Falls Prevention

Strength & Balance Programme

Exercise Booklet

Working together to prevent falls

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 This booklet describes the exercises which form the
strength and balance component of the Trust falls
prevention programme. Having stronger muscles and
improving your balance reduces the risk of falling.
Exercise can also improve your general fitness and sense
of well-being.

Your physiotherapist or exercise instructor will teach you

the exercises and update your booklet when it is safe for
you to continue each exercise at home. Some exercises
may need to be modified or may not be suitable for you,
therefore it is very important that you do not attempt any
exercises before they have been taught to you.

To be most effective, the exercises should:-

1. Challenge your balance.
2. Be completed in a standing position.
3. Be progressive in nature.
4. Be completed for a total of 50 hours over a 6 month
period - this is 2 hours exercise per week.

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 Safety

STOP exercising immediately and contact your

doctor if you feel unwell or if you experience any
chest pain, dizziness or severe shortness of breath.

Don’t exercise if:-

• You are feeling unwell
• Have a raised temperature
• Have unstable blood sugars
• Have acute confusion
• Have vomiting/diarrhoea
• Are extremely tired.

When completing the exercises, ensure your chair

is stable and sturdy. Balance exercises, if support is
needed, should be carried out holding onto a surface
which will not move eg kitchen worktop, high table.

If you experience pain in your joints or muscles stop,

check your position and try again. If pain persists stop
that exercise and seek advice from your instructor. You
may experience some soreness within your muscles
the day after exercising. This is a normal response and
shows that the exercises are effective.

The exercises will be prescribed for you as an

individual and recorded at each exercise for aid of
use.
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 Before you start to exercise

You will require:-

• To wear lightweight comfortable clothing
• To wear flat supportive footwear
• To have a sturdy chair
• To have a sturdy support eg. kitchen worktop or high
table
• To have adequate space to move around, free from any
trip hazards.

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 Posture

It is important to maintain good posture during all

exercises. This will ensure the correct muscles are
working and muscles are not being strained.

Incorrect sitting Correct sitting

posture posture

Correct seated posture checklist:-

• Sit on a sturdy chair in such a position that you are not
leaning against the back of it
• Feet are hip width apart
• Sit up tall and look straight ahead
• Chest is lifted and shoulders are relaxed.

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 Incorrect Correct
standing posture standing posture

Correct standing posture checklist:-

• Stand up tall with head lifted and look straight ahead
• Feet hip width apart
• Chest lifted and shoulders relaxed.

Breathing

It is important not to hold your breath during any of the

exercises. Breathing should be slow and controlled,
breathing out on the effort during the strengthening
exercises.

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 Warm up

Always complete warm up exercises prior to exercising to

prepare your body for exercise and reduce the likelihood
of injury.

For each exercise, sit tall towards the front half of the
chair with legs hip width apart and feet resting on the floor.
Perform each warm up exercise for approximately 30
seconds and then move onto the next until all have been
completed.
1. Marching arms

With elbows bent and in

a comfortable position
(ideally 90o), march arms
alternatively forwards
and backwards.

2. Marching legs

March your legs by lifting

alternate knees. One
foot should always be in
contact with the floor.

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 3. Side claps

Turn to the side, reach

as far as is comfortable
and clap your hands.
Repeat to the other side.

4. Toe taps

Take half a step forward

with one foot. Tap the
toes gently up and down.
Repeat on the other foot.

5. Heel taps

Gently raise and lower

one heel off the floor,
maintaining floor contact
with the toes throughout.

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 Stretches

Always complete stretches after the warm-up exercises.

A stretch will be felt within the targeted muscles. If pain
is experienced ease off the pressure until just a stretch is
felt. Hold each stretch for 8-10 seconds. For each stretch,
start by sitting tall and towards the front of the chair.

1. Thigh stretch

Straighten one leg out in front with the heel on the floor
and toes pointing towards the ceiling. Place both hands
just above the knee on the other leg. Keeping the back
straight, bend forward from the hip until a stretch is felt in
the back of the thigh on the straight leg. Repeat with the
other leg.

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 2. Calf stretch

Straighten one leg out in front with the heel on the floor.
Keep the heel on the floor, whilst moving the toes towards
the body until a stretch is felt in the back of the calf.

3. Chest stretch

Place both hands lightly on the shoulders. Raise the

elbows up to shoulder level, or as far as comfortable.
Draw the elbows back, squeezing the shoulder blades
together. Don’t allow the shoulders to move up towards
the ears. A stretch will be felt across the chest.

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 Strengthening exercises

Your exercise instructor will advise you when you can

start doing each exercise, how many times to repeat the
exercise and how you can progress the exercises when
ready to do so. Remember to exercise both sides of the
body unless advised otherwise.
1. Knee Extensors (front of thigh)
Sit tall in the chair with your back well supported.
Straighten the leg, keeping the thigh in contact with the
chair, hold for a few seconds and slowly lower.

2. Hip abductors (side of the hip)

Stand tall, holding your support

with both hands. Keep feet hip
width apart and pointing forward.
Lift one leg out to the side keeping
the knee straight and body tall,
hold for a few seconds and slowly
lower.
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 3. Hip extensors (back of the hip)
Stand tall, holding your support
with both hands. Keep feet hip
width apart and pointing forward.
Bring one leg out behind you,
hold for few seconds and try to
keep your knee straight. Do not
bend your body forward in an
attempt to move further.

4. Knee flexors (back of the thigh)

Stand tall, holding your support

with both hands. Keep feet hip
width apart and toes pointing
forwards. Bend one knee so that
your foot moves towards your
bottom, hold for a few seconds
and slowly lower.

Number of
Date Exercise Progression Signature
repetitions

10

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 5. Calf raises
Stand tall, holding your support with
both hands. Keep feet hip width apart
and pointing forwards. Keep looking
straight ahead. Come up onto your
toes and slowly lower the heels to the
floor.

6. Toe raises
Stand tall, holding your support with
both hands. Keep feet hip width apart
and pointing forwards. Transfer your
weight back onto the heels of both
your feet and raise the front of the
foot slightly off the ground. Hold for a
few seconds and lower the feet to the
starting position.

Number of
Date Exercise Progression Signature
repetitions

11

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 Balance retraining exercises
For all of the balance retraining exercises, with the
exception of sit to stand, begin by standing tall and hold
your support with one or both hands unless advised
otherwise by your instructor.

1. Knee bends

Keep feet hip width apart and

pointing forwards. Squat down
by bending your knees so that
they move over your feet. Don’t
allow your heels to move off the
floor. Slowly straighten up to the
starting position

2. Walking sideways

Keep feet and hips pointing forwards. Take steps to the

side, keeping hips facing forward at all times.

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 3. Walking backwards

Walk backwards, holding the support. Turn around

towards the support, hold with the other hand and walk
backwards to the starting position

4. Heel-toe standing

Place one foot directly in front of

the other so they form a straight
line. Hold this position, aiming for
10 seconds, while maintaining your
balance. Repeat with the other foot.

Number of
Date Exercise Progression Signature
repetitions

13

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 5. Heel-toe walking

Place the right foot directly in front of

the left so that they form a straight
line. Bring the left foot directly in front
of the right. Repeat so as to walk
forwards holding the support. Turn
around towards the support, hold
with the other hand and repeat.

6. Heel-toe walking backwards

Place the right foot directly behind

the left so they form a straight line.
Bring the left foot directly behind
the right. Repeat so as to walk
backwards holding the support.
Turn around towards the support,
hold with the other hand and repeat.

Number of
Date Exercise Progression Signature
repetitions

14

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 7. Sit to stand

Sit on a sturdy chair which is not too low and has arms
supports if required. Move towards the front half of
the seat. Place your feet behind your knees and lean
forwards. Stand up, using your hands to help if required.
Bend forwards to slowly sit back down and repeat.

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 8. Toe walking

Start with your feet hip width apart.

Rise up onto your toes and walk
forwards on your toes, holding the
support. Lower heels to the ground,
turn towards the support, hold with
the other hand and repeat.

9. Heel walking

Start with your feet hip width apart.

Come back onto your heels, raising
the front of your foot off the floor and
walk forwards on your heels, holding
the support. Lower toes to the
ground, turn towards the support,
hold with the other hand and repeat.

Number of
Date Exercise Progression Signature
repetitions

16

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 10. Stand, reach and clap

Stand with feet hip distance apart. Clap the hands from
side to side, progressing to clapping high and low and
to the side in the formation of a square. Continue with
this sequence of movements. Bend at the knee when
reaching low.

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 11. Single leg stand

Keep feet and hips pointing forwards. Lift one foot off the
ground and stand on one leg. Aim to hold for 10 seconds
and maintain your balance. Repeat with the other leg.
12. Marching

March gently on the spot holding

onto the support with 1 hand. Lift
the knees higher and swing the
arm(s) more energetically as
confidence and balance improve.

Number of
Date Exercise Progression Signature
repetitions

18

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 Number of
Date Exercise Progression Signature
repetitions

19

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 Cool down

After you have completed all your exercises, take a few

minutes to cool down to allow your body to adjust slowly
and gradually from exercise to rest. To cool-down repeat
the warm up exercises slowly and complete the stretches
again.

For more information or advice

Contact your physiotherapist or exercise instructor.

Name: ________________________________________

Telephone number:______________________________

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 Designed by Communications Department

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