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How to Improve Balance and Prevent Falls

Practicing Tai Chi

Balance is vital to performing activities of daily living, including household chores, shopping, cooking, and traveling, safely in older adults. Maintaining balance independence is crucial for health and well-being during the aging process. Poor balance has been shown to be a major risk factor for falls; and falls are a leading cause of hospitalization and nursing home admission. About a third of adults over the age of 65 experience at least one fall per year, and the rate and severity of associated complications increases significantly with age. The good news is that balance can be improved with appropriate exercises, helping to reduce the risk of falls.

Why Is There an Increased Risk of Falling?

The increased risk of falling is often caused by the difficulty that older adults have in maintaining postural control when carrying out their normal activities. Adequate postural control is dependent on the body’s ability to synchronize various systems in the body including the sensory systems (visual, vestibular, and somatosensory), the cognitive system (central nervous system), and the musculoskeletal system. With aging a number of changes happen in these body systems. For example, the visual system is affected by a reduced ability to judge distance, detect low contrast trip hazards, and perceive spatial relationships, leading to increased risk of falls. In regards to the vestibular system, there are reduced hair cells in the semicircular canals, maculae of the saccule and the utricle of the ears, and in the primary and secondary vestibular neurons. This leads to a decreased ability to detect position and direction of movement. This combined with decreased lower extremity strength and sensation also increases the risk of falling in older adults.

Test Balance at Home

There are a few ways to test balance at home. Keep a chair or countertop nearby to steady yourself. When testing balance at home, it is important to have someone with you in case you need assistance.

Double Foot Test – Stand with your feet together with your arms folded across your chest . You should be able to hold this position for a minute without moving your feet.

Tandem Stance – Now, position your left foot directly in front of your right You should be able to hold this position on both sides for a minimum of 40 seconds.

Single Leg Balance Test – Stand on one foot and bend your opposite knee, lifting it off the floor with your eyes open. You should be able to hold this position for 20 seconds.

Alternate Single Foot Test – Stand on one foot with your hands positioned on your hips. Place your non-supporting foot on the inside part of the knee of your supporting leg and raise your heel off the floor. You should be able to hold this position for 25 seconds on both sides.

If you’re not able to reach the target times for these quick balance tests at home, you might want to consider starting a balance training program to improve your balance and reduce your risk of falls.

What Type of Training is Effective to Improve Balance?

Various strategies have been evaluated to improve balance and reduce the risk of falls, including center-based interventions, home-based intervention, and self-selected sites for exercise. There is mounting evidence that shows that exercise programs that include lower extremity strengthening exercises combined with functional balance training improve physical fitness and decrease the risk of falling in older adults. Further, research has found that home-based exercise programs that involve low-intensity strength training combined with balance training not only improve balance but reduce the risk of falls by approximately 40%.

Exercises That Improve Balance

If you’re looking to improve your balance, there are a few simple exercises you can try, including:

Hold on to a counter or table. Stand with your feet together and slowly lift one foot off the floor. Aim to hold the position for 30 seconds on both sides. To challenge yourself, stand on an unstable surface such as a pillow, or try closing your eyes.

Try walking for 20 paces heel to toe forwards, and then walk backwards toe to heel.

Try walking for 20 paces on your tippy toes forwards, and then backwards.

Try walking for 20 paces on your heels forwards, and then backwards.

Practice standing up from a seated position.

Practice walking up and down stairs.

 If you’re looking for more in-depth exercises, consider consulting with a physical therapist that specializes in fall prevention. Various clinics have specially designed fall prevention programs that can be individually tailored to your goals.


Problems with balance that occur with aging can make performing every day activities difficult, and can lead to falls, which can have a negative impact on quality of life. The good news is that engaging in simple exercises on a regular basis can help to improve balance and reduce the risk of falls. If your balance is not as good as it used to be, consider trying some of the exercises mentioned above to regain your balance and confidence when performing your daily activities.






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