Occupational therapy interventions can reduce falls for those at risk – Cochrane review results

A recent review led by Lindy Clemson, Professor Emeritus at the University of Sydney, provides evidence that reducing fall hazards around the home can reduce falls by 26%. When delivered to people at higher risk of falling, the beneficial effect is an almost 40% reduction.

The review highlights the benefits of occupational therapy, with even greater effects observed when the intervention is delivered by an occupational therapist, with a 32% reduction.

“Falls can cause serious injury or even death, but they are preventable. In this review we wanted to examine which measures could have the biggest impact on reducing falls among older people living at home,” said Professor Clemson of the University’s Faculty of Medicine and Health.

The Cochrane review, titled Environmental interventions for preventing falls in older people living in the community, was undertaken by Lindy Clemson, Susan Stark, Alison C Pighills, Nicola J Fairhall, Sarah E Lamb, Jinnat Ali and Catherine Sherrington and published in March 2023. Professor Clemson and colleagues analysed the results of 22 studies including data on 8,463 older people living in the community.

The review found that, for those at risk of falls, being aware of fall hazards in and around the home, removing fall hazards and adapting with safe behaviours can significantly reduce their risk of falling. Based on their analyses, the reviewers found that if 1,000 people who had previously had a fall followed these measures for about a year, the total number of falls would come down from 1,847 to 1,145. Click here to read the full review and results.

An occupational therapist can provide these interventions while matching the person’s functional capacity and personal fall risk to the environmental fall hazards, engaging the person to understand their risk and supporting them in what they need to do. That is, making necessary behavioural changes, modifying the environment (such as strips on steps or removing clutter in walkways), identifying assistive equipment to reduce risk and teaching them safer ways of carrying out everyday activities. The research also shows that simply removing hazards does not reduce falls, thus professional intervention is recommended.

“It appears that interventions to reduce fall hazards around the home need certain elements of assessment and support to work, not just a short check list of things to tick off. So, while everyone can take more care about their home environment and should do exercise for balance and lower limb strength, professional support from an occupational therapist is an important intervention for many people living at home,” Professor Clemson said.