Falls are common in older people and become more frequent with advancing age, with a fall incidence of 40% per year in community dwellers aged 80 years or over. Injurious falls leading to severe medical, psychological, and social sequelae are associated with high treatment costs. They lead to ongoing posttraumatic health problems, motor and psychological restriction, and a threatening loss of autonomy. Although many factors, such as aging, chronic illness, sedentary lifestyle, and medication, may contribute to the risk of falling, preventable or reversible motor deficits seem to be a key to successful intervention by physical training. Lack of strength, coordination, and functional performance are well-known predictors of falls and disability in older people and the rehabilitation outcome of patients with a history of falls. In intervention trials designed to reduce the incidence of falls in older, community-dwelling populations, physical training has been unsuccessful or only partly successful, dependent on the kind and intensity of training, chosen outcome variables, study populations, and statistical power. In other studies that successfully reduced the incidence of falls through physical training, motor function did not improve or so only partially. Successful intervention programs combined intervention strategies of strength, coordination, or complex motor training and multifactorial interventions, including intensive motor training. The efficacy of secondary prevention of falls in older patients with a history of injurious falls, who are at a high risk for subsequent falls, however, has not yet been studied.
