After traffic accidents, falls are the second leading cause of accidental death in the world.
According to a 2018 World Health Organization report, about 646,000 people die every year as a result of a fall, while 37.3 million falls are serious enough to require medical attention.
Not only is the number large, but in the last two decades the number has doubled, and the age at which falls typically begin to occur (which typically occur in adults over 60 or 65 years old) is getting ahead.
The data show that, in part, human beings are losing the ability to keep in balance, such a natural ability for us that we rarely realize all the processes involved.
How have we been losing this skill and what can we do to regain it?
Although staying upright and balanced is something that comes naturally to us, it is an activity that sets in motion several physical and cognitive processes that feed into each other.
“Balance requires a series of sensory information“Dawn Skelton, professor at the Department of Physiotherapy and Paramedicine at Glasgow Caledonian University, in the United Kingdom, explains to BBC Mundo.
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“Vision is one of the main elements, but not the only one. Your eyes work with your ears and the vestibular system of the inner ear (a series of fluid channels that move when you move your head, to tell the brain in which direction it is and how fast it moves) “.
With this information, the muscles of the legs and trunk are adjusted to maintain the posture.
This system that combines different elements begins to train during the childhood, and our ability to maintain balance in the future will depend on its development.
“If you look at a young child learning to stand up, you will see that they trip and fall all the time,” explains Skelton.
“By the time he is 2 or 3 years old, he stops falling so often. This is because the nervous system is beginning to integrate information from the muscles, eyes and ears and to better understand how to balance. And by playing and doing lots of physical activity, he puts all of this into practice on a regular basis. ”
The big problem is the change in our lifestyle, which since childhood has become much more sedentary and, as a consequence, the possibility of practicing has been reduced.
“Two generations ago, most children were walking to school and not sitting in a car. But also in schools now there is much less physical activity,” says Skelton.
Life outside of school follows similar patterns, with activities mostly centered around a screen.
“If you spend your time staring at a screen, your vision will be affected. Staring for a long time at something that is close to you will make you turn nearsighted because you are not using your eyes to look further, and vision is part of the balance mechanism. ”
“If you can’t quickly adjust your vision from something close to something far away, your balance will suffer.”
If the mechanisms that come into play don’t have time to fully develop When we are young, and later as adults, we do sedentary jobs that do not represent a challenge for balance, when we reach old age, vulnerability to falls appears faster, argues the expert.
“My concern is not only the balance, but what will happen with the indices of fractures. Since we haven’t built enough bone density, they will also come earlier. ”
In the end, he concludes, it is a very simple concept: what you don’t use, you lose. “When you stop using your muscles, they disappear, and the same happens with bone density. In a week you can lose up to 1% and it can take a year to recover it.”
Other factors that affect balance have to do with our emotional state and mental health.
“The physical profile of patients with schizophrenia is characterized by a slow gait and a reduced stride, those with anxiety disorders are characterized by balance disorders and those with depression, by a slow gait and a stooped posture”, says a study published earlier this year by a team of researchers led by Ron Feldman of the Department of Anatomy and Anthropology at the Sackler School of Medicine at Tel-Aviv University in Israel.
In the case of depressed people, as they tend to accommodate their head – whose average weight ranges between 5 and 6 kilos – further forward, their entire body weight is tilted in that direction, and that makes it easier to lose weight. balance, especially since our base – the feet – are relatively small in relation to the size of the body.
Also, “because depressed people tend to take shorter steps, without raising their feet much, it is easier for them to trip,” explains Skelton.
All these effects occur without taking into account the medication, which is also another factor that can upset the balance.
In relation to anxiety, the muscles are in a constant state of alert due to the circulation of adrenaline.
“This means that the nervous system is very alert, focused on what may or may not happen, but not on maintaining balance,” says the researcher.
Balance in motion
Fortunately, there is a lot we can do to strengthen our sense of balance.
All kinds of exercise help, but particularly those activities or sports that take place in movementsays Skelton, where many things happen at the same time and we have to turn our heads regularly, and the brain must work hard to keep us balanced.
Some examples are dancing, racket sports, soccer, or riding a bike (not in a velodrome, but in a place where we have to pay attention to the environment).
But they don’t necessarily have to be activities that require a lot of strength or great physical dexterity.
Walk It is very good, especially on an uneven surface, so that the nervous system is activated so as not to fall.
“Balance is not just a matter of having strong or flexible ankles, it is also about our brain integrating information quickly, and acting quickly based on it,” explains Skelton.
For the elderly or frail, simple exercises such as stand on one foot, or go up and down in toes, O walk backwards (with help and extreme care) they also help strengthen balance.
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