For Healthcare Professionals

Mechanism of Action

Mechanisms of Fall Prevention

Falls occur, among other reasons, when the postural control system cannot compensate for a loss of balance in time. Manabi addresses various components of this system:

• Improvement of static, dynamic, anticipatory and reactive balance. The twelve balance exercises – for example tandem stance and tandem walking, single-leg stance, heel-to-toe walking, rising from a chair and turning movements – repeatedly challenge the balance system close to its limits of stability. Meta-analyses show improvements in static, dynamic and anticipatory balance. Better balance increases the probability of compensating for a disturbance of body stability in time, before it turns into a fall. [4]
• Improvement of sensorimotor processing and proprioception. Repeated balance exercises train the central interplay of nerves and muscles and improve the perception of position and movement of the legs. At the same time, visual and vestibular information is used more strongly for postural control. Age-related limitations of proprioception and balance function can thereby be partially compensated. [5–6]
• Improvement of gait and postural stability. Stronger leg muscles and better balance lead to a more stable gait and better control of body posture. This can reduce the risk of stumbling, slipping and the falls that result from them. Walking speed and functional mobility – for example in the Timed Up and Go test or when rising from a chair – also improve. [3][6–7]
• Reduction of fear of falling and improvement of confidence in one's own movement safety. Manabi strengthens confidence in one's own balance and can reduce the fear of falling. This matters because pronounced fear of falling can lead to a cautious, stiff gait and to a restriction of physical activity. Lack of exercise in turn promotes the decline of physical capacity and can further increase the risk of falling. Greater movement confidence, by contrast, supports natural movement patterns and the maintenance of physical activity. [4][6][8]
• Increase of the physical performance reserve. The combination of improved muscle strength, balance, endurance and possibly also cognitive performance increases general physical function and physiological reserves. This contributes to the observed reduction of falls and fall-related injuries. The underlying neuronal mechanisms, however, are not yet fully understood; scientific reviews explicitly point out these remaining uncertainties. [6][8–9]