Exercise and Fall Prevention

Abstract

The prevention of falls and subsequent osteoporotic fractures can reduce disability, improve quality of life, and reduce the costs of health care for older adults. Exercise plays an important role in preventing falls. A consensus has been reached that exercise programs that include balance and muscle-strengthening exercises, but not brisk walking, reduce the incidence of falls among older adults, especially among those with an increased risk of falls. However, muscle power as assessed by measuring the chair-rising time has been emphasized as a key factor in preventing falls among older adults, since the chair-rising test evaluates the power of the vertical movement and the hip muscles as the most important neuromuscular risk factor for falls and fall-related fractures. Muscle power exercises are superior to balance exercises for improving physical function, and a multidisciplinary exercise program aimed at improving flexibility, body balance, muscle power, and walking ability has been reported to prevent falls among older adults. Vitamin D supplementation has also been shown to reduce the incidence of falls. Older adults with osteoporosis often have sarcopenia (sarco-osteoporosis), and muscle-strengthening and muscle power exercises, together with adequate protein and vitamin D intake, should be recommended to improve sarcopenia. In conclusion, programs that include balance, muscle-strengthening, and muscle power exercises, but not brisk walking, together with adequate protein and vitamin D intake appear to be useful for preventing falls among older adults.