Fear of falling (FoF) has a great impact on functioning and quality of life for older people. But its effects on gait and balance are largely unknown. Yet the connection exists. The quality of life as we age has a strong connection to our strength, or the lack thereof.
Grip strength has been suggested to be a biomarker of aging. As such, its value as an explanation of current status and predictor of future outcomes has been widely researched and reviewed.
Part of this article was found in a study that was published in the Clinical Intery Aging, August 2019: 1681 – 1691. Richard W. Bohannon, Department of Physical Therapy, Campbell University, Lillington, NC, USA.
The use of grip strength as a biomarker of current health status and the strength of other muscle actions of both healthy individuals and adults with limitations and illnesses. Based on this research and the practicality of hand-grip dynamometry, the measurement of grip strength has been widely adopted as a singular indicator of overall strength. This adoption notwithstanding, clinicians and scientists should be cautious in using grip strength as an indicator of overall strength as there is evidence that grip strength may not always be reflective of overall strength and may provide a better indication of overall strength if used in conjunction with a measure of lower limb strength.
As the pull of muscles on bones has an effect on the latter, it should not be surprising that muscle strength is related to bone mineral density. What is noteworthy is the consistent demonstration across cultures of a relationship between grip strength and bone mineral density/osteoporosis at different sites, not all involving bones attached to muscles involved in hand-grip. Strength is a better explanation of bone mineral density/osteoporosis than muscle mass.
In another study it reports that women with low grip strength had significantly lower bone mass density (BMD) at the spine and femoral neck than those with normal grip strength, according to a 2005 study, and men with low grip strength had lower BMD at the spine and hip. Additionally, women in that study with low grip strength were at increased risk for incident vertebral fracture.
Grip strength is an indispensable biomarker in older adults, providing insight not just on overall strength, but also as a potential indicator of poor upper limb function, malnutrition, cognitive impairment, and quality of life.
“Basically, the weaker your grip, the weaker your body is overall,” Carole Kishi, DPT, a physical therapist at Providence Saint John’s Health Center in Santa Monica, California said. “This is such a simple tool and after seeing this research, I’m planning on incorporating it into my own practice more often.”
Weakness is a commonly observed impairment in the lower limbs of individuals with diabetes, with weakness being greater in the presence of neuropathy. Some research, however, also suggests limited grip strength in individuals with diabetes or prediabetes. That strength has also been shown in a few studies to be inversely related to measures of glucose control such as fasting glucose, HBA1c, and hyperglycemia and to systemic inflammation. Grip strength is also related to multi-morbidity whether or not diabetes is a component of the morbidity load. NOTE: Multi-morbidity is defined as the co-occurrence of two or more chronic conditions and has been estimated to effect up to 95% of primary care population aged 65% years and older.
Maintaining balance is also very important. Many years ago I completed a certification from ABLE Bodies Balance and Training. ABLE Bodies is an acronym that stands for Adventures in Better Living through Exercise. The textbook is written by Sue Scott. She is an exercise consultant, balance specialist, and active living consultant. the book might still be available through Human Kinetics, the publisher.
Throughout our aging process we need to stay focused on maintaining strength and flexibility. Appropriate physical activities can restore, maintain and improve physical capabilities.
There are five components in your balance training tool kit. The components are flexibility, posture and core stability, strength for purpose, balance and mobility, cardiorespiratory endurance. Without the combination our perception of how we move fails. Falls happen and many land in the hospital with a broken hip or other injury.
Balance difficulties, also called postural instability, usually have multiple causes in older adults. Not all of them can be fixed or positively altered with activities, but many can!
Structure dictates function. Posture is the structure of the human body, and that structure has a direct relationship to balance. if you lean forward, your center of gravity moves forward toward your feet. When you stand tall, your weight stays centered over the feet. Positioning and posture affect how you balance and move. In frail adults, a forward-leaning, hyperflexed posture makes them more vulnerable to falling and often precipitates the need for a walker.
Posture even plays a role in mood and confidence. Our bodies are integral to self-expression and emotion. Filling the lungs and standing tall leads to feelings of confidence and capability, and building confidence in participants is an important goal.
For those who have let their strength and balance vanish it is possible to regain all of it. It isn’t lost forever. Find a physical therapist or a fitness trainer who can evaluate your current condition then they can help start you in the right direction.
Many studies have been conducted demonstrating the progress many elderly find themselves in. A grant from the National Blueprint-Active Aging Partnership evaluated the effectiveness of ABLE Bodies techniques.
The subjects were 70 years of age or older and living in assisted living or retirement facilities, 38% used walkers. Results showed that ABLE Bodies training significantly improved balance, mobility and activity levels in people who participated in this study. The prime feature of this study was that it had a multi-component nature of the program. Many types of training together into one program, contributing to its success. This study is consistent to other research has been done by Tufts University and ACSM (American College of Sports Medicine) have been done. We are never too old to regain strength and balance.
All components of exercise provides powerful medicine that can change lives. The benefits of effective exercise prescription can improve strength, endurance, balance, function, and quality of life. Exercise science can prescribe exercises to rehabilitate a hip, a knee, or a heart; train a sprinter to be faster; or train a weightlifter to be stronger. Whether you want speed, strength, agility, or simply less back pain, there are established protocols for achieving those goals. Today new exercise protocols are being developed, tested, and implemented to improve the balance of frail adults.
In my last article How to Get Back To Your Goals, I mentioned Joel Harper. He has a many DVD’s available on his site and one shows you to obtain valuable balance training. His site is www.joelharperfitness.com. Order his incredible book while there!
