Sunday, July 31 2016 11:09

Taking Steps Toward Better Balance

Written by Amy Spiegel, Physical Therapist, Bryn Mawr Hospital

As we age, it’s not uncommon to experience some loss of agility or to find we’re not as graceful as we once were. Balance issues are an increasingly common problem for seniors. In fact, the Centers for Disease Control and Prevention report that every 13 seconds an older adult is treated in the emergency room for a fall. Quite simply, falling is one of the most serious medical problems facing older people.

Many individuals are quick to blame these balance issues on deteriorating joint health or changes in posture, and it’s true that after we hit 30, the muscles we use to stand weaken, the length of our stride shortens, and the pace of our steps slows. Yet, these problems aren’t the only factors at play.

What Causes Poor Balance?

Reduced hearing and vision loss can also affect your risk of losing your balance and falling. Many body systems—muscles, bones, joints, vision, the balance organ in the inner ear, nerves, heart and blood vessels—must work normally for good balance. Medical issues, such as arthritis, both high and low blood pressure, numbness in feet and legs (neuropathy), diseases of the nervous system (multiple sclerosis, Parkinson’s and Alzheimer disease) and certain medications can also affect balance.

Balance issues affect most seniors, and these issues range in severity. Some people say balance problems don’t affect their life as much as they affect others, yet balance disorders are the number one health complaint of patients over 70, with one in three adults over 65 taking a serious fall each year.

Sadly, too many of those who fall will fracture a hip—a serious, life-threatening injury that generally requires surgery or hip replacement and months of physical therapy. The statistics for women are sobering: About 20% who fracture a hip become permanently disabled and another 20% die within a year. Health problems linked to hip fractures result in more deaths for women than breast cancer.

What Can You Do?

One of the best things you can do to avoid injury is to take charge of the physical and environmental factors that can cause problems with your balance.

Environmental Changes for Better Balance

Anyone can slip and fall on a stray rug, trip over a small step, or take a dive on a slippery surface. But these types of environmental hazards are more likely to cause long-lasting injuries when they happen to seniors.

Because so many falls occur in the home, it’s important to take steps to prepare your living area to prevent hazards. You can help prevent injuries by addressing potential fall risks in your home.

Install bright indoor and outdoor lights in high-traffic areas and sensor lights in driveways and walkways.
Carry a flashlight when you walk after dark.
Make sure indoor pathways are clear by removing clutter and moving furniture towards the walls and out of walkways.
Remove throw rugs and secure carpet runners with non-skid tape.
Install banisters and handrails on stairs and grab bars and non-skid mats in tubs and showers.
Wear sturdy shoes with adequate support.

Physical Changes for Better Balance

In addition to making changes to your home, you should also take steps that will benefit your physical health and, in turn, your balance. Exercise is one of the best things you can do for your body and overall health, and that includes your balance. Individuals who exercise daily experience benefits including improved leg strength, endurance and flexibility plus reduced muscle atrophy.

But before you begin a new workout routine, check with your health care provider. If it’s your first time exercising in a few years, or you need an adapted exercise program, your health care provider may recommend a physical therapist to help.

Almost any activity that involves standing and moving helps you maintain good balance. One of the best and easiest ways to improve balance is by walking. Research has found that certain exercise programs can also improve your balance, including tai chi, dance, yoga, gait training (programs to improve how you walk) and strength and resistance exercises.

Here are a few exercises to help improve your balance:

Leg Raises: Stand straight, with legs together. Hold onto a counter or wall. Keep your knee straight and kick your leg slowly to the front. Bring it back to the center. Repeat, but kick it to the side, then bring it back to the center. Repeat, but kick behind you. Repeat all three directions 20 times on each leg. Repeat daily.

Single Limb Stance: Stand near a counter or wall. Let your hands hang next to you, but keep them close to the counter or wall. Lift your left leg, and balance on your right leg for 10 seconds. Switch, and balance on the other leg. Repeat 5 times on each leg. Repeat daily.

Eyes Closed Stances: Stand near a counter or wall. Start with feet together. Stand with eyes open for 10–30 seconds, then eyes closed for 10–30 seconds. Repeat with feet semi-tandem (one slightly ahead of the other); eyes open, then closed. Then repeat with feet heel to toe; eyes open, then closed. Repeat each position 3 times. Repeat daily.

Take More Steps

If you’re concerned about poor balance and your risk of falling, there are many options available to help you take control. I encourage patients to take advantage of balance assessments offered by physical therapists and the resources available in their communities. Senior centers, libraries, hospitals, health centers and insurance companies usually offer fitness memberships and classes at reduced rates for seniors.

It’s never too late to take a first step to improve your balance and your health! 

Balance Tests

From the editor:Think you’ve got great balance? We were so intrigued by this topic that we searched for some quick tests to see how good your balance is. Can you pass these four tests?

Feet Together: Set a timer with seconds or get someone to time you. Stand with feet together, arms crossed in front of you, eyes closed. Can you stand for 60 seconds without moving your feet? It’s OK to sway, but no moving your feet.
Heel to Toe: Set a timer or find a helper. Stand with one foot in front of the other, eyes closed. Can you stand for 38 seconds? What if you put the other foot in front?
One Foot: Stand on one foot, other leg bent and not touching the supporting leg (no yoga tree pose). Can you stand for 29 seconds? Those 60 and under can; it’s 22 seconds for those older. Now assume the same position and close your eyes. You may want to stand near some support. Averages are 21 seconds for those 60 and under and 10 seconds for 61 and up.
Ball of the Foot: Hands on hips, stand on one foot, other foot on inside of knee of supporting leg (now it’s time for that tree pose). Raise your heel and stand on the ball of your foot. Can you stand for 25 seconds? Then you’ve got great balance or take lots of yoga classes!

Want another challenge? Try the sitting-rising test on YouTube. Google it.

Calculate your balance-age here

Amy Spiegel, PT, MSPT, DPT, is a physical therapist with clinical strengths in joint mobilization, postural training, ergonomic training and vestibular training, at Bryn Mawr Hospital, part of Main Line Health. Now with 17 years of outpatient physical therapy experience, she completed her Masters of physical therapy at University of Delaware and her Doctorate at Widener University.