fall prevention balance training

Falls of Seniors: What to do

More than one third of person 65 years of age or older fall each year and in half of such cases the falls are recurrent.

If you are a senior, ie 60 year or older that means you need to take more care and precautions for yourself. Other than medical conditions or diseases which you take care by doing routine blood tests and investigations, you should not forget to keep yourself free from falls.

What are falls?

Falls include dropping from a standing or sitting position or from ladder or stepladder.

Falls are common in elderly. It has been proven scientifically that with aging, a lot of brain structures, muscles strength, vision, hearing and sensations show a gradual decline.

Causes of fall

Many things can put you at higher (double or triple) risk for a fall.

Medical Risk Factors

·         Impaired musculoskeletal function, gait (read walking style) abnormality and osteoporosis                 falls

·         Cardiac arrhythmias (irregular heartbeat), blood pressure fluctuation

·         Depression, Alzheimer’s disease and senility

·         Arthritis, hip weakness and imbalance

·         Neurologic conditions including stroke, Parkinson’s disease, multiple sclerosis etc.

·         Urinary and bladder dysfunction

·         Vision or hearing loss

·         Cancer that affects the bones

·         Side effects of medications

Personal Risk Factors

·         Age. The risk for a fall increases with age. Normal aging affects our eyesight, balance, strength, and ability to quickly react to our environments.

·         Activity. Lack of exercise leads to decreased balance, coordination, and bone and muscle strength.

·         Habits. Excessive alcohol intake and smoking decrease bone strength. Alcohol use can also cause unsteadiness and slow reaction times.

·         Diet. A poor diet and not getting enough water will deplete strength and energy, and can make it hard to move and do everyday activities.


Falls and accidents seldom “just happen”      People should not fall

Why should you NOT fall?

As a result of fall, you may get a small injury like a bruise or mild bleeding or a muscle pull to some serious injuries like fracture (break in bone) or brain injury and deaths too.

If you are osteoporotic (a condition in which bones are already weak) chances of fracture increases.

Fall risk increases with age. Henceforth, falls are common and serious health problem with devastating consequences in elderly

Prevention of fall is possible by early diagnosis and awareness about intervention. Fall should not be perceived as inevitable part of aging. All elderly, be sure to discuss the fall with doctor, even if you are not hurt. It can also be a sign of new medical condition like diabetes or change in blood pressure.

Physiotherapists play a vital role in prevention of falls.


Physiotherapy and rehabilitation at ReLivaTM for fall prevention

Reliva therapists conduct a detail check of elderly muscles strength and sensations of body more specifically for legs. Reliva therapists also conduct scientifically proven validated scales (Fall risk assessment scale and Berg Balance scale) to know if there is any risk of fall and to know balance problems in elderly.

Based on which, Reliva therapists design an exercise protocol to improve strength and balance in sitting, standing as well as walking. Physiotherapists are specially trained for balance specific exercises.  If required, they will prescribe an assistive device (walker or stick which can later be gradually discontinued ) with regular supervised exercise sessions.

Call Reliva if:

You are an elderly

You want to get fall risk check

You want to get balance check

You want strengthening and balance exercises

You want home modification tips.

For simple Tips to Prevent Falls, click here and see the infographic.

What to do if you had a Fall

  • Do not panic. Assess the situation and determine if you are hurt.
  • Slide or crawl along the floor to the nearest couch or chair and try to get up.
  • If you cannot get up, call for help.
  • If you are alone, slowly crawl to the telephone and call nearest hospital or relatives.
  • Once you are ok, do see a doctor or a Physiotherapist even if you haven’t hurt yourself, to ascertain the reason for the fall.

Related articles: Falls Prevention Tips

This article is purely for general information. Please contact your healthcare expert for specialised medical care. Please go through our Disclaimer and Privacy policy.

Dementia and Alzheimer

Dementia & Alzheimer’s: Points of care

What is Dementia & Alzheimer’s Disease?

Dementia, a brain condition that causes problems with thinking and memory, is a major worldwide health problem among older people. Alzheimer’s Disease contributes approximately 70% of all Dementia cases. Epidemiological studies in India suggest about 1/3rd of the prevalence of Dementia & Alzheimer’s Disease (AD) as compared to The United States and other developed countries. Incidence of AD increases sharply after age 65.

Alzheimer’s is a progressive disease of the brain that slowly impairs memory and cognitive function. It is characterised by decline and loss of multiple Cognitive functions such as loss of memory and atleast one of the following:

  • Loss of Ability to understand (Aphasia): for example, Inability to respond to “Your daughter is on the phone”.
  • Loss of Ability to perform Complex tasks of daily routine (Apraxia): for example, Dressing, Bathing etc.
  • Loss of ability to plan, organise, execute normal activities of daily living:  for example, going Shopping etc.

Alzheimers vs Dementia

The task of being Caregiver for a loved one with Alzheimer’s or Dementia, can be extremely daunting. One may have to experience behavioral problems such as wandering, aggressiveness, hallucinations, or sometimes sleeping and eating difficulties. By learning how to make changes in the caring atmosphere, you can improve the Quality of life for both the patient and your ownself.

Tips for the Caregiver

  • Try to put yourself in the person’s situation. Look at your loved one’s body language &  imagine what he/she might be feeling or trying to express.
  • Are the patient’s needs being met? Is the patient hungry, thirsty or in pain?
  • Make necessary changes in the home environment or atmosphere to comfort the patient.
  • Create a calm & soothing environment. Keep yourself calm and stop being anxious or upset in response to their behavioral problems as it can increase patient’s stress or agitation.
  • Establish a daily routine for the patient such as a schedule for bathing; as all these tasks would be difficult and can be done only when the patient is very calm and agreeable.
  • Expect things to take longer than they used to and give step by step instructions when you ask your loved one to do something.
  • Encourage them to participate in physical activity or Exercises as it is a great way to reduce stress, improve balance and coordination and other activities of daily routine.


How does Physiotherapy help in Alzheimer’s disease?Care for Alzheimers dementia

Regulated and supervised exercises during Physiotherapy can help the patient of Alzheimer’s disease in several ways, some of which are listed below:


  • Exercise is an excellent stress reliever and it can give solutions to most of the problems such as aggression, wandering and lack of sleep or sleep disturbance.
  • Physiotherapy improves muscle strength, mobility, balance and Co-ordination and ensures proper training for activities of daily living such as eating, dressing, etc.
  • Physiotherapy is crucial for patients in pain and reduces symptoms with use of Electrotherapy.
  • Physiotherapy can assess one’s ability to walk safely, the risk of falls & other functional tasks. The therapist will develop a treatment program, including exercise, to help maintain your loved one’s current abilities.
  • Even in late stages of Alzheimer’s, physiotherapy can help prevent & manage shortening of the muscles or joints.
  • Physical activity creates valuable opportunities to socialise with others & can help improve & maintain a person’s independence which is beneficial both to the people with Alzheimer’s & Dementia & also to their Caregivers.
  • Several studies show that exercises performed for 15-30 minutes, thrice a week, prove to be beneficial for patients with Alzheimer’s disease.


“A Person does not need to remember having engaged in an Exercise Program to reap the benefits of Exercise- they just have to participate!”


Every person is unique & will have different levels of ability and activities they enjoy. If you want to find out more about suitable Exercise & Physical activities, Contact us at ReLivaTM

Related Articles : Seniors Fall: What to do, Fall Prevention Tips

“This article is purely for general information. Please contact your healthcare expert for specialised medical care. Please go through our Disclaimer and Privacy policy at http://reliva.in/disclaimer.php”

physiotherapy for parkinson's

Physiotherapy for Parkinson’s Patients

Physiotherapy involvement for Parkinson’s Disease is supported by a growing evidence base of high quality research and leading best practice guidelines1,2,3. Various benefits to patients of Parkinson’s, in a range of physical and quality of life measures have been identified through systematic reviews. Studies have also shown improved flexibility, strength, walking, balance and fitness in patients who participate in a physiotherapy program.

Physiotherapy at ReLiva for Parkinson’s disease focuses on the following:

  • Improving or maintaining fitness through exercise
  • Helping you to move about
  • Helping you to maintain independence in your daily life
  • Helping to prevent or manage falls
  • Maintaining or improving effective breathing
  • Providing pain relief

In the early stages of Parkinson’s, your physio can give you advice, education and support in keeping up your fitness levels and good posture to help you remain independent. As the condition gets worse, your physio may focus on your walking, posture and balance.

There are different types of pain which could be associated with Parkinson’s. These are pain in the muscles and bones (musculoskeletal), involuntary muscle spasms (dystonic), primary or central pain nerve pain (neuropathic) and restlessness, or being unable to keep still (akathisia-related pain).

A physiotherapist can assess the pain and can then use methods such as manual therapy, heat, or cold, ultrasound to help relieve pain you may have.

ReLiva can provide the physiotherapy treatment at our clinics or by a visit to your home. We can provide advice on aids and equipment that you could use to make things easier for you.

1. Keus S, Domingos J, Rochester L, et al. European physiotherapy guideline for Parkinson’s disease [draft]. s.l.: European Parkinson’s Disease Association; 2013.

2. Tomlinson CL, Patel S, Meek C, et al. Physiotherapy versus placebo or no intervention in Parkinson’s disease. Cochrane Database Syst Rev. 2013;9:CD002817.

3. Allen NE, Sherrington C, Paul SS, et al. Balance and falls in Parkinson’s disease: a meta-analysis of the effect of exercise and motor training. Movement Disorders. 2011 Aug 1;26(9):1605-15.

What is Parkinson’s Disease ?

Parkinson’s disease is caused by the deterioration of nerve cells in an area of brain known as the ‘substantia nigra’. When functioning normally, the nerve cells produce a chemical known as dopamine which serves as a chemical messenger allowing communication between the substantia nigra and another area of the brain called the corpus striatum. This communication coordinates smooth and balanced muscle movement. A lack of dopamine results in abnormal nerve functioning, causing a loss in the ability to control body movements.

Parkinson’s is a progressive neurological disease which progressively leads to by motor and non-motor problems. As Parkinson’s progresses, the amount of dopamine produced in the brain decreases, leaving a person unable to control movement normally.

Diagnosis of Parkinson’s is usually based on clinical examination. People with Parkinson’s might present with falling, loss of confidence and independence and reduced quality of life The three main symptoms are bradykinesia (slowness), rigidity (stiffness) and tremor.

In the early stages of Parkinson’s disease, your face may show little or no expression, or your arms may not swing when you walk. Your speech may become soft or slurred. Parkinson’s disease symptoms worsen as your condition progresses over time.

What causes Parkinson’s ?

Why Parkinson’s disease occurs and how the nerve cells become impaired is not known.

Symptoms of Parkinson’s disease also differ from person to person. The symptoms also change as the disease progresses. Symptoms that one person gets in the early stages of the disease, another person may not get until later-or not at all.

Symptoms typically begin appearing between the ages of 50 and 60. They develop slowly and often go unnoticed by family, friends, and even the person who has them.

What is the benefit Parkinson’s patient can expect with Physiotherapy ?

As the diseases progresses, the symptoms can get worse and it can become increasingly difficult for patient to carry out everyday activities. Many people respond well to treatment and only experience mild to moderate disability, whereas few may not respond as well and can, in time, become more severely disabled.

Parkinson’s doesn’t directly cause people to die, but it can make some people more vulnerable to serious and life-threatening infections. However, with advances in treatment, most people with Parkinson’s disease now have a normal or near-normal life expectancy.

Physiotherapy plays an important role in helping the patients manage the symptoms and the benefits to patients include:

  • Improving or maintaining fitness
  • Help in retaining independence
  • Help in movement/function
  • Managing fall risk and balance
  • Pain management

Studies have shown improved flexibility, strength, walking, balance and fitness in patients who participate in a physiotherapy program.

More about Parkinsons

It’s thought around 1 in 500 people are affected by Parkinson’s disease. An estimated seven to 10 million people worldwide live with Parkinson’s disease, which is more than the combined number of people diagnosed with multiple sclerosis, muscular dystrophy and Lou Gehrig’s disease.

Most people with Parkinson’s start to develop symptoms when they’re over 50, although around 1 in 20 people with the condition first experience symptoms when they’re under 40 and men are slightly more likely to get Parkinson’s disease than women.

Parkinson’s disease, in particular, can be profoundly frustrating, as walking, talking and even eating become more difficult and time-consuming. Although friends and family can be your best allies, the understanding of people who know what you’re going through can be especially helpful.

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