Empowering Safer Movement: Fall Prevention Strategies for Osteoporosis Care

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You’re listening to On the Frontlines of Osteoporosis on ReachMD. On this episode, we’ll hear from Dr. Karen Kemmis, who’s a board-certified clinical specialist in geriatric physical therapy and an instructor in the Doctor of Physical Therapy program at Upstate Medical University. She’ll be sharing strategies for safe exercise in osteoporosis prevention and management. Here’s Dr. Kemmis now.

Dr. Kemmis:
Balance and fall prevention is such a critical part of the program for any individual, and we think about older individuals needing these interventions, but really, as soon as somebody starts to have any risk of balance challenges or increased risk of falls, we should focus on this. I think the best way for somebody who is having some problems with balance or is at high fall risk is to work with a physical therapist. The physical therapist can do testing to determine what particular impairments with an individual might be contributing to the balance problem, and then the interventions can be focused on that.

One thing that people can do to improve balance is to do a Tai Chi class. Tai Chi is generally incredibly safe. It’s very similar across all areas. If somebody accesses a Tai Chi class at a community center or via videotape, it’s going to be very similar, and it’s very safe for individuals to carry out. And research has clearly shown that people who do Tai Chi have improvements in lower extremity strength, their sensory system at their ankles and knees improve, and they generally will have improved balance. So Tai Chi is a great way to have people go into the community or stay at home and work on improving their balance to decrease the risk of falls. 

So if an individual has a high risk of fracture, then we’d really want to go to the basics, thinking about any postural issues that they might have to allow for safe body mechanics and especially focusing on decreasing the risk of fractures in the spine. We’d want to look at balance and fall prevention with a strong focus on that. If an individual has decreased bone density and falls, the risk of fracture is great. Balance is incredibly important. Fall prevention is incredibly important. Look at those exercises that have impact or resistance to them and modify them so that they are safe for an individual. So where somebody might do a strength training program where their resistance is heavy enough that they’re fatiguing by eight or 10 repetitions, if somebody’s at high risk of a fracture, maybe we ask them to decrease the resistance so they can get to 15 or 20 repetitions to fatigue. Even though this might not help with the bone density, it will allow for more safety as they do their activities. If we’re looking at impact-type activities, we would consider looking at what their normal activities are currently and then maybe just adding a little bit more impact to those activities, but not going too far into high-impact exercises or activities.

The other thing is to look at safety. So an individual who’s at high risk of fracture should maybe consider having a home assessment. There are several good pieces available. The Centers for Disease Control and Prevention have nice pieces that somebody can look at and walk through their own home to make sure that their home safety is where it should be. And they should probably work with their primary care provider to do a medication overview to make sure they’re not taking medications that could increase fall risk, and even have a vision assessment to make sure that their vision is up to par, or if they have glasses, to make sure that they’re appropriate.

I think it is important when working with an individual to acknowledge if they have concerns about getting injured with exercise because it certainly can happen. Fortunately, the studies on individuals at risk or with osteoporosis generally have little to no increased injuries, but it’s because they’re carefully monitored. So if somebody is concerned about an injury, it’s probably best that they start working with somebody—either a physical therapist, an occupational therapist, or an exercise specialist in the community—who really has an understanding of osteoporosis and safe movements and safe exercises. There’s also good resources available online. The Bone Health and Osteoporosis Foundation website has some really good information about posture and proper body mechanics and some opportunities for engagement with individuals with support groups to seek out information to see what might be safe for an individual rather than just trying things on their own. 

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That was Dr. Karen Kemmis discussing safety considerations for exercise in osteoporosis prevention and management. To access this and other episodes in our series, visit On the Frontlines of Osteoporosis on ReachMD.com, where you can Be Part of the Knowledge. Thanks for listening!