Why falls prevention exercise works
Research consistently shows that structured exercise programs reduce falls risk in older adults by 20–30%. The most effective programs combine balance training, lower limb strengthening, and functional movement — all of which can be done at home with minimal or no equipment.
Unlike medication or environmental modifications (removing rugs, installing grab rails), exercise addresses the underlying cause of most falls: reduced muscle strength, slower reaction time, and impaired balance. A program designed by an accredited exercise physiologist targets these factors directly and progresses over time as your capacity improves.
Important: The exercises in this guide are general in nature. Before starting any new exercise program, speak with your GP or contact Exercare for an individualised falls prevention assessment. If you have a significant falls history, osteoporosis, or cardiovascular conditions, a supervised program is strongly recommended.
What causes falls in older adults?
Falls rarely have a single cause. Most falls result from a combination of:
- Reduced lower limb strength — particularly in the quadriceps, glutes and calf muscles
- Impaired balance and proprioception (the body's sense of its own position)
- Slower reaction time — reducing the ability to catch yourself when you begin to fall
- Reduced walking speed and gait changes
- Medication side effects including dizziness, sedation and low blood pressure
- Vision impairment
- Home hazards — uneven surfaces, poor lighting, loose rugs
- Fear of falling — which causes people to reduce activity, further weakening the muscles that prevent falls
Exercise addresses the physical factors directly. An exercise physiologist will also screen for medication and vision concerns and refer appropriately.
The four pillars of an effective falls prevention program
1. Balance training
Balance exercises challenge your body's ability to maintain stability in different positions and under different conditions. They work by training the neural pathways that control postural stability — making your body's balance responses faster and more reliable.
Single-leg stand
Stand behind a sturdy chair with both hands lightly resting on the back. Slowly lift one foot off the floor and hold for up to 30 seconds. Focus on keeping your standing leg slightly soft (not locked) and your core gently engaged. Alternate legs.
3 × 30 seconds each side · DailyTandem stand (heel-to-toe)
Stand with one foot directly in front of the other, heel touching toe, with a wall or chair beside you for safety. Hold this position for up to 30 seconds. Progress to closing your eyes briefly when confident.
3 × 20–30 seconds · DailyWeight shifting
Stand with feet hip-width apart, hands lightly touching a chair. Slowly shift your weight to your right foot, lifting your left foot slightly, then return and shift left. Perform slowly and with control.
10 repetitions each side · Daily2. Lower limb strengthening
Strong legs are essential for falls prevention. The quadriceps (front of thigh), glutes (buttocks) and calf muscles are the primary muscles that keep you upright and absorb the force of stumbling.
Sit-to-stand
Sit toward the front of a firm chair with feet flat on the floor, hip-width apart. Cross your arms over your chest. Lean forward slightly and stand up by pushing through your heels. Lower yourself back down slowly and with control. This is one of the most functional and effective falls prevention exercises available.
3 sets of 10 repetitions · 3–4 times per weekCalf raises
Stand behind a chair with both hands lightly resting on the back. Rise onto your toes slowly, hold for 2 seconds, then lower back down. Progress to single-leg calf raises when the double-leg version feels easy.
3 sets of 15 repetitions · 3–4 times per weekMini squat
Stand with feet shoulder-width apart, hands on a chair for support. Bend your knees to about 30–45 degrees (as if beginning to sit down) then push back up. Keep your knees tracking over your toes and your back straight throughout.
3 sets of 12 repetitions · 3 times per week3. Gait and walking training
How you walk — your stride length, pace, foot clearance and arm swing — significantly affects your falls risk. Gait training involves practising walking patterns that improve safety and confidence.
Heel-to-toe walking
Walk along a hallway placing each foot directly in front of the other, heel touching the toe of the back foot. Use one hand on the wall for safety initially. Builds balance and awareness of foot placement.
2 lengths of hallway · DailyBackwards walking
In a clear, safe space with a wall behind you, take 10 slow steps backwards. This activates different muscle groups and balance systems to forward walking and significantly challenges proprioception.
3 × 10 steps · 3 times per week4. Functional movement practice
Practising the movements of daily life — bending, reaching, turning — in a controlled way reduces the risk of falls during those activities.
Reaching exercise
Stand at arm's length from a wall. Reach forward and touch the wall, then step back. Repeat reaching to different heights — shoulder level, above head, and hip height. This trains the balance response to reaching — a common trigger for falls.
10 reaches at each height · DailyProgression matters: The exercises above are starting points. An accredited exercise physiologist will progress your program over time — adding difficulty, reducing support, and introducing dual-task training (doing a cognitive task while balancing) as your capacity improves. This progression is what makes a clinical program significantly more effective than a static handout.
Want a personalised falls prevention program?
Exercare provides home-based falls prevention programs across south-east Melbourne, funded through aged care packages, Medicare CDM plans and private health. We come to you.
How to fund a falls prevention program
A supervised falls prevention exercise program with an accredited exercise physiologist can be funded through several sources:
- Aged care Home Care Package / Support at Home — falls prevention is one of the most commonly approved allied health services under HCP. Contact your home care provider to arrange.
- Medicare CDM plan — if your GP has identified falls risk as part of a chronic condition management plan, exercise physiology sessions can be bulk billed under Medicare.
- NDIS — for participants under 65 with disability, falls prevention is fundable under Capacity Building supports.
- Private health extras — most extras policies covering exercise physiology will apply to falls prevention sessions.
- Self-funded — available with no referral required.
Frequently asked questions
How quickly will I see results?
Most people notice improved confidence and stability within 4–6 weeks of consistent training. Measurable improvements in balance tests typically occur within 8–12 weeks. Falls risk reduction builds over 3–6 months of regular exercise.
Is it safe to exercise if I've already had a fall?
Yes — provided you've been medically assessed following the fall. Exercise physiology is often recommended following a fall specifically to prevent the next one. Your exercise physiologist will work within your current capacity and build from there safely.
Do I need any equipment at home?
The exercises in this guide require only a sturdy chair. A supervised Exercare program may eventually introduce resistance bands or light weights, but these are optional and introduced gradually.
This article was written by the Exercare team. Exercare provides mobile exercise physiology including falls prevention programs across south-east Melbourne. Learn more about our falls prevention service →