Reducing falls by focusing on hip muscles

Three million older adults find themselves being treated in emergency departments annually for injuries related to falling. Falls are the leading cause of injury related death and non-fatal injuries in those 65 and older.

Ask Air Force Veteran Raymond Payne and Army Veteran David Webber, both 78, whose balance and foot-related issues have caused them to fall.

“I started having problems with balance and falling,” Payne said. Webber echoed the sentiment: “I took quite a spill in the bathroom because of my feet, and it’s remarkable I didn’t get seriously hurt.”

For Dr. Odessa Addison, the focus on fall prevention—while important—can be dovetailed with an emphasis on fall reduction. She is spearheading a research exercise program, Reducing Fall Risk, with the use of Neuromuscular Electrical Stimulation to maximize the hip abductor muscles in older Veterans, to help concentrate on fall reduction.

Addison is a physical therapist and research health scientist at Maryland VA’s Geriatric Research Education and Clinical Center.

“As people age, the muscles in the hip change faster.”

Addison’s aim in the 12-week exercise program is to reduce the risk of falling by helping Veteran participants move better. Participants come to VA three times a week to participate in group classes during which they perform exercises designed specially to strengthen balance and hip muscles. Half the group receives electrical stimulation in the hip muscles.

“As people age, the muscles in the hip that aid hip abduction (the process of using the abductor muscles to move legs out away from the body) change faster than other muscles. Hip abduction is an important part of moving and walking around.”

As the hip abduction muscles grow weak or fatigued with age, it can impact gait and balance and cause falls. After the 12 weeks, participants are followed for a year to see how long improvements last and if they fall. More than 30 Veterans have participated in the study, which is open to new participants.

Both Payne and Webber report they have seen major improvements in their balance. “Since the study, I am not falling at all,” Payne said. He noted he enjoyed the obstacle course part of the exercise program.

“Having to tap my toe helped me have better foot control.”

Webber, who is still in the 12-week phase of the study, agreed with Payne about the effectiveness of the obstacle course. “They used those small orange cones. Stepping around those small cones and having to tap my toe to the top of each one helped me have better foot control.”

Both Veterans also spoke to another side effect of the study. Although they are participating in different groups and at different times, they both spoke about the new friends they made while participating in the program, meeting new people and exchanging tidbits of stories about their individual military service times.

“One of the reasons we choose to do a study with group exercise, as opposed to individual exercise sessions, is because we think the social connections are really important. It’s what keeps people coming back to our program and what helps push them to do better each week in class,” Addison added. “We love watching all of our Veteran participants improve their balance. We hope at the end of this study to expand this program to help more Veterans.”