What works: Falls and physical activity - Stay On Your Feet
|Physical activity has been shown to be the most promising falls prevention strategy, both as a single intervention 71, 124 and as a part of a multi-factorial approach 124. Research shows that specific exercises such as Tai Chi, balance, gait training and strength building group classes or individualised in-home programs reduce falls risk by 12% and the number of falls by 19% 78, 115. These interventions can also increase the time before a person falls for the first time 71. Strength training is the only reliable intervention that improves wasting muscles (sarcopenia) by increasing muscle mass, strength and power 125, but has not been shown in isolation to reduce falls. A physical activity program should be specific for individuals 71, 126 and include exercise that challenges balance at a moderate to high extent 169 with a 'twice weekly program over 25 or more weeks' 169.|
Motivating older people to participate in physical activity
Research indicates that it is never too late to start physical activity and gain health benefits 205. Identifying the reasons why people undertake physical activity is important and can be used to promote and encourage people to be active. Studies show that older people participate in physical activity because they:
- were advised and encouraged by health professionals, specifically a doctor 151, 208
- felt better overall, were able to cope better and do more 206
- felt more positive about their social identity
- there was approval for them to take part from family, friends and doctors 207
- they know someone else who is attending 208 or the group leader (this is sometimes due to participants being encouraged to bring a friend 152)
- enjoy the activity (or it "sounds like fun") 208
- enjoy having a social coffee/tea gathering as part of the activity 208
- are able to access appropriate and affordable classes held in the morning by public transport 127
- understand incidental physical activity counts, helping to relieve any guilt felt if extra activity wasn't done 205.
Research 205 recommends three important points to highlight when promoting physical activity among older people:
- the benefits of incidental physical activity
- you can accumulate short bouts of moderate intensity physical activity throughout the day to total the recommended thirty minutes
- it's never too late to benefit from being more physically active.
- Participating in an approved physical activity program for older people
Who can help older people get active?
- Health promotion officers
- Local government
- Exercise providers (such as exercise physiologists, physiotherapists, therapy assistants and fitness providers)
- Postural sway and leaning balance test
- Functional reach
- Alternate step test
- Six metre walk test
- Timed up and go test
- Sit to stand test
- Spring balance
- Berg balance scale
- Tinetti performance-oriented mobility assessment tool
- Falls Efficacy Scale International
Research on falls and physical activity
- Exercise to prevent falls in older adults: an updated meta-analysis and best practice recommendations (2011) by Catherine Sherrington A,B,E, Anne Tiedemann A,B, Nicola Fairhall A,C, Jacqueline C.T. Close B,D and Stephen R. Lord B
- Exercise for preventing falls in older people living in the community 2019 by Catherine Sherrington, Nicola J Fairhall, Geraldine K Wallbank, Anne Tiedemann, Zoe A Michaleff, Kirsten Howard, Lindy Clemson, Sally Hopewell, Sarah E Lamb
- Research into the effects of physical activity on falls risk factors in adults aged 40-65, Queensland Health commissioned research by eminent Australian injury prevention researcher, Dr Cathie Sherrington, to investigate the possible effects of increased levels of physical activity on known falls risk factors for adults aged between 40 and 65 years of age.
- NSW Falls and Balance Research Group, Neuroscience Research Australia (NeuRA), formerly Prince of Wales Medical Research Institute, Sydney - research papers and useful links.
Resources related to physical activity and falls
- Otago Exercise Programme (OEP)
- Otago Exercise Programme Manual
- Physical Activity Guidelines for Australians
- Be Active Australia
- Older, Smarter, Fitter guide - for those running physical activity programs for older Australians, produced by the Australian Department of Veterans Affairs
- Queensland Stay On Your Feet® image library - images related to healthy, active ageing and physical activity
- Physical activity programs for older people in Queensland
- Exercise for older adults:
To find out more about risk factors
For more in-depth information about falls risk factors, risk awareness, risk screening and assessment methods, refer to the Queensland Stay On Your Feet® Community Good Practice Guidelines.