Falls can happen to anyone, but for some NDIS participants, mobility challenges or balance changes can make a fall more likely. This article looks at how physiotherapy supports falls prevention through strength and balance programs, home safety, and practical equipment.
Common Contributors to Falls Risk
Falls rarely have a single cause. More often it's a combination of factors that, together, tip the balance. Reduced leg strength can make it harder to recover if you trip or lose balance momentarily. Changes in balance and coordination affect how quickly the body corrects itself. Vision changes, reduced sensation in the feet, and fatigue can all play a part too. Environmental factors matter just as much as physical ones: loose rugs, poor lighting, clutter in walkways, and slippery bathroom floors are frequent contributors regardless of a person's physical condition.
Footwear that doesn't fit well or lacks grip is another often-overlooked factor. Medication changes can also affect balance and alertness, which is why it's worth discussing any new prescriptions with a GP or pharmacist. Because risk factors are usually layered, a physiotherapist will typically look at the whole picture rather than focusing on just one element in isolation.
Balance and Strength Programs
Physiotherapists use structured, progressive exercise programs as one of the main tools for reducing falls risk. These typically combine strength work, especially for the legs and core, with balance training that challenges stability in a controlled, supported way. Programs might include standing on one leg with support nearby, weight shifting exercises, sit-to-stand practice, or walking with directional changes.
The emphasis is always on gradual progression: starting at a level that's manageable and safe, then building up as strength and confidence improve. Consistency tends to matter more than intensity - short, regular sessions often produce better results than occasional, demanding ones.
Home Safety Assessments
Because so many falls happen at home, a home safety assessment is often a key part of a falls prevention plan. This usually involves a walk-through of the home, sometimes jointly with an occupational therapist, looking at lighting, flooring, furniture placement, stair access, and bathroom layout. Simple changes can make a meaningful difference - securing loose rugs, improving lighting in hallways and entryways, clearing regularly used pathways, and installing non-slip mats in wet areas.
Where structural changes like grab rails or ramps are being considered, this is generally coordinated with an occupational therapist, as they specialise in that kind of environmental and equipment assessment.
Assistive Equipment That Supports Safety
The right equipment can reduce falls risk while supporting independence, but it needs to suit the individual and be set up correctly. Mobility aids such as walking sticks, four-wheel walkers or frames are commonly recommended, with a physiotherapist typically advising on the right type and correct height and technique for using it safely. In the bathroom, non-slip mats, raised toilet seats and shower chairs can reduce the physical demand of tasks that often carry higher falls risk.
It's worth noting that poorly fitted or incorrectly used equipment can sometimes increase risk rather than reduce it, which is why professional guidance on selection and setup matters.
Building Confidence and Staying Active
Fear of falling can itself become a barrier - some people start avoiding activities they're still capable of, which can lead to further loss of strength and balance over time. Part of a physiotherapist's role in falls prevention is helping rebuild confidence gradually, through activities that are appropriately challenging but well supported.
Small, consistent wins often matter more for long-term confidence than dramatic short-term change. The goal isn't to eliminate all risk, which isn't realistic for anyone, but to reduce it where possible while supporting a person to keep doing the things that matter to them.
Nhanya Foundation is a not-for-profit organisation and registered charity. Our services are guided by community benefit, not private profit. Any proceeds are reinvested into charitable activities supporting people experiencing hardship and disadvantage.
For current information on Nhanya's NDIS registration, search the NDIS Commission Provider Register at ndiscommission.gov.au.
Contact Nhanya Foundation at nhanya.org.au/contact or call 03 8595 9012. Referrals can be submitted at nhanya.org.au/referral.
Frequently Asked Questions About Falls Prevention and Physiotherapy: Supporting Safety and Independence at Home
How do I know if falls prevention physiotherapy is relevant for me or the person I support?
If there's been a fall, a near-fall, or a noticeable change in balance, strength or confidence with everyday movement, it's worth raising with a GP or physiotherapist. They can assess individual risk factors and recommend an appropriate plan.
Will a home safety assessment mean major changes to my house?
Not necessarily. Many recommendations are simple adjustments like better lighting or removing trip hazards. Larger changes, such as ramps or bathroom modifications, are only suggested where relevant and are usually assessed jointly with an occupational therapist.
Can falls prevention support be included in my NDIS plan?
Physiotherapy and related supports can be funded where they are assessed as reasonable and necessary for a participant's disability-related needs. Funding decisions depend on individual circumstances and plan goals.
Do I need a referral to see a physiotherapist for falls prevention?
This can depend on your NDIS plan and funding category, as well as the provider. Some participants access physiotherapy directly under their plan, while others may need a referral through a GP.
How long does it take to see results from a balance and strength program?
This varies significantly between individuals and depends on factors like consistency, starting ability and overall health. Some people notice improved confidence within weeks, while strength and balance gains typically build gradually over a longer period with regular practice.