Why should older adults perform balance training?
Performing this type of training can improve balance, postural stability and gait and reduce the risk and fear of falls. One-third of community-residing adults over 65 years of age suffer a fall each year (Tinetti et al., 1988). With more than 35 million older adults in the USA, this equates to more than 10 million falls each year. Falls are not only the leading cause of injury-related deaths in older adults, but they are also a significant cause of morbidity and disability (National Safety Council, 2000). In 2000, 1.8 million falls resulted in an emergency room visit for head trauma, soft tissue injuries, fractures, and dislocations. These falls accounted for $16.4 billion in direct medical expenses (Kochera, 2002). Of these injuries, hip fracture in older adults is the most devastating. From 1988 to 1996, the estimated number of hospital admissions for hip fracture increased from 230,000 to 340,000 (Graves & Owings, 1998).
Falls are often caused by a loss of balance. The ability to balance depends, in large part, on three sensory systems: the visual, vestibular, and somatosensory systems. With increasing age, however, sensory function decreases and negatively affects balance control (Era et al., 1996). In addition to the three sensory systems, muscle strength plays a role in balance and mobility. Deficits in leg strength are related to diminished gait velocity, stride length, and balance (Sandler et al., 1991). Hip extensor power is significantly related to the ability to rise from a chair, climb stairs, and walk (Bassey et al., 1992). Increasing strength may offset some of the contraction speed-associated deficits in the elderly and may further modify other factors (i.e., postural control, proprioceptive input, range of motion, fear, etc.) that would reduce the risk for falls (Brown et al., 1995).