Otago-Style Home Fall-Prevention

A home program modeled on the evidence-based Otago Exercise Programme, pairing progressive leg strengthening with balance retraining. Designed to be kept up with periodic progression.

How often: 1–5 sessions/week · trial frequency reported by the sources of the review summary this routine was written from (2 of 5 sources named by SR09.1 state one) · planning default: 3x/week, 12+ weeks · the review report’s bottom line: 2–3 sessions/week (the report's bottom-line parameter set)

When: any time · the sources state no time of day; the planner's slot is a default

The time slot is a planning choice: a swap can keep it.

The evidence applies to the practice, not to these particular steps — they are one way to carry it out.

1
Sit-to-Stand
10 reps x 2
Progress toward no-hands over weeks.
Slot: strength-for-balance
Scaffold: app-designed stepApp-designed prescriptionthe finding states duration, which this step does not carry; the finding states no sets or reps for this.
4 options for this requirement
These are the practices the completed Round-2 reviews name for strength-for-balance. The evidence rating on this routine belongs to the practice and its dose, not to any one of these. Choosing one changes what you read on this page only — it is not saved on any session in your week, and it never changes what the routine prescribes. To keep a choice, make it on the session itself in My Week.
Multicomponent programme
Compared in the review
1 paper put it in this slot · dose unit not stated
What the review holds
Otago Exercise Programme
Compared in the review
10 papers put it in this slot · dose in duration
Cannot be used here: This step's dose is measured in repetitions and this option's in duration. Converting between them is not something the research says, so the swap is refused rather than converted.
Evidence and how-to
Pilates for balance
Compared in the review
2 papers put it in this slot · dose unit not stated
What the review holds
Tai Chi
Compared in the review
5 papers put it in this slot · dose in repetitions
Evidence and how-to
2
Heel Raises (Calf Raises)
10-15 reps x 2
Fingertip support; progress to single-leg.
Slot: strength-for-balance
Scaffold: app-designed stepApp-designed prescriptionthe finding states duration, which this step does not carry; the finding states no sets or reps for this.
4 options for this requirement
These are the practices the completed Round-2 reviews name for strength-for-balance. The evidence rating on this routine belongs to the practice and its dose, not to any one of these. Choosing one changes what you read on this page only — it is not saved on any session in your week, and it never changes what the routine prescribes. To keep a choice, make it on the session itself in My Week.
Multicomponent programme
Compared in the review
1 paper put it in this slot · dose unit not stated
What the review holds
Otago Exercise Programme
Compared in the review
10 papers put it in this slot · dose in duration
Cannot be used here: This step's dose is measured in repetitions and this option's in duration. Converting between them is not something the research says, so the swap is refused rather than converted.
Evidence and how-to
Pilates for balance
Compared in the review
2 papers put it in this slot · dose unit not stated
What the review holds
Tai Chi
Compared in the review
5 papers put it in this slot · dose in repetitions
Evidence and how-to
3
Toe Raises (Tibialis Raises)
10-15 reps x 2
Light support; keep knees soft.
Slot: strength-for-balance
Scaffold: app-designed stepApp-designed prescriptionthe finding states duration, which this step does not carry; the finding states no sets or reps for this.
4 options for this requirement
These are the practices the completed Round-2 reviews name for strength-for-balance. The evidence rating on this routine belongs to the practice and its dose, not to any one of these. Choosing one changes what you read on this page only — it is not saved on any session in your week, and it never changes what the routine prescribes. To keep a choice, make it on the session itself in My Week.
Multicomponent programme
Compared in the review
1 paper put it in this slot · dose unit not stated
What the review holds
Otago Exercise Programme
Compared in the review
10 papers put it in this slot · dose in duration
Cannot be used here: This step's dose is measured in repetitions and this option's in duration. Converting between them is not something the research says, so the swap is refused rather than converted.
Evidence and how-to
Pilates for balance
Compared in the review
2 papers put it in this slot · dose unit not stated
What the review holds
Tai Chi
Compared in the review
5 papers put it in this slot · dose in repetitions
Evidence and how-to
4
Tandem (Heel-to-Toe) Stance
10-15s hold x 3 per side
Near a counter.
Slot: static balance
Named by a Round-2 review (by reading)App-designed prescriptionBelow the finding’s stated duration ≥180 per week (this routine’s is 90); session length (batch 27's derivation) and frequency are not this batch's to change.
9 options for this requirement
These are the practices the completed Round-2 reviews name for static balance. The evidence rating on this routine belongs to the practice and its dose, not to any one of these. Choosing one changes what you read on this page only — it is not saved on any session in your week, and it never changes what the routine prescribes. To keep a choice, make it on the session itself in My Week.
Dance for balance
Compared in the review
1 paper put it in this slot · dose unit not stated
Evidence and how-to
Multicomponent programme
Compared in the review
1 paper put it in this slot · dose unit not stated
What the review holds
Otago Exercise Programme
Compared in the review
7 papers put it in this slot · dose in duration
Cannot be used here: This step's dose is measured in sets × time and this option's in duration. Converting between them is not something the research says, so the swap is refused rather than converted.
Evidence and how-to
Pilates for balance
Compared in the review
2 papers put it in this slot · dose unit not stated
What the review holds
Proprioceptive training
Compared in the review
1 paper put it in this slot · dose unit not stated
Evidence and how-to
Tai Chi
Compared in the review
7 papers put it in this slot · dose in repetitions
Cannot be used here: This step's dose is measured in sets × time and this option's in repetitions. Converting between them is not something the research says, so the swap is refused rather than converted.
Evidence and how-to
Tandem stance / walking
Compared in the review
2 papers put it in this slot · dose in duration
Cannot be used here: This step's dose is measured in sets × time and this option's in duration. Converting between them is not something the research says, so the swap is refused rather than converted.
Evidence and how-to
VR / exergaming
Compared in the review
2 papers put it in this slot · dose in duration
Cannot be used here: This step's dose is measured in sets × time and this option's in duration. Converting between them is not something the research says, so the swap is refused rather than converted.
Evidence and how-to
Yoga for balance
Compared in the review
2 papers put it in this slot · dose in duration
Cannot be used here: This step's dose is measured in sets × time and this option's in duration. Converting between them is not something the research says, so the swap is refused rather than converted.
What the review holds
5
Single-Leg Stand
10-30s hold x 3 per leg
Support within reach; foundational fall-prevention item.
Slot: static balance
Named by a Round-2 reviewApp-designed prescriptionBelow the finding’s stated duration ≥180 per week (this routine’s is 90); session length (batch 27's derivation) and frequency are not this batch's to change.
9 options for this requirement
These are the practices the completed Round-2 reviews name for static balance. The evidence rating on this routine belongs to the practice and its dose, not to any one of these. Choosing one changes what you read on this page only — it is not saved on any session in your week, and it never changes what the routine prescribes. To keep a choice, make it on the session itself in My Week.
Dance for balance
Compared in the review
1 paper put it in this slot · dose unit not stated
Evidence and how-to
Multicomponent programme
Compared in the review
1 paper put it in this slot · dose unit not stated
What the review holds
Otago Exercise Programme
Compared in the review
7 papers put it in this slot · dose in duration
Cannot be used here: This step's dose is measured in sets × time and this option's in duration. Converting between them is not something the research says, so the swap is refused rather than converted.
Evidence and how-to
Pilates for balance
Compared in the review
2 papers put it in this slot · dose unit not stated
What the review holds
Proprioceptive training
Compared in the review
1 paper put it in this slot · dose unit not stated
Evidence and how-to
Tai Chi
Compared in the review
7 papers put it in this slot · dose in repetitions
Cannot be used here: This step's dose is measured in sets × time and this option's in repetitions. Converting between them is not something the research says, so the swap is refused rather than converted.
Evidence and how-to
Tandem stance / walking
Compared in the review
2 papers put it in this slot · dose in duration
Cannot be used here: This step's dose is measured in sets × time and this option's in duration. Converting between them is not something the research says, so the swap is refused rather than converted.
Evidence and how-to
VR / exergaming
Compared in the review
2 papers put it in this slot · dose in duration
Cannot be used here: This step's dose is measured in sets × time and this option's in duration. Converting between them is not something the research says, so the swap is refused rather than converted.
Evidence and how-to
Yoga for balance
Compared in the review
2 papers put it in this slot · dose in duration
Cannot be used here: This step's dose is measured in sets × time and this option's in duration. Converting between them is not something the research says, so the swap is refused rather than converted.
What the review holds
6
Tandem Walk (Heel-to-Toe Walking)
10 steps x 2
Along a wall/rail; clear the path first.
Slot: gait and stepping
Named by a Round-2 review (by reading)App-designed prescriptionthe finding states duration, which this step does not carry; the finding states no sets for this.
7 options for this requirement
These are the practices the completed Round-2 reviews name for gait and stepping. The evidence rating on this routine belongs to the practice and its dose, not to any one of these. Choosing one changes what you read on this page only — it is not saved on any session in your week, and it never changes what the routine prescribes. To keep a choice, make it on the session itself in My Week.
Gait training
Compared in the review
2 papers put it in this slot · dose unit not stated
Evidence and how-to
Multicomponent programme
Compared in the review
1 paper put it in this slot · dose unit not stated
What the review holds
Otago Exercise Programme
Compared in the review
6 papers put it in this slot · dose in duration
Cannot be used here: This step's dose is measured in repetitions and this option's in duration. Converting between them is not something the research says, so the swap is refused rather than converted.
Evidence and how-to
Perturbation training
Compared in the review
1 paper put it in this slot (inferred by the extraction, not stated in the paper) · dose in duration
Cannot be used here: This step's dose is measured in repetitions and this option's in duration. Converting between them is not something the research says, so the swap is refused rather than converted.
Evidence and how-to
Square-stepping
Compared in the review
1 paper put it in this slot · dose in repetitions
Evidence and how-to
Tai Chi
Compared in the review
3 papers put it in this slot · dose in repetitions
Evidence and how-to
Yoga for balance
Compared in the review
2 papers put it in this slot · dose in duration
Cannot be used here: This step's dose is measured in repetitions and this option's in duration. Converting between them is not something the research says, so the swap is refused rather than converted.
What the review holds
7
Backward Walking
10 steps x 2
Beside a rail; clear space behind.
Slot: gait and stepping
Named by a Round-2 reviewApp-designed prescriptionthe finding states duration, which this step does not carry; the finding states no sets for this.
7 options for this requirement
These are the practices the completed Round-2 reviews name for gait and stepping. The evidence rating on this routine belongs to the practice and its dose, not to any one of these. Choosing one changes what you read on this page only — it is not saved on any session in your week, and it never changes what the routine prescribes. To keep a choice, make it on the session itself in My Week.
Gait training
Compared in the review
2 papers put it in this slot · dose unit not stated
Evidence and how-to
Multicomponent programme
Compared in the review
1 paper put it in this slot · dose unit not stated
What the review holds
Otago Exercise Programme
Compared in the review
6 papers put it in this slot · dose in duration
Cannot be used here: This step's dose is measured in repetitions and this option's in duration. Converting between them is not something the research says, so the swap is refused rather than converted.
Evidence and how-to
Perturbation training
Compared in the review
1 paper put it in this slot (inferred by the extraction, not stated in the paper) · dose in duration
Cannot be used here: This step's dose is measured in repetitions and this option's in duration. Converting between them is not something the research says, so the swap is refused rather than converted.
Evidence and how-to
Square-stepping
Compared in the review
1 paper put it in this slot · dose in repetitions
Evidence and how-to
Tai Chi
Compared in the review
3 papers put it in this slot · dose in repetitions
Evidence and how-to
Yoga for balance
Compared in the review
2 papers put it in this slot · dose in duration
Cannot be used here: This step's dose is measured in repetitions and this option's in duration. Converting between them is not something the research says, so the swap is refused rather than converted.
What the review holds

Safety, and where each line comes from

1 reported by the review's sources25 product safeguard (app-authored)5 source silent

Each line below says where it comes from. “Reported by the review’s sources” is the source’s own words about adverse events or contraindications. “Product safeguard” is written by this app, not by the research. “Source silent” means the studies behind this routine report nothing on that point, which is not the same as saying it carries no risk.

Who should modify or avoid this

Reported by the review's sourcesRelative: High-risk individuals should avoid brisk walking programs; modifications are needed for residential care settings and those with cognitive impairment
SR09.1 · canon row 2685, contraindications field · Exercise to prevent falls in older adults: an updated meta-analysis and best practice recommendations. · studied: WHAT: Balance training with a moderate or high challenge to balance, including reducing base of support, movement of center of gravity, and reducing need for upper limb support. Walking training may be included but not brisk walking for…
Product safeguard (app-authored)Start with professional instruction where possible; progress load gradually.
From this routine’s block record, written by this app.
Product safeguard (app-authored)Designed for community-dwelling older adults, including frailer individuals.
From this routine’s block record, written by this app.
Product safeguard (app-authored)Designed for adults who can stand unaided. A recent fall, a balance or vision condition, or a fear of falling changes what is appropriate here and calls for support within reach.

Prerequisites

Product safeguard (app-authored)Written for beginner level. Equipment: chair, none. Warm up before the working sets, and learn each movement at a light load or short range before adding effort.
Source silentThe sources behind this routine's finding report nothing on prerequisites or starting level.

Hazards and adverse events

Product safeguard (app-authored)Sit-to-Stand: Fall risk: use a stable, non-rolling chair against a wall; key strength driver for standing balance.
From the exercise catalogue, written by this app.
Product safeguard (app-authored)Heel Raises (Calf Raises): Fall risk: rising onto toes reduces base—keep light support until steady.
From the exercise catalogue, written by this app.
Product safeguard (app-authored)Toe Raises (Tibialis Raises): Fall risk: shifting weight to heels can tip you backward—keep support behind or beside you.
From the exercise catalogue, written by this app.
Product safeguard (app-authored)Tandem (Heel-to-Toe) Stance: Fall risk: narrow base is unstable—position near a wall or counter and avoid on slick floors.
From the exercise catalogue, written by this app.
Product safeguard (app-authored)Single-Leg Stand: Fall risk: high—keep firm support within reach; strong predictor of fall risk, progress gradually.
From the exercise catalogue, written by this app.
Product safeguard (app-authored)Tandem Walk (Heel-to-Toe Walking): Fall risk: perform along a wall or rail; older adults should have a spotter until confident.
From the exercise catalogue, written by this app.
Product safeguard (app-authored)Backward Walking: Fall risk: you cannot see behind you—clear the space, use a rail, and prefer supervision for older adults.
From the exercise catalogue, written by this app.
Source silentThe sources behind this routine's finding report no adverse events.

Progression and regression

Product safeguard (app-authored)Sit-to-Stand: regress with Push off the armrests or thighs; Use a higher/firmer seat; Fewer reps and progress with No hands; Slow 3-second lowering; Single-leg-assisted stand.
From the exercise catalogue, written by this app.
Product safeguard (app-authored)Heel Raises (Calf Raises): regress with Two-hand support; Smaller range; Fewer reps and progress with No hands; Single-leg heel raise; Eyes closed at top.
From the exercise catalogue, written by this app.
Product safeguard (app-authored)Toe Raises (Tibialis Raises): regress with Two-hand support; Smaller lift; Fewer reps and progress with No hands; Hold at top; Combine with heel raises (rocking).
From the exercise catalogue, written by this app.
Product safeguard (app-authored)Tandem (Heel-to-Toe) Stance: regress with Fingertip support on a rail; Use semi-tandem instead; Hold 10-15s and progress with Eyes closed; Foam pad; Head turns or arm reaches.
From the exercise catalogue, written by this app.
Product safeguard (app-authored)Single-Leg Stand: regress with Hold a chair back or counter; Keep toe of lifted foot lightly touching floor (kickstand); Hold 10s and progress with Eyes closed; Stand on foam pad; Add arm reaches or ball toss (dual-task).
From the exercise catalogue, written by this app.
Product safeguard (app-authored)Tandem Walk (Heel-to-Toe Walking): regress with Walk beside a wall/counter for fingertip support; Allow a small gap between steps; Shorten distance and progress with Eyes forward with head turns; Walk on a line/tape; Carry a tray (dual-task).
From the exercise catalogue, written by this app.
Product safeguard (app-authored)Backward Walking: regress with Walk beside a rail; Very short steps; Have a spotter and progress with Longer path; Add turns; Dual-task counting.
From the exercise catalogue, written by this app.
Source silentThe sources behind this routine's finding report nothing on how to progress or regress it.

Stop conditions

Product safeguard (app-authored)Stop if you lose balance without support to hand, feel dizzy or lightheaded, or cannot recover a stumble in one step; sit down and rest before continuing.
Source silentThe sources behind this routine's finding report no stop conditions.

When to seek supervision or clearance

Product safeguard (app-authored)Two or more falls in the past 12 months, or any fall with injury
From this routine’s block record, written by this app.
Product safeguard (app-authored)Dizziness, lightheadedness, or fainting during standing or movement
From this routine’s block record, written by this app.
Product safeguard (app-authored)New or worsening unsteadiness, neurological symptoms, or numbness in the feet
From this routine’s block record, written by this app.
Product safeguard (app-authored)Fear of falling severe enough to restrict daily activity
From this routine’s block record, written by this app.
Product safeguard (app-authored)Ask a clinician or physiotherapist before starting if you have fallen in the past year, have a condition affecting balance or vision, or feel unsteady on your feet; do the first sessions with someone present.
Product safeguard (app-authored)Signs of a medical emergency (chest pain or pressure, trouble breathing, fainting, sudden weakness or numbness) mean 911 or your local emergency services; thoughts of self-harm or suicide mean the 988 Suicide & Crisis Lifeline. This app does not diagnose, treat or give personalised medical advice.
Source silentThe sources behind this routine's finding report nothing on supervision or clearance.

How to do it

The Otago Exercise Programme is a structured home routine of progressive leg-strength and balance exercises plus a walking plan, delivered over months with periodic support.

3×/week strength+balance plus 2×/week walking, ≥12 weeks, ideally ongoing

The research observed benefit across this range but hasn't pinned down the minimum amount that still works. A shorter session may still help; it just isn't validated as enough on its own.

What the evidence says

The evidence is inherited from the practice this routine implements. Any duration is allowed; the label shows where you land against the studied dose.

This practice is one way to carry out what the sources on the concept entry (phys.neuromotor.concept-dose-response) studied: exercise as a single intervention and falls or balance in older adults. Sherrington 2016 (meta-analysis, 88 studies, 19,478 participants) reports a 21% reduction in falls and concludes that exercise as a single intervention can prevent falls in community-dwelling older people, with larger effects from programmes that challenge balance and are of a higher dose; it does not single out the Otago programme. Zhang 2025 (network meta-analysis, 93 studies, 5,114 participants) lists Otago among the exercise modalities it compared and reports that exercise improves balance in healthy older adults. Pillay 2024 (meta-analysis, 219 studies, 167,864 participants) reports that evidence is most certain for benefit, at least over 1 to 2 years, from supervised, long-duration balance and resistance training and group Tai Chi. The full account, source by source, is on the concept entry this practice links to (phys.neuromotor.concept-dose-response).

Key sources

meta-analysisExercise to prevent falls in older adults: an updated meta-analysis and best practice recommendations.C. Sherrington, A. Tiedemann, N. Fairhall, J. Close., S. Lord (2011) · New South Wales Public Health Bulletin · 10.1071/nb10056 · full text

meta-analysisTai Chi for fall prevention and balance improvement in older adults: a systematic review and meta-analysis of randomized controlled trialsWeidong Chen, Min Li, Hai Li, Yanzhao Lin, Zhoushan Feng (2023) · Frontiers in Public Health · 10.3389/fpubh.2023.1236050 · full text

meta-analysisFalls prevention interventions for community-dwelling older adults: systematic review and meta-analysis of benefits, harms, and patient values and preferencesJ. Pillay, L. Gaudet, S. Saba et al. (2024) · Systematic Reviews · 10.1186/s13643-024-02681-3 · full text

Each source is shown by its own study design.

5 meta-analyses

Agreement: consistent for this claim. Direction recorded for 2 of 5 sources; not yet recorded for the rest.
The claim's outcome: Outcome not yet recorded
Certainty: No source states a certainty rating.
Authors: Sources share authors: C. Sherrington (first author of 2 sources); S. Lord (senior author of 2 sources).

What each source measured and concluded (5)

meta-analysis · 2011

Sherrington et al. (2011) — Exercise to prevent falls in older adults: an updated meta-analysis and best practice recommendations.

What it measured: Rate of falls
Direction it states for the claim's outcome: Improved
How it was read: read in full text
What the review says it includes: systematic review with meta-analysis
Studies and participants, as stated: N = not reported participants across 54 studies

meta-analysis · 2023

Chen et al. (2023) — Tai Chi for fall prevention and balance improvement in older adults: a systematic review and meta-analysis of randomized controlled trials

What it measured: Number of fallers, number of falls, balance assessment indicators (TUG, FRT, SLB, BBS, SPPB, FES, gait speed).
How it measured it: Standardized tests (TUG, FRT, SLB, BBS, SPPB, FES, gait speed assessment).
How it was read: read in full text
What the review says it includes: meta-analysis, systematic review
Studies and participants, as stated: N = 4,497 participants across 24 studies
Heterogeneity, as stated: Potential heterogeneity across studies

meta-analysis · 2024

Pillay et al. (2024) — Falls prevention interventions for community-dwelling older adults: systematic review and meta-analysis of benefits, harms, and patient values and preferences

What it measured: Number of fallers, falls, injurious fallers, fractures, hip fractures, residential status/institutionalization, health-related quality of life (HRQoL), functional status.
How it measured it: EQ-5D utility measurement for HRQoL; other outcomes likely measured through trial data, but specific tools not detailed.
Direction it states for the claim's outcome: Improved
How it was read: read in full text
What the review says it includes: systematic review with meta-analysis
Studies and participants, as stated: N = 167,864 participants across 219 studies

meta-analysis · 2016

Sherrington et al. (2016) — Exercise to prevent falls in older adults: an updated systematic review and meta-analysis

What it measured: Rate of falls in older adults.
How it was read: read in full text
What the review says it includes: systematic review with meta-analysis
Studies and participants, as stated: N = 19,478 participants across 88 studies

meta-analysis · 2025

Zhang et al. (2025) — Effects of different exercise modalities on balance performance in healthy older adults: a systematic review and network meta-analysis of randomized controlled trials

What it measured: Berg Balance Scale (BBS), Timed Up and Go Test (TUG), gait speed (GS), and one-leg stance with eyes open (OLSEO).
How it measured it: Validated clinical scales and tests: BBS, TUG, OLSEO, and GS.
How it was read: read in full text
What the review says it includes: systematic review and network meta-analysis
Studies and participants, as stated: N = 5,114 participants across 93 studies

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