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Showing posts from tagged with: falls
Have you been diagnosed with Parkinson’s disease and worried about what the future holds?
Have you been diagnosed with Parkinson’s disease and worried about what the future holds?
Do you want to optimise your quality of life now and in the future? Parkinson’s disease is a debilitating disorder, where nerve cells in a part of the brain that produce dopamine are affected. The nerve damage affects the brain’s control of the muscles, which causes shaking (tremor), increased muscle stiffness, slowed movements and balance problems. Parkinson’s disease also affects your thinking abilities, especially the ability to control and regulate behaviour, and may cause anxiety and depression. Drugs can control the symptoms in most patients, but unfortunately only for a limited time.How can exercise help?
Exercise benefits the health and wellbeing of people with Parkinson’s disease in many ways. By increasing fitness, exercise protects against many complications of the disease. For example, better mobility may improve quality of life and prolong independent living. Exercise may also have positive effects on mood and improve brain function and make drug therapy more effective. It also provides a means by which individuals can actively participate in the management of their disease. Walking speed in people with Parkinson’s disease is related to muscle strength in the legs, so exercise programs focuses on increasing leg strength are beneficial. Programs using resistance training like Clinical Pilates, increase muscle mass and strength, and also improve step length, walking speed and walking distance. Rhythmic stimulation of the brain via the eyes or ears while walking can help, and balance training combined with resistance training (like Clinical Pilates) can improve balance and stability. ‘Cueing exercises’ involve walking while listening or seeing cues that mimic the rhythm of walking. These exercises can help improve your walking movements and overcome difficulty with gait initiation and freezing. ‘Dance’ provides exercise to music that can facilitate functional and expressive movement. It also provides important social interaction and can lead to improvements in perceived quality of life. ‘Dual tasking’ exercises, where a secondary task (like counting backwards) while walking can help. These exercises usually try to improve one aspect of walking at a time.The Parkinson’s Program we run at Pottsville and Cabarita Physio caters for individual abilities and incorporate all the above factors.
Osteoarthritis and supplements
Osteoarthritis and supplements
Osteoarthritis is a common inflammatory condition characterised by joint pain. See below example.
Osteoarthritis affects 2.1 million Australians. The prevalence is higher in women and joint symptoms are experienced by more than 25% of people aged 65 years or older.
Osteoarthritis is particularly burdensome, on individuals and on the healthcare system and is the main reason for knee replacement surgery. This is of great concern considering the projected rise in the aging population.
In recent years, omega 3 fatty acids (from fish oil), glucosamine and chondroiten have increased in popularity. Research into these and osteoarthritis is showing some promising results, however more research is still needed.
Should you take these supplements if you have Osteoarthritis??
You can as there is some worthwhile evidence but it should form only a small part of your management plan.
Score your pain on a scale of 1-10 before taking the supplement, then after 3-6 months score your pain again to see if there has been any change.
If you are taking chondroitin it is recommended that you take a supplement containing 800mg such as BioOrganics glucosamine 750g and chondroitin 400mg.
There is much stronger evidence to show that dietary induced weight loss (>10% of body weight) and physical exercise such as strength training and aerobic exercise can have a moderate to large improvement in pain, function and quality of life.
In addition, learning effective pain – coping skills have been shown to have positive outcomes not only for pain but also for function, stiffness and disability.
Balance – Falls Prevention
What is a fall?
The World Health Organisation defines a fall as "inadvertently coming to rest on the ground, floor or lower level, excluding intentional change in position to rest in furniture, wall or other objects". Falls in older people cover a wide range of events, including:- trips on raised obstacles (eg. loose rugs, cords, mats) or uneven surfaces (eg. footpaths, roads)
- slipping on wet or highly polished surfaces
- tumbles and stumbles down steps or stairs
- falling off a ladder or stepladder
- falling over in a shopping centre or while using public transport.
What a fall is not:
- Falls in older people are not accidents. Similarly, falls are not an inevitable or unavoidable part of life. The causes of a fall can usually be identified and the sequence of events leading up to the fall can be predicted and therefore can be prevented. o Unintentional falls continue to be the leading cause of injuries requiring hospitalisation in Australia.
Risk factors for falls
Physical inactivity- Physical activity has been shown to be the most promising falls prevention strategy, both as a single intervention and as a part of a multi-factorial approach.
- Research shows that specific exercises such as Tai Chi, balance, gait training and strength building group classes or individualised in-home programs reduce falls risk by 12% and the number of falls by 19%.
- These interventions can also increase the time before a person falls for the first time. A physical activity program should be specific for individuals and include exercise that challenges balance at a moderate to high extent with a attendance twice weekly.
What you can do to prevent a fall ?
Physical activity is key to preventing falls and improving well being! A holistic program including:- Proprioceptive retraining – challenging your body on unstable surfaces such as wobble discs and bosu balls helps to retrain your ability to recognise where your body is in space.
- Strengthening – a full body strength program including lower limb, upper limb and core strengthening will help to mitigate the loss of muscle mass common in the older population.
- Exercises such as squats, bridges, push ups and calf raises are useful examples of this.
Other modifiable risk factors for falls
Incontinence- Problems with bowel and bladder control can impact on an older person's ability to stay active, healthy and independent.
- Incontinence, urinary frequency and assisted toileting have been identified as falls risk factors for residents in residential aged care facilities.
- Physiotherapy can assist with incontinence.
- Sore, aching or tired feet make it difficult for an older person to stay active and independent, and can affect the way they walk.
- Some types of footwear such as slippers, thongs or scuffs, and wearing socks without shoes can increase the risk of falls
- Low vision, impaired vision, a change to vision or vision affected by medication can increase the risk of an older person falling. Vision impairment ranks sixth in the world's major causes of loss of wellbeing, and the prevalence of vision loss increases with age.
- There is strong evidence that falls risk is increased by medications which act on the central nervous system, such as those used to treat depression, sleep disorders and anxiety.
- For those using these medications to assist with sleep disorders and anxiety related health issues, there is a need for longer term support and use of non-pharmacological alternatives such as relaxation, reducing caffeine intake, increasing physical activity and meditation in the first instance. Home safety
- The relative risk of falls can be reduced by 20% in those with a history of falling by an occupational therapist conducting a thorough home risk assessment and arranging the recommended modifications.
- Tidying up behind you and not leaving objects on the floor can also help to prevent falls.
- Nutrition is an important factor in falls prevention, as frailty results from a loss of muscle mass and strength, neuromuscular impairment, immobilisation and malnutrition.
- Older Australians are at risk of developing nutritional health problems due to reduced energy needs and a decreased ability to absorb nutrients.
