As we age, the fear of falling often increases. As was discussed in a previous post, falls are the most common cause of injuries in children and older adults.¹ In 2005, falls among older adults cost the United States an estimated 23.6 billion dollars.²

How do you prevent falls?
In addition to common prevention methods such as wearing appropriate shoes, keeping areas well-lit, and standing slowly, exercises to improve muscular fitness are often suggested. Muscular fitness includes muscular strength, muscular endurance, and power--all of which can be improved through resistance training.

When considering muscular fitness, most people focus on the aspects of muscular strength and muscular endurance. But a focus on power may be more important. The shift of focus to power training for older adults was reported in the recent summary of the most current research on the topic in ACSM’s Position Stand, Quantity and Quality of Exercise for Developing and Maintaining Cardiorespiratory, Musculoskeletal, and Neuromotor Fitness in Apparently Healthy Adults: Guidance for Prescribing Exercise, which was published in Medicine and Science in Sports and Exercise.³ 

The position paper found that research studies “indicate that the risk of accidental falls and resultant bone fractures is more closely related to a decline in muscular power than strength.” As a result, “resistant training for the older person should emphasize the development of power.”

How do you train for power with an older individual?
Recommendations from research have shown that “completing three sets of 8-12 repetitions at a very light to moderate intensity (20%-50% of a 1 repetition maximum lift) effectively increases strength and power and improves balance in older persons.” A few simple exercises that you might be able to incorporate into your routine, or suggest to others, to help prevent falls include the following:

Chair Get-Ups – Sitting down in a chair, quickly get up out of the chair as if in a rush, then slowly sit back down and repeat.

All Fours to Standing – With a soft mat on the ground, carefully squat down and then move to the ground onto hands and knees (all fours). Then reverse and get back up off of the ground and repeat.

Walking Stairs – Carefully, but briskly, walk up a set of stairs. Then walk down and repeat 2-4 times in a row.

Standing Wall Push-up to Clap – Stand upright in front of a wall, about two to three feet away, facing the wall. Then, while keeping the hips in line with the body, extend arms outward from the shoulders to the wall (like the top of a push-up) about shoulder width apart. Then slowly lower the upper body towards the wall (as if doing a push-up). At the bottom of the push-up, when the arms are about 90 degrees, push away from the wall so that your arms come off of the wall and you can clap your hands before returning to the wall to repeat.

Horizontal Medicine Ball Wall Throw – This exercise uses a rubber medicine ball and solid wall that a ball can be thrown against. Facing the wall, stand about three to five feet from the wall with the medicine ball in your hands. With feet in a stable position, hold the ball with both hands near the chest. Next, as if passing the ball to a partner, push the ball forward from the chest towards the wall and let go (but be careful as the ball will come back at you, just as fast as it went towards the wall). Then catch the ball, or pick-up from the ground, and repeat.

The research and exercises discussed above focus on power, but what about the role muscular strength and muscular endurance have in falls. Baseline levels are definitely needed prior to beginning power exercises. As you might imagine, if an individual does not have enough strength or endurance, they will not be able to do power exercises, such as those listed above. But should the focus only be on power? Next week, we will discuss the significant role that muscular strength and endurance have to do with falls.

Of course, prior to beginning any new exercise or exercise program it is important that individuals are healthy enough for exercise and that the benefits outweigh any potential risks.

¹Robertson, Clare, John Campbell, Melinda Gardner, and Nancy Devlin. "Preventing Injuries in Older People by Preventing FAlls: A Meta-Analysis of Individual-Level Data." Journal of American Geriatrics Society (2002): 905-11. 
²"Cost of Fall Injuries in Older Persons in the United States, 2005." Centers for Disease Control and Prevention. USA.gov, 10 Feb. 2011. Web. 10 May 2011. <http://www.cdc.gov/>.
³American College of Sports Medicine. (2011). Quantity and Quality of Exercise for Developing and Maintaining Cardiorespiratory, Musculoskeletal, and Neuromotor Fitness in Apparently Healthy Adults: Guidance for Prescribing Exercise. Medicine and Science in Sports and Exercise. 43(7), 1334-1359.