Exercise-Based Fall Prevention in the Elderly

Problem Statement

It is worth noting that falls among senior adults are a common phenomenon. Most senior people who live at home fall at least once a year. Such a situation can be observed with those individuals who live in nursing homes as well. In the USA, falls are one of the frequent causes of deaths applicable to persons over 65 years of age. Moreover, the danger of the situation lies in the fact that if a person fell once, this will happen again in most cases.

Falls can lead to serious trauma, including fractures since many older people have porous, brittle bones (osteoporosis) (Bartl & Bartl, 2017). Current preventive measures and methods to combat this problem are not effective enough and have not led to a change in statistics. The purpose of this paper is to develop a problem statement for future research on the use of the soft robot as a fall prevention instrument.

Discussion

The core of the problem is that falling in senior people leads to a loss of independence, disability, and even mortality. Due to the fact that the frequency of falls increases by 10% every ten years of life, it is necessary to apply more effective and advanced measures. Falls cause serious damage in 10-15% of cases, and fractures – in 5% (Bartl & Bartl, 2017). It is important that among the risk factors for extra vertebral fractures, falls are more significant than the decrease in bone mineral density.

At present, it is known that this negative phenomenon occurs due to various reasons, but the main factor is the inability of a senior adult to respond correctly to a loss of balance. In particular, any movement is associated with the displacement of the center of gravity; maintaining balance implies maintaining the center of gravity over the support (Kane, Ouslander, Resnick, & Malone, 2017). The internal structure of the human body suggests that the body can maintain balance due to muscle tension (muscles of the lower leg, thigh, ligamentous apparatus of the joint). Also, this can happen due to an increase in the area of the support (that is, taking a step backward or holding onto a foreign object).

The body must evaluate possible obstacles, the direction of movement, the support site, and, most importantly, provide adequate speed and strength of skeletal muscle contraction, which is often impossible for a senior patient. In particular, age-related changes in the nervous system, a decrease in muscle mass, and a deterioration in neuromuscular transmission lead to the fact that the individual cannot control their body effectively. Age-related changes in muscle function occur due to loss of muscle mass, which is sarcopenia (Kane et al., 2017). It becomes impossible for the senior adult to have a rapid and strong muscle contraction when there is the threat of a fall since the step reactions necessary to maintain equilibrium are changed.

Numerous studies indicate that there are many techniques to prevent the possibility of falls. Most approaches focus on the importance of performing regular exercises to strengthen muscles and bones (Donath, van Dieën, & Faude, 2015). Systematic workouts at home (recommended by specialists) designed to develop dynamic balance and strengthen muscles, as well as walking, are the main recommendation that is found in the literature. In addition, many researchers advise removing things from the house that can cause falling and storing the necessary items in easily accessible places.

Group exercises based on Tai Chi are indicated for most senior patients to develop dynamic balance (Donath et al., 2015). Studying the composition of drugs under the guidance of a specialist (especially if their number reaches four or more) and excluding psychotropic substances is also a frequently observed recommendation. Most patients over the age of 65 are advised to wear comfortable shoes with non-slip soles and use orthopedic insoles to compensate for static foot failure.

With severe gait instability, the patient needs to use a cane or crutches. It is important that targeted strategies, the goal of which was to change the nature of behavior and modify risk factors, were the most effective for people living at home. Effective results were obtained in the implementation of integrated measures programs, including risk assessment and screening.

However, an additional difficulty lies in the fact that when conducting research, patients with injuries such as a hip fracture fall into the attention of specialists. For less severe injuries, patients prefer not to seek help (Tsuda, 2017). Considering that, in most cases, falls remain unnoticed by doctors, the statistical indicators of the frequency of falls among senior adults are largely based on data recorded retrospectively. Therefore, it is impossible to state objectively if the proposed measures are effective enough.

Concluding Points

Thus, it can be concluded that the application of traditional integrated measures did not give the desired results since the problem persists. Falls are a serious problem in senior patients and one of the most significant risk factors for extra vertebral fractures and soft tissue injuries. For that reason, it is necessary to study the potential of unmanned systems in preventing falls (Zhang et al., 2017). It is assumed that they will help in improving senior adults’ safety and reducing healthcare costs linked to unintentional injury.

References

Bartl, R., & Bartl, C. (2017). Bone disorders: Biology, diagnosis, prevention, therapy. New York, NY: Springer.

Donath, L., van Dieën, J., & Faude, O. (2015). Exercise-based fall prevention in the elderly: What about agility? Sports Medicine, 46(2), 143-149.

Kane, R. L., Ouslander, J. G., Resnick, B., & Malone, M. L. (2017). Essentials of clinical geriatrics (8th ed.). New York, NY: McGraw Hill Professional.

Tsuda, T. (2017). Epidemiology of fragility fractures and fall prevention in the elderly: A systematic review of the literature. Current Orthopaedic Practice, 28(6), 580-585.

Zhang, T., Li, Q., Zhang, C. S., Liang, H. W., Li, P., Wang, T., … Wu, C. (2017). Current trends in the development of intelligent unmanned autonomous systems. Frontiers of Information Technology & Electronic Engineering, 18(1), 68-85.