Thursday, 13 December 2012

Posture and Falls in the Elderly

In my last blog, I discussed the importance of ankle rehabilitation and continued mobility in maintaining balance, especially in the elderly population. I also briefly mentioned how poor posture in the elderly can often contribute to the high prevalence of falls. Here, I will discuss this in more detail.

As I mentioned previously, a common trait in the elderly is their shuffled walking pattern and stooped posture, both significant contributing factors to the high incidence of falls in older adults.

Many factors play a role in contributing to the stooped posture seen in the elderly:
·         Reduced eyesight, causing people to look down at their feet to see where they are going
·         Weakened abdominal muscles
·         Weakened upper back and neck muscles
·         Limited arm swing
·         Shuffled walking due to reduced hip flexion, poor balance and limited ankle flexibility and stability – discussed previously

Poor eyesight will not be dealt with here, but it is important to remember that even if you see a step and it is right in front of you, chances are it will be too late for you to correct your step before tripping. Rather keep your head up, and focus your eyes about 3 metres ahead of you on the ground. This way, you simply have to drop your eyes slightly and you have time to step appropriately before tripping over any uneven surface ahead of you.

Abdominal strengthening exercises should be done regularly in order to maintain core strength, as this keeps one’s posture upright. When you walk, pull you navel in towards your spine, keep your hips underneath your shoulders and walk with long strides, striking the ground with the heel first. Pretend you have a piece of string attached to the top of your head that is gently pulling you up as you walk.

It is very important to maintain strength of the upper back and neck muscles because it is weakness in these muscles that causes the head to drop and the typical stoop to develop. This causes one’s centre of gravity to shift forward, contributing to falls. In order to prevent this, one must keep looking straight ahead and keep the chin tucked in by gently pulling the head back. The upper back muscles can be strengthened by squeezing the shoulder blades together and releasing 10 times and then holding the squeeze for 10 counts at a time. This can be done while waiting in a queue or watching TV.

Finally, arm swing must be maintained to keep balance and a good stride length. As soon as one’s upper body stiffens, the rest of the body does as well, resulting in a shuffle.  

So, remember: walk tall, look ahead, keep the shoulders back, swing the arms, lift the knees and feet, and strike the ground with your heel first! J

Merry Christmas and may you all have a happy and healthy 2013! J

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