Balance is essential for carrying out everyday activities such as walking, getting out of a chair, bending down to put on shoes and shopping for groceries. If an older adult has impaired balance, they are at greater risk of falling.
Whilst one quarter of falls among older people are caused by poor balance and changes in their walking style, older people 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?
Building an older adults’ balance can be achieved through regular balance exercises. During balance exercises a person’s centre of gravity is constantly moving and they need 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. Before prescribing an older adult a balance exercise program, it is important to assess their current capabilities. This assessment can be used to prescribe the most suitable exercises. It can also 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
To improve balance, an exercise program needs to be challenging yet safe. To ensure a sufficient challenge to the individuals balance, the program should aim to 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 closer together or standing on one leg); and
- 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 to the older adult’s capabilities, ensure exercises are set up in a safe way (such as next to a wall or counter for support as required) and that exercises are supervised if necessary. This is particularly important if the older adult is frail.
Tai Chi is a safe and effective balance exercise that older adults can do to reduce falls. The benefits of Tai Chi include improvements in balance, flexibility, muscle strength and postural alignment. There are various forms of Tai Chi so it is important to choose an appropriate form suitable to your older person.
Training: Would you like to deliver a Tai Chi program to older adults living in the community? Click here to view our upcoming Tai Chi training opportunities.
What does the evidence say?
Group-based Tai Chi has been 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 the number of falls, the risk for falling, fear of falling and also improved functional balance and physical performance in physically inactive persons aged 70 years and older.
Tai Chi can also significantly reduce the fear of falling in transitionally frail older adults.