Balance And Falls Prevention

Hydrotherapy to help with balance and prevent falls

Falls are one of the largest public health problems among elderly people due to the high morbidity and mortality. Falls cost the NHS 2.3billion annually.

The main reasons for falls in this population are multifactorial – a fall is the result of the interplay of multiple risk factors such as having a history of falls, muscle weakness, poor balance, visual impairment, slower reaction time, polypharmacy and the use of certain medicines as well as environmental hazards.

Researchers have reported that elderly women have a higher susceptibility for falls because of less lean body mass and muscle strength. The likelihood and severity of injury resulting from this event is related to bone health. People with low bone mineral density are more likely to experience a fracture following a fall. Over three million people in the UK have osteoporosis (low bone mineral density) and they are at much greater risk of fragility fractures.

How to try and prevent falls:

We’ve all heard about the importance of regular exercise for general health. It is recognized in the literature that physical activity practiced throughout life can reduce bone and muscle loss, and reduce the risk of fractures by up to 60%.  In addition, physical activity promotes increased muscle strength, aerobic conditioning, flexibility and balance, reducing the risk of falls and improves quality of life.

As people get older their muscle strength and balance reduces, which can lead to a fall. Exercises designed to improve muscle strength and balance can reduce the risk of a fall by maintaining strong muscles and bones, and also helping with balance.

NHS Choices have advice on exercises for older people (link at the end of article) which can be undertaken at home – including exercising when seated.

Hydrotherapy to reduce falls:

Hydrotherapy has been used to help treat rheumatic, orthopaedic and neurological conditions for a long time. The aquatic environment is considered safe and efficient for the rehabilitation of elderly people, because water acts both on musculoskeletal and balance systems.

Some factors that can create barriers for the elderly exercising on land can be eliminated or reduced when in water, such as: pain, muscle weakness, balance deficits, obesity, arthritic diseases and fear of falling.

The different physical properties of water (density, specific gravity, hydrostatic pressure, buoyancy, viscosity and thermodynamics) can play an important role in improving balance control in the elderly and permitting balance training in safe conditions.

The buoyancy of water can be used as a support therefore providing safe conditions to exercise, avoiding falls and reducing the fear of falling. The buoyance also reduces the load on the joints, therefore reducing any pain and can allow arthritic joints to move more freely, in turn strengthening the muscles.

The water properties of drag or turbulence can also be utilised in exercising to provide an environment that challenges stability and balance. In addition, floating allows individuals to perform exercises and movements that cannot be done on the ground.

Water buoyancy reduces gravity and an aquatic environment can be considered a microgravity environment. Research has documented modifications of static and dynamic postural control in prolonged microgravity. Performing exercise in a different gravity environment can lead patients to transform an automatic movement in a voluntary movement improving learning, which can then be transferred onto land to prevent a stumble turning into a fall.



Top Tips to reduce the risk of falls:
  • Exercise regularly: Focus on activities that challenge your balance and strengthen your legs and arms.
  • Medical check-ups: Some health conditions or medications can affect your ability to stay balanced. You might not notice your health changing as it can happen gradually, so it’s important to have regular check-ups so any issues can be picked up before it causes a fall.
  • Take care of your eyes: Eyesight changes as we age and can lead to a trip or loss of balance. Get your eyes and glasses checked regularly, at least every two years.
  • Check for hearing problems: Problems with your ears can severely affect your balance, and the risk of hearing loss increases with age. Talk with your GP if you notice hearing changes are affecting your day-to-day living or social life.
  • Keep your bones strong: Discuss with your GP if you should be taking supplement calcium and Vitamin D.
  • Environment: Many slips, trips and falls happen in or around the home. Keeping an eye out for potential hazards can make your home a safer place.
  1. Check if you have good lighting, especially on the stairs?
  2. Are stairs and steps clutter free?
  3. Are your floors clear of trailing wires, fraying carpets or anything else that you might slip on?
  4. Rugs can also be a falls hazard.
  • Footwear: Problems with your feet or shoes can affect your balance and increase your risk of tripping or falling. Talk to your GP or  podiatrist about any foot issues:
  1. Make sure your shoes fit well and don’t have a tendency to slip off.
  2. Well-cushioned shoes offer comfort and support.
  3. Avoid sandals with little support and shoes with high heels.
  4. Wear slippers that have a good grip and that fasten and stay on properly.
  5. Always wear shoes or slippers, and never walk indoors in bare feet, socks or tights.

NHS exercises for older people:
More info can be found at:

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