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Chiropractic Research Review

Elderly Balance and Risk of Falls: Influence of the Cervical Spine

Maintaining and/or restoring balance and mobility are crucial to the elderly and those undergoing rehabilitation. Maintaining one's balance is determined by many factors, including visual clues, mobility, and inner ear function.

Mounting evidence suggests that there is also an important relationship that exists between the spine - especially the cervical spine - and the complex neurological components that involve vision, balance and coordination. However, the relationship between the cervical spine and the risk of falling has yet to be investigated thoroughly.

This paper reviews the common causes of falls, possible interventions, and clinical measures that can assess balance and the risk of falling. In the elderly, falls are one of the leading causes of injury and physical impairment, and the sixth leading cause of death; 75% of all people who die from a fall are over the age of 65. Slipping and tripping are the most common causes of falls in the elderly. It is estimated that 36% of all falls are caused by unknown factors, while 34% are intrinsic (related to the individual who falls) and 11% are extrinsic (or caused by the environment).

In the clinical setting, practitioners may use the scientifically tested clinical tests discussed in this paper to assess a patient's balance and predict the risk of falling. These three tests are simple to use in the clinical environment and include the Berg Balance Scale, Functional Reach, and Time Up & Go. The authors also suggest a paper-and-pencil 10-item questionnaire as a means of measuring confidence in performing activities of daily living.

Several programs designed to decrease the risk of falls are established, including exercise, home hazard improvement and educational programs. The role of— chiropractic in reducing the risk of falling has yet to be studied. However, the researchers note that the cervical spine "has a significant role in postural control, and thus is more likely to affect risk of falling." In addition, they point out that "many recognized causes of instability such as vertigo, joint disorders and some peripheral neuropathies could be successfully managed by chiropractic care."

Walsh MJ, Polus BI, Webb MN. The role of the cervical spine in balance and risk of falling in the elderly. Chiropractic Journal of Australia March 2004;34(1):19-22.

Chiropractic Research Review

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