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The effectiveness of multimodal physiotherapy in preventing falls among community-dwelling older adults in the U.S

Krisha Kansara 1 and Felix Kaiser 2, *

1 Department of Kinesiology, Missouri State University, USA.
2 Faculty of Pharmacy and Pharmaceutical Sciences, Kwame Nkrumah University of Science and Technology, Ghana.
 
Research Article
International Journal of Frontline Research in Life Science, 2025, 03(02), 035-042.
Article DOI: 10.56355/ijfrls.2025.3.2.0027
Publication history: 
Received on 09 August 2025; revised on 23 September 2025; accepted on 26 September 2025
 
Abstract: 
Objective: To evaluate the effectiveness and cost-effectiveness of multimodal physiotherapy comprising balance, strength, gait, and functional training in preventing falls among community-dwelling adults aged ≥65 in the U.S., with implications for national implementation.
Methods: MEDLINE, Embase, CINAHL, and Cochrane were searched (2000–April 2025) for randomized controlled trials (RCTs) and economic evaluations. Studies included ≥2 exercise modalities, had community-dwelling populations≥65 years, and reported falls, injurious falls, functional outcomes, QALYs, or costs. Meta-analysis used a random-effects model.
Results: Seventeen RCTs (n = 5,425) and eight economic evaluations were included. The combined effect on fall risk yielded an incidence rate ratio (IRR) of 0.72 (95% CI [0.62, 0.83]), a 28% reduction. Injurious falls decreased (rate ratio = 0.63 [0.51, 0.77]). Incremental costs averaged US$786 per person, with negligible QALY gain (0.00 [–0.04, 0.04]); unimodal resistance exercise was more cost-effective (IRR = 0.72, cost = US $128, QALY = 0.09).
Conclusions: Multimodal physiotherapy significantly reduces falls and fall-related injuries. Although cost-effective under conventional thresholds, resistance-only programs offer better value. U.S. implementation should target high-risk older adults, leverage group models, and align with CMS and CDC fall-prevention initiatives.
 
Keywords: 
Multimodal Physiotherapy; Falls; Community Dwelling; Older Adults
 
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Copyright information: 
Copyright © 2025 Author(s) retain the copyright of this article. This article is published under the terms of the Creative Commons Attribution Liscense 4.0