# Balance and preventing falls > Exercise that challenges your balance, such as standing up from a chair and stepping in different directions, is the best-supported way to reduce falls. Adding strength work helps, but walking and general activity alone are unlikely to prevent falls. If you're 65 or over, aim for balance-focused exercise on at least 3 days a week. - Type: Guide - Topic: Evidence & Guidelines › Healthy Ageing - Reviewed by: Andrew Schox, BSc(Hons) PGradDipPod MPod, Podiatrist (2026-10-21) - URL: https://twikka.com/learn/balance-and-preventing-falls - Updated: 2026-10-21 - **Balance and functional exercise is the best-supported way to reduce falls:** programmes of this kind cut the rate of falls by 24% [1]. - **Strength work is a useful addition:** add it alongside balance work [2]. - **Aim for at least 3 days a week:** the WHO recommends varied activity that emphasises balance and strength for adults aged 65 and over [3]. - **Walking is worth doing, but general activity alone is unlikely to prevent falls** [4]. ## Which exercises reduce the risk of falls? Exercises that challenge your balance are the best-supported way to reduce falls, and strength work is a useful addition. Exercise programmes reduce the rate of falls in older people by 23% and the number of people who fall by 15% [1]. Programmes built around balance and functional exercises, such as standing up from a chair and stepping in different directions, reduce the rate of falls by 24%. Programmes that combine balance and functional exercises with resistance exercises probably reduce it by 34% [1]. Strength training is important for older adults generally, but on its own it isn't effective for preventing falls. Balance work comes first, and strength is added to it [2]. A strong guideline recommendation says older adults should be offered programmes with balance-challenging and functional exercises, tailored to the person, getting harder over at least 12 weeks and continuing longer for greater effect. It applies to all older adults, whatever their age or assessed risk of falling [4]. The WHO recommends that adults aged 65 and over do varied activity that emphasises balance and strength, at moderate or greater intensity, on at least 3 days a week, to improve how well they can do everyday things and prevent falls [3]. That is a minimum to aim for. Doing more is fine, and doing less still helps. Adults of any age should also aim for muscle-strengthening activities at moderate or greater intensity, working all major muscle groups, on at least 2 days a week. Any strength activity is better than none. Tai Chi may reduce the number of people who fall by about 20%; how much it reduces the number of falls is less certain [1]. For programmes that are mainly resistance training, dance or walking, the effect on falls is uncertain [1]. Guidance says general activity alone, such as walking, is unlikely to prevent falls [4]. Older adults should still be as active as their abilities allow; the balance exercises go on top. > **Try this:** Choose one balance-challenging movement, such as standing up from a chair or stepping to the side, and practise it on three days this week. ## How does exercise reduce falls in older adults? Exercise appears to reduce falls by training the muscle coordination and balance control you need to stay upright while you move [2]. Falls tend to happen during movement, such as walking or moving from standing to sitting, and rarely during quiet standing [5]. Slips and trips are described as leading to most falls among older adults living in the community [6]. That may be why exercises that copy everyday movements are likely to give more benefit [2]. General exercise may help less because it doesn't practise the quick actions that stop a fall, such as taking a step to catch yourself or grabbing something nearby [5]. Balance training is thought to work partly by helping you anticipate a stumble so you need less recovery, and partly by changing how you respond when one catches you out [6]. Strength matters too. Low muscle strength and power, and poor balance, are linked with a higher risk of a first fall, repeat falls and falls that cause injury [7]. Programmes that include functional balance and muscle strength training are the most effective, and the exercise should get progressively more challenging, be ongoing and be enough in amount [8]. It isn't simply a matter of being more active. More active people have fewer falls, but encouraging older people to be more active doesn't appear to prevent them. Specific exercise for balance and strength needs to be done regularly over a sustained period [2]. Turning up counts: programmes where people completed at least 75% of sessions were linked with bigger reductions in falls [9]. ## When to check with a health professional If you're starting exercise after a long break, it's always a good idea to see your doctor first. For an injury or a health condition, see a health professional, such as your doctor or a physio. If you have had a fall or are worried about your balance, it's sensible to talk to a doctor or physio. People at higher risk of falls may need more support to exercise safely, and some people need other measures alongside exercise. This applies to people with complex medical conditions, a recent hospital stay, or risk factors that exercise doesn't improve. Ask a doctor or physio what suits you [8]. Problems from exercise programmes like these are mostly minor and mainly to do with muscles or joints [1]. If a joint or muscle starts to hurt, stop or ease off, and see a doctor or other health professional if it persists or gets worse. If you feel dizzy, stop and rest; if it keeps happening, see a doctor. Call your local emergency number for chest pain or pressure (or pain spreading to the arm, neck, jaw or back, especially with sweating or feeling sick), severe breathlessness, fainting or collapse, signs of a stroke, a serious injury, or someone who isn't safe. ## Quick answers ### Do exercise video games help with balance? In healthy older adults, movement-based video games improved steadiness more than traditional exercise training, though the advantage for moving balance was small. If you enjoy them, they can be one way to practise balance. Most balance apps haven't been tested, so treat them as an extra rather than a replacement for balance exercises. ### Can I do balance exercises safely at home? If you practise balance exercises at home, do them next to something steady, such as a wall or a sturdy chair, so you can steady yourself if you wobble. As an exercise gets easier, make it a little harder, for example by standing rather than sitting, and keep practising regularly so the benefit builds. ## Sources 1. Sherrington C et al. (2019). Exercise for preventing falls in older people living in the community. The Cochrane Database of Systematic Reviews. https://doi.org/10.1002/14651858.cd012424.pub2 2. Exercise and Sports Science Australia. Updated position statement on exercise for preventing falls in older people living in the community. https://www.essa.org.au/Common/Uploaded%20files/Publications/Position-statement-updated-exercise-falls-prevention.pdf 3. Bull FC et al. (2020). World Health Organization 2020 guidelines on physical activity and sedentary behaviour. British Journal of Sports Medicine. https://doi.org/10.1136/bjsports-2020-102955 4. Montero-Odasso M et al. (2022). World guidelines for falls prevention and management for older adults: a global initiative. Age and Ageing. https://doi.org/10.1093/ageing/afac205 5. Gerards MHG et al. (2017). Perturbation-based balance training for falls reduction among older adults: Current evidence and implications for clinical practice. Geriatrics & Gerontology International. https://doi.org/10.1111/ggi.13082 6. McCrum C et al. (2022). Perturbation-based balance training: Principles, mechanisms and implementation in clinical practice. Frontiers in Sports and Active Living. https://doi.org/10.3389/fspor.2022.1015394 7. Public Health England. Muscle and bone strengthening and balance activities for general health benefits in adults and older adults. https://assets.publishing.service.gov.uk/media/5b3b6359ed915d33bb4b1200/MBSBA_evidence_review.pdf 8. Tiedemann A et al. (2025). Exercise and Sports Science Australia updated position statement on exercise for preventing falls in older people living in the community. Journal of Science and Medicine in Sport. https://doi.org/10.1016/j.jsams.2024.09.003 9. Hua Y et al. (2026). Adherence and effectiveness of multicomponent exercise fall prevention programmes across delivery formats in community-dwelling older adults: a systematic review and multilevel meta-analysis. Archives of Gerontology and Geriatrics. https://doi.org/10.1016/j.archger.2026.106304 --- Source: Twikka (https://twikka.com/learn/balance-and-preventing-falls). General information about physical activity, not medical advice.