REACTIVE BALANCE AS A KEY COMPONENT OF FALL PREVENTION IN OLDER ADULTS

Falls represent a major global public health concern among older adults, contributing substantially to morbidity, mortality, and reduced quality of life. Impairments in pos­tural control are among the most significant intrinsic risk factors for falls, driven by age-related changes in sensory integration, neuromuscular function, and motor responses. While traditional research and rehabilitation approaches have focused on static and dynamic balance, growing evidence highlights the importance of reactive balance – the ability to respond to unexpected perturbations – in real-world fall prevention.

This narrative review aims to examine the role of reactive balance in reducing fall risk among older adults and to dis­cuss its implications for physiotherapy practice.

Methods: a comprehensive literature search was con­ducted across major databases, including PubMed, Scopus, and Google Scholar, focusing on studies published between 2020 and 2025. Studies involving adults aged ≥60 years and addressing reactive balance, postural control, or fall prevention were included.

Results: current evidence indicates that reactive balance is strongly associated with functional stability in unpredicta­ble environments. Age-related declines in neuromuscular capacity, sensory processing, and central integration impair reactive responses, increasing fall risk. Interventions such as perturbation-based balance training demonstrate consistent improvements in reactive postural control and may reduce fall incidence. Integrating reactive balance training into phy­siotherapy programs represents a clinically relevant strategy for enhancing fall prevention and supporting healthy aging.