OpenIDEO is an open innovation platform. Join our global community to solve big challenges for social good. Sign Up / Login or Learn more

Interview with an Occupational Therapist/Senior Group Fitness Instructor

Group fitness instructor for seniors shares insights about falling and fall prevention

Photo of Kaitlin Graff
1 3

Written by

My mom has been a group fitness instructor for seniors for the past 5 years and has been an occupational therapist for 25 years. She talks about fall prevention during her exercise classes and helps seniors strengthen their bodies to live healthier lives. 

Here are some of her insights:

Summary and Main Takeaways

  • Fall prevention is multi-system approach. There are multiple causes of falls and solutions need to deal with a variety of issues. 
  • It is critical that people deal with the fear of falling that many seniors have. People often don’t talk about falling because they think it is scary. Unfortunately, many older adults stop going into the world because they feel like it is too big. They become weaker because of their lack of activity which makes them retreat even more. It become a vicious cycle. 
  • It is important for people to learn about the body and how it works. A lot of people don’t know how the body works which can be unnerving when things go wrong with it. 
  • People should take action early, when they notice changes related to aging. It can be really easy to let new problems that come up become the new normal. Aging can sneak up on people. It’s important to know where you are 
  • Know your stats: take the STEADI tests (https://www.cdc.gov/steadi/materials.html), check yourself each year. If a person can’t do something, there are steps he/she can take to improve. Once people take a baseline test, give them hope and a good plan. 


Sample Fall Prevention Class 

  • Start with breathing: helps participants to calm down, be more alert, and more aware
  • Work on posture: if people are hunched over, they are  more likely to fall forward. Discuss what posture is and what people can do about it. There are certain predictable muscle imbalances that we have based on our sedentary lifestyle. Focus exercise on reversing these predictable patterns of aging (chest gets tight, back is slack; hip flexors are tight, glutes are slack)
  • Exercise core muscles

Use breathing, posture, and core as foundation for the rest of the class

Strength Training

  • Ankles: first responders for fall prevention. Need to be strong but flexible 
  • Neck: Needs to be able to look around
  • Hip abductors: used to stabilize the hip
  • Work on eccentric contractions (control descent) through slow chair squats: Sit really slow, 4-10 count, helps to control movement against gravity

Balance

  • Reach and balance to mimic reaching in everyday life

Teach people how to fall and how to get up from a fall

  • Instead of bracing, roll into a ball


Shame/Fear Leads to Inactivity

Older adults often have fear and shame associated with falling. If they fall, they might say, “Don’t tell my son/daughter that I fell.” They feel like they will have to go to a nursing home and lose their independence if they divulge that information. Some seniors stop doing activity because they don’t want to fall leading to them become weaker and wanting to do even less activity. It is a vicious cycle.


Causes of Falls

It is a combination of factors:

  • Visual changes including worsening depth perception. Vision changes, peripheral vision isn't as good
  • Medication side-effects, including dizziness 
  • Hypotension: blood pressure drops when going from sit to stand
  • Weakness in core and legs 
  • Typically, people don't pay attention to their feet, sometimes because they can’t feel their feet, don’t notice uneven surfaces, muscles aren’t strong enough 
  • Someone calls name and hip abductors aren't strong and they break a hip, fall sideways,
    • To strengthen, do lateral movements in class
  • Dementia and cognitive problems, people might take chances they shouldn’t take when judgment and spatial skills are off 
  • Older people lose fast-twitch muscles, can’t move fast enough to get out of the way of an obstacle
    • To improve, do agility and move feet faster in class


Stories of Falls from Class Participants

  • A 91 year old fell during a beach ball exercise in class. It looked like she was softly lowering to the ground. She relaxed into the fall and did not get hurt. 
  • One woman was at Lowe’s and felt like she was about to fall as she stepped off of the curb. Since she did ankle exercises in class giving her ankle flexibility and control. She “danced” and didn’t fall down.

1 comment

Join the conversation:

Comment
Photo of Kate Rushton

Hi Kaitlin!

This is incredibly useful, Thank you for posting this post and the one about sarcopenia.

I really like how you highlighted how certain individuals benefitted from the exercise classes e.g.

'A 91 year old fell during a beach ball exercise in class. It looked like she was softly lowering to the ground. She relaxed into the fall and did not get hurt.
One woman was at Lowe’s and felt like she was about to fall as she stepped off of the curb. Since she did ankle exercises in class giving her ankle flexibility and control. She “danced” and didn’t fall down.'

With all the insights you have gathered from your Mum's work and observations from the classes, could an optimal fall prevention program be created which includes exercise as one facet?

The ideas phase of the challenge is open - https://challenges.openideo.com/challenge/fall-prevention/ideas

It would be great to see you there.