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Avoid a Bad Fall By Exercising to Improve Your Balance

Before she enrolled in the nine-week study to see if Iyengar yoga could prevent falls by improving stability and balance, Maryann Brown wasn’t sure she’d do it for long.  “I went kicking and screaming,” says the 65-year-old retired schoolteacher and West Philadelphia native.

But Brown stuck with the program run by researchers at the Temple University Gait Study Center. “During one session, I heard a ‘pop’ and thought I’ll never get off the floor,” Brown says. But she did, and she walked better and felt better than she had in years.

More than one-third of adults age 65 and older fall at least once each year. Falls are the most common cause of nonfatal injuries and hospital admissions for trauma among adults over 65. A study released in March by the federal Centers for Disease Control and Prevention reported that in just a three-month period in 2006, nearly 16 percent of all Americans over 65 fell at least once. Close to one-third of them—1.8 million people—sustained an injury so serious that they visited a doctor or had to restrict their activities for at least a day.  “We learned from this survey just how wide-spread falls are,” says Judy Stevens, an epidemiologist with the CDC’s Injury Center. “This is a huge public health issue.”     

Falls are costly in both pain and money.  Most fractures among older adults are caused by falls, with hip fractures being the most frequent bone break, and among the most costly to treat. The CDC estimates that by 2020, falls may cost the nation $43.8 billion in direct and indirect costs. Falls are also deadly. Every 35 minutes an older American dies as the result of a fall.  The deaths of former Washington Post owner Katharine Graham, newscaster David Brinkley and diet doctor Robert Atkins resulted from traumatic brain and head injuries precipitated by falls.

While the focus of fall prevention has been mainly directed toward people over 65, falls are also increasing among baby boomers, says Stevens. “Inactivity is a major risk for falling, and if you’re inactive when you’re younger and carry that into your older years, you’re increasing that risk,” she says.

One key to reducing the risk of serious falls is exercise. “Several studies show that exercise and activity, specifically those that help in strengthening, flexibility and balance, can make a significant difference in minimizing one’s chance of falling,” says Jennie Chin Hansen, president of AARP, which has made fall prevention a priority in its efforts to promote healthy behaviors. “The great news is that we all can do this at virtually no or very low cost, on our own or with our friends.”

In the Temple University yoga study, Jinsup Song, the principal investigator and director of the Gait Study Center, says that for most participants, “measurable changes occurred. The subjects stood taller, walked faster and their balance improved.”  He also found the program eased back and knee pain for some. Song is planning a larger project to evaluate Iyengar yoga’s effect on the function of the foot and its relation to falls prevention.

After experiencing a series of ministrokes, Gus Bodin, a retired telephone company worker from Guilford, Conn., was unsteady on his feet. Still active, the 77-year-old wanted to live without fear of falling. Bodin learned about a program called ActiveStep, a computer-controlled treadmill with a support harness. “With ActiveStep, we can challenge a person’s balance and they can experience what it feels like to fall without actually hitting the ground,” says Jamie Fitzgibbons, director of inpatient rehabilitation at Masonic Healthcare in Wallingford, Conn.  “Then we can educate patients in how to prevent falls,” she says.  It worked for Bodin. “Now, I know how to regain my balance, and have less fear of falling in real-life situations,” he says.

 But high-tech programs like ActiveStep may not be available to all older adults.  “These tools are valuable in clinical settings serving individual patients, but less useful for community-wide programming,” says Debra Rose, co-director of the Center for Successful Aging at the California State University at Fullerton. Rose developed a community-based fall prevention exercise program called Fallproof. Cal State Fullerton trains and certifies Fallproof instructors, who in turn offer the program at senior centers and residential care facilities throughout Southern California.

In April President Bush signed the Safety of Seniors (SOS) Act, a bill to raise awareness of falls and support projects to prevent them.  “The SOS Act is a critical first step in reducing the life-altering and sometimes fatal consequences of falls,” says Howard Bedlin, vice president for public policy and advocacy at the National Council on Aging. The next step, he says, is to urge Congress to fund fall prevention activities.

For some people, such programs can be life-changing. Just ask Maryann Brown. She is hooked on Iyengar yoga now, and spends up to six hours a week practicing it. “I love what it does for me. It has made a huge difference,” says Brown, who had falls before she started the session but doesn’t any more. “I feel stronger, more confident. It has made a huge difference.”

Where to find more information and tips on preventing falls:

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