Arpesella, Marisa

Boratto, Renata

Combi, Federico

Cusella De Angelis, Maria Gabriella

Spairani, Lorenzo

Tazzi, Antonio

Viani, Marta

Firenze University Press: E-Journals

IJAE Vol. 115, n. 1/2 (Supplement), 2010
41
“Wake-up Time Activation”: Exercise therapy for 
prevention of falls in older adults
Federico Combi1, Marta Viani2, Maria Gabriella Cusella De Angelis1,2, Renata Boratto1, Antonio Taz-
zi1,2, Marisa Arpesella3, Lorenzo Spairani1
1 Department Exp. Medicine, Human Anatomy Unit, University of Pavia, Italy
2 CRIAMS (Centro Interdip. di Ricerca Attività Motorie), University of Pavia, Italy
3 Department Preventive Medicine, Public Health Unit, University of Pavia, Italy
Physical inactivity is a major risk factor for developing coronary artery disease and 
stroke. It also contributes to other risk factors, including obesity, high blood pressure, a 
low level of HDL (“good”) cholesterol and diabetes. On the other way, physical activity 
doesn’t need to be strenuous to bring health benefits. What’s important is to include 
physical activity as part of a regular routine. 
Thanks to our pluriannual experience in this field, we developed and here suggest 
a sequence of movements that allow individual recovery of balance and tensile prop-
erties of periarticular and intra-articular structures, tipically reduced after sleep; this 
causes morning stiffness and, day by day, a consistent reduction of the Range Of Motion 
(R.O.M.), mainly in the Vertebral Columna. Here we describe a method consisting in a 
progression of exercise to be performed starting within the bed, waking in the morning, 
from supine, continuing in a sitting position, and finally standing. In the last 5 years, 
moore than 500 patients followed thi Protocol showing benefits which are immediate, 
persistent and bring to back pain reduction, articular R.O.M. increase, recovery of bal-
ance and coordination. 
Also older adults can gain significant health benefits with a moderate amount of dai-
ly physical activity. Anatomical and physiological aspects underlying postural reflection 
and balance deteriorate gradually with age not only because muscular aging, sarcopenia 
and arthosis but also for “ipocinesia”. We assume that subministration of this protocol 
will improve the elasticity and the reflection in older people, reducing the incidence 
of falls in this part of the population. In fact, literature data demonstrate an increment 
of falls in older within the first minutes after wake-up in the morning (not only due to 
anxiolytics or sleeping pills intake). Therefore we propose a randomized controlled trial 
and economic evaluation with the aim of improve mobility and reduce falls and related 
devastating consequences for elderly persons.
References 
Community-based group exercise improves balance and reduces falls in at-risk older 
people: a randomised controlled trial. Barnett et al. Age and Ageing 2003; 32: 407–414 
Age and Ageing Vol. 32 No. 4 # 2003, British Geriatrics Society.
Update on falls prevention for community-dwelling older adults: Review of single and 
multifactorial intervention programs. Costello et al. Journal of rehabilitation research 
& development; Volume 45 Number 8, 2008, p.1135-1152.
Interventions for preventing falls in elderly people (Review). Gillespie et al. 2009, Issue 
2 http://www.thecochranelibrary.com


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