We often hear that “it’s normal to get older.”
At the Dr.E Rehabilitation Center, we don’t share this fatalistic view.
Yes, the risk of falling increases after 65.
But no, falls are not an “inevitable” stage of aging: it is possible to prevent risk, in particular through targeted exercises focusing on strength, balance and mobility.
In this article, we explain why structured physical exercise is one of the most effective ways to reduce the risk of falling, what the major scientific studies show, and how we have integrated this knowledge into our daily practice at the Dr.E Rehabilitation Center.
Why are falls so common after 65?
As we age, several factors combine:
- Muscle strength gradually decreases, especially in the legs (sarcopenia)
- Balance becomes more fragile
- Certain medications can affect alertness or blood pressure
- Vision changes
- The environment (stairs, rugs, lighting, bathroom) is not always adapted
Stairs, rugs, and an unsuitable environment increase the risk of falling after age 65.
As a result, it is estimated that at least 1 in 3 adults over the age of 65 living at home experience a fall each year.
Beyond bruises and possible fractures, a fall can also trigger a fear of falling again, a loss of confidence and a reduction in activities – which, paradoxically, further accelerates the loss of strength and balance.
The good news is that this vicious circle can be broken.
What the studies say: exercise really makes a difference
Several major reviews of the scientific literature (including a Cochrane Review and documents from the World Health Organization) clearly show that well-designed exercise programs can significantly reduce the risk of falls in older adults living at home.
The main findings are:
- Programs focused on balance and functional abilities (standing up, turning, stepping over an obstacle, etc.) reduce fall rates
- Multicomponent programs that combine balance training + strength training are particularly effective
- Certain practices such as Tai Chi also help reduce the risk of falling by improving postural control, coordination and confidence
A key point highlighted by these studies is the “dose” of exercise:
the best results are seen with programs totaling at least 3 hours per week, with a strong emphasis on balance and functional daily tasks (and not only on “classic” weight training while seated on a machine).
The pillars of an effective fall-prevention program
To be effective, a fall-prevention program cannot be reduced to a few generic exercises. It is built on several complementary pillars:
1. Strengthening the muscles that protect walking and transfers
Muscle strength is a “safety net.”
We pay particular attention to:
- Quadriceps (for standing up, sitting down, climbing stairs)
- Hip abductors and extensors (pelvic stability during walking, single-leg balance)
- Plantar flexors (calf muscles), essential for propulsion and stability
This strengthening is not just “bodybuilding”: it is integrated into functional movements (sit-to-stand, step-ups, quick steps, etc.).
2. Training balance in a progressive and realistic way
Balance can be trained, just like strength.
This is done through exercises that gradually increase in difficulty: changes in base of support, single-leg stance, changes in direction, slightly less stable surfaces, etc.
The aim is to challenge the system without ever leaving the safety zone.
Targeted training, supervised by a professional, helps build strength, balance, and confidence in movement.
3. Training reactions in case of imbalance
This is often referred to as “reactive stepping”: the ability to quickly take one or more steps to recover from a loss of balance before a fall occurs.
These exercises may seem simple, but they require real coordination and good confidence in one’s body. They play a key role in preventing a misstep from turning into a fall.
4. Improving walking, power and movement speed
Today we know that walking speed is an important indicator of functional health after age 65.
Exercises aimed at improving:
- The speed of getting up from a chair
- Step length and cadence
- The ability to speed up or slow down
help make a person more reactive, stable and independent in their movements.
5. Integrating “dual-task” training
In real life, we don’t walk while only thinking about our feet. We talk, carry a bag, look for an address, watch a grandchild…
That’s why it is useful, in a safe setting, to introduce dual-task exercises: walking while counting backwards, answering questions, handling an object, etc.
This helps train the brain and body to manage several pieces of information at the same time, while maintaining balance.
How we apply these principles at Dr.E
At Dr.E, we have structured our fall-prevention programs around this scientific evidence, while taking into account the reality of each individual patient.
A first step: the Strength & Fall-Risk Test
The starting point is a specific assessment that allows us to answer several questions:
- What is the strength level of the lower limbs and trunk?
- Is balance stable in single-leg stance, during changes of direction, or with small perturbations?
- How fast does the person stand up from a chair, walk and turn?
- Have there already been falls? Fear of falling ?
- Does the home environment include particular risk factors (stairs, rugs, slippery bathroom, poor lighting, etc.)?
This test is both quantitative (measurements, times, repetitions) and qualitative (observation of posture, confidence and coordination).
Then an individualized, structured and progressive program.
Based on this assessment, we design a program that is adapted to each person:
- Strengthening of the legs and trunk
- Balance training and recovery reactions
- Gait, transfer and power training
- Dual-task work, when relevant
We make sure the program is progressive (adapted to the starting level) and measurable (with tests repeated at regular intervals).
The goal is not to “do sport” for its own sake, but to regain concrete abilities: standing up without help, climbing stairs, walking outdoors, feeling safe in daily life.
A global view: environment, vision, medication
In some cases, we also suggest:
- Simple adjustments at home (moving a rug, adding a grab bar, improving lighting)
- Checking vision and, if necessary, updating correction
- Discussing with the GP the potential adjustment of certain medications (when they may promote dizziness, low blood pressure, drowsiness, etc.)
Fall prevention is more effective when this global view is adopted.
Who is the Strength & Fall-Risk Test for?
This assessment is particularly relevant if:
- You are 65 or older and feel your legs are “getting weaker”
- You have already had one or more falls, even without a fracture
- You notice that you avoid certain activities (stairs, going out, uneven ground) for fear of falling
- A relative has pointed out that you seem less stable
- You are supporting an older parent and would like an objective assessment
The aim is not to create fear, but rather to regain control over a situation that can be improved.
What does an assessment at Dr.E look like in practice?
In practical terms, a Strength & Fall-Risk Test includes several stages:
- Individual interview
We review your history (falls, pain, associated conditions), your activities, your goals and your concerns. - Measurements and functional tests
We assess strength, balance, gait, and the speed of certain movements (for example, the time needed to stand up from a chair and walk a few meters), as well as your stability in different situations. - Analysis and explanation of the results
We clearly explain where your main vulnerabilities lie, your strengths, and what this means in terms of fall risk. - Proposal of a personalized exercise plan
If appropriate, we suggest a specific program with weekly frequency, measurable goals and follow-up over time.
Preventing a fall means preserving independence
Preventing falls is not just about avoiding a fracture.
It is about protecting what matters most: independence, mobility, self-confidence and quality of life.
The goal of fall prevention: to continue performing daily activities with confidence.
At Dr.E, our priority is that each person can continue to live as long as possible according to their own choices – and not according to a fall that changed everything.
If you are asking questions for yourself or for a loved one, you can:
- Book a Strength & Fall-Risk Test via our contact form:
https://dr-e.ch/en/contact-us/ - Or contact us to discuss the situation before making a decision.
