According to the U.S. Centers for Disease Control and Prevention one in four Americans aged 65+ falls each year. It is also reported that every 11 seconds an older adult is treated in the emergency room for a fall, and every 19 minutes an older adult dies as a result of a fall. Falls are more common among those adults recovering from or living with neurological conditions. In fact, community dwelling individuals with neurological conditions are twice as likely to fall as their age-matched peers without neurological involvement. Despite the above mentioned, it is important to know that falling is not an inevitable part of aging.
Our bodies and environments can change, but we don’t have to fall as a result of this. There are three main systems that maintain our balance, these systems are our visual, somatosensory and vestibular. Vision is comprised of focal vision which is used for localizing features in the environment. Did you know that vision of 20/50 is enough of an impairment in visual acuity to affect postural stability? Ambient vision also plays a part in balance, this implicit vision uses the entire visual field to help us do things like navigate crowded places. Our somatosensory system gives feedback from our body to tell us where we are in space. People with loss of sensation such as those with neuropathy will often have balance impairments due to the effect it has on their somatosensory system. The vestibular system is made to detect rotational movements and accelerations. By age 40 vestibular dysfunction occurs in 35.4% of Americans and contributes to the high number and frequency of falls in the elderly. By age 70 we have lost approximately 40% of the hair cells and nerve cells within this system.
How does one strengthen their balance systems? One proven to be effective way is participation in warm water therapy and exercise. The pool is easier for the therapist to control the person who loses their balance compared to on land. When in the water movements are slowed to allow for increased righting reactions. The hydrostatic pressure and drag forces in the water will allow for additional proprioceptive (somatosensory) input compared to being on land. The pool will stimulate proprioceptors by immersion itself and by changing your body's directions, ranges and planes of movements. The pool is also a great environment to challenge your limits of stability because it is a safe environment. If someone falls in the pool they simply get their hair wet versus a fall on land which can result in serious injury. At water temperatures of 90 degrees or above your muscles relax and tone reduces which allows for more freedom of movement and less pain. Exercises to strengthen the ankles, knees, hips and core can be done in the pool. Strengthening to all of the above are directly tied to improved balance. Research has shown that aquatic exercise combined with functional training done two to three times a week for four or more weeks will improve your balance. The best news is balance can improve at any age with the right training. If you or someone you know deals with balance issues you are encouraged to talk with your healthcare provider about balance training and how warm water therapy can help.