Falls among the elderly are prevalent, dangerous, and can diminish their ability to lead an active and independent life. About one in three seniors above age 65, and nearly one in two seniors over age 80, will fall at least once this year, many times with disastrous consequences. Physical therapists can help prevent falls with evaluation and development of individualized treatment plans including exercises to improve strength, mobility, and balance. 

Risk factors associated with falls:

1. Being older
2. Difficulty with balance or walking
3. Poor vision
4. Leg or trunk weakness
5. Pre-existing medical conditions, such as Parkinson disease, stroke, or diabetes
6. Being on more than four medications simultaneously
7. Use of an assistive walking device
8. A past history of falls

Maintaining Physical Activity

The most critical action seniors can take to help prevent falls is to maintain physical activity. Physical therapists recommend activities of any fitness level, including gardening, line dancing, and yoga to help improve balance and movement.

Test Your Balance

Balance may be improved with exercises that strengthen the ankle, knee, and hip muscles and with exercises that improve the function of the vestibular (balance) system. A simple assessment of your current balance can be done at home.

Do not attempt to do this test alone—make sure that you have someone next to you to
decrease the potential risk of falling.

Perform this test standing with a counter surface in front of you:

1. Stand tall, wearing flat, closed shoes, with your arms folded across your chest. Keep your eyes open, focus on an object in front of you, raise one leg, bending the knee about 45 degrees, and start a stopwatch. 
2. Remain on one leg, stopping the watch immediately if you uncross your arms, tilt sideways more than 45 degrees, move the leg you are standing on, or touch the raised leg to the floor.
3. Repeat this test with the other leg.
4. Repeat steps 1 – 3 above with your eyes closed.
5. Compare your performance with eyes closed to the norms for various ages: 20 to 49 years old (24 to 28 seconds); 50 to 59 years (21 seconds); 60 to 69 years (10 seconds); 70 to 79 years (4 seconds); 80 and older (most cannot do this test).

Once a physical therapist has reviewed a complete medical history and thoroughly examined you, he or she will design an individualized program of exercises and activities with an emphasis on strength, flexibility, and proper gait.

A personalized plan may include a walking regimen that includes balance components such as changes in surfaces/terrains, distance, and elevations; Tai Chi (which emphasizes balance, weight shifting, coordination, and postural training); and aquatics classes geared toward balance and coordination. The physical therapist also may teach specific strengthening and balance exercises that can be performed at home.

If necessary, the physical therapist will refer you to other medical professionals, such as an ophthalmologist or neurologist.

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This a reprint of an APTA Brochure on Balance and Falls. Physical therapists are health care professionals who diagnose and manage individuals of all ages who have medical problems or other health-related conditions that limit their abilities to move and perform functional activities in their daily lives. Physical therapists examine each individual and develop a plan of care using treatment techniques to promote the ability to move, reduce pain, restore function, and prevent disability. Physical therapists also work with individuals to prevent the loss of mobility by developing fitness-and wellness-oriented programs for healthier and more active lifestyles.

The American Physical Therapy Association (www.apta.org) is a national organization representing physical therapists, physical therapist assistants, and students nationwide. Its goal is to foster advancements in physical therapist education, practice, and research. Consumers can access physical therapy news and information at www.apta.org/consumer.