on his excercise bike at home. I think I tend to underestimate the need to discuss excercise in elderly people who look frail.

Posted By Kelly-Ann Looby / Posted At 4/3/05 8:46 PM

This just furthers the fact that almost everyone can directly benefit from exercise. It seems as though exercise and weight are the cures for just about everything

Posted By George Hoeft / Posted At 4/3/05 10:01 PM

Yet more evidence that shows the benefits of physical exercise (CV, weight-bearing, etc.) no matter what the age of the patient. I agree with Kelly-Ann's last statement; I definitely have not discussed exercise enough with my elderly patients, something I'll be sure to improve on.

Posted By Sean Orenstein / Posted At 4/4/05 4:51 PM

I agree with the above. The study said they offered classes for 12 months. I wonder how frequently and how long the classes were, if I wanted to start something like this in the future in podunk town Minnesota, don'yah know.

Posted By Ryan Lussenden / Posted At 4/4/05 6:34 PM

I have also seen many elderly patients in the office, many of whom have already falling and hurt themselves or who are at increased risk of doing so. Advising them of these exercise and activity techniques would be very beneficial in improving their quality of life and preventing future morbidity secondary to falls

Posted By Emeka U. Onyedika / Posted At 4/4/05 7:06 PM

I read something recently that states that over half the people that break a hip die within two years from complications. I was shocked, but I can't remember where I read that. If anyone knows, let me know!

Posted By Jennifer Morris / Posted At 4/8/05 1:50 PM