The CDC estimated in 2013 that more than 2.3 million older adults suffered non-fatal falls in the US with an associated cost of 34 billion dollars. While physical injuries associated with unintentional falls is easily recognized, the psychological costs are less obvious and often more persistent. Following a fall, up to 50% of people report a subsequent fear of falling with self-imposed restriction of healthy activities, resulting in further functional loss and significant psychological depression

We cannot escape the fact that our thoughts and emotions have a powerful effect on our physiology and vice versa.  In actuality these elements are never truly separate and when our thoughts, emotions, and bodily (aka “holistic) functions are in harmonious alignment “falls prevention” as well as a host of other issues take care of themselves.  Obviously, it can appear challenging to address the seemingly elusive elements of thought and emotion as part of a functional rehabilitation program, however fortunately there are three simple techniques that can both enhance balance and re-integrate holistic function.

1. Feel your feet on the ground: Promising research in the area of mindfulness and balance training* continues to highlight the importance of mental attention on physical performance, yet often our ability to constructively direct someone else’s attention gets lost in the myriad of possibilities. In rehabilitation settings overloading patients with verbal cues to direct exercise or gait function tends to both cause frustration and diminished outcomes.  Keeping it simple with consistent cueing towards a positive base of support (repeat after me….“feel your feet on the ground”) both engages postural responses and holds attention in the present moment.  Worried about clients with peripheral neuropathy?  **Practicing Tai Chi has been shown to improve both physical and sensory function in people dealing with peripheral neuropathy.

2. Take a long, slow, and deep exhalation: It is well accepted that breathing is one of the most, if not the most important physiological function. Intertwined with all other bodily processes, the capacity to both inhale necessary resources and exhale metabolic waste products is critical to life.  Perhaps more underappreciated is the affect that conscious breathing has on the autonomic nervous system, especially the result of activating a parasympathetic nervous system shift with a long, slow, deep exhalation.  Parasympathetic nervous system activation has been shown to reduce anxiety and fear responses in the body, which contribute greatly to fall risk. Does anyone else have patients who are afraid of falling?  Breathe it out!

3. Watch where you’re going: Have you ever been driving your car, looked out the side window, and then found yourself swerving in that direction?  Whether it is golfing, skiing, or just plain walking our neuromuscular function is driven by the direction of our gaze.  Interestingly enough this holds true whether its directing gaze with our eyes open or visualizing with our eyes closed.  Most of us depend heavily on visual cues, real or imagined, for conscious decision making yet don’t appreciate their impact on reflexive muscular and balance function.  Pre-gait activities including seated visual scanning exercises and positive imagery are highly effective strategies for balance enhancement as well as using visual targets while performing upright functional activities. 

Interested in learning how to apply more holistic strategies for balance enhancement and falls prevention?  Join me in learning how to use tai chi in Fall Prevention Strategies.

References:

*Mindfulness-based interventions in multiple sclerosis: beneficial effects of Tai Chi on balance, coordination, fatigue and depression Janina M Burschka, Philipp M Keune, Ulrich Hofstadt-van Oy,Patrick Oschmann and Peter Kuhn. BMC Neurology 201414:165

** Li, Li & Manor, Brad. (2010). Long Term Tai Chi Exercise Improves Physical Performance Among People with Peripheral Neuropathy. The American journal of Chinese medicine. 38. 449-59. 10.1142/S0192415X1000797X.

Brian Trzaskos, PT LMT CSCS CMP MI-C, founder and director of the Institute for Rehabilitative Qigong & Tai Chi, believes education is powerful medicine that allows people to access their own highest healing potential. As a practicing physical therapist and student of eastern movement and meditation practices for over two decades, Brian holds multiple advanced certifications in both the Western and Eastern healing arts. After practicing for 16 years under the constraints of managed care, Brian experienced a deep discontentment with the health insurance system and its inability to place quality of care above costs. Notably, this time of frustration was accompanied by a series of stress-related illnesses which had seriously impacted Brian’s life, prompting him to delve more deeply into himself and strengthening his commitment to serve others. Out of this experience he created his own private pay practice and rediscovered the power of both Tai Chi and Qigong for personal cultivation and inner strength. He is now an author, national public speaker and thought leader in holistic therapeutic movement. Brian and his family live in the beautiful Champlain Valley in upstate NY.

• NY Physical Therapy Licensure
• NY Massage Therapy Licensure
• Neuromuscular / Connective Tissue Release Specialist
• Certified Strength and Conditioning Specialist
• Certified Mulligan Practitioner
• Certified Meditation Instructor
• Certified Integral Qigong and Tai Chi Instructor
• Certified Tai Chi for Arthritis Instructor
• Certified Tai Chi for Energy Instructor
• Certified Tai Chi for Rehabilitation Instructor
• Certified Sun 73 Forms Tai Chi Instructor
• Senior Trainer Tai Chi Easy/Healer Within Foundation