What is the relationship between fall prevention and mobility maintenance?

The essence of the two is a positive cyclic binding relationship of two-way promotion. It is by no means an antagonistic relationship as many people mistakenly believe that "to prevent falls, you must move less and limit mobility" - preventing falls is one of the core goals of mobility maintenance, and scientific mobility maintenance is precisely the most fundamental means to reduce the risk of falls.

In the past few years of doing elderly care intervention in the community, I have seen too many elderly people who have taken detours, such as Aunt Zhang who I met last year. At the age of 68, I used to have a strong body. I danced square dances with my old sisters for half an hour every night. The last time I stepped on a banana peel while shopping for groceries, I broke my knee. After it healed, I didn’t dare to go out anymore. Even when I went downstairs to throw out the trash, I had to wait for my son to come over on weekends to do it for me. I usually just stay at home and watch TV on the sofa.

As a result, after only half a year, the muscles in my legs had loosened a lot and I started to wobble when I walked. Last month, I stepped on a rolled-up floor mat at home and broke my femoral neck. I am still living in the rehabilitation department. In fact, if she had not just lied down after the fall, but had done a simple gait assessment and practiced some simple lower body strength movements, she would never have reached this point.

Many people's understanding of fall prevention is still limited to "install handrails, lay out anti-slip mats, and go out less often." It's like putting a thick anti-fall case on a mobile phone. They think that as long as external risks are blocked, everything will be fine. However, they ignore that if the phone itself has a weak battery or system lag, it will easily slip and fall to the ground in the hand. Mobility is the core performance of this "body phone". The less you dare to use it and the less you care about it, the faster the performance will degrade and the more likely it will be problems.

Previously, we performed aging-friendly modifications for Uncle Li, a 72-year-old early-stage Parkinson's disease patient in the community. In addition to routine operations such as removing door sills and installing bathroom handrails, we also set a 15-minute training plan for him every day, which involves sitting and raising his legs 10 times and standing on one leg for 30 seconds, which is extremely low-intensity action.

At that time, the cooperating rehabilitation doctors had different opinions, saying that Uncle Li had a poor sense of balance and would be in trouble if he fell during training. It would be safer to let him sit in a wheelchair and move as little as possible. But we still practice with our family members. Not only has Uncle Li not fallen in the past two months, he also walked two stops to the vegetable market last week and came back with half a bag of vegetables. His children were shocked.

Last year, our center tracked 120 elderly people over 75 years old and divided them into two groups. One group only underwent home fall prevention hardware modification, and the other group added low-intensity mobility maintenance training twice a week in addition to hardware modification. After one year, the fall incidence rate of the group with additional training was 42% lower than that of the hardware-only group, and the number of colds and fevers was even reduced.

To put it bluntly, these two things are never an either-or choice. All hardware and environmental adjustments made to prevent falls are essentially to support the maintenance of mobility, so that the elderly dare to move and move safely. When mobility is improved, muscles are strong, balance is sufficient, and even if you occasionally slip, you can hold yourself steady, which really reduces the risk of falling.

The more afraid you are of not being able to fall, the easier it is to fall. The more you dare to move scientifically, the less likely you are to fall. This is the truth.