According to the Centers for Disease Control, one in three adults aged 65 and older falls each year. Seniors are hospitalized 5 times more often for fall-related injuries than for any other type of injury. One cause of falls among older adults is disorders of the inner ear vestibular system, stated a recent study. Published in the May 25 issue of the Archives of Internal Medicine (2009; 169 [10], 938–44), the study found that 35% of adults aged 40 years and older experience vestibular dysfunction, and those with vestibular dysfunction are 12 times more likely to have a serious fall than those free of the disorder. “Vestibular imbalances need to be taken seriously because falls can be fatal and injuries can be painful, lead to long hospital stays and result in loss in quality of life,” stated study author Lloyd B. Minor, MD.

Though vestibular disorders must be diagnosed by a physician, this study highlights the
importance of focused balance training for older-adult clients, states IDEA presenter Stephanie Hoffman, MS, PT, owner of La Jolla Physical Therapy. “Personal trainers can help the client focus on good proprioception by giving single-leg stance exercises,” she adds. “For example, have the client stand on one leg for 30 seconds and alter the position of the arms while maintaining balance.” Hoffman suggests placing emphasis on holding the ankle in a neutral position. Once mastered, this same exercise can be upgraded to balancing on an uneven surface. “Progress these exercises to holding the foot steady while nodding or shaking the head. This challenges the vestibular system, and therefore improves it.” Discontinue the exercise if the client experiences dizziness, she warns.

For more information on this topic, check out the following resources at

  • “A Fall Prevention Program,” by Catherine Logan, MSPT, September 2006 IDEA Fitness Journal
  • “What Types of Exercises Do You Use to Help Older Adults Prevent Falls?” Tricks of the Trade, January 2008 IDEA Fitness Journal
  • “Improving Functional Abilities in Older Adults,” by Cody Sipe, MS, February 2007 IDEA Fitness Journal
  • Effective Fall Risk-Prevention Programs, DVD from 2006 IDEA Personal Trainer