The CDC released some disturbing data on falls for the year 2017. More than one in four seniors experienced falls. Among Americans, falls were the number one cause of injury and death from injury. The CDC recorded 29 million falls, 3 million emergency room visits, resulting in $31 billion in medicare costs. Most alarming was the fact that two thirds of those who fell, fell again within six months.

Fall prevention remains a major focus in the home care environment. I had some trepidation when I first transitioned from hospital work to home care. I had to learn to think on my feet when home safety and fall prevention were issues. There was no exercise equipment or additional personnel to rely on. What could I do for a patient who couldn’t walk because of weakness and poor balance? I posed this question to my supervisor. She told me that the most effective thing that I could do with such a patient,
was to wheel him/her to the kitchen sink, and assist them to stand.

At this stage of my career I didn’t know why this simple intervention would be beneficial. My supervisor was very experienced, so I had no reason to doubt her. Somehow, intuitively, I knew that she was right. I also knew that many martial artists supple-mented there training by holding static postures/stances up to thirty minutes at a time. Anecdotally, they reported increased leg strength, balance, and improved body usage as a result of this practice.

I told my patients that the sink was their “ballet bar”; a place for them to build a solid foundation. They would use the sink to stand, and keep holding on to it if their balance was too poor. Standing time would be gradually lengthened, and trials of unsupported (grip free) standing would be added in order to stimulate the body’s own reflexive balance reactions.

This progressive standing appeared to have a broad range of beneficial effects. It improved balance, leg strength, coordination, and even alertness. I believed that these changes resulted from improved nervous system function.

Years later, I came across studies that explained what I was witnessing. An article in the Journal of Physiology proved to be a game changer for me. A group of volunteers was recruited to undergo six weeks of bed rest in order to assess changes in leg size andmuscle strength. As expected, the volunteers lost considerable muscle girth and strength. Surprisingly, the strength loss was far greater than could be accounted for by the loss of muscle size. The researchers hypothesized that the additional strength loss was caused by decreased “neural drive”. Just as an orchestra requires a skilled conductor to produce coherent music, muscles require uninterrupted nerve impulses from the brain in order to function properly. The prolonged period of bed rest (non-weight bearing) appeared to have impaired communication between the brain and leg muscles.

Another study, summarized in Science Daily, removed any remaining doubts that I may have had. The title was “Leg Exercise Is Critical To Brain and Nervous System Health”. Mice were restricted from using there hind legs over a period of 28 days. At the end of the trial researchers found that the area of the brain (sub ventricular zone) that has the role in maintaining nerve cell health and is responsible for the growth of new nerve cells was severely compromised. The researchers concluded, “Our study supports the notion that people who are unable to do load-bearing exercises, such as patients who are bed-ridden, or even astronauts on extended travel not only lose muscle mass, but there body chemistry is altered, and even their nervous system is adversely impacted. Neurological health is not a one way street with the brain telling the muscles, to walk, run, etc”. In other words weight bearing sends nerve impulses back to the brain ensuring its health. My supervisor was spot on.

I am an ardent Tai Chi practitioner. I wholeheartedly believe that this is the best activity to help one age gracefully. Part of aging gracefully is preventing falls. Tai Chi has proven to be a solid evidence based activity to improve balance and prevent falls. As much as I encourage people to take up this practice, I’ve come to realize that Tai Chi is not meant for everyone. It takes patience and persistence to reap it’s benefits. Some find considerable difficulty memorizing the choreography. Others may desire a more vigorous form of exercise.

What are some other ways to maintain good balance and prevent falls? The most logical way is to spend less time sitting and more time upright and moving with activities such as walking, hiking, and even dancing.

Earlier in this article I mentioned that many martial artists practice holding static postures. The Chinese call this Zhan Zhuang—translated as “Standing Like A Tree”.
Practitioners assume various postures (see below) attempting relax their weight into the ground. The legs become the roots of a tree, the arms, the branches. Stance time is gradually increased while the practitioner continually monitors and releases areas of bodily tension. I’ve found that this practice has similar benefits to Tai Chi and may be easier for many to incorporate into their daly routine.

Master Fong Ha, a prominent Chinese martial artist describes Zhan Zhuang as “The fine art of doing nothing but achieving everything”. You can find an excellent resource for Zhan Zhuang on youtube. Type “Stand Still- Be Fit” in the search box. You will be treated to a very informative, user friendly tutorial by Master Lam Kam Chuen. It may change your life.

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