The list of factors that make us fall is extensive: nutritional deficit, footwear, objects on the way, a sudden stop in public transport, health problems and so on.
As you age, the risks of falling increase due to cognitive impairment, visual and auditory acuity, depression, anxiety, pain, loss of muscle mass and strength, reduced mobility, pathologies in the vestibular (ear) system, foot deformities and the use of various medications (polypharmacy). Cardiac, respiratory or neurological dysfunctions also impact.
“Body imbalance is one of the main factors that limit the life of the elderly. In most cases, it cannot be attributed to a specific cause, but to a compromise of the balance system as a whole. more severe, followed by fractures, hospitalization, psychological complications, fear, loss and reduction of independence, autonomy and mortality”, says Lindbergh Barbosa Affonso, physical therapist at the HC (Hospital das Clínicas) of UFPE (Federal University of Pernambuco), connected to the Ebserh network (Brazilian Hospital Services Company).
“Falling is not normal with aging”, says Karina Gramani Say, physical therapist and professor at the Department of Gerontology at CCBS (Center for Biological and Health Sciences) at UFSCar (Federal University of São Carlos).
According to her, the issue should be dealt with widely by public managers, in order to increase safety on public roads and in public transport. “Regarding the care of the elderly by the family, caregivers and medical staff, it is necessary to plan and pay attention to the signs before the falls.”
Keeping active and practicing physical activities are strategies that reduce the impacts of the aging process, protect against fractures and cognitive losses, avoid chronic diseases, preserve functional capacity and increase quality of life.
“Practiced regularly and globally, the exercises improve health conditions, such as gains in muscle mass, stability and body flexibility”, says Roberto Ranzini, orthopedist, sports doctor, medical staff at Hospital Israelita Albert Einstein and Hospital German Oswaldo Cruz, both in São Paulo.
The body’s general metabolism is benefited by the restoration of motor capacity to perform simple daily tasks, which require strength, mobility and flexibility, regardless of age.
This maintenance or improvement of mobility has a positive impact on metabolic, neurological, cognitive aspects and even on the socialization of individuals, with an increase in self-esteem and mood. There is also a decrease in excessive tension in the muscles and relief from stress in the joints.
To prevent gait disorders and falls, priority should be given to the development of aerobic capacity, flexibility, balance, endurance and muscular strength.
Water aerobics, walking, stretching, weight training and dancing are some varieties for maintaining body stability, in addition to activities:
Multimodal: set of combined physical exercises in different modalities that include strengthening, driving training, gait and dual task, stretching and work for attention, executive function and spatial orientation.
Stimulation of body balance: yoga, tai chi chuan, pilates, training with balls, bosu —acronym for both sides up, half-ball-shaped equipment—, boards, trampoline, among others.
Functional and core-focused: which relates to the muscles of the abdominal, lumbar and pelvic regions.
proprioceptive: that stimulate the perception or sensitivity of the position, displacement, stability, weight and distribution of the own body. Performed in a controlled manner, the stimuli cause destabilization in order to elevate alignment by the central and peripheral nervous system.
Regarding muscle stretching, experts explain that among the results are the range of motion of the joints and the blood supply to the muscles.
Flexibility prepares the movement, favors the acceleration of recovery and prevents injuries. “By putting this type of training in the routine, elasticity is added to the muscle system and the body’s tendons, which improves physical conditioning. In addition, flexibility exercises promote relaxation and reduce tension”, explains the physical therapist in HC-UFPE.
According to the professor at UFSCar, if the individual has a loss of flexibility, this leads to a reduction in their ability to protect themselves when suffering an imbalance. “No one falls due to being shortened, but muscle shortening reduces the ability to regain balance if there is any postural instability. That’s why the exercises need to be individualized.”
Sources: André Pedrinelliorthopedist, traumatologist, sports doctor, full professor at the Department of Orthopedics and Traumatology at FMUSP (Faculty of Medicine at the University of São Paulo), member of the SBOT (Brazilian Society of Orthopedics and Traumatology), of the AAOS (American Academy of Orthopedic Surgeons), Slard (Latin American Society of Arthroscopy and Sports Medicine), Isakos (International Society of Arthroscopy, Knee Surgery and Sports Medicine) and ACSM (American College of Sports Medicine); Karina Gramani Sayphysical therapist, professor at the gerontology department at the CCBS (Center for Biological and Health Sciences) at UFSCar (Federal University of São Carlos), advisor in the postgraduate program in gerontology, coordinator and professor of the interdisciplinary specialization in pain, coordinator of the reference center for interdisciplinary pain care and coordinator of the MBA Healthcare Management, all from the same institution; Lindbergh Barbosa Affonso, physical therapist at the HC (Hospital das Clínicas) of the UFPE (Federal University of Pernambuco), linked to the Ebserh network (Brazilian Hospital Services Company); and Roberto Ranziniorthopedist, sports doctor, medical staff at Hospital Israelita Albert Einstein and Hospital Alemão Oswaldo Cruz, both in São Paulo, member of SBOT, SBTOC (Brazilian Society of Shock Wave Therapy) and AAOS.