Falls in Geriatric Populations and Hydrotherapy as an Intervention: A Brief Review

Abstract

Falls and fall-related injuries are a serious health concern in geriatric populations, especially with age-related deficits in postural control and during postural control challenging dual-task situations. Balance training has been reported to be beneficial in reducing falls. However, some of these exercises have their inherent physical challenges that prevent the elderly population from performing them effectively. Other concomitant age-related illness in the elderly pose further challenges in performing these exercises. Hence, the topic of finding alternative types of balance training that are effective and are performed in a safer environment is constantly researched. One such alternative is hydrotherapy that focuses on balance and postural perturbation-based exercises in water-based environments such as aquatic swimming pools or in dedicated hydrotherapy pools. Hydrotherapy for geriatric populations has been reported to be beneficial in improving balance, motor and cognitive tasks with improved motivation and positive attitude towards exercises. Additionally, hydrotherapy also has properties of buoyancy, resistance and temperature, which benefit biomechanical and physiological wellness and offers a safe environment to perform balance training. Hydrotherapy balance training need to be scaled and prescribed according to individual needs and can serve as an effective training and rehabilitation protocol in reducing falls in geriatric population.

Keywords: aging; balance training; geriatric falls; hydrotherapy; postural control.

Figure 1

(a) Level 1 Exercise: Standing with support hand support from the wall, wide-base foot stance, lifting one foot from the pool base at a time. (b) Level 2 Exercise: Same as Level 1, but no external support.

Figure 2

(a) Level 3 Exercise: Standing in unilateral stance while the opposite leg flexes and extends the knee with “noodle” under the foot. (b) Level 4 Exercise: Cutting in different directions (e.g., anteriorly/posteriorly and medial/lateral), at differing speeds and in deeper water.

Figure 3

Level 5 Exercise: Similar to level 4 but while standing on noodle, shifting base of support, while opening/closing eyes, adding cognitive tasks.