Riding a bicycle in the countryside or searching mushrooms in the woods can be part of relaxation and leisure time. However, it can also be the start of a long and painful hospital stay since a fall on the hip often results in a femoral neck fracture. In Germany, this concerns about 100,000 people over 65 each year.
An increased risk of falling down applies to vital old people as well as to less active senior citizens. Less active people fall because of untrained and weak muscles. „However, we know that many active people fall, too “, says Ellen Freiberger, sports scientist and gerontologist at the University of Erlangen-Nürnberg in Germany. The reason: missing self-assessment and a risky behaviour. „This is the case, for example, when an 80-year-old person climbs a ladder to clean the gutter.” Active pensioners often act true to the motto: I always have done certain things and will still do them today.
Quick treatment is of most importance
When a fall ends in the hospital bed, time becomes an important factor. „The patient should already get out of bed on the day after surgery if possible“, says Dr Bernd Gritzbach, leading senior physician of the casualty surgery at University Medical Centre of Heidelberg. The advantages: The shorter the period of staying in bed relates to a smaller risk of developing a thrombosis or pneumonia and the muscles lose only little strength. Getting out of the hospital bed quickly is only possible when the broken bone is operated in a way that it can put up with a lot of strain. „Either we apply an osteosynthesis method in which the bone is supported with nails and bolts or we use a prosthesis“, explains Gritzbach.
And indeed, studies show that patients who are rehabilitated quickly have a bigger chance to return to their old lifestyle. This is where the interdisciplinarity of geriatric medicine plays an important role since it looks at an old person from a holistic perspective: Analysing the cause of a fall is a complex undertaking since weak muscles as well as dizziness possibly caused by drugs could be responsible. As well as a visual defect, signs of dementia or Parkinson’s. However, only few hospitals have a geriatric unit which stresses the relevance of casualty surgeries and geriatric centres cooperating.
In any case, it is crucial that the patient gets physiotherapy as quickly as possible since muscles need to be strengthened. „A study showed that patients with a specific muscle training have a lower risk of falling again after surgery“, explains doctor Clemens Becker, head of department of the clinic for geriatric rehabilitation at the Robert Bosch hospital in Stuttgart. That exercise program did not only train muscles but also improved balance, walking performance and bone metabolism making it especially suitable for those suffering from osteoporosis. This turns the process of muscle training into a mixture of rehabilitation on one side and prevention on the other.
Fall prevention in a sports club
„Many people lose their self-confidence after a fall “, says the sports scientist Freiberger. Fearing another fall is the beginning of a vicious circle: Affected people are scared of leaving home, they move around less, muscles keep diminishing and the chance to fall again increases. In many cases, preventive muscle training in local sports clubs could prevent such a scenario if it would not be so difficult to reach the target group. „Many people keep their fall a secret or minimise the problem and feel indifferent about fall prevention programmes,” according to Freiberger. However, a small psychological trick could help. „If one substitutes the phrase fall prevention programme by muscle training or balance training, it addresses more people“, she explains.