SECOND OF TWO PARTS

Participating in a tai chi class, striking a yoga pose or engaging in core-strengthening exercises is good for your health, and not just in the ways you might expect.

Especially for the elderly, activities that stabilize the body and improve flexibility and balance can help people avoid falls, said Teresa Wong, manager of the Rehab at Nuuanu outpatient clinic, part of the Rehabilitation Hospital of the Pacific.

"Falls happen to everyone of all ages. However, as we age, the frequency increases and the consequences are much more significant. ‘Body-proofing’ halts and often reverses the natural impact of aging on our musculoskeletal system," she said.

Those natural impacts include decreased vision, slower reflexes, diminished strength and poor coordination and balance — a dangerous mix that increases the risk of stumbling or falling. The consequences include brain and spinal cord injuries; fractures of the hip, pelvis, ankles and forearms; and worse.

Falls are responsible for almost half the injury-related deaths among Hawaii’s elderly, according to the state Health Department. And about a quarter of those who survive their initial injuries succumb within a year to complications such as thrombosis, pneumonia, wound infections and bedsores. Others find their mobility has been severely limited and they are no longer able to live independently.

Stella Moon says that since she began taking Pilates classes at Rehab at Nuuanu, "my balance has gotten better."

"By strengthening my core muscles, I’m able to do things better," said the Honolulu retiree, who was demure about revealing her age.

"We oftentimes take things for granted and move without thinking. I’m more flexible, so I’m less likely to get injured," she said.

Moon says her Pilates routine has improved her posture and increased mobility in her neck. "I’m using muscles that I never use in everyday life. I can tell because I’m sore the next day," she said.

The exercises are keeping her young, Moon claimed. "Age is just a number," she said. "It’s what you think, how you feel and what you do."

WONG SAID MOST people confuse cardiovascular fitness with overall fitness. "Walking alone will not address the impact of aging on strength, flexibility and balance, which causes falls. More people need core strengthening," she said.

Body-proofing against falls means improving muscular strength in the back, hips and legs; flexibility in the back, hips, knees and ankles; and balance awareness with core-muscle control. Secondary steps include routine vision screenings to ensure you are using the proper prescription for eyeglasses; staying hydrated and eating smaller meals more frequently to prevent dizziness; wearing rubber-soled shoes and clothes that fit closer to the body; and hip protectors, if needed.

The side effects of taking multiple medications also can contribute to falls, and regular checkups are important to review prescriptions, if needed, and maintain good health. "Checking blood pressure on a regular basis helps to make sure that it is not too low, which can be a sign of dehydration and result in dizziness," Wong said. "Making sure enough protein is consumed in the diet also helps."

Stan Michaels, injury prevention coordinator at the state Health Department, recommends "Tai Chi for Health" programs, developed by Dr. Paul Lam for people with arthritis, diabetes, back pain and other conditions. It is especially suited for the elderly because it can be done while seated. (See list of fall-prevention programs.)

"Seniors who are frail or weak can learn the breathing techniques and core-strengthening exercises. If they feel secure, they can stand up, but they still gain the benefits while seated," he said.

Personal trainer Rick Tashima, owner of BalanceCore Fitness Studio, said "functional training" — training the body for activities performed in daily life — should not be overlooked.

In addition to strengthening core muscles to help with balance and stability, he recommends resistance training to keep muscles fit.

Simple exercises include balancing on alternating legs, or sitting in a chair and lifting one leg at a time, and using small weights or even a can of corn, for example, to do bicep curls or lifts above the head.

"It doesn’t need to be elaborate," Tashima said.

Picking up your feet when you walk, instead of shuffling, also can cut the chances of tripping, he said.

"Everyone is in a rush these days," Tashima said. "It’s all about picking up your feet and walking slowly … just being more conscious."

In addition to improving balance, flexibility and fitness to lessen the risk of falling, seniors can learn to minimize injuries in the event of a tumble. The Hawaii Academy, a private school that emphasizes lifetime fitness, gymnastics and human science, offers a "Safe Falling" workshop and Senior FlexFit Program that teach participants how to fall "safely" using techniques adapted from tumbling and other methods.

"As long as we walk on two feet, we are prone to falls, no matter how old we are," said the academy’s Max Vercruyssen.

"Falls are inevitable, but injuries are preventable."