Key to maintaining balance is to just keep on moving
Shirley Eckman awoke early one morning this month frightened.
“I was really, really dizzy, and as I walked I felt like I was going to one side,” she says. The room felt like it was spinning. “My balance was off. It was a horrible feeling.”
Fortunately, the New Kensington resident did not fall. “That was my main concern,” she says. Her condition, believed to have resulted from dislodged calcium crystals in the fluid of the inner ear, proved temporary. After a three-day hospital stay and physical therapy treatment, she smiles as she announces: “I feel good as new.”
Eckman, well aware that she was fortunate, has a renewed appreciation of the necessity of living life, literally, in balance, a reminder too often delivered only after someone falls. She now finds herself doing simple balancing exercises, even subconsciously, throughout her day. She encourages her 76-year-old mother to stay in motion with her.
Tom Porter, director of therapy services for Westarm Therapy and Nursing, serving parts of Allegheny, Westmoreland, Butler, Armstrong and Beaver counties, which provided Eckman's physical therapy, applauds her positive approach.
“Our goal is to recognize early on some of the factors that can cause falls (in order) to prevent them. We tell people, ‘What you do today will help you tomorrow,'“ he says.
Such advice cannot be overstated, given the high mortality rate of those 65 and over who fracture their hips, say health experts. If you want to be better equipped to prevent falls later in life, they suggest, the time is now to work on developing balance. While many people do not experience significant issues until their 50s, some in the health field cite the 30s and 40s as being a significant age to begin basic exercises designed to help keep us upright as we grow older.
“It's hard to say if one decade is more important than any other. We should be active throughout our lifespan,” says Jennifer Brach, associate professor at the University of Pittsburgh's department of physical therapy. “We need to build a reserve.”
Falls can start a vicious cycle, Brach says. “People become fearful of falling again, limit their activity and become weaker and at greater risk for falls,” she says. “We need to find ways to safely stay active.”
Twenty-four hours of immobility is all it takes for muscle to begin to atrophy, says Larry Wagner, physical therapist with Allegheny Valley Outpatient Rehabilitation. “The longer someone remains inactive, the weaker they become. Weakness contributes to balance decline, and other medical issues also arise,” he says.
A quarter of elderly people who fall and break their hip “end up dead in a year, and of those who live, 50 percent don't live well because they can't do what they did before,” says Susan Whitney, program director of the Centers for Rehab Services Vestibular Rehabilitation Center at the University of Pittsburgh Medical Center, and professor in physical therapy in Pitt's School of Health and Rehabilitation Sciences. The nationally recognized physical therapist lectures internationally on vestibular dysfunction, balance and rehabilitation.
“There are a whole realm of exercises you can do to enhance balance. Being able to stand on one leg is not all there is to balance,” she says. “Balance comes from three different areas of your body: your inner ears, your eyes and the information from your feet. Our feet provide very important information about where we are in space.”
If we start balance exercises now, maybe we will not pay later, she says.
“If we preserve function earlier, people will live better later,” Whitney says. “Moving is life. We have to move, any way people feel safe doing that.”
Brach believes activities that encourage a person to learn new moves are important for honing balance.
“I really like the idea of different forms of dance, such as line, ballroom, square dancing, Zumba, etc.,” she says. “Some would even suggest video-game dancing, such as ‘Dance-DanceRevolution,' as long as it is targeted to an individual's ability level.”
She believes that developing hip strength also is often overlooked. The hip musculature plays an important role in walking, she reminds, an activity where falls often occur.
Kimberly Metzger, physical therapist for Excela Health, Greensburg, specializing in vestibular and concussion treatment, says the number of falls increases progressively with age in both sexes and all racial and ethnic groups.
The mental aspect is very important, she says.
“I teach my patients from the start that the way balance improves is by doing the tasks they have difficulty performing,” she says.
She finds their confidence increases over time when there is improvement in these and other activities.
Regular exercise, including flexibility, strengthening, cardiovascular and balance activities, is the key component to fall prevention, she says.
Whitney recommends that people walk “just a hair faster” to increase the heart rate. “That releases good chemicals that make the brain happy. Happy chemicals keep you from being depressed,” she says.
Having a positive attitude, says Larry Wagner, “can make a world of difference.”
“You're never too old or young to start strength or balance training,” he says.
After all, adds Susan Whitney, “We all want to live well, not just longer.”