8: Balance, Gait and Falls

KINE 4646: Delivering Exercise to the Aging

Knowledge to Action

Lecture 8: Balance, Gait & FallsInstructor: Prof. Chip Rowan – PhD, CSEP-CEP

Update

  • Upcoming Guest Lecture:

    • Focus on psychosocial factors

    • Scheduled for Thursday via Zoom

  • No In-person Classes:

    • Nov 4 – 8

  • Program Design Assignment:

    • Part I: Due Nov 15

    • Part II: Due Nov 22

    • Peer Review: Due Nov 29

    • Reflection Part II: Due Dec 3

    • Final Exam: Date TBA

Assignment Update

Program Design Assignment Overview

  • Weight: 25%

    • Part I (10%):

      • Due: Nov 15, 5 pm via eClass

      • Length: 5-6 pages, double-spaced

    • Part II (15%):

      • Due: Nov 22, 5 pm via eClass

      • Length: 5-6 pages, double-spaced

    • Peer Review (5% + 2%):

      • Due: Nov 29, 5 pm via eClass

Part I – Program Review

Program Details (4 marks)

  • Name of the program

  • Location

  • Mission of program

  • Funding sources (membership fees, government grants)

Members (2 marks)

  • Eligible participants

  • Attendee demographics (age, sex, socioeconomic status, etc.)

  • Recruitment/marketing methods

Staffing (3 marks)

  • Program administration details (staff, volunteers)

  • Training and expertise levels

  • Community/organizational partnerships and their impact

Space and Equipment (2 marks)

  • Safety and monitoring of space/equipment

  • Accessibility considerations

Physical Activity Opportunities (7 marks)

  • Types of activities offered

  • Safety and appropriateness of exercises

  • Inclusion of pre-screening

  • Social/peer support available

  • Individual vs. group-based activities

  • Educational material on PA/exercise participation

Summary/Conclusion (4 marks)

  • Strengths and weaknesses of the program

  • Recommendations for older adults

  • Overall impressions

Part II – Program Design

Program Details (4 marks)

  • Name of program

  • Location

  • Mission and vision statements

  • Hypothetical funding structure (membership fees, donations, etc.)

Members (2 marks)

  • Target audience demographics

  • Recruitment/marketing strategies

Staffing (3 marks)

  • Program administration details (staff, volunteers)

  • Community partnerships

Space and Equipment (2 marks)

  • Description of space/equipment safety

  • Accessibility considerations for clientele

Activities Provided (7 marks)

  • Specific physical activity opportunities

  • Safety and guideline compliance

  • Pre-screening importance

  • Social/peer support mechanisms

  • Educational material distribution

Knowledge Translation/Marketing (4 marks)

  • Creation of marketing tool (e.g., infographic)

  • Content should include program information and PA relevance

  • Must adhere to health literacy best practices

Peer Review

  • Template for review provided separately

  • Peer review contributes 5% of course grade

  • Focus on Part II of the assignment

  • Provide constructive comments and scoring (1-10)

Implications of Aging

Physical Transformation

  • Movement changes with age

  • Impact on physical activities

Aging and Physical Function

  • Terms: Physical Function, Capacity, Independence, Disability

  • Increased function correlates with higher health-related quality of life (HRQOL)

  • Function vs. disease presence as health predictors

Frailty

  • Definition: Health state resulting from aging with reduced reserves

  • Strongest predictor: Age

  • Classification: Weight loss, muscle strength, gait speed, exhaustion

  • Risks: Falls, mobility issues, hospitalization

Balance

Components of Balance

  • Integration of sensory, motor, and cognition

  • Proactive vs. Reactive balance strategies

Sensory Changes

  • Vision: Declines in acuity, sensitivity, common diseases

  • Somatosensation: Deterioration in touch/pressure detection

  • Vestibular System: Gradual decline affects balance perception

Motor System Changes

  • Loss of neuron function, decline in neurotransmitters

  • Reaction time is significantly affected

  • High-risk scenarios for balance loss

Gait Cycle

Key Attributes for Normal Gait

  1. Lower-body strength and trunk stability

  2. Joint mobility

  3. Timing of muscle activation

  4. Sensory input

Age-Associated Changes

  • Gait velocity and variability decline with age

  • Specific changes: Step length reduction, increased double support time

Falls

Public Health Issue

  • Second leading cause of injury deaths among older adults

  • Significant healthcare costs associated with falls

Defining a Fall

  • An unexpected event leading to ground contact

Fall Risk Factors

  • Intrinsic Factors: Age, muscle weakness, impaired cognition

  • Extrinsic Factors: Environmental hazards, footwear issues

Preventing Falls

  • Exercise programs, vision assessment, and environmental modifications recommended

  • Importance of comprehensive assessments involving medication review

Novel Approaches

Hip Airbags

  • Technology that detects falls and deploys airbag for protection

Consequences of Hip Fractures

  • Associated with high morbidity and mortality rates

  • Critical year following a fracture

Program Implementation

Strategies to Mitigate Fall Risks

  • Progressive exercise, balance training, and environmental interventions

Post-Class Reflection Task

  • Identify fall hazards in the classroom

  • Reflect on accessibility challenges faced by older adults