Fall Risk Assessment and Balance and Stability Exercises You Can Do on Your Own

October 12, 2018 Akkarapol Klaiput, M.D. Pantasak Tansakul, M.D. Assist Professor Visal Kantaratanakul, M.D.

HIGHLIGHTS:

Older adults aged 60 and over have an increased risk of falls. Older adults must practice and manage their balance skills and work to increase muscle strength in order to strengthen the body and prevent potential accidents.

 

Why should we test our balance?

As we get older, aging and degeneration begin to affect the functioning of our body systems, such as the visual system, nervous system and musculoskeletal system. Degeneration of these various systems will cause a gradual decrease in strength, as well as a decline in balance abilities, thus increasing the risk of falls.

Falls, of course, bring a number of additional risks with them, such as broken or fractured bones, spondylolisthesis (when a spinal vertebra slips over the one below it, causing nerve roots to be squeezed) and other disabilities. It’s therefore extremely important to undergo balance testing in order to determine the level of risk of falls in elderly patients.

Balance Test

Timed Up and Go Test (TUG)

Remarks: Rise from the chair, walk three meters, turn around, walk back to the chair and sit down. This process will be timed from start to finish. If it takes longer than 12 seconds to complete the exercise, this indicates the patient has an increased risk of falling. Do this once. 

The 30-Second Chair Stand Test

Chair Stand Below Average Scores
Age Range (years)	Men [Time]	Women [Time]
60-64	<14	<12
65-69	<12	<11
70-74	<12	<10
75-79	<11	<10
80-84	<10	<9
85-89	<8	<8
90-94	<7	<4

Remarks: Set a timer for 30 seconds. Once the timer starts, the patient must rise to a full standing position and then sit back down again. Count the number of times the patient comes to a full standing position in 30 seconds. Compare that number to the normal number for their age range. If the patient’s number is below average, this indicates an increased risk of falling.

Balance Tests

The 4-Stage Balance Test

Do each set of stretches twice, 10 times per set.

Steps for testing: At each stage, the patient must hold a certain standing position for a total of 10 seconds. Elderly patients who cannot hold the 3rd stance (tandem stance) for at least 10 seconds are at an increased risk of falling.

Exercises to Increase Muscle Strength

Do each set of stretches twice, 10 times per set.

Exercises to Improve Stability

For walking exercises, do each set twice, walking 10 steps per set.

Factors Affecting Risk of Falls

Internal Risk Factors	External Risk Factors
1. Increased age	1. No handrails
2. History of falls	2. Stairway steps too high or too narrow
3. Weak muscles	3. Obstructions in walkway
4. Problems with balance or walking	4. Inadequate or overly bright lighting
5. Problems with vision	5. Slippery floors or uneven surfaces
6. Postural hypotension (a drop in blood pressure due to a change in body position)	6. Use of inappropriate walking aids
7. A chronic disease, such as osteoarthritis, Parkinson’s disease, diabetes, bowel incontinence, etc.	7. Medication affecting the nervous system
8. Fear of falling

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