Have you fallen lately?? . 
Falls are becoming an epidemic with individuals over 65 years.

The financial toll for older adult falls is expected to increase as the population over 65 increases  55% by 2030.

Every 11 seconds a person arrives at an emergency room because of a fall . By 2030 72 million of americans will fall.

20 -30% of indivuals falling never get back to previous activities.

One out of 4 persons over age of 65 will suffer a fall this year.  Risk of a fall increases every year after age 65. 

FALL PREVENTION EXERCISE PROGRAM

“SIT LESS..MOVE MORE”  “Activate the Cerebellum:Improve Balance & Reduce Falls Utilizing Pilates  Concepts/Techniques”.

 Edward Yuiska, PT, Sports Physical Therapist conducts the program.  

 Weekly Exercise Class held @ LaHacienda Rec. Center  on Mondays @10:00 am to 11:00 am

“ Learn to improve balance, strengthen your body and improve your lifestyle utilizing Pilates core stabilization/proper posture. Learn how  Better Balance activities can become part of your daily  activities. 

Learn how to fall and get back up.  Also, strengthening  hip and ankle musculature utilizing therapeutic theraband.

A tree needs a strong trunk or core, to survive “bad weather”.So does the body need a strong core to survive “bad weather”.Pilates believed that in order to achieve happiness, it was imperative to master your own body.

No flip flops, participants need one small ball (tennis ball size) plus therapeutic theraband.

 To reduce falls… SIT LESS and MOVE MORE!!! 

 Along with:

1.  Maintaining Pilates (proper) posture throughout the day.

2.  Consistently stimulating the Cerebellum which controls walking, posture, balance, coordination, motor learning.

3.  Increase strength of core and lower extremity musculature.

Test your risk of a fall.

Evidence shows as individuals age their balance diminishes, depending on their activity level.Practicing balance activities daily while maintaining lower extremity strength reduces the risk of falls. Practice 3-5 better balance activities for 3-5 minutes each. Alternating  better balance activities daily. 

Maintain Pilates Posture stand erect, by elongating the spine, keep the head on the shoulders, not the chest. pull belly button upwards to the spine pulling pelvis up and level) Think of the pelvis as a bucket, keeping it level. Breathe out maintaining the level pelvis. 

1. Single leg stance 30 Seconds

Stand on one leg , other leg not touching static leg. Hold the position,  maintaining  the posture. No body swaying, etc. When toe touches other leg or floor time ends.  Alternative method:  stand on one leg for 30 seconds.  Record each time one needs to touch chair to regain balance.

As the number decreases , it is an indication balance is improving.

IF unable to maintain minimum 10-15  seconds, it indicates  increased risk of falling evident. 

single leg stance

 Age:        50 – 59  60 – 69    70 -79   80 – 89     90 – 94

  Sex          M –  F       M –  F       M –  F      M –  F        M –  F

Seconds     41   40      33  30       25  23     15  10       10   6

2. One Foot in front heel/toe touching Test

Brace chair against wall. Place one foot in front with heel and toe touching               

GOAL: Maintain balance for 30 seconds. Repeat with opposite foot. Keep track of  number of touches. As the number decreases , it is an indication balance is improving.

3.  Sit to Stand Test 30 Seconds

Brace chair against wall.  Sit in middle of chair  with feet flat and arms crossed.On “go” rise to full stand then return to seat continue for 30 seconds Scoring:  Number of total full stands.

 

      

Age    60-64   65-69     70-74    75-79     80- 84    85-89     90-94

Sex    M – F     M – F     M – F     M – F     M –  F      M – F      M – F

Reps 23  21   23  19     21 19     21  19       19  18     17  16      16  16

Excellent exercise for strengthening trunk and lower extremities by doing on a daily basis until able to match the reps above.

Improving Balance W/ Pilates Core Stabilization 

Control the Core!!! The keystone to a better lifestyle.

The concept of lengthening and strengthening muscles was initiated by Joseph Pilates, who died in 1967.   He based this technique on extremely sound principles.  He devised his unique conditioning program after looking at various forms of yoga,ballet and martial arts.  The method lengthens muscles while strengthening them, stabilizing the lumbar spine and pelvis along with controlled breathing, facilitates deep abdominal contraction.  All energy for the Pilates exercises flows outward to the extremities.

The core muscles are a large group of muscles in our center, encompassing the abdomen, lower back, hips and buttocks.  These muscles stabilize the spine,pelvis and shoulders and provide a solid foundation for movement  in the extremities.  These muscles help control movements,transfer energy, shift body weight  and move in any direction.

A strong core distributes the stresses of weight bearing and protects the back. .

Stabilize the Core Muscles

Abdominals get all the credit for protecting the back and being the foundation of strength, but they are only a small part of what makes up the core.  In fact, it is weak and unbalanced core muscles that are linked to low back pain.  Weak core muscles result in a loss of the appropriate lumbar curve and a swayback posture. Stronger, balanced core muscles help maintain appropriate posture and reduce strain on the spine.

Core Muscles Improve Balance

Because the muscles of the trunk and torso stabilize the spine from the pelvis to the neck and shoulders, they allow the transfer of powerful movements of the arms and legs.  All powerful movement originates from the center of the body out, not from the limbs alone. Before any powerful rapid muscle contractions can occur in the limbs, the spine must be solid and stable and the more stable the core, the more powerful the extremities can connect.

Training the muscles of the core also corrects postural imbalances that can lead to injuries. The biggest benefit of core training is to develop functional fitness – that is fitness that is essential to both daily living and regular activities.To facilitate an active core contraction:

CONTROL YOUR CORE….The Keystone to a Better Lifestyle!!!!

To initiate core stabilization:

Sitting in a chair: sit to stand test

Push the low back against the back of the chair.

Inhale to prepare. Blow out and pull the belly button up and back, pushing the back against the chair, (think of pelvis as a bucket, getting it level) elongate the spine ,pull head back on shoulders and sit up straight. Inhale to relax and repeat.

Standing up:

  1. Inhale to prepare

2.   Stand up straight keep the head on the shoulders, not the chest.

3.  Blow out forcefully, like blowing out a candle at the same time pull the pubic bone to the ribs and drive the belly button inward towards the spine, pause and breath in slowly.

4.  Repeat every 5 seconds

5..Visualize your pelvis is a bucket of water, pull up on the bucket and keep it level.

6..Repeat through out the day with daily activities including recreational.

7.  As the core muscles become stronger less effort is required to “keep your bucket level”

       

                                                                                     

What is the Better Balance System?

It is a series of important exercise activities designed to give you the tools to practice fall prevention in the comfort of your own home and at your pace.  By routinely performing the Better Balance System you will benefit: Complete 3-5 activities daily for 3-5 minutes. Vary the activities daily throughout the week.

1. Exercising In Bed Improves:

 Flexibility and mobility by warming your muscles and ligaments
Better physical fitness overall.

Increased ability to walk safely.

Increased mental and physical relaxation.

Reduced tightening of muscles and leg cramps.

Reduced soreness of muscles.

Reduced chances of injuring joints, muscles or tendons.

EXERCISES LYING DOWN IN BED, HOLD STRETCH 15-30 seconds.  

  1.  STRETCH arms out  overhead/legs straight out and raise few inches.Do hand flexion/extension/ ankle dorsi/plantar flexion, circles 5 reps each direction.
  2. STRETCH: bend both knees with feet flat on bed.  Rock legs to side with knees touching bed.Hold 15 seconds Repeat 2-3 reps
  3. STRETCH: Bring bent knee to chest with hands behind knee.  Straighten knee stretching hamstrings, pull ankle towards knee/pushing ankle away stretching heel cord Hold 15 sec. repeat 2-3 reps.
Hip abd stretch

Cross left leg over right leg with left knee flexed. Apply pressure with right hand on knee to feel stretch in left hip. Hold 30 seconds.  Repeat with opposite leg.  Complete 2-3 times

 

 

Prone on hands/knees for DOG/CAT STRETCH. Breathing out / push belly button towards spine and elevate back( like a cat getting ready to attack). Hold 5 seconds. Breathing in and drop pelvis down create sway back. Hold 5 seconds.  Repeat 5 times. Avoid increased pain in low back.

 

 Child’s yoga pose

Prone on hands/knees.  Bend forward/ extending the arms. Sit back on heels seeping arms out straight. Hold for 30 seconds. Breathing in and out every 5 seconds, tightening core muscles when breathing out.
 

 

 

hamstring/gastroc stretchHamstring Stretch: hang right leg over edge of bed.  Extend left leg  reaching forward grasp foot with both hands. Try to get left leg flat on bed.  If unable still stretch for 30 seconds. Repeat with right leg by turning around and dropping left leg over edge of bed . Repeat 2-3 times

 

CoreStrengtheningExercises

Begin in the plank position with forearms toes on the table/floor. Keep torso straight and rigid, body in a straight line from ears to toes, no sagging or bending. head relaxed. Pull the belly button to your spine as you breathe in & out. Hold this position 10 sec Repeat 3 reps. Every 2 weeks increase 5 sec until doing 30 or 45 sec then repeat 1 rep. Add variations of the regular Plank. Plank with alternating leg lift. PlankW/ alternating arm lift.

                  

Lie on side, shoulder over elbow, and toes on table/floor lift both legs up. Keep torso straight and rigid, body in a straight line from ears to toes, no sagging or bending with head relaxed. Pull the belly button to your spine as you breathe in & out. Hold this position10 sec. Repeat 3 reps. Every 2 weeks increase 5 sec, until doing 30 or 45 sec then repeat 1 rep.

2.Balance Exercises  (Refer to article”Make New Balance Exercises a Part of Your Daily Activities)

Achieve better posture, increase leg strength, improve confidence and stabilize your body through a series of Balance Activities.

Keeping one’s balance is a complex process.

It involves the use of many of the body’s mental and physical attributes.

To balance safely, one must rely on a constant flow of information to and from the brain about how the body is positioned.

                                 

 

 

 

Always have a chair or counter close by in case you lose your balance.  Always wear shoes.

Level 1 face chair or counter. One or two fingers touching the chair. touch the toes forward on the ground or floor. Touch  the toes backward on the ground or floor.  Touch toes across the body on floor or ground.  Touch toes out to the side of the body Bring foot to resting foot.  Repeat with other foot.  Alternate 3-5 times. If able to complete the 4 different exercise movements  5 times  3-5 days in a row without balance loss progress to next level.

Level 2 Same as level 1 touching chair .  Point toe to the floor.  Do not touch the floor.  Complete all 4 positions.Repeat with other foot.  Alternate 3-5 times. If able to complete the 4 different exercise movements  5 times 3-5 days in a row without balance loss progress to next level.

Level 3 Sam as level 2 , do not touch the chair.Repeat with other foot.  Alternate 3-5 times. If able to complete the 4 different exercise movements  5 times 3-5 days in a row  without balance loss progress to next level.

Level 4 Same as level 2 and hold for 5-7 sec.Repeat with other foot.  Alternate 3-5 times. If able to complete the 4 different exercise movements  5 times 3-5 days in a row without balance loss progress to next level.

3.Ball Handling Activities

Discover your body’s natural ability to balance, think, and move at the same time by performing easy, energizing Ball Handling Activities.

Helps to develop many skills:

Body Balance              

Endurance

Coordination

Agility

Lateral Balance

Spatial Awareness

Kinesthetic Awareness

Eye/Hand Coordination

Gross motor coordination

Visual Motor Coordination

EXERCISES: Follow the ball with your eyes.  Maintain Pilates posture.  Repeat 3-5 reps.

Go to next level when able to complete the activity 4-5 days without mistakes.

  1.  SITTING: Gently passing the ball back/forth.
  2. SITTING:  Tossing theball back/forth.
  3. SITTING: One hand overhead/other at waist. Drop ball to waist hand. Maintaining position
  4. STANDING: Repeat # 1-3.
  5. STANDING: Place feet in heel-toe position. Repeat # 3.  Alternate feet
  6. STANDING: Walk forward/ back 3-5 steps.
  7. STANDING: Repeat #5  walking forward/back 3-5 steps with heel-toe position
  8. STANDING: Bounce ball on floor from  one hand to another. 3-5 reps 
  9. STANDING: Repeat #8 stepping sideways each direction.  3-5 steps
  10. STANDING: Repeat #8 with grape-vine step each direction.  3-5 steps

 

4. Walking While Talking on the Phone.

The objective of this exercise activity is to practice “dual tasking”, performing two activities at the same time “walking”and “talking”.

Go to next level when able to complete the activity 4-5 days without mistakes.

  1.  STANDING: Assume heel-toe stance Hold 30 sec.  Change feet.  Repeat 3-5 reps
  2. STANDING: Walk forward-back  3-5 steps with normal step. Repeat 3-5 times
  3. STANDING: Assume heel-toe stance. Walk forward-back  3-5 steps.  Repeat 3-5 times
  4. STANDING SIDEWAYS: Take 5 steps sideways left, then 5 steps sideways right.  Repeat 8-10 times.

 

5. The Slump

  Reduce your fear of falling and avoid or limit injury from a fall by practicing the “Art of Falling”.

                  

Teaching your body and cerebellum to relax is important in reducing falls.  

Do this once nightly when watching TV, during the advertisements.

Have the backs of the knees touch the chair, hands across the chest, drop your chin to your chest,

look down at your knees, bend at the waist and slump down into the chair, relaxing the body.  

The SLUMP enables a person to slump and experience total body relaxation while learning “how to fall”.

The Slump exercises simulate a person with a loss of balance, but under conscious and thoughtful conditions.

People who have practiced slumping don’t resist when they fall.  They are training their proprioceptive sense, which is one’s ability to sense their bone joint position and joint motion.

 

6. Dancing with a pillow.

With a soft pillow as a dance partner, learn to move freely.and improve your balance 

DANCE POSITION:

  1.  WALTZ:  Use internet U-Tube for beginner steps.
  2. RUMBA:  Use internet U-Tube for beginner steps.
  3. HUSTLE: Use internet U-Tube for beginner steps.
  4. GRAPE-VINE(line dance): Use internet U-Tube for beginner steps.

7.  Floor Balance  walking:  

  . Find the lines on the tile floor or wooden floor. .  Stand next to a counter or table . Proceed to level 1.

                  Level 1    Stand beside table or counter with feet on a line of the tile or wooden floor hold on to table/chair walking 5 steps forward & backwards staying on the line.  Repeat 5 times.  When able to complete the walking staying on the line for 5 days advance to level 2.                                                                                                                                                                                

Level 2.  Repeat level 1 without holding onto  the table or counter, etc.  Repeat 5 reps staying on the line forward & backwards.  When able to complete the activity 5 days without losing balance proceed to  level 3

Level 3. Stand beside table or counter.  Place the feet in heel- toe position on the line.. Walk forward /backwards staying on the line holding onto the counter/table 5 reps. Repeat by changing the feet.  When able to complete the activity 5 days proceed to level 4.

Level 4.  Stand beside counter/table.  Place the feet in heel-toe position on the floor line. Walking forwards/backwards without holding onto counter/table 5 reps.  Repeat by changing the feet. Complete 5 reps.  When able to complete 5 days with out falling off the line. Go to level 5.

Level 5.  Repeat level 4 once a week.

8. Sit to Stand 

sit to stand test   

 

 

 

 

 

 

 

Sit in chair against a wall.  Sitting forward in stationary chair.  Feet comfortable distance apart with arms crossed.. Rise to full stand, return to fully seated position for 30 seconds.  Every 2 weeks add 2 reps until able to do twenty reps.  Continue at 20 reps.

9 Strengthening Lower Extremities w/ Therapeutic Tubing 

Many balance problems can become worse with leg strength and active motion deficits. Utilizing therapeutic tubing  to reduce the weakness is an excellent method to use with easy application.

     

 

Attach one end of tubing to table leg or object that will not move. Place chair next to you to hold on to for balance.  Stand erect and maintain  Pilates posture, move leg in 3 different directions. Each time you move the leg against resistance breathe out and pull the belly button to the spine, breathing out for 5 seconds and breathe in 5 seconds when relaxing taking the leg back to original position.

Repeat 12 reps each of the directions.  As you get stronger replace the tubing with heavier resistance or move further away from the attachment for increased resistance.

To improve balance hold lightly to the chair or release hand occasionally.

 

 

10.  Strengthening Lower Extremities with Theraband

         

Place theraband around ankles. D0 a partial squat, keep the pelvis level. Step sideways and back.  Step forward laterally, step backwards laterally, return to starting position. Repeat each direction 10 – 15 reps. Keep chair close to body if having balance problems .  As balance improves walk slowly sideways /forward/backwards.

11.  Strengthening Ankle Musculature with Theraband

Place theraband over toes/hold with other foot.  Straighten knee/pull toes towards knee. Hold 5-10 seconds. Repeat 10-15 reps. Repeat with other foot.

 

“I’ve Fallen!” Ways to Getting off the Floor.

slipping/falling down   

 View video from www.homeability.com

Many people experience a fall and find themselves uncomfortably trapped on the floor for hours or in some cases days, unable to get up. If you find yourself in this unfortunate predicament, there are a number of things you can do to help increase the chance of either getting yourself off the floor or alerting others you need help.

View video: Click on “I’ve Fallen”. Click  How to get up from the floor MacGyver style

Getting off the floor

Many times people experience a fall which does not result in any injuries, but then find they are unable to get from the floor. If you do find yourself in such a situation, it is helpful to be aware of ways to rescue yourself if there is nobody around to help. Two fall recovery strategies are described below.

Basic Fall Recovery Technique: If you are able to do so, roll yourself over onto your stomach, ease yourself up onto your hands and knees, and then try to crawl to the nearest chair, couch, or your bed. We’ll use a “chair” as an example here. Begin by kneeling in front of the chair. Place both hands (or elbows if need be) on the seat. Then, bend the knee of your strongest leg, drawing it upwards, followed by placing your foot flat on the floor. Next, push down through your arms on the seat while using your bent leg to give you leverage to aid in standing up. The basic fall-recovery technique can be viewed in this video.

MacGyver-Style Techniques: If you are unable to get up using the standard fall recovery technique, then it is time to turn on your MacGyver-style thinking and find a way to use the things around you to aid you in getting up from the floor. See Video: How to Get Up From the Floor MacGyver-style!

Get Someone’s Attention

If you sustain a serious injury during the fall, your emphasis should not be on getting up on your feet because you could worsen the injury. Instead, your focus should be on getting someone’s attention to come help.

Below are some steps you can take to try to alert others you need help.

If you cannot access a phone to call for help, do your best to scoot yourself closer to a door or window where people are more likely to hear you call out for help. You can try using the Glute Scoot or Inch Worm technique shown at the end of the video “How to Get Up From the Floor MacGyver-style!” to move yourself closer to a door or window.

Combine yelling together with banging items to get people’s attention. Use the sole of your shoe, the TV remote or whatever item is available within easy reach to bang against the floor or wall while you are yelling for help.

What time do your neighbors come and go from work? Try to position yourself by a window on the side closest to their home. As soon as you hear their car, bang on the door, wall, or window and call out continuously.

What time does your mailman usually drop off the mail? If you anticipate the mailman will be coming soon, try to make your way near to the door or window closest to your mailbox, so you are ready to call out to them when they stop by.

A whistle can be a useful aid to get someone’s attention to come help. Consider making it part of your daily routine to wear a small whistle as a pendant or consider storing a whistle in every room of your home, somewhere within easy reach of the floor, so you can access one if needed. A package containing multiple whistles can often be purchased for as little as $10 or less.

 

  • Important Fall Prevention Tips

1.  Always wear supportive shoes.

2.    NEVER stand on a chair when you change a light bulb or reach to a high shelve or cabinet. If you must reach a high shelf, purchase a sturdy stepladder or step stool.

3.  Check with your doctor or pharmacist to see if any of your medication should have the side effect of dizziness or loss of balance. Every time you visit a new doctor, you should take ALL of your prescription bottles so they can see if there could possibly be a drug interaction side effect causing instability.

4. Use special caution on the stairs.  If someone calls your name while on the stairs, do not turn around to answer them as this may throw off your balance.  Wait until you get to the bottom.

5. It is important to be aware of your last step!  It is very easy to think you are on the last step but, if you are not paying attention, you may still be on the second or third step from the bottom.  At home memorize the number of steps to be negotiated.

6. Get rid of your throw rugs. Even when tacked down securely, the change in surface height has caused many fall.

7. Be careful with pets. Older adults have been known to trip over their pets(especially if eyesight is poor).  Also, be aware of any toy or item your pet may have put in your pathway that you did not know about.  (this goes for Grandkids , too)

8. Try to avoid quick jerky movements.  Many falls that occur on slippery or icy surfaces could have been avoided with slower movements and become more aware of the condition of the ground.

9. Have your vision checked regularly?

10. Have your hearing checked regularly?

11. Use caution in getting up to quickly after eating, lying down or resting.  Changes in blood pressure may cause dizziness at these times.

12. Alcohol can cause a loss of balance, particularly with older adults as most are on multiple medications.  Your body may not be able to metabolize the alcohol the same as when you were younger, be careful and moderate in your consumption.

13.  Curbs can be dangerous.Some are poorly identified, broken, very high and sometimes poorly illuminated.  Be alert as you enter and exit areas that have curbs.  It is so easy to be talking to a friend and not be alert to danger.

14.  Maintain a regular program of activity.  Find a suitable exercise program for you and stick to it.

15.  If you do not feel 100% confident on escalators, do not use them.  Take the extra time to seek out an elevator.  One study showed 40,000 falls occurring in one year.

16.  Do not be shy about asking for assistance when you need it.  Many older adults do not want to “bother” anyone asking for household repairs, for example, but if you fall and sustain serious injuries, there will be much caregiving needed.

17.  Practice daily standing one one leg while holding onto your countertop: count to 5 slowly.  Then switch legs and repeat 3 times, once you are able to do that without quivering, let go of the countertop. Gradually work up to 10 seconds on each side, repeat 3 times.  

18.  Consider getting a home assessment and get your home “fall Proofed”.  There are companies that will go through your home and assess what would be helpful.  More guard rails, better lighting, etc.

falling down stairs