Falls Prevention: exercise plan
Strong legs and good balance are the best insurance you can’t buy. Programs that mix balance and strength exercise cut falls by about a third.
- Safety first: check with your GP before starting if you’ve had a recent fall, have heart or lung problems, or get dizzy. Hold a sturdy kitchen bench or chair, wear supportive shoes, and have someone nearby at first if you’re unsteady.
- Stop straight away: for chest pain, dizziness or severe breathlessness. Call 000 if it doesn’t settle. Mild muscle soreness the next day is normal.
- How often: these exercises 3 times a week, plus a walk at least twice a week. Build the walk from 5–10 minutes up to 30 minutes, at a pace where you can still talk.
- How to lift: lift over a slow count of 3, lower over a count of 5. Breathe normally.
- Progress when: you feel confident. Hold on with less of your hand, one finger at a time, until you need only a fingertip, then none. For leg strength, a physio can add ankle weights.
- Based on: the Otago Exercise Programme home booklet and the Cochrane review of exercise for preventing falls (Sherrington 2019).
Your exercises
- Sit to standFrom a sturdy chair, stand up, then sit down slowly. Use your hands if you need to; progress to no hands.Up to 10, 3 times a week
- Front knee strengthenerSit tall. Slowly straighten one knee (without locking it), then lower. Progress with an ankle weight.Up to 10 each leg, 3 times a week
- Side hip strengthenerStand holding the bench. Lift one leg out to the side, toes pointing forward and body upright, then lower slowly.Up to 10 each leg, 3 times a week
- Heel raisesStand holding the bench. Rise up onto your toes, keeping your weight over your big toes, then lower slowly.10–20, 3 times a week
- Heel-toe standHolding the bench, stand with one foot directly in front of the other, heel touching toe. Swap feet. Progress by holding on less.Hold 10 seconds each way, 3 times a week
- One-leg standHolding the bench, stand on one leg. Progress by holding on less, then not at all.Hold 10 seconds each leg, 3 times a week
- Sideways and backwards walkingAlong the kitchen bench, walk sideways 10 steps each way, then walk backwards 10 steps, holding on as needed.10 steps each way, 3 times a week
Home safety: worth doing if you’ve already fallen, recently been in hospital, or have poor eyesight or balance. Common fixes: grab rails in the shower and toilet, non-slip bath mats, rails on stairs, clearing loose rugs and clutter, and good lighting (especially at night). An occupational therapist home visit gets the best results; ask your GP.
Also counts: tai chi classes, and staying on your feet and active through the day.
Stop and see your GP or physio if
- You’ve had a fall, especially if you were hurt or couldn’t get up
- You blacked out, or feel dizzy or faint when you stand up
- Sudden weakness, confusion, or trouble speaking (call 000)
- Chest pain or unusual breathlessness when exercising
- Your medicines make you drowsy or dizzy (ask for a medicine review)
- Fear of falling is stopping you going out
Want a supervised program?
A physio or exercise physiologist can run the full Otago program with you at home, set ankle weights and progress the balance work safely. Many areas also have group strength and balance classes; ask your GP or local council. If you have a chronic condition, ask your GP about a GP Chronic Condition Management Plan (GPCCMP): it gives a Medicare rebate for up to 5 allied health visits a year (physio, exercise physiologist or podiatrist).
Evidence and more information
- Otago Exercise Programme: Strength & Balance home exercise booklet (Later Life Training)
- Sherrington et al, BJSM 2020: Exercise for preventing falls in older people living in the community, abridged Cochrane review
- NeuRA: Home safety interventions to prevent falls, a mini-review
maladywise.com/exercises/falls-prevention/