Balance is essential for carrying out everyday activities such as walking, getting out of chairs, bending down to put on shoes and shopping for groceries. Older adults who have impaired balance are at great risk of falling.
A quarter of falls among older adults are caused by poor balance and changes in walking style. However, older adults can maintain and even regain their strength, balance and mobility by staying active and healthy.
How can I assist older adults to build their balance?
Older adults can build their balance by regularly practicing balance exercises. During these exercises, the individual’s centre of gravity is constantly moving, forcing them to engage muscles to stabilise themselves.
The most effective falls prevention exercises consist of challenging and progressive balance and strength exercises intended to slowly improve balance over time. It is important to assess an older adult’s current capabilities before prescribing a balance exercise program. This assessment can help to identify the most suitable exercises, and can be used to measure improvements in balance over time.
- Timed up and go (tug test)
- The 4-stage balance test
- The 30-second chair stand test
How to challenge balance safely
In order to improve balance, an exercise program needs to be challenging yet safe. To ensure that the exercises pose a sufficient challenge to the individual’s balance, the program should include:
- Exercise in a standing position
- Minimal upper limb support (minimise the use of rails or chairs for support while exercising; however it is useful for older people to exercise near supportive objectives so they can steady themselves when necessary)
- A minimal base of support (i.e. exercise that involves standing or walking with the feet close together or standing on one leg)
- Controlled movements of the body’s centre of mass, such as stepping, reaching or dancing
Exercises that challenge an older adult’s balance have the potential to cause a fall. To reduce this risk, only prescribe exercises suitable for the individual’s capabilities, ensure exercises are set up in a safe way (e.g. next to a wall or counter for support), and supervise exercises if necessary. These recommendations are particularly important if the older adult is frail.
Tai Chi is a safe and effective balance exercise that older adults can do to reduce their risk of falls. Tai Chi can help to improve balance, flexibility, muscle strength and postural alignment. There are various forms of Tai Chi so it is important to choose a form which is suited to your older person.
What does the evidence say?
Group-based Tai Chi was shown to significantly reduce falls in a trial of people aged 70 years and over.
A program of Tai Chi classes for one hour per week for 16 weeks was also effective in reducing falls by 33% at six months in older people aged between 60 and 96 years.
A six month Tai Chi program consisting of three sessions per week was effective in decreasing incidence of falls, falls risk and fear of falling in physically inactive individuals aged 70 years and older. It also improved functional balance and physical performance in the target group.
Tai Chi can also significantly reduce the fear of falling in transitionally frail older adults.