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Tyler Nyquvest

If you want to spend longer living at home as the years pass rather than moving to a care home, exercise professional Geoffrey Bland offers a key piece of advice: get physically active.
“Taking the first step can always be stressful – particularly for senior relatives who have no prior experience of exercise or even being in a gym,” he says. “[For family members], accompanying your relative to the gym or a clinic can help ease their anxiety or stress and help them get stronger and more stable.”
Born and raised in Hong Kong, Bland moved to Australia to complete a bachelor’s degree in exercise science and a master’s in exercise physiology.
As his experience grew, he became more engaged in the geriatric community, developing strength and balance training programmes for seniors to help them take control of their mobility and avoid injury.

Since returning to Hong Kong, Bland has been dividing his time between the geriatric community and other clients. He finds fall-prevention work especially rewarding. He recalls in particular being approached last November by someone seeking to help her mother improve her strength and mobility, and reduce the likelihood of her taking a potentially damaging tumble.
“She had a history of stroke, spinal fusion and impaired walking ability. Through once-a-week strength and balance training with some prescribed home exercises, she is now able to ascend stairs without the use of a walking aid,” Bland says.
Elderly people die waiting for overstretched Hong Kong care services
According to the World Health Organisation, falls are the second leading cause of accidental or unintentional injury deaths worldwide, accounting for an estimated 646,000 deaths annually. Another 37.3 million falls every year are severe enough to require medical attention. Most fatal falls are in adults aged 65 or older.
Consistent conditioning through strength and balance programmes can help seniors reduce fall rates, according to a June study published in The Journal of the American Medical Association.
The study by the University of British Columbia (UBC), in partnership with the Falls Prevention Clinic at Canada’s Vancouver General Hospital, showed that in-home exercise programmes can reduce falls in high-risk seniors by 36 per cent.

The 12-month clinical trial involved 344 adults aged 70 or older who had been referred to the clinic following a fall that resulted in a visit to a medical facility. Doing exercises using simple equipment like free weights at least three times a week led to participants being less likely to fall again. They also showed improved cognitive functioning.
“Falls in older adults cost C$2 billion [US$1.5 billion] per year in Canada,” said Dr Teresa Liu-Ambrose, principal investigator at the Vancouver Coastal Health Research Institute and professor of physical therapy at UBC. “Falls and fall-related injuries are key factors that predict an older adult’s transition from independent community living to a long-term care home.”
Liu-Ambrose and her team at the Centre for Hip Health and Mobility are now looking at whether taking part in the exercise programme results in reduced health-care costs.
We have a very crowded space [in Hong Kong], with very small flats. An elderly person’s home has a lot of obstacles that restrict them from doing too much exercise there
Dr Regina Sit, associate professor, CUHK’s JC School of Public Health and Primary Care
According to the Hong Kong government’s Elderly Health Service, about one in five community-dwelling adults in Hong Kong aged 65 and over fall at least once every year. Almost half of falls occur indoors and the incidence is higher in winter. Most people who fell reported injuries, with nearly 10 per cent breaking bones. The rates are higher after 75 and among residents of old age homes.
Experts agree that even though there are proven benefits to seniors exercising, many elderly people don’t take part in the available training programmes.
“As a practitioner and physician for almost 15 years, I would say only half [of seniors] are taking advantage of exercise programmes,” said Dr Regina Sit Wing-shan, associate professor at the JC School of Public Health and Primary Care at the Chinese University of Hong Kong (CUHK).
“They don’t know how to start, they have no source … We have a very crowded space [in Hong Kong], with very small flats. An elderly person’s home has a lot of obstacles that restrict them from doing too much exercise there.”

She suggests that more targeted government campaigns might encourage seniors to get active to safeguard their health.
Timothy Kwok Chi-yui, director of CUHK’s Jockey Club Centre for Osteoporosis Care and Control, has been running an assessment and intervention programme with his team since 2017 for people who suffer falls. Nearly 1,500 seniors have been assessed and had fall prevention counselling. Kwok says hundreds of others who struggle for balance and have a history of falls have taken part in CUHK programmes to improve balance and strength.
While Kwok and his team are opening more clinics around the city, he recommends seniors adopt a simple routine at home.
“Strengthening exercises can include repeated sit-stand training for quadriceps strengthening, and tiptoeing exercises to strengthen the calf muscles,” he says.
Sit-stand exercises are exactly that: sitting down slowly and then standing back up again, without the support of arms or rails, if possible. Tiptoeing exercises entail standing on tiptoes, with a wall or bar support nearby, and then allowing the heels to drop to the ground in a slow, gradual movement.

Examples of balance training include standing on one leg, and tandem walking – in which the toes of the back foot touch the heel of the front foot in each step. Kwok advises having a handrail, wall or other supporting surface nearby in case you lose your balance.
In-home exercises must be performed regularly to improve balance and maintain the fall-prevention effect. Kwok encourages people to integrate exercises into their daily life, such as performing single-leg standing while watching TV.
For those who are not sure how to get started, Bland recommends focusing on the basics.
“Working on strength rather than hypertrophy [muscle building] is very beneficial. The ability to recruit muscles quickly and rapidly can decide whether a fall occurs,” he says.
A simple cognitive task paired with a balance exercise, such as balancing on one leg while reciting multiplication tables aloud, “also proves to be both useful and fun”, he adds.


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Falls are the second leading cause of accidental or unintentional injury deaths worldwide, with most occurring in adults aged 65 or older
Simple exercises, including sit-stand training and tiptoeing exercises, can make a significant difference, but often seniors don’t know where to start


A fall can easily mean broken bones or even death for people in later life. Simple exercises, including sit-stand training and tiptoeing exercises, can make a significant difference. We find out how.


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