International Journal of Physiology Health and Physical Education · Aug 2026

Fall prevention in older adults: Role of physiotherapy in improving balance and functional independence

By Sadavarte VS, Avtar R, Jallewar K et al.

Fall-related injuries and secondary complications represent one of the most pressing public health challenges in aging populations globally. Falls among older adults lead to high rates of morbidity, premature mortality, loss of functional independence, and substantial healthcare expenditure. Grounded in a complex interplay between intrinsic factors-such as sensorimotor decay, neuromuscular degeneration, cognitive decline, and vestibular dysfunction-and extrinsic environmental hazards, fall risks demand comprehensive clinical intervention. Physiotherapy serves a cornerstone role in mitigating these risks through evidence-based, multidimensional rehabilitation strategies. This comprehensive review synthesizes the pathophysiological mechanisms underlying age-related postural instability and evaluates the primary clinical assessments used to identify fall risks, including the Timed Up and Go (TUG) test, the Berg Balance Scale (BBS), the Short Physical Performance Battery (SPPB), and dynamic gait indexes. Furthermore, it provides an in-depth examination of core physical therapy modalities, including progressive resistance training, dynamic and static balance training, perturbation-based training, vestibular rehabilitation, dual-task cognitive-motor integration, and environmental hazard mitigation. Standardized home-based and community-based protocols-such as the Otago Exercise Program (OEP), Lifestyle-Integrated Functional Exercise (LiFE), and Matter of Balance-are evaluated alongside emerging technology-driven therapies, including virtual reality, active video gaming, dynamic posturography, and wearable biosensors. Overall, tailored physical therapy interventions significantly reduce fall rates, improve dynamic postural control, restore functional mobility, and disrupt the debilitating cycle of fear of falling.

doi.org/10.33545/26647265.2026.v8.i8a.196 Open access Interventions