Try standing on one leg for 30 seconds. Now the other one. Not so easy.
As we age, this ability to balance on one leg declines more dramatically than other signs of aging such as grip and knee strength, and can lead to dangerous falls, according to recent Mayo Clinic research. The researchers studied balance, strength and gait — the way we move — in healthy people over 50. Half of the participants were 50 to 64 and the rest were 65 and older. They found that the time participants could stand on their nondominant leg dropped by 21% per decade of age and on the dominant leg by 17% per decade.
A gradual decline in physical strength necessary to maintain balance typically results from aging. With people living longer, Georgia-area medical professionals say there are ways to spot balance issues and take steps to improve them before they lead to further complications such as falls or other accidents.
Falls are the leading cause of injury for adults ages 65 years and older, according to the Centers for Disease Control and Prevention. More than 14 million, or 1 in 4 older adults, report falling every year, the CDC reports.
Standing on one leg is just one way to assess balance issues in aging patients, said Wanda Jirau-Rosaly, a family medicine doctor at Wellstar MCG Health in Augusta who specializes in geriatrics, treating patients 65 and older.
She said her physical exams include observing a patient and how difficult it is for them get up out of a chair or how they walk. “I have them walk about 10 feet and turn around and that tells me about their risk of falls. I have them grab my finger and I try to pull it out to measure their strength. I have them lift their legs and not let me push them down. I can measure whether one side is stronger than the other as well as any deficits in upper versus lower body strength.”
If Jirau-Rosaly discovers back problems, she may request medical imaging. She also checks a patient’s medication to determine if it increases risks of falls by affecting sleep, which could contribute to instability.
Once she assesses the issues, she said she may refer a patient to a physical therapist to work on specific areas of concern. She also recommends patients continue exercising, eating healthy and building muscle mass through strength training to ward off aging.
“We know that muscle mass decreases after age 30. There is no good pill to keep us young forever. The longer you can stay doing exercise, the better it is for you. Any time we can push ourselves to increase muscle mass and stay active and healthy, it is how we are going to prevent complication as we age.”
Jirau-Rosaly suggests patients find exercises that work well for them. “My mom is 83 and she goes three times a week to the pool to exercise.” Even with foot pain, she can build her muscles through pool exercises and resistance training, Jirau-Rosaly said.
Rob Riesing, rehab services manager of Piedmont Columbus Regional Hospital, often treats patients referred by primary care doctors, orthopedists or other medical professionals. Patients may notice they have an issue, whether they feel weak or if they’ve had a fall, Riesing said. “It’s not normal to be falling once a week.”
Credit: Provided by Piedmont Columbus
Credit: Provided by Piedmont Columbus
Other signs patients have balance issues include swaying while walking after turning their head, looking at the ground while walking slowly or needing to hold onto a shopping cart to move through store aisles, he said.
Many of his older patients visit him after having joint surgery, such as hip or knee replacements. “They may lose their balance after surgery,” Riesing said. “Strength training and muscle training ... will decrease their weakness and balance issues.”
Exercises such as standing on one leg may help patients walk stairs or step onto curbs without falling, he said. “It forces the muscles to communicate to the brain to stand upright.” For those who can balance on one leg, he suggested progressively increasing the time or trying standing on a pillow for a more challenging exercise.
“Our job as physical therapists is to get to the point where they don’t need us any more.”
For patients with balance concerns, Riesing also recommended 30 minutes to an hour of activity daily, suggesting:
· Yoga and Pilates
· Walking up and down stairs without holding onto the railing
· 10 squats near a chair without holding onto it
“Be as active as you can be,” Riesing said. He said it’s important older adults continue to exercise, even if you have some joint pain, to avoid losing the strength gained from it.
“It’s a common downfall of therapy. People stop doing the stuff we work on and they lose the benefits. They need to be more active and challenge their limits.”
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