Falls are very prevalent in older people. More than 30% of people older than 65 suffers at least one fall a year, of which half experience multiple falls (Gillespie et al. 2009). Of these falls from 24% to 53% requires medical attention and from 5% to 10% result into severe injuries, with hip fractures (1%) being the most frequent (Gillespie et al. 2009).

Many studies have been carried out in order to determine the causes of the falls in the older population as well as establishing prevention strategies. Many socio-demographic factors, medical conditions and impairments of sensorimotor function, balance and gait have been strongly related to falls.

There is now strong evidence to support interventions in the prevention of falls in older people. Strategies shown to successfully reduce falls in randomised controlled trials include exercise, occupational therapy interventions incorporating education and home hazard modification, psychotropic medication withdrawal, expedited cataract extraction, cardiac pacing for carotid sinus hypersensitivity and targeted multi-factorial interventions (Gillespie et al. 2009).

Among the different approaches for the reduction of the risk of falls and the rate of falls, exercise is the most tried and tested approach to falls prevention and has been shown successful as a single intervention strategy in community dwelling populations

Exercise covers a wide range of physical tasks (balance, strength, flexibility etc.) delivered in numerous formats, some of which are likely to result in greater reductions in falls than others. In the meta-analysis of Gillespie et al. 2009, the authors classified the needed exercises as follows:

• Gait/Balance/Functional training
• Strength/resistance training
• Flexibility training
• 3D (Tai Chi, dance, etc.)
• Endurance training
• Others

Whilst there are many health and social benefits from a range of exercise regimes, it is primarily moderate to high level balance training that has been shown to impact significantly on falls rates (Sherrington et al. 2008). Effective programs could be either conducted in a group setting (such as Tai Chi) or as an individualized program at home. It has also been suggested that the minimal effective exercise dose would equate to a twice-weekly program running over 25 weeks. Strategies for achieving long term exercise participation are therefore crucial in the prevention of falls.