Exercises and measures to prevent falls - How you can prevent falls in everyday life

A person can also arm themselves against a fall, for example by minimising unwanted side effects through good medication settings, through physiotherapy, which will be discussed later in the article, and by wearing safe footwear in the home. Yeliz Bektas advises against non-slip socks, as in her experience these can actually become more of a fall risk. "It's more advisable to replace the non-slip socks with normal 'finches'. We do the same here at the hospital and also check our patients' footwear if they don't already do so themselves." Aids that older people in particular need should also be regularly adjusted and optimised. These include glasses, hearing aids and various walking aids, for example. Each of these aids can provide enormous support with gait safety, as they help the person to orientate themselves.

"As an additional aid for our patients in hospital, there are additional safety precautions in the rooms depending on assessment and need, as well as floor mats, seat cushions and an alarm edge," says Yeliz Bektas. Patients can also contact the nursing staff at any time via the call bell if they are unsure, which is checked daily by three different services to ensure that it works around the clock.

Proper nutrition also plays an important role when it comes to preventing falls. A lack of fluids and inadequate nutrition are key risks for falls. Our nutritionists at Zollikerberg Hospital describe the alarming signs of this: "A lack of fluids initially manifests itself with a simple feeling of thirst, but can then increase to confusion and lead to everything from headaches to a decline in mental and physical performance."

The reduced feeling of thirst in old age, forgetfulness or deliberate restriction of oral fluid intake to reduce visits to the toilet also contribute to the risk of dehydration and thus favour the risk of falls. Our nutritionists therefore recommend consuming an optimum of one and a half litres of unsweetened drinks. Sweating or heat increase the need for fluids and should therefore be compensated for by drinking more.

Malnutrition, in particular a lack of energy, protein and vitamin D, can also lead to additional functional losses of the limbs in addition to the natural age-related reduction in muscle mass and therefore represents an increased risk of falling. This risk can be reduced with a needs-covering energy and protein intake, which optimally supports muscle mass and strength, including in the legs. Although the energy requirement decreases with age, the vitamin and mineral requirement remains the same. The protein requirement (protein requirement) is even higher.

Our nutritionists therefore recommend: "Choose nutrient-rich foods. Protein-rich, vitamin- and mineral-rich components should be favoured. Sugar, fat and alcohol-rich components should be reduced. It is therefore essential to include fruit, vegetables and starchy side dishes such as wholemeal bread, potatoes, pasta and polenta along with proteins every day. Fruit and vegetables can be eaten both fresh and frozen."

In order to optimise training that is tailored to individual needs, it is particularly important to draw up a diagnosis as a first step in order to identify the specific difficulties. "To do this, we have fixed tests and scales that we can use to test balance and gait stability," explains Tanja Andres.

Examples include the Berg Balance Scale (BBS), which determines the sense of balance using 14 short practical tests, or the Functional Gait Assessment (FGA), which assesses gait stability. But which systems in the body are actually crucial for balance? "There are three of them. The first is the visual system, the second is the balance organ in the inner ear (vestibular system) and the third is the information from the individual joints and surface receptors of the whole body (somatosensory system)," she explains.

Normally, we humans use around 70 per cent somatosensory, 20 per cent vestibular and 10 per cent visual information for balance when we are standing still. However, in diseases such as polyneuropathy, a disease in which the transmission of stimuli in the body is disturbed, this weighting can shift and thus lead to unsteadiness when walking or standing. There is also a test for this called the Clinical Test for Sensory Interaction in Balance (CTSIB), which can accurately measure such changes.

General programmes without specific adaptations for the individual person are not useful in such situations and only prevent falls to a limited extent. However, as muscle strength generally decreases, especially in old age, strengthening exercises are almost always part of fall prevention. The therapists work with the patients to determine exactly which exercises to do. Floor training under therapeutic guidance, in which lying down and standing up are practised, can also be useful. It can reduce the fear of falling and of tasks such as picking up objects on the floor.

Exercises to do at home are an important addition to training in courses, in the gym or in individual therapy at our therapy centre. These are usually strengthening or balance exercises. "The treating therapist puts these exercises and their dosage together and adapts the difficulty to the patient's level," says Tanja Andres.

Tanja Andres has further tips for minimising the risk of tripping in everyday life at home: You should install a good light, remove carpets and also wear suitable footwear in the home. If necessary, it is also a good idea to use an assistive device, for which you can seek advice from your physiotherapist. An emergency call button can also be useful in the event of a fall. "Finally, regular checks of visual aids such as glasses or contact lenses are also important, as visual problems can also lead to falls," emphasises the physiotherapist.