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A high-fat, low-carbohydrate diet may help adults as well as children to control epileptic seizures, a study finds. Many children with hard-to-control epilepsy use a ketogenic diet. This diet is 3 or 4 parts fat to 1 part carbohydrates and protein, as measure...

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Howard LeWine, M.D., is chief editor of Internet Publishing at Harvard Health Publications. He is recognized as an outstanding clinician and teacher and is a recipient of the Internal Medicine Teacher of the Year award at Brigham and Women's Hospital. Dr. LeWine continues to practice Internal Medicine; most recently he became a hospitalist after practicing primary care for over 20 years.

Question:

What exercise or exercises should I do to help prevent falls?

Answer:

Ideally, you want to create a structured exercise program that includes some light aerobic exercise, resistance training and balance training. Start low and go slow, meaning: Keep it simple at first, using relatively light weights. Increase the complexity of balance exercises and the heaviness of the weights a little at a time.

Resistance training to reduce falls is directed primarily at increasing core strength and leg muscle strength. Core strength refers to toning and strengthening of the abdominal and back muscles.

Here is a sample session for a resistance training program:

Warm up with 10 to 15 minutes of light aerobic activity, such as walking on a treadmill or riding a stationary bike with little resistance. The goal is to slightly increase the heart rate without heavy breathing. One way to be sure that you are not working too hard at this stage is to see if you can easily talk in full sentences.

Once you are warmed up, spend the next few minutes on core strength. Start with simple abdominal muscle exercises, such as modified sit-ups called crunches. Additional abdominal exercises can be added as you get more comfortable. If you feel any strain in your low back, decrease your range of motion during your repetitions.

Next, move into some progressive resistance exercises for the legs. This can be done at home with or without ankle weights. However, using the resistance machines at the gym is easier.

The main muscle groups that you will work are the muscles that move the hips in and out, the front and back thigh muscles, and the calf muscles. I advise asking a trainer to walk you through the exercises on the machines. Start with light resistance, making sure that you can complete at least two sets of eight to 12 repetitions before adding more weight on your next workout.

Limit resistance training to three times per week.

Balance training should begin immediately. The type, duration and intensity of balance exercises depend on what a person is most comfortable starting with. No specific routine or approach is the best. You want to create a balance program that you will do every day.

Here is a simple balance exercise to get you started. See how long you can stand on one leg. You will need a stable structure (a doorway is a good choice) to hold on to before you even try to lift the leg. Practice a few times while holding on. Once you are comfortable, lift one leg slowly. Then slowly release your hands while keeping the leg lifted off the ground. Repeat with the other leg.

Measure the number of seconds you are able to keep the leg lifted without needing to grab the doorway or put the leg down. Balancing on one foot is an excellent exercise, and by measuring how long you can hold each leg up, you can keep track of your progress.

Consider learning Tai Chi -- a series of slow, purposeful body movements coordinated with mindful breathing and mental focus. It's a great way to improve balance and also increase muscle tone and strength.

Author: Howard LeWine, M.D.
Date Last Reviewed: 10/5/2007
Date Last Modified: 7/20/2009
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