• Introduction
• Client Information
• Healthcare Professional Information
• Falls pathway
• How do I assess for falls?
• Exercise to reduce the risk of falls
• Exercise interventions for fallers, patients at risk of falls and/or fearful of falling
• Exercise advice and recommendations for exercise outside health service provision
• Community exercise programmes
• Community exercise class
• Otago home exercise programme
• Strength and balance Class
• One to one physiotherapy
• Occupational Therapy
• Assessment and Referral Forms
• Relevant Falls Related Information
• News

Healthcare Professional Information

Exercise to reduce the risk of falls

All clients should be assessed by a physiotherapist (and any medical cause(s) for fall(s) excluded) prior to commencing exercise intervention. If muscle weakness, poor balance or co-ordination and/or fear of falling is identified on assessment, a programme of strength and balance exercises is recommended. There are a number of different options for learning these exercises depending on the level of support or supervision required to carry out the exercise effectively, and the choice of the individual taking part.

It is important to remember that exercise must be continued for life to maintain the benefits.

Types of exercise interventions

Depending on the client’s level of motivation and physical and cognitive function, the various exercise opportunities available are:

• One to one strength and balance training with physiotherapist/assistant
• Physiotherapy led strength and balance class run at falls clinic
• Otago home exercise programme with rehabilitation assistant/physiotherapy assistant
• Community exercise class run by postural stability instructor
• Exercise groups in the community (including chronic disease exercise groups)
• Leisure card scheme at local leisure centre for general exercise
• Walking groups.

How do I choose the most appropriate intervention for my client?

Once a cause of falls has been established (and any medical cause has been excluded), the segmentation chart should always be used to determine the most appropriate exercise intervention for the client. Please refer to the Assessment section of the website if the client has not been assessed. The type of exercise intervention indicated is dependent on the presence and severity of any strength, balance and cognitive impairment.

Segmentation matrix

SLIPS Segmentation	No/mild balance impairment Low/no/mild falls risk score on PPA	Moderate balance impairment Ability to stand unsupported for 30 seconds Moderate/marked falls risk score on PPA but balance is adequate for safe independent exercise	Severe balance impairment Inability to stand unsupported for 30 seconds Marked falls risk score on PPA but balance is inadequate for safe independent exercise
Able to participate independently (Good cognition/ motivation)	Leisure card for general exercise. Walking groups. Advice on exercise.	Otago home exercise programme. Community exercise groups.	One-to-one strength and balance training with physiotherapist/assistant.
	1A	2A	3A
Unable to participate independently (Poor cognition/motivation/extreme fear of falling)	Exercise groups in community including chronic disease exercise groups.	Strength and balance class. Exercise in care homes/day centres.	One-to-one strength and balance training with physiotherapist/assistant.
	1B	2B	3B

Falls referral pathway

Please ensure that the falls pathway is followed to ensure that clients receive the most effective falls management. The following care pathway should be used.

Any questions?

If any aspect of the assessment and referral pathway is unclear, please contact us.