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Fall and Fracture Reduction in Community Recreation Centers

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Fall and fracture reduction is a complex problem facing many elderly individuals, especially women.

There is really no such thing as a “fall prevention” program. We can’t prevent falls, but we can limit the number and severity of injuries by offering a drug-free program designed to isolate and strengthen the physical and neurological components related to falls and fractures.

 

First, the number one indicator of susceptibility to a fall is muscular weakness.

Many elderly people suffer from Sarcopenia, or loss of muscle mass. A specialized strength training program involving properly designed equipment and complex/compound movements performed to near muscular failure can improve muscle mass, capillary density and posture, in addition to a bevy of other benefits. Typically, the circuit would include a leg press, back extension, triceps dip, mid row and neck machine. This circuit has been used successfully in over 1000 long-term care and rehab facilities, with proven cost of care reduction and zero reported injuries.

The second signal of the potentiality for a fall is balance.

It is critical to document and challenge an individual’s visual, vestibular and proprioceptive capabilities. Then, with baselines established, a one-two punch can be utilized to improve balancing ability. Computerized balance training systems assess and provide progressive interventions to create an autonomic response, improving balance. Also, controlled instability can be used to stimulate sub conscious proprioceptive responses, preparing the individual for inevitable real life instability events.

Third, bone weakness increases the potential for a fall.

The bone itself must be strengthened. A relatively new technology has been introduced to compress, or deform bone in an axial fashion. This starts the bone remodeling adaptive chain of osteoclatic and osteoblastic activity: the shedding of old cortical bone and the reabsorption of calcium into trabecalar bone.

These machines provide multiple body weight compression to the bones, emulating the high forces put on bones through aggressive sports activity, in which most people in their later years cannot participate.

Fourth, a shuffle, or inflexible, unsteady gait is a precursor to a fall.

Observation and analysis of diminished gait and flexibility can be addressed with specialized stretching. By using controlled instability platforms and strength training, posture and gait can improve dramatically.

Fifth, sound nutritional foundation is difficult to achieve for many elderly individuals.

Strenuous regimens meant to increase muscle mass and create an anabolic effect could backfire, and create a catabolic effect if proper nutrition underpinning is not present. Nutrition and pharmacological analysis must be included in a program intended to reduce falls and fractures. Augmenting the adaptive programming with a medically designed nutritional program ensures best outcomes. Identifying the quantity and frequency of prescriptives, if client will share, can help ascertain the best course of action to minimize falls and injury.

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Dean Sbragia

Dean Sbragia, MBA, CDP, CMDCP, is the CEO of Medical Fitness Solutions and the founder of the LifeSpan Health program. LifeSpan is a comprehensive, non-pharmacological program focusing on the challenges of aging. As the owner of a healthcare products development company, he has authored three patents with others pending on workplace, rehabilitation and gaming products. Mr. Sbragia has lectured to domestic and international audiences on topics relating to rehabilitation and fitness programming; his “Break Free” osteoporosis program was a California state finalist in the SBA/Microsoft “InnovateHER” competition in 2015. He was also a contributing author to “Fight the Fall”, a women’s guide to osteoporosis, which published in 2021.

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