Ladies and Gentlemen, I am hoping that you are staying well, getting you COVID-19 vaccination (both doses!), social distancing, washing your hands, and wearing your mask! Through these behaviors, you reduce your risk of acquiring the COVID-19 virus, while you protect others from exposure.
For this message, though, I want to focus on the mask that you are wearing. The mask should be secured enough to your face to cover both your nose and mouth to prevent airborne spread of the virus. Yes, you must ensure that both your nose and mouth are properly covered. This practice requires that the top border of the mask fits onto the top of your nose right under your eyes. I expect that you, like me, are frequently adjusting your mask to ensure that your nose is covered properly. This correct mask placement results in decreased vision, blocking your peripheral lower visual field.
To compensate for this loss, we are looking down more often, so that we are actually looking at our feet, our foot placement, as we walk, navigate pathways and ascend and descend steps. We are making an extra effort to look down at our feet and see where we are going, which is a logical compensatory strategy to decreased vision.
Also, you, like me, may wear glasses, bifocals, that also requires that we take special precautions while we walk be because of changes in depth perception. Our glasses fog up as we breath while wearing our mask. This fog diminishes and sometimes blocks our vision, requiring us to slow down or even stop walking until our glasses clear.
These problems are unintended consequences of wearing masks, which are essential to keep us and others safe from becoming infected with the COVID-19 virus. Well, researchers are concerned, have investigated these problems, and offered solutions.
In October, 2020, researchers from the United Kingdom became interested in understanding the effects of masks on walking safely and increasing fall risks, with special focus on older adults (Kal, Young, & Ellmers, 2020).
They found that indeed face masks block the lower part of our peripheral visual field for all persons, of greater concern for older adults because of the importance of full visual fields for safe ambulation and balance. An unobstructed lower visual field is essential to scan for walking hazards, navigate walk-ways, and safely step up and down without falling. Because of the sensory loss from less visual capacity, we have increased risk of slipping, tripping or falling.
Because of their findings, these researchers suggest that our logical compensatory strategy is to make extra efforts to look down, which is not safe. They also suggest that we must slow down and make sure your mask fits properly on your face. Here are their recommendations.
Don’t Look Down
The researchers remind us that we must look forward and scan our environment for obstacles in order to walk safely through the environment. Looking down prevents us from being as safe as we need to be to walk, navigate pathways, and plan for a safe pathway. By looking at the ground, at our feet, we can also experience stepping errors and miss tripping hazards. So, we must look forward, keep our head up to be able to look forward and around the environment. These same safety recommendations applies to persons with balance problems, Parkinson’s disease, and / or diabetic sensory neuropathy. Maximum vision is vital to maintaining balance. By keeping your head up and looking forward while wearing your mask, you increase your safe ambulation, reduce your fall risks, and remain vigilant to hazards in your environment.
The second safety strategy the researchers recommend for us is to take our time walking, to slow down. If we are walking at a fast pace, we have to turn our head with and look around more often. When we slow down, we have less “need for large, rapid head and eye movements while walking”, which puts us at greater risk for slipping, tripping and falling.
Secure Mask Fit
Lastly, the researcher advise that we must make sure the mask fits tightly on and around our nose and cheeks. A tight fitting mask increases your safety by protecting you from being infected with the COVID-19 vaccine, maximizing your lower visual field so the mask not sliding up closer to your eyes, and reducing the fogging of your glasses. So, have a mask that you can pinch around your nose or is already fitted for your nose and cheeks.
While everyone must wear masks, the loss of the lower peripheral vision, the fogging of glasses, the change in gait and balance, are all unintended and real consequences that increase fall risks and are manageable. By following these simple recommendations, you can continue to adjust to mask-wearing, maximize your function, safely navigate within your environments, and reduce your fall risks.
Your Harmony Team is committed to reducing your fall risks, to help you prevent falls, with our goals to promote your function and independence.
I hope this message is helpful to you and provides easy strategies for your safety. If you have concerns, remember to talk to you Harmony Team. Open communication with your healthcare team as you adjust to this changed way of living, helps you to maximize your health and function, essential to reducing your fall risks.
As always, stay safe, strong, active, wear your tight-fitting mask, look forward and around, and remain connected with your healthcare team.
Your Harmony Team is here to help you!
Thank you for reading this message.
Kal, E.C., Young, W.R., & Ellmers, T.J. (2020). Face masks, vision, and risk of falls. BMJ, 371: m4133. Available: https://www.bmj.com/content/371/bmj.m4133