What is the relationship between fall prevention and mobility maintenance?

The essence of the two is a symbiotic relationship of two-way support and mutual causation - fall prevention is the core bullseye of mobility maintenance, and continuous and scientific mobility maintenance is the core focus of reducing the risk of falls from the root cause.

It’s interesting to say that in the five years I have been doing geriatric rehabilitation in the community, I have seen many families separate these two things, and they have stepped into many pitfalls. There used to be a 68-year-old Aunt Zhang who fell and bruised her skin. Her daughter was so frightened that she "locked" her in the house and refused to let her go downstairs. She always brought her meals to her. However, when she was only three months old, she tripped her foot on the floor while walking to the bathroom and broke her femoral neck. She lay there for half a year. When she got up again, she even struggled to walk with a walker. She could still buy groceries and cook by herself, but now she is completely inseparable from others.

There are actually two common disagreements about these two matters. Many family members feel that "the less you move, the less likely you will fall." They equate preventing falls with restricting activities, which in turn destroys the elderly's mobility.； There are also some impatient old people who think that they need to practice vigorously to prevent falls. They walk 20,000 to 30,000 steps a day and insist on standing on one leg. As a result, they either wear out their knees, or they lose their center of gravity and fall directly during practice, which is counterproductive.

In fact, to put it bluntly, mobility is like the load-bearing wall of your old house. Preventing falls means preventing the wall from collapsing. You regularly check, repair cracks, and strengthen the structure. This is to maintain mobility. The wall is naturally strong and will not collapse easily.； If you are afraid of the wall collapsing, you won't even dare to live in the house or even open the windows. Instead, the wall will slowly get damp, soften, and collapse faster. I talked to doctors in the rehabilitation department of a tertiary hospital before, and they said that clinically, more than 80% of the elderly who fall and fracture are not "accidental" in nature, but are caused by insufficient muscle mass in the lower limbs.

Last month, there was a 78-year-old Uncle Li in our community. He used to hold on to a walker and was afraid to move his legs for fear of falling. We measured his muscle mass and balance ability, and the plan we gave him was to stand on the dining table for 5 minutes every day, sit on a chair and lift his legs 10 times, and then slowly go downstairs and walk around the unit door twice. Usually, He was reminded to wear non-slip cloth shoes and all the cardboard boxes in the aisles of his house were cleared. In just two months, Uncle Li can now carry a small cloth bag downstairs to buy soy sauce. He has not fallen once in almost half a year. He told me a while ago that he now has strength under his feet and can hold on even if he steps on a pebble, and he is no longer afraid of falling.

In fact, these two things are not separate at all. The adjustments you make to prevent falls, whether it is clearing obstacles at home or wearing non-slip shoes, are actually paving the way for mobility maintenance, allowing the elderly to dare to move and move safely.； And the strength and balance you slowly develop will in turn prevent you from falling even if you encounter a small accident. There is no need to go to extremes.