Physical Therapy Management of Fall Risk in Community-Dwelling Older Adults: An Evidence-Based Clinical Practice Guideline From the American Physical Therapy Association - Geriatrics.
Neva Kirk-Sanchez, Christine McDonough, Keith G Avin and 2 others
PMID 40245873WHAT IT FOUND
Multicomponent exercise with progressive balance training is the most effective way to reduce falls.
Tai Chi works well for lower-risk patients. Resistance training or education alone does not reduce falls and should not be used in isolation.
Key findings
01Multicomponent exercise programs that include balance training significantly reduce fall rates and risk, with the strongest evidence supporting progressive, challenging balance exercises.
02Resistance training alone and education alone are not recommended for fall reduction because they offer limited or no benefit when not combined with other interventions.
03Tai Chi is strongly recommended for reducing falls, particularly for older adults at lower risk, but multicomponent exercise is preferred for those at high risk.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTsWhat it means for SLPs
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What it does not show
The guideline excludes studies on individuals with specific conditions like Parkinson's disease, dementia, or hip fractures, so it does not address fall management for these populations. It does not define a standard for 'high risk' vs 'low risk' due to inconsistent definitions in the literature, requiring clinicians to use judgment. The evidence for reactive step (perturbation) training is mixed, leading to only a weak recommendation. Group vs. individual exercise delivery showed no significant difference in effectiveness, leaving the choice to patient preference and availability.
Declared interests
The authors declared no conflicts of interest. The guideline was developed by the APTA-Geriatrics Academy.
The easy way to misread this
Do not prescribe resistance training or patient education as standalone interventions for fall prevention. The evidence shows these methods alone do not significantly reduce fall rates or risk. They must be part of a multicomponent program that includes progressive balance training.