Falls are the leading cause of injuries among older adults. To understand how or why falls occur, it is important to be aware of the fall risk factors. Fall risk factors include muscle weakness, poor balance and gait, certain medications, environmental hazards, and the fear of falling itself. Fall prevention programs aim to create an awareness about these risk factors, implement training regimens to combat and prevent these risks, and thus reduce the falling rates among older adults. The study, “Community Fall Prevention Programs: Comparing Three InSTEP Models by Level of Intensity” in the Journal of Aging and Physical Activity, tested the effectiveness of such models in reducing falling rates.
The study involved comparing three progressive-intensity fall prevention program InSTEP (Increasing Stability Through Evaluation and Practice) models which differed in the intensity level (High, Medium and Low). Each model was implemented as a 12-week program to small class sizes of about 12-15 participants aged 65 or older. All three InSTEP models contained a physical activity, a home modification, and a fall risk assessment/medical management component. To assess fall risk factors, physical performance tests such as the Fullerton Advanced Balance Scale and components of the Rikli Jones Senior Fitness Test were conducted. Administered questionnaires, home safety evaluations, and fall diaries were utilized as well. The results showed that overall, fall rates were reduced, self-perception of gait and balance improved, and dynamic functional ability improved as well. The Medium-Intensity Model, which consisted of a group balance, strength and flexibility program taught by an exercise professional (for 60 minutes, twice a week, for 12 weeks), an in home assessment by a social worker, as well as a fall risk screening by a social worker, showed a significant reduction in self-reported falls compared to the other two models (high and low intensity). The findings suggest that a more sustained moderate-to-high level physical activity component would be the most beneficial. Overall, the InSTEP models were successful in reducing fall rates in older adults.
Fall prevention methods are crucial to the well-being and health of older adults. As seen in the study, a physical component that focuses on balance, strength, gait and flexibility is extremely helpful in preventing falls. Ways that older adults can improve on these modes of fitness include participating in fitness classes such as tai-chi, chair seated yoga or beginner/intermediate yoga, and strength training, all of which are common in senior centers. The study also showed that home modification is very important in preventing falls by eliminating certain risks. Options to create a safe home environment include installing grab bars, using bathroom transfer benches or chairs, removing throw rugs, and improving lighting. Fall risk screening to identify health problems that could result in falls such as arthritis and hypertension is also a key component to preventing falls. The combination of a physical component, home modification and fall risk screening is vital to preventing and reducing falls in older adults.
References
Kramer, B. J., Creekmur, B., Mitchell, M. N., Rose, D. J., Pynoos, J., & Rubenstein, L. Z. (2014). Community Fall Prevention Programs: Comparing Three InSTEP Models by Level of Intensity. Journal of Aging and Physical Activity, 22(3), 372-379. doi:10.1123/japa.22.3.372
http://journals.humankinetics.com/doi/abs/10.1123/JAPA.2012-0344