8 Ways to Improve Balance, Reduce Risk of Falling, and Improve Longevity

Aging and chronic conditions can impact balance and longevity. When you lack good physical balance, it can be difficult to recover from slips and avoid falls. Many people experience balance issues particularly as they age from poor posture, medication, neurological issues, or chronic pain conditions. The good news is, that there are ways to train your body to support proper balance.

As we age, research has proven a link between the ability to balance and longevity.¹ Balance disorders often overlap with falls and other mobility issues. Unfortunately, this can lead to a significant risk of harm and even death from serious falls.

Falls are a huge problem for hospitals due to the high population of patients who are in a weakened or compromised physical and/or mental state.² Hospitals have been putting a lot of resources into decreasing patient fall risks and fall reporting has been required by the Centers for Medicare and Medicaid (CMS) since 2008. However, the impact of the CMS no-pay policy on hospital-acquired falls, while proven to increase the implementation of Nursing prevention measures to reduce falls, has not proven to be effective in reducing fall rates according to one study.3 Hospital clinicians need to be aware that increases in patient-reported symptoms, sleep disturbances, fatigue, or diarrhea can increase the risk of falls.⁴

Falls are also a risk even in your own home. Millions of people fall at home each year according to the Centers for Disease Control (CDC) and one in five experience a significant injury. Risk is increased especially if you suffer from physical problems impacting your mobility. Examples may include chronic pain (arthritis, fibromyalgia), impaired neurological functioning (stroke, diabetes, Parkinson’s Disease),  or neurocognitive disorders (Alzheimer’s Disease, dementia) impacting balance.

Here are some ways to predict the risk of falling:

• Self-screen for falls risk or have a professional falls risk evaluation. There are a number of tools that have been studied for reliability.^5–11 However, assessment tools may not be totally reliable in of themselves.
• Get your blood pressure checked both lying down and standing to make sure that you don’t have orthostatic hypotension. Hypotension can lead to dizziness and an increased risk of falling.
• Evaluate your environment. If you have an unsafe home or work environment, where there is clutter, loose rugs, and obstacles present in your walking pathway, this can increase the risk of falls. Nurses and other health professionals can evaluate your home environment for fall risk and early interventions to avoid falls. ¹²
• Reliance on opioids, alcohol, sedatives or other mind-altering drugs or medications can either directly impact balance or cause drowsiness or mental fogginess.
• Perform a 10-second balance test. For people over 50 years old, a study published in the British Journal of Sports Medicine demonstrated that not being able to stand on one foot for 10 seconds was associated with a higher risk of death from all causes within the next decade.¹

Here are 8 ways to Improve your balance to support healthy aging and improve your longevity:

• Exercise regularly and consistently within your capabilities. Consult your health care provider for guidance on exercise.
• Change up forms of exercise to promote different types of movement and help to promote resilience, strength, balance, and mobility.
• Take appropriate safety precautions with exercise. Here’s a guide for easy tips to exercise safely when you have chronic pain.
• Reduce sedative medications or alcohol intake that may cause drowsiness or fogginess.
• Get adequate sleep. Lack of quality sleep promotes drowsiness and can increase the risk of falls.
• Stand up slowly from a seated or lying position to avoid drops in blood pressure that can lead to dizziness.
• Use an assistive walking device when needed to help you balance, whether it is a cane, pronged walking device, walker, or trekking poles.
• Get your eyesight checked and use correction when needed. Keep your eyeglasses within reach and put them on before getting out of bed. Be aware that certain disease states may affect peripheral vision such as Parkinson’s Disease.¹³

Select Forms of exercise that can improve balance:

Mind-body therapies have been studied in a number of chronic conditions for safety and effectiveness in improving balance, strength, and mobility. ¹⁴

• Tai Chi has been studied extensively for its ability to improve balance and strength and prevent falls in a number of chronic conditions. ^15–20
• Qi Gong can be a safe and effective practice to help those with chronic arthritis pain. ²¹
• Yoga can help improve strength, flexibility, and balance through the use of physical positions called asanas that help to reduce stress, oxygenate tissues, and stimulate circulation.²²
• Specific programs have been designed and studied for their ability to improve strength and balance with chronic conditions such as osteoporosis, osteoarthritis knee pain, or fibromyalgia.^23–26
• Balance-training devices may help promote balance and reduce the risk of falls. One study indicated that balance training may significantly reduce the frequency of falls in patients with osteoporosis.²⁷ This has also been demonstrated in Parkinson’s Disease.²⁸
• Virtual reality games may offer visual support for biofeedback and enhance balance training.²⁹

Summary

Good balance is a key factor in preventing falls and promoting longevity. Many people underestimate their potential for falling. Falling can result in significant harm and a long-term impact on quality of life. If you have compromised mobility, pain, nerve damage, or other conditions, it is important to perform activities regularly to support building strength, mobility, and balance. It is also important to assure safe exercise conditions and a safe environment.

References:

1.          Araujo CG de S e SCLJ et al. Successful 10-second one-legged stance performance predicts survival in middle-aged and older individuals. Br J Sports Med. Published online 2022.

2.          LeLaurin JH, Shorr RI. Preventing Falls in Hospitalized Patients. Clin Geriatr Med. 2019;35(2):273-283. doi:10.1016/j.cger.2019.01.007

3.          Fehlberg EA, Lucero RJ, Weaver MT, et al. Impact of the CMS No-Pay Policy on Hospital-Acquired Fall Prevention Related Practice Patterns. Innov Aging. 2017;1(3). doi:10.1093/geroni/igx036

4.          Lerdal A, Sigurdsen LW, Hammerstad H, Granheim TI, Gay CL. Associations between patient symptoms and falls in an acute care hospital: A cross-sectional study. J Clin Nurs. 2018;27(9-10). doi:10.1111/jocn.14364

5.          Wang Z, Rong Y, Gu L, Yang Y, Du X, Zhou M. Reliability and validity of the fall risk self-assessment scale for community-dwelling older people in China: a pilot study. BMC Geriatr. 2022;22(1):272. doi:10.1186/s12877-022-02962-3

6.          Kim T, Xiong S. Comparison of seven fall risk assessment tools in community-dwelling Korean older women. Ergonomics. 2017;60(3). doi:10.1080/00140139.2016.1176256

7.          Yip WK, Mordiffi SZ, Wong HC, Ang ENK. Development and validation of a simplified falls assessment tool in an acute care setting. J Nurs Care Qual. 2016;31(4). doi:10.1097/NCQ.0000000000000183

8.          Luo S, Kalman M, Haines P. Evaluating a Fall Risk Assessment Tool in an Emergency Department. Journal for Healthcare Quality. 2020;42(4). doi:10.1097/JHQ.0000000000000233

9.          Poe SS, Dawson PB, Cvach M, et al. The Johns Hopkins Fall Risk Assessment Tool: A Study of Reliability and Validity. J Nurs Care Qual. 2018;33(1). doi:10.1097/NCQ.0000000000000301

10.        Callis N. Falls prevention: Identification of predictive fall risk factors. Applied Nursing Research. 2016;29. doi:10.1016/j.apnr.2015.05.007

11.        Nunan S, Brown Wilson C, Henwood T, Parker D. Fall risk assessment tools for use among older adults in long-term care settings: A systematic review of the literature. Australas J Ageing. 2018;37(1). doi:10.1111/ajag.12476

12.        Tiefenbachová P, Zeleníková R. The effect of educational intervention by nurses on home environmental risk factors for falls. Central European Journal of Nursing and Midwifery. 2019;10(2). doi:10.15452/CEJNM.2019.10.0009

13.        Hunt D, Stuart S, Nell J, et al. Do people with Parkinson’s disease look at task relevant stimuli when walking? An exploration of eye movements. Behavioural Brain Research. 2018;348. doi:10.1016/j.bbr.2018.03.003

14.        Fogaça LZ, Portella CFS, Ghelman R, Abdala CVM, Schveitzer MC. Mind-Body Therapies From Traditional Chinese Medicine: Evidence Map. Front Public Health. 2021;9:659075. doi:10.3389/fpubh.2021.659075

15.        Kim H, Kim YL, Lee SM. Effects of therapeutic Tai Chi on balance, gait, and quality of life in chronic stroke patients. International Journal of Rehabilitation Research. 2015;38(2). doi:10.1097/MRR.0000000000000103

16.        Gao Q, Leung A, Yang Y, et al. Effects of Tai Chi on balance and fall prevention in Parkinson’s disease: A randomized controlled trial. Clin Rehabil. 2014;28(8). doi:10.1177/0269215514521044

17.        Penn IW, Sung WH, Lin CH, Chuang E, Chuang TY, Lin PH. Effects of individualized Tai-Chi on balance and lower-limb strength in older adults. BMC Geriatr. 2019;19(1). doi:10.1186/s12877-019-1250-8

18.        Burschka JM, Keune PM, Oy UH van, Oschmann P, Kuhn P. Mindfulness-based interventions in multiple sclerosis: Beneficial effects of Tai Chi on balance, coordination, fatigue and depression. BMC Neurol. 2014;14(1). doi:10.1186/s12883-014-0165-4

19.        Hackney ME, Earhart GM. Tai Chi improves balance and mobility in people with Parkinson disease. Gait Posture. 2008;28(3). doi:10.1016/j.gaitpost.2008.02.005

20.        Wang LC, Ye MZ, Xiong J, Wang XQ, Wu JW, Zheng GH. Optimal exercise parameters of tai chi for balance performance in older adults: A meta-analysis. J Am Geriatr Soc. 2021;69(7). doi:10.1111/jgs.17094

21.        Marks R. Qigong Exercise and Arthritis. Medicines. 2017;4(4):71. doi:10.3390/medicines4040071

22.        Swetha G, Premavathy D. Impacts on yoga asana practice on physical and mental health in females. Drug Invention Today. 2019;12(4).

23.        Rodríguez-Mansilla J, Mejías-Gil A, Garrido-Ardila EM, Jiménez-Palomares M, Montanero-Fernández J, González-López-arza MV. Effects of non-pharmacological treatment on pain, flexibility, balance and quality of life in women with fibromyalgia: A randomised clinical trial. J Clin Med. 2021;10(17). doi:10.3390/jcm10173826

24.        Cave K, Lipman M, Thomas S, Bradshaw E. An exercise group for the management of chronic knee pain: a service evaluation. Physiotherapy. 2020;107. doi:10.1016/j.physio.2020.03.219

25.        Dohrn IM, Hagströmer M, Hellenius ML, Ståhle A. Balance training increases health-enhancing physical activity in older adults with osteoporosis. Physiotherapy. 2015;101. doi:10.1016/j.physio.2015.03.521

26.        Brosseau L, Taki J, Desjardins B, et al. The Ottawa panel clinical practice guidelines for the management of knee osteoarthritis. Part one: introduction, and mind-body exercise programs. Clin Rehabil. 2017;31(5):582-595. doi:10.1177/0269215517691083

27.        Zhou X, Deng H, Shen X, Lei Q. Effect of balance training on falls in patients with osteoporosis: A systematic review and meta-analysis. J Rehabil Med. 2018;50(7). doi:10.2340/16501977-2334

28.        Wong-Yu ISK, Mak MKY. Multisystem Balance Training Reduces Injurious Fall Risk in Parkinson Disease. Am J Phys Med Rehabil. 2019;98(3). doi:10.1097/PHM.0000000000001035

29.        Kotov-Smolenskiy AM, Klochkov AS, Khizhnikova AE. Balance training at low physical fitness using virtual reality system. Physical and rehabilitation medicine, medical rehabilitation. 2020;2(1). doi:10.36425/rehab20644