FARGO
In some ways, the fact that we stay standing is an amazing thing.
"We've got this large mass and two little feet to hold us upright," says Beverly Johnson, who does work in the area of balance and fall prevention.
Vision, the vestibular (inner ear) system, muscles, joints and the skin all contribute to balance. Some people rely on certain bodily cues more than others, says Johnson, an associate professor and director of clinical education with the University of North Dakota School of Medicine's physical therapy department.
But as the body ages, it can lose some of these abilities. Muscles weaken. Skin loses sensation. And things like taking multiple prescription medications and getting multifocal lenses can interfere with balance.
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Johnson has done research looking at the rate of people falling in the workplace. As expected, the older people were, the more likely they were to fall. But she was surprised how early she was seeing an increased risk.
"I expected to see it later in life, but at 50 it was statistically significant as far as increase," she says.
Simple balance screenings can indicate whether a person is at risk for falling. Johnson's students will measure how far a person can reach before needing to take a step, and how long it takes them to stand up, walk a set distance and sit back down.
Skip Frappier of Fargo has recently begun offering balance testing through his business, Better Balance USA. He says his interest in balance issues grew after his father was diagnosed with vertigo and his mother got dizzy and fell while holding a grandchild.
He says he's screened more than 1,000 people. Clients stand on a platform that measures their sway while standing with their eyes open and their eyes closed. The system then compares their balance assessments with people of the same age and gender. Those below the acceptable levels are encouraged to undergo further tests.
Frappier says he often hears people dismiss poor balance as a part of aging.
"We just become acceptable to the fact that as we get older, we fall," he says. "Our seniors need to understand there is something we can do."
Sometimes balance problems are caused by a common condition known as BPPV, benign paroxysmal positional vertigo. It is caused by displaced crystals in the inner ear and can be treated by a series of movements repositioning the head.
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Environmental changes can also prevent falls, for example, by removing trip hazards like area rugs and keeping a light on at night.
Johnson says customized exercise programs, combined with a review of medications people are on, have been proven most effective in reducing fall risks.
"Our bodies were meant to move," Johnson says.
Mary Jo Wagar, a physical therapist with MeritCare in Fargo, agrees a program that helps people increase or maintain strength is important for balance.
"We see people who generally have some kind of medical condition that might be contributing to their difficulty," Wagar says. "So we design exercise programs that are more specifically geared to people.
"For a general population that's healthy with no serious difficulties going on, I think a combination of exercise that includes balance, strength, endurance and agility are the best."
Tai chi has been scientifically proven to help with balance, Johnson says. "It's slow, controlled movement, plus you do a lot of one-legged activities with that," she says.
Johnson also recommends a few simple exercises that can generally help with balance.
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While brushing your teeth, stand on one leg and close your eyes. Do this as long as you can, then switch legs.
Alternately tap your toes as high as you can while keeping your heel on the ground.
March in place, lifting your legs as high as you can. Hold on lightly to a counter or table if necessary.
Practice leaning back and forth and side to side. Learn to control your sway.
Wagar and Johnson both say the risk of falling goes beyond physical injuries.
"The fear of falling becomes an even greater problem," Wagar says. "The individual may be more self-limiting. They may not be comfortable going for a walk or participate in activities they used to from fear."
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