Staying strong, steady and independent.

Why It Matters

Falls are common, and they are studied closely.

Around one in three adults over 65 has a fall each year in the UK, and the consequences can be severe: fractures, loss of independence, fear of falling, and a significant impact on quality of life. The figures on this page are national statistics, and the sources are listed at the foot of the page.

NICE recommends that older people at risk of falling are offered a strength and balance training programme, and an independent review of the research by the National Institute for Health and Care Research found that long-term exercise programmes reduced falls and injuries in older adults. That is the published evidence base; what any one person experiences depends on their own circumstances, and no physiotherapist can promise an outcome.

Who it helps

• Has had a fall in the past year, or is worried about falling
• Feels unsteady or lacks confidence when walking
• Has been diagnosed with Parkinson's disease
• Has had a hip or knee replacement and wants to regain full function
• Has reduced mobility after an illness, surgery or hospital stay
• Is deconditioning — becoming weaker from reduced activity
• Has difficulty with stairs, getting up from chairs, or walking outside

What treatment involves

Every programme is personalised. After an initial assessment at your home, your physiotherapist designs a plan around your specific goals and what is actually causing the problem.

• Balance training. Progressive exercises to improve proprioception and steady-state balance.
• Strength work. Building leg and core strength, which is critical for stability.
• Gait retraining. Improving walking pattern, step length and confidence.
• Functional practice. Sit-to-stand, stair climbing, getting up from the floor.
• Home hazard advice. Going through the home to identify trip hazards, lighting and furniture that make moving around harder.
• Parkinson's-specific exercise. LSVT BIG principles and amplitude-focused movement.

Why at home is better here

For elderly patients, home-based physiotherapy is not just convenient. Practising balance and strength in the exact environment where you live means:

• Exercises are relevant to your actual furniture, flooring and layout
• No exhausting travel or hospital car parks
• Family members can be involved and coached to support the programme
• Real scenarios are practised — your stairs, your chair height, your garden steps
• No risk of infection from clinical environments

Working with families and carers

Falls prevention often involves the whole family. Your physiotherapist takes time to explain the programme to family members and carers, and can give guidance on how to support exercises between sessions and what to watch for.

For families concerned about an elderly relative's mobility or safety but unsure where to start, an initial assessment provides both reassurance and a clear action plan.

Questions Sheryll is asked

Where these figures come from

Individual circumstances vary widely, and no physiotherapist can promise a particular outcome. The figures and recommendations on this page are national statistics and published guidance, from:

• NICE guideline NG249, Falls: assessment and prevention in older people and in people 50 and over at higher risk — the recommendation to offer strength and balance training to those at risk.
• National Institute for Health and Care Research evidence alert — independent review finding long-term exercise programmes reduced falls and injuries in older adults.
• Age UK, falls prevention — the one-in-three figure for adults over 65, and general guidance for families.