The importance of geriatric physiotherapy in the prevention of falls and concomitant injuries of the spine

  • S Ntamaris
  • E Vassileiadis
Keywords: elderly, falls, prevention, physical therapy, spinal cord injury


Due to demographic issues, world population tends to age gradually. Physiological deterioration over time can lead to decreased balance capacity and increased risk of falls in old age. Frailty syndrome is therefore defined as the age-related reduction of multiple physiological processes and functions, with a negative impact on multiple areas of health such as disability, injury, various diseases, hospitalizations, falls and mortality, affecting the spine directly and indirectly.

Prevention of falls among the elderly is therefore imperative for healthcare systems. Interventions such as resistance training, balance training, endurance training, coordination training, combination exercises (ie, simultaneous strength, endurance and balance training) as well as Tai-chi, have yielded beneficial results in some functional parameters.

Recent technological developments have also led to the introduction of new virtual reality-based practice methods for performing different tasks. There is evidence that falls can be prevented by screening for risk factors and prescribing custom interventions. Determining the type of exercise intervention that is safest, most effective and most easily applicable would greatly assist clinical physiotherapists and caregivers in making informed decisions about which interventions to perform, always depending on the given clinical goals and budgets restrictions.


Download data is not yet available.

Author Biographies

S Ntamaris

Postgraduate training program: “Rehabilitation following spinal cord lesions. Spinal pain management”, National & Kapodistrian University of Athens, Greece

E Vassileiadis

3rd Department of Orthopaedic Surgery, National & Kapodistrian University of Athens, KAT General Hospital of Attica, 2 Nikis Street, Kifisia, 14561, Greece.


1. Thomas E, Battaglia G, Patti A et al. Physical activity programs for balance and fall prevention in elderly: A systematic review. Medicine (Baltimore). 2019;98(27):e16218
2. Chittrakul J, Siviroj P, Sungkarat S et al. Multi-System Physical Exercise Intervention for Fall Prevention and Quality of Life in Pre-Frail Older Adults: A Randomized Controlled Trial. Int J Environ Res Public Health. 2020;17(9):3102
3. Tricco AC, Thomas SM, Veroniki AA et al. Comparisons of Interventions for Preventing Falls in Older Adults: A Systematic Review and Meta-analysis. JAMA. 2017;318(17):1687-99.
4. Cadore EL, Rodríguez-Mañas L, Sinclair A et al. Effects of different exercise interventions on risk of falls, gait ability, and balance in physically frail older adults: a systematic review. Rejuvenation Res. 2013;16(2):105-45.
5. Cho GH, Hwangbo G, Shin HS. The Effects of Virtual Reality-based Balance Training on Balance of the Elderly. J Phys Ther Sci 2014;26(4):615–17
6. Avin KG, Hanke TA, Kirk-Sanchez N et al. Academy of Geriatric Physical Therapy of the American Physical Therapy Association. Management of falls in community-dwelling older adults: clinical guidance statement from the Academy of Geriatric Physical Therapy of the American Physical Therapy Association. Phys Ther 2015;95(6):815-34.
7. Li F, Harmer P, Fitzgerald K et al. Effectiveness of a Therapeutic Tai Ji Quan Intervention vs a Multimodal Exercise Intervention to Prevent Falls Among Older Adults at High Risk of Falling: A Randomized Clinical Trial. JAMA Intern Med 2018;178(10):1301-10
8. Harnish A, Dieter W, Crawford A, Shubert TE. Effects of Evidence-Based Fall Reduction Programing on the Functional Wellness of Older Adults in a Senior Living Community: A Clinical Case Study. Front Public Health. 2016;4:262.
9. Toronjo-Hornillo L, Castañeda-Vázquez C, Campos-Mesa MD et al. Effects of the Application of a Program of Adapted Utilitarian Judo (JUA) on the Fear of Falling Syndrome (FOF) for the Health Sustainability of the Elderly Population. Int J Environ Res Public Health. 2018;15(11):2526.
10. Mittaz Hager AG, Mathieu N, Lenoble-Hoskovec C et al. Effects of three home-based exercise programmes regarding falls, quality of life and exercise-adherence in older adults at risk of falling: protocol for a randomized controlled trial. BMC Geriatrics 2019;19:13
11. Kwak CJ, Kim YL, Lee SM. Effects of elastic-band resistance exercise on balance, mobility and gait function, flexibility and fall efficacy in elderly people. J Phys Ther Sci. 2016;28(11):3189-96.
12. Mańko G, Pieniążek M, Tim S, Jekiełek M. The Effect of Frankel’s Stabilization Exercises and Stabilometric Platform in the Balance in Elderly Patients: A Randomized Clinical Trial. Medicina (Kaunas). 2019;55(9):583
13. Długosz-Boś M, Filar-Mierzwa K, Stawarz R et l.. Effect of Three Months Pilates Training on Balance and Fall Risk in Older Women. Int J Environ Res Public Health. 2021;18(7):3663.
14. Cederbom S, Arkkukangas M. Impact of the fall prevention Otago Exercise Programme on pain among community-dwelling older adults: a short- and long-term follow-up study. Clin Interv Aging. Clin Interv Aging. 2019;14:721-26.
15. Kang KY. Effects of visual biofeedback training for fall prevention in the elderly. J Phys Ther Sci. J Phys Ther Sci. 2013;25(11):1393-5
16. Cho SI, An DH. Effects of a Fall Prevention Exercise Program on Muscle Strength and Balance of the Old-old Elderly. J Phys Ther Sci. 2014; 26(11):1771-74
17. Zhuang J, Huang L, Wu Y et al. The effectiveness of a combined exercise intervention on physical fitness factors related to falls in community-dwelling older adults. Clin Interv Aging. Clin Interv Aging. 2014;9:131-40.
18. Vincenzo JL, Hergott C, Schrodt L et al. Physical Therapists as Partners for Community Fall Risk Screenings and Referrals to Community Programs. Front Public Health. 2021;9:672366
19. Peng HT, Tien CW, Lin PS et al. Novel Mat Exergaming to Improve the Physical Performance, Cognitive Function, and Dual-Task Walking and Decrease the Fall Risk of Community-Dwelling Older Adults. Front Psychol.2020;11:620
20. Day L, Fildes B, Gordon I et al. Randomized factorial trial of falls prevention among older people living in their own homes. BMJ 2002;325(7356):128
21. Finnegan S, Seers K, Bruce J. Long-term follow-up of exercise interventions aimed at preventing falls in older people living in the community: a systematic review and meta-analysis.Physiotherapy.2019;105(2):187-99
22. Cho SI, An DH. Effects of a Fall Prevention Exercise Program on Muscle Strength and Balance of the Old-old Elderly. J Phys Ther Sci 2014; 26(11):1771-74.
23. Wetherell JL, Bower ES, Johnson K et al. Integrated Exposure Therapy and Exercise Reduces Fear of Falling and Avoidance in Older Adults: A Randomized Pilot Study. Am J Geriatr Psychiatry. 2018;26(8):849-59.
24. Arena SK, Wilson CM, Boright L et al. Impact of the HOP-UP-PT program on older adults at risk to fall: a randomized controlled trial. BMC Geriatrics 2021;21:520
25. Clemson L, Fiatarone Singh MA, Bundy A et al. Integration of balance and strength training into daily life activity to reduce rate of falls in older people (the LiFE study): randomized parallel trial. BMJ 2012;345:e454726.
26. van het Reve E, de Bruin ED. Strength-balance supplemented with computerized cognitive training to improve dual task gait and divided attention in older adults: a multicenter randomized-controlled trial. BMC Geriatr. 2014;14:13427.
27. Reed-Jones RJ, Dorgo S, Hitchings MK et al. Vision and agility training in community dwelling older adults: incorporating visual training into programs for fall prevention. Gait Posture. 2012;35(4):585-89
28. Wang Y, Wang S, Bolton R, Kaur T, Bhatt T. Effects of task-specific obstacle-induced trip-perturbation training: proactive and reactive adaptation to reduce fall-risk in community-dwelling older adults. Aging Clin Exp Res. 2020;32(5):893-905
29. Goble DJ, Hearn MC, Baweja HS. Combination of BTrackS and Geri-Fit as a targeted approach for assessing and reducing the postural sway of older adults with high fall risk. Clin Interv Aging. 2017;12:351–57
30. Zhou TY, Yuan XM, Ma XJ. Canan Outdoor Multisurface Terrain Enhance the Effects of Fall Prevention Exercise in Older Adults? A Randomized Controlled Trial. Int J Environ Res Public Health.2020;17(19):7023.