Author Affiliations: Institute of Health Policy Management and Evaluation (Dr Detsky), Department of Medicine (Drs Sinha and Detsky), University of Toronto, Ontario, Canada; and Department of Medicine, Mount Sinai Hospital and University Health Network, Toronto, Ontario, Canada (Drs Sinha and Detsky).
The ability to maintain an upright posture and walk are crucial to human survival. Until the development and dissemination of mobility assistance devices over the last few centuries, once a person lost these abilities, death often followed. Movement and upright posture are also important in protecting the integrity of organ systems and body functions such as skin, coagulation homeostasis, and cardiovascular fitness. Humans have developed considerable redundancy to sustain movement while either standing upright or sitting in a mobility assistance device like a wheelchair. Injury to one part of the neuromusculoskeletal system is compensated by recruiting other parts of the body to preserve upward mobility. However, with increasing age and injury, maintaining upright posture and movement becomes increasingly difficult. Falls are a manifestation of this phenomenon, serving as identifiers of other geriatric syndromes such as frailty and polypharmacy.
Sinha SK, Detsky AS. Measure, Promote, and Reward Mobility to Prevent Falls in Older Patients. JAMA. 2012;308(24):2573-2574. doi:10.1001/jama.2012.68313