Preventing Falls

Some new recommendations regarding fall prevention (meaning “falling down” rather than the season Fall) have recently been published in the Journal of the American Medical Association (JAMA).  This has been a topic of previous blog posts here and elsewhere, but new guidelines were issued in April 2018 by the U.S. Preventive Services Task Force (USPSTF) so it seems worth revisiting.  The USPSTF is a group of nationally recognized experts on evidence-based medicine and primary care appointed by the government’s Agency for Health Care Research and Quality (AHRQ).

The USPSTF conducted a review of 62 studies evaluating various interventions among older adults at risk for falls.  They found that of the interventions studied, exercise tops the list by “significantly reducing the risk for experiencing a fall”.  Although specific types of exercise were not highlighted, group exercise was included in the majority of the studies reviewed.  According to the review, “initial, exploratory analyses suggest that group-based exercise (vs individual-based exercise), [including] multiple exercise components (vs single exercise component), and . . . strength or resistance exercises . . . were more likely to be associated with a greater reduction in falls and number of persons experiencing a fall.”

The reason for the effectiveness seems to be the strengthening effects of exercise.  But I would add some additional possibilities, particularly relevant to yoga, Pilates, Tai Chi and other practices which focus on connecting mind to body.   These include an emphasis on training your mind as well as your body to pay attention to what’s happening right now in this moment.  Practitioners are encouraged to learn how their bodies work and to gain greater awareness of their surroundings as they move through space.  We call that “proprioception.” Balance training is also inherent in all of these practices in addition to strength training.  Also, group exercise has the added benefit of a social component.  This may seem like it would not be relevant to fall prevention, but I would contend that it has an impact on all aspects of one’s life, including continued mobility both physical and mental.

Falls are something we all worry about, especially as we age, but they can be devastating at any age.  According to USPSTF

“Falls are the leading cause of injury-related morbidity and mortality among older adults in the United States. In 2014, nearly 29% of community-dwelling adults 65 and older reported falling, for a total of 29 million falls. Of these, more than one-third necessitated medical treatment or restricted activity. There were an estimated 33,000 fall-related deaths in 2015”

Anything we can do to strengthen our resources against this danger is certainly worthy of our attention.  This provides just another piece of evidence to recommend regular exercise for everyone.  It’s never too late to start.  No matter how inflexible or out-of-shape you think you are, if you can move and breathe, there is some form of exercise that you can do.  Starting is the hardest part.  That requires a decision.  Every journey begins with the first step.  Take that first step and then add to it.  Gradually.  Start slowly and keep moving.  You’ll improve if you stick with it.  You might still experience a fall, but by building your strength, you may also find that you recover that much more quickly.  That’s certainly worth the effort.


Power in Community

January has come and gone.  According to just about every article on the subject, most New Year’s resolutions have now reached the graveyard of good intentions.  Fortunately, any time is appropriate to get back on that bandwagon and try again.  As we all know, every day is a new day and a new opportunity.  There are many tips for setting goals and maintaining resolve, but the one I’d like to focus on here is the value of community.  A group of like-minded and supportive practitioners can help keep you motivated, especially when barriers start appearing in your path.

The great Vietnamese philosopher Thich Nhat Hahn wrote “A good [community] is crucial for practice.” He continues “A good teacher is important, but sisters and brothers in the practice are the main ingredient for success.”  Of course, he may be referring to a different type of practice here, but I would venture that even he would not object to expanding the meaning more broadly to include many types of practice.  Especially those practices with the ultimate goal of self-improvement.

If one of your self-improvement goals is to add more movement to your life, a group can be a huge help to keep you on that path.  A recent article in the Washington Post  cites two new studies that demonstrate the value of even “light activity” as being “helpful for outcomes like daily functioning, mental well-being, good quality of life and so on.”  Improved methods are now being used to conduct such studies.  In the past they have mostly been based on self-reporting which is notoriously inaccurate.  But with new technology such as Fitbits and similar activity tracking devices, more objective data can be collected.  The result of these 2 studies show that the benefits of movement, even light movement, are far more impressive than previously thought.  In fact, these studies found that “the most active subjects had a 50 to 70 percent decline in mortality during a defined follow-up period compared with the least active, most sedentary participants. Previous self-report research had pegged this benefit at about 20 to 35 percent.” This is comparable to the health benefits gained by non-smokers vs. smokers.  So it is particularly significant.

Interestingly, these studies tracked individuals (male and female) in their late 60’s and 70’s.  The researchers believe that the results will correlate to younger people also.  But the results add further evidence to support the notion that it is never too late to start moving.  Furthermore, any movement beats being sedentary.  The studies show that “all physical activity counts toward improving health status. You don’t have to play basketball for an hour or run three miles to accrue benefits. You simply have to move . . .”

One great way to do that is to join a group.  That’s what exercise classes provide – a group that is working together to keep moving.  Classes also provide a specific time and place for this activity.  You can set that time aside in your schedule and like any other appointment.  Not only will this help you remember, but it can also help you keep other appointments from interfering.

The word “yoga” is translated as “union” from Sanskrit.  This can mean many things.  It can mean union of mind and body.  Or union of movement and breath.  For this purpose I would suggested that “union” can also refer to a group that practices together.  This is true not just of yoga, but of any group that practices movement together.

Recently one of the members of our Pilates group was sick.  We missed her while she was gone and worried about her sending healing energy for her quick return.  When she got better we were elated to have her back and welcomed her accordingly.  As part of a group your well-being becomes important to others as well as yourself.  Of course, your friends and family will also benefit from your good health, but wouldn’t it be great to have a supportive group to share your efforts with.  You can and should continue to move on your own, but a group can encourage that also.  The more you move, the better you will feel which will encourage more movement.  So if you’re still hoping to at least try to fulfill your pledge to yourself, let a group help you.  We all need each other.  Take advantage of the benefits of community.