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Die Angst vor dem Sturz

Around a third of people over the age of 65 and half of those over 80 fall once a year.

„Fear of falling“ is a term that is often used in health care. Patients are asked: „Are you afraid of falling?“ And the answers are often recorded as survey results. Fear of falling affects 50% of people who have actually fallen before and 50% of people who have not yet experienced a fall. But if you think about it, it would be a bit unusual if there were people who weren’t afraid of falling. Who would be happy if they fell? If someone told me I was falling this week, it would definitely keep me busy. But what we really want to know is whether someone is so afraid of falling that he no longer dares to do some things and he B. no longer walking around the house or going outside.

There are two main factors that are likely to influence our fear of falling: First, how likely it is that we are at all fall? Second, how serious are the consequences if we actually fall? Essentially, we carry out a risk assessment of our personal mobility, which in turn influences our behavior. When I think there is a good chance I will fall at something, I think twice about whether I will do it. Likewise, if I think I would be significantly injured if I fell doing something, I would think twice about it too. If I believe that there is a high risk of falling AND serious injury in the process, it would be unlikely that I would even undertake such an activity.As a 33-year-old with no previous illnesses, I don’t think it’s likely that I will fall while walking or that more than my pride will be harmed. when i fall So I am not thinking of a fall, and no fear of falling prevents me from going for a walk. But if I were sent to ice skate, things would look very different: I would be very afraid of falling and would adjust my behavior accordingly – most likely by holding onto the railing and moving very slowly forward. Or by not even going on the ice. My fear of falling would then be higher. Or by not even going on the ice. My fear of falling would then be higher. Or by not even going on the ice. My fear of falling would then be higher.

The greatest risk factor when falling is a previous fall, which can often lead to an even greater fear of falling and thus to a changed behavior. A few years ago, I was jogging down a muddy coastal path, slipped and fell on my head. Fortunately, I landed on soft, muddy grass and was able to get up and continue walking. For the rest of the run, however, I was much more concerned about falling. I ran much more slowly, holding onto trees until my confidence returned. But imagine what it would be like if you no longer had that much strength and a poorer sense of balance and basically found walking around the house like an ice rink or a slippery mud path? To make things even more difficult, that you fell and broke your wrist or hip in the past month.It would be understandable if you had less confidence in your mobility and if it were better not to walk around so much worrying that you might fall again. This is exactly what I have observed many times in hospital corridors and in general during my work as a physiotherapist: someone falls with or without the resulting injury, he loses self-confidence and no longer leaves the house or does not walk around much in the apartment reduce the risk of another fall. that you could fall again. This is exactly what I have observed many times in hospital corridors and in general during my work as a physiotherapist: someone falls with or without the resulting injury, he loses self-confidence and no longer leaves the house or does not walk around much in the apartment reduce the risk of another fall.that you could fall again. This is exactly what I have observed many times in hospital corridors and in general during my work as a physiotherapist: someone falls with or without the resulting injury, he loses self-confidence and no longer leaves the house or does not walk around much in the apartment reduce the risk of another fall.

The problem with this is that the decrease in physical activity with which one would like to reduce the risk of falling in everyday life actually increases the risk of future falls. Falling can lead to fear and fear of falling. This is based on a process known as “deconditioning” which has recently come into focus in the healthcare sector through various actions. In deconditioning, physical abilities deteriorate due to lack of activity. Muscle strength decreases, fitness decreases and the sense of balance is lost. “If you rest, you rust” is a well-known saying that is absolutely true when it comes to our physical abilities. Over time, inactivity can lead to weakness and decreased mobility, which in turn can lead to an increased risk of falling.This creates a vicious circle of falls, increasing fear of another fall and inactivity:

 

Fear of falling> reduced activity> deconditioning> increased risk of falling> falls

 

 

 

 

 

 

 

 

 

 

Once caught in this vicious circle, it is difficult to get out. It is important to encourage and enable physical activity. Here, effective strengthening and balance exercises help as part of a versatile overall assessment and intervention, and the fight against deconditioning in order to strengthen the self-confidence of the person again and break the vicious circle:

 

Confidence> Physical activity> Improving strength and balance> Less risk of falling> Fewer falls

 

 

The multifactorial assessment of the risk of falling can reduce falls by 24% and can be carried out on all older people who have already fallen or who are at risk of falling. By recognizing your fear of falling and the associated consequences, we can contribute to fall prevention and prevent this fear that leads to falls.

 

Author: Oliver Williams, Physiotherapist and Resident at Public Health, Wales



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