Why good balance matters as we age

Most people wake up in the morning, get out of bed and start their day without thinking about balance. It’s something we take for granted as we navigate around furniture or walk the family dog, but it’s much more complicated than you’d think. Good balance requires many body systems working cohesively to detect and understand the world around you. It involves your visual system, the vestibular system (inner ear), the central nervous system and an extensive network of position-sensing nerves (somatosensory system). And if all that wasn’t enough, even your muscles are pressed into action as you try to step over the dog without falling as you rush out the door in the morning. Age-related changes to any of these areas then can affect your balance and result in a devastating fall.

Physiotherapist Christa Rusk, a FallProof™ certified balance and mobility instructor who specializes in balance training for older adults, said we rely heavily on our sensory system to maintain good balance. A deterioration in visual acuity (crispness), depth perception and peripheral (side) vision can impact balance. As early as age 30 you start to lose the hair cell density in your inner ears that is responsible for sensing head movement. Age-related changes in reaction times, muscle strength and cognition can also affect balance. “Ten percent of adults over 65 and 50 percent of adults over 80 have some deficits in cognition. This affects balance as it makes it difficult for people to divide attention between tasks, i.e., stepping around an obstacle while having a conversation,” Christa explained. Even our sense of touch, how we feel pain and pressure, changes as we age. “There is a reduced ability to feel the contact between your feet and the ground.”

So is there a silver lining? The good news is that it’s never too late to improve your balance, even into your 90s. The even better news is that balance training can prevent up to 40% of falls. “There is growing evidence that we can slow down or even reverse some of these age-related changes,” Christa stated, “but to have an effect on falls, any given balance training program needs to have 50 percent of the exercises balance specific.” A recent study published in the online web edition of the British Medical Journal also supports this idea, finding that the most successful exercise programs for fall prevention emphasized balance training. Balance focused programs resulted in improved muscle strength, coordination, reaction time, gait (how a person walks) and overall physical conditioning including cognitive functions.

The type and duration of recommended balance exercises varies - where to start depends a lot on where you are. If you’re already physically active with no balance issues, try challenging different body systems with weight shifting exercises like dancing, racquet sports or even Tai Chi. To improve cognition, Christa recommends counting or playing a word game while exercising. If you’re a beginner with some mobility issues for example (you already use a walker or mobility aide), supervised, one on one training with a physiotherapist is a good, safe place to start. “It is ideal to seek advice from a certified healthcare professional. Physiotherapists are trained to assess and give advice; an assessment will tell you what part of balance you need to work on.” Most private health insurance policies will cover the cost of physiotherapy assessments and treatments up to a maximum amount.

The Winnipeg Regional Health Authority’s Staying on Your Feet program also has some home balance and strength exercises on their website. Here is a simple introduction to balance training:

1. Stand next to a sturdy counter for support and hold on.
2. Focus on a spot straight ahead and try to maintain good posture.
3. Lift your foot off the ground and hold it for 5 seconds.
4. Repeat with the other foot.
5. Do this 8 times on each leg.

Balance training must be done regularly to help reduce your risk of falls so talk to your doctor or physiotherapist and remember - it’s never too late to start! Christa Rusk runs her own mobile physiotherapy practice and can be found online by clicking this link. To find a physiotherapist near you, please visit the Manitoba Physiotherapy Association.

If you are concerned about falling, you may also want to consider a personal alert button with fall detection technology like Victoria Lifeline's HomeSafe with AutoAlert. For more information on how it can help you quickly access help in the event of a fall, please visit our AutoAlert page.

The information in this article is meant to be informational in nature. Please consult a trained healthcare professional before starting any exercise program.

Krystal Stokes is the communications manager with Victoria Lifeline, a community service of the Victoria General Hospital Foundation.

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