Largely unsupervised balance training nearly halves fall rate in community-dwelling older adults, trial finds

A multicentre randomised controlled trial recruited 216 community-dwelling adults aged 65 and over who had fallen at least once in the previous six months, assigning them to self-administered dual-task training (n=99) or self-administered single-task training (n=117) [Primary Study]. Both groups completed 36 sessions over 12 weeks, but only 6 of those sessions were supervised; the remainder were home-based and self-directed. The dual-task group had a significantly lower fall rate than the single-task group (incidence rate ratio 0.47, 95% confidence interval 0.34–0.64), together with improved general health and global cognition immediately after the intervention, and sustained improvements in dynamic balance and global cognition at 6-month follow-up. No adverse events were recorded.

Both trial arms received an active, self-administered intervention — this trial did not compare dual-task training against no intervention at all, so the finding demonstrates dual-task training’s advantage over single-task training specifically, not over usual care. The authors themselves note that future studies should test self-administered dual-task training against a genuine usual-care control group.

The notable feature is the delivery model: a clinically meaningful reduction in falls was achieved with only 6 of 36 sessions requiring face-to-face supervision. That is relevant to falls-prevention services covering geographically dispersed or rural populations, where sustaining frequent in-person clinic attendance is difficult to resource.