Exercise for falls management: Rationale for an exercise programme aimed at reducing postural instability

Abstract

It is evident in the scientific and health promotion literature that interest in methods of reducing the risk factors associated with falls, in falls themselves, and in fall-induced injuries is increasing. However, the scientific evidence supporting the role exercise has to play in the management of elderly people who fall is inconsistent and, therefore, confusing. There have been calls for further research evidence, models of practice, guidelines on prevention, and treatment initiatives. Strategically, current guidelines are helpful but more detail is needed in order to assist practitioners to design effective exercise programmes for this vulnerable group. This paper provides a rationale for a specific, tailored, progressive programme of exercise. The programme not only incorporates all the basic fitness components seen in any well-run seniors' exercise class, but also includes specific falls management strategies, such as bone loading, gait, dynamic posture, balance, reaction and co-ordination training, together with adapted Tai Chi and functional floor activities to improve coping skills and confidence. This Falls Management Exercise Programme (FaME) is being evaluated in a controlled trial, funded by Research into Ageing and conducted at Imperial College School of Medicine, London, UK.