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Week 11

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Reason 11

Exercise Prevents Falls

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Falls and fall-related injuries in older people

Falls and fall-related injuries are significant issues in the older population. At least one-third of community-dwelling people over the age of 65 fall each year and the rate of fall-related injuries increases with age [1]. These injuries can be serious, with around 10% of falls resulting in a fracture. Fall-related fractures can cause serious suffering and may even contribute to early death in older adults [1]. Falls can also have various psychological effects on older people, increasing their fear of falling and damaging their confidence. As a result, individuals who have experienced a fall may limit their physical activity, affecting their social life and physical ability [1].

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Exercise decreases the risk of falls by 23%

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Exercise helps in reducing falls

A review by Sherrington and team investigated the beneficial effect of exercise in reducing falls. They analysed the results of 81 trials which included 19,684 participants and found that exercise reduced the risk of falls by about 23 % [1].

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Types of exercise programmes that help reduce falls

The Otago Exercise Programme (OEP) is a home-based exercise programme that was developed in Otago, New Zealand, by Robertson and Campbell. The programme contains strength and balance exercises, which was initially designed to improve stability and coordination in the elderly to reduce falls [2]. The original study recruited 233 participants. The Otago Programme was prescribed to 116 community-dwelling women aged 80 and over [2]. The control group consisted of 117 women of the same age group who were prescribed standard care. After one year of intervention, there were 88 falls in the group of women who exercised compared to 152 falls in the group of women who only received standard care [2]. On average, women who were in the Otago Exercise Programme group only fell 0.8 times during the one-year period, whereas those who only received standard care fell an average of 1.3 times [2]. In addition, the Otago group reduced their risk of fall-related injury by almost 40% and improved their balance scores significantly as compared to those in the group who received standard care [2]. The study concluded that the Otago Exercise Programme improved physical function (balance), reduced the risk of falls and decreased fall-related injuries in women over 80 [2].

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Exercise helps in reducing falls

Tai chi is a popular form of Chinese martial arts practised for meditation, defence, and health purposes. It involves slow dance-like movements and deep breathing. As Tai chi is a form of low-intensity exercise, it is suitable for older adults. Tai chi has been shown to be effective in improving dynamic and one-legged balance, as well as aiding in fall prevention [3].

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Tai chi involves maintaining different postures

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Yoga focuses on meditation, slow movements, posture and breathing. It is similar to Tai chi, but rather than involving martial arts movements, yoga incorporates the holding of poses and mental concentration. Like Tai chi, the low-intensity nature of yoga means that it is suitable for older adults. A 2016 review of the literature found that yoga improved both balance and physical mobility in people aged 60 and over [4].

Long-term effects of exercise interventions on falls

Finnegan and team reviewed the long-term effects of exercise on fall prevention in older adults [5]. The researchers assessed the results of 24 studies, which included over 7,500 participants [5]. They found that exercise interventions can reduce both the rate and risk of falling, even after 12 months [5]. Finnegan and colleagues concluded that fall prevention exercise programmes resulted in a long-term

reduction of fall rates. This was maintained for up to two years after completion of the intervention [5]. This shows that even if there is a gap and failure to perform the exercise for a certain period, all is not lost, and one can restart the exercise when it becomes more convenient.

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The effect of exercise in preventing falls can persist for a long period

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Metaphor 11 – How Often Should I Take My Pain Medication?

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What is the story?

Prakash had a lovely garden. He heard on the news that it was going to be a scorching summer with very little rain for the next six months. Prakash realised that he needed to choose how he would care for his plants. His options were:

Never water his plants and just rely on the rain, if
Water the plants only when they were withering and
Water the plants three times a
Water the plants twice a

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So, what went wrong?

If Prakash opts for options one, two or three, it is likely that his plants won’t survive. Options one and two provide “too little”, and option three provides “too much”. Option four provides the plants with adequate water for their needs.

How can we relate this story to our health?

If we experience pain, we need to take the recommended dosage of medication. Avoiding medications is not helpful. Similarly, delaying taking your pain medication until your pain is severe is also harmful, as shown by studies.

Moral of the story

Pain medication – Not too much, not too little, but just right.

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Exercise Notes For Week 1

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“Lorem ipsum dolor sit amet, consectetur adipiscing elit, sed do eiusmod tempor incididunt ut labore et dolore magna aliqua. Ut enim ad minim veniam, quis nostrud exercitation ullamco laboris nisi ut aliquip ex ea commodo consequat. Duis aute irure dolor in reprehenderit in voluptate velit esse cillum dolore eu fugiat nulla pariatur. Excepteur sint occaecat cupidatat non proident, sunt in culpa qui officia deserunt mollit anim id est laborum.”

“At vero eos et accusamus et iusto odio dignissimos ducimus qui blanditiis praesentium voluptatum deleniti atque corrupti quos dolores et quas molestias excepturi sint occaecati cupiditate non provident, similique sunt in culpa qui officia deserunt mollitia animi, id est laborum et dolorum fuga. Et harum quidem rerum facilis est et expedita distinctio. Nam libero tempore, cum soluta nobis est eligendi optio cumque nihil impedit quo minus id quod maxime placeat facere possimus, omnis voluptas assumenda est, omnis dolor repellendus. Temporibus autem quibusdam et aut officiis debitis aut rerum necessitatibus saepe eveniet ut et voluptates repudiandae sint et molestiae non recusandae. Itaque earum rerum hic tenetur a sapiente delectus, ut aut reiciendis voluptatibus maiores alias consequatur aut perferendis doloribus asperiores repellat.”

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Remember the traffic light system should be used when you exercise.
Please do not go through the red light or break the pain barrier!

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Short intro of encouragement to compliment the notes above.

Please now go to the video page and begin you exercise plan for the week.

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Head and Neck

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Lower Back

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Otago

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References

Sherrington C, Fairhall NJ, Wallbank GK, et al. Exercise for preventing falls in older people living in the community. Cochrane Database Syst Rev. 2019;1(1):CD012424. Published 2019 Jan 31.
Robertson MC, Campbell AJ, Gardner MM, Devlin N. Preventing injuries in older people by preventing falls: a meta- analysis of individual-level data. J Am Geriatr Soc. 2002;50(5):905-911.
Wong AMK, Lan C. Tai Chi and balance control. Med Sport Sci. 2008;52:115-123.
Youkhana S, Dean CM, Wolff M, Sherrington C, Tiedemann A. Yoga-based exercise improves balance and mobility in people aged 60 and over: a systematic review and meta-analysis. Age Ageing. 2016;45(1):21-29.
Finnegan S, Seers K, Bruce J. Long-term follow-up of exercise interventions aimed at preventing falls in older people living in the community: a systematic review and meta-analysis. Physiotherapy. 2019;105(2):187-199.

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