For falls prevention, it is recommended that exercise programs are designed or delivered by a trained professional, such as a physiotherapist or exercise physiologist. This will ensure the exercises are challenging yet safe for older adults to do.
The intensity of exercise programs should be individually prescribed and progressive. It is important that the instructor is sensitive to an older adults level of fatigue and tailor the intensity of the program accordingly.
Exercise programs may be delivered in a group setting or individually with one older adult and instructor. The exercise program should be delivered on an ongoing basis and include a maintenance component to avoid a deconditioning effect if it does conclude (a decrease to the muscle strength and balance benefits of exercise when the older adult finishes the program).
The following exercise programs are designed to reduce the rate of falls and risk of falling in older people living in the community
Tip: It is also important to consider what activities or programs the older person will enjoy and if it is something that they will participate in!
The Otago Exercise Program (Otago)
The Otago Exercise Program is an individually prescribed home exercise program comprising of balance retraining, lower limb muscle strengthening and walking components. Randomised controlled trials have shown that it is effective in reducing falls in older people when delivered for one year by an experienced physiotherapist, or by a training nurse (under physiotherapist supervision).
Overall, in four trials, the Otago Exercise Program reduced the rate of falls by 35% and the rate of injuries by 35%. The program was found to be more effective (and therefore more cost effective) in people aged 80 years and older, and in people who had fallen previously. However it is suitable for the majority of older adults living in the community.
Lifestyle-Integrated Functional Exercise Program (LiFE)
The LiFE Program approach involves older adults learning movements that are specifically prescribed to increase lower limb strength or improve balance. These movements are then integrated into activities of daily living so they can be conducted multiple times during the day. A randomised controlled trial has demonstrated that the LiFE Program reduced falls in older adults by 31% and also significantly and moderately improved their dynamic balance.
Tai Chi for Falls Prevention
Tai Chi for falls prevention is a safe and effective balance exercise that older adults can do to reduce falls. The benefits of Tai Chi include improvements in balance, flexibility, muscle strength and postural alignment.
Group-based Tai Chi has been shown to significantly reduce falls in a trial of people aged 70 years and over. However the same intervention in a group of transitionally frail older adults was not effective, indicating that Tai Chi is likely to be more beneficial in the less frail population. A program of Tai Chi classes for one hour per week for 16 weeks was also effective in reducing falls by 33% at six months in older people between 60 and 96 years.
There are various forms of Tai Chi so it is important to choose an appropriate form with your older person.
Training in Otago, Life and Tai Chi for Falls Prevention
Would you like to deliver a strength and balance exercise program such as Otago, LiFE or Tai Chi for falls prevention to older adults living in the community? Click here to view upcoming Stay On Your Feet® training.
Living Longer Living Stronger
Living Longer Living Stronger is a Western Australian evidence-based progressive strength training and exercise program designed specifically for people aged fifty and over to reduce falls, improve health, quality of life and fitness. Qualified program instructors deliver individualised and supervised exercise programs in a safe and friendly environment.
Falls clinics – Falls Clinics are located at a number of hospitals throughout Perth. These clinics treat older people who have had a number of falls, one fall with a significant injury (e.g. broken bone), or are at high risk of falling due to problems with their balance, walking or medical conditions.
Falls specialist program – Falls Specialists are co-located at some falls clinics and target older adults over the age of 65 who are at risk of a fall, or have already experienced a fall and would benefit from a detailed assessment of their risk of falling.
Community physiotherapy services – The Community Physiotherapy Service offers community based rehabilitation, incorporating physical activity and education programs for adults with chronic conditions. Specific falls prevention programs are designed to minimise falls risk and optimise balance, physical ability and function. They are targeted at adults identified as at risk, or with a history of falls.
Physiotherapists – Physiotherapists can assist older adults in reducing their risk of falling through assessment and prescribing exercises tailored to the individual’s needs and capabilities.
Accredited Exercise Physiologists – Exercise Physiologists deliver exercise for the prevention and management of chronic diseases and injuries.
What does the evidence say?
A meta-analysis of group-based exercise programs found that programs that challenge balance and include frequent exercise, reduce falls rates more than programs without these features. The pooled results from 44 trials of exercise programs to prevent falls indicated that people allocated to exercise programs had 17% fewer falls that those who weren’t (control group). Programs that include greater challenge to balance and a higher dose of exercise, but did not include a walking program, had the greatest effect on falls. These programs reduced falls by 42%.
- Are you interested to learn how to deliver Tai Chi or Otago? Why not find out when our next training is being held?
- Are you working with an older adult who would benefit from participating in an exercise program that challenges and improves their strength and balance? Click here for a directory of providers of exercise programs throughout Western Australia.
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