Falls prevention · London
Otago falls-prevention programme - London.
The evidence-based home exercise programme for community-dwelling adults aged 65 and over, delivered by a specialist physiotherapist over 12 months. Around 35 percent fewer falls when done as designed.
Why families choose us
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Physiotherapists who specialise in older adults
Named MSK and neuro physios with dedicated falls-prevention caseloads, working alongside geriatricians and occupational therapy.
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The programme as it was designed to be delivered
The full Otago protocol, individually prescribed and progressed, reviewed at 8, 26 and 52 weeks, not a generic exercise sheet.
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Independent, and free
We are paid by no clinic, so the recommendation is impartial and costs you and your family nothing.
What Otago is
Five exercises, done at home, that keep you on your feet.
Developed at the University of Otago in New Zealand, and now the most widely evidenced home-based falls-prevention programme in the world.
The Otago Exercise Programme was developed at the University of Otago in the late 1990s and refined in a series of randomised trials in community-dwelling adults aged 65 to 97. It is a set of five lower-limb strength exercises done with ankle cuff weights, twelve progressive balance retraining exercises, and a walking plan of at least twice-weekly 30-minute walks.
The programme is individually prescribed and progressed by a physiotherapist, then practised at home three times a week for around 30 minutes. It is not a leaflet handed over at discharge, and it is not a group class. That distinction, evidence tells us, is what makes it work.
Delivery is designed around four to six physiotherapy visits over 12 months, at home or in clinic, with formal reviews at 8, 26 and 52 weeks. The physio checks technique, adds resistance or harder balance tasks as you get stronger, and adjusts the plan around other conditions.
It is safe in mild frailty, in Parkinson\'s, after stroke, in peripheral neuropathy and after hip-fracture rehabilitation. In all of these groups it has been shown to reduce falls when delivered as designed.
The evidence
Around 35 percent fewer falls.
The Cochrane review of exercise for preventing falls in older people living in the community found that the Otago Exercise Programme, delivered as designed over 12 months, reduces the rate of falls by around 35 percent and the rate of fall-related injuries by around 32 percent.
These effects are comparable to well-run structured group programmes such as FaME. The efficacy is largest in those aged 80 and over and in those with a history of falls. Adherence over 12 months is the strongest predictor of benefit, which is why individualised prescription and regular physio review matter so much.
Who benefits
Who Otago is designed for.
Otago was designed for older adults living independently at home. It is safe and effective alongside a wide range of long-term conditions.
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Age 65 and over
Otago was designed and tested in community-dwelling adults aged 65 to 97. The benefit is largest in those over 80.
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History of falls or near-falls
One or more falls in the last year, or repeated stumbles, is the strongest reason to begin a structured programme.
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Fear of falling
Loss of confidence is itself a risk factor. Structured, progressive practice rebuilds trust in your own balance.
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Mild frailty
Slower walking, lower grip, unintentional weight loss. Otago is safe and effective in this group when delivered by a specialist physio.
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After a hip fracture or joint surgery
Once acute rehabilitation is finished, Otago sustains strength and balance gains and reduces the chance of a second fracture.
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Comorbid balance conditions
Parkinson's, peripheral neuropathy, stroke recovery, low vision. Otago is tailored around them, alongside condition-specific therapy.
The programme
From first assessment to twelve-month review.
One physiotherapist across the year. Home visits or clinic, whichever suits you better.
- 01
You send us the story so far
A short, confidential form. Recent falls or near-falls, current mobility, medical conditions, medications, and what you want to be able to do again.
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We match a physiotherapist
Within one working day: a CSP-registered physio who runs Otago, home or clinic delivery, indicative cost across the full 12 months.
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Initial assessment
A 60 to 90 minute visit. Timed Up and Go, four-stage balance test, 30-second chair-stand, falls history, medications review and a look at trip hazards at home.
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Individualised plan
Five strength and balance exercises are prescribed at your starting level, with ankle cuff weights sized to you, plus a walking plan of twice-weekly 30 minute walks.
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Ongoing physio visits
Four to six visits over 12 months at home or in clinic. The physio checks technique, progresses resistance and adds harder balance tasks as you get stronger.
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Home practice, three times a week
You work through the exercises for around 30 minutes, three times weekly, in your own home. A simple diary keeps track.
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Review at 8, 26 and 52 weeks
Formal re-testing at each review, with the plan progressed or eased. Warm handover to a community strength and balance group at the end of the year.
The assessment
What the physio actually measures.
The tests are simple, repeatable and give a clear baseline to progress from. The same measures are repeated at 8, 26 and 52 weeks.
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Timed Up and Go (TUG)
Stand from a chair, walk three metres, turn, return and sit. Over 13.5 seconds signals a raised falls risk.
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Four-stage balance test
Feet together, semi-tandem, tandem and single-leg stands. Holds under 10 seconds in tandem are a red flag.
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30-second chair-stand test
Repeated sit-to-stand without using arms. Measures functional lower-limb strength.
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Falls history and context
How, when and where. Indoors or out, at night, going to the loo. Patterns guide the plan.
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Medications review
Sedatives, antihypertensives, anticholinergics and polypharmacy all raise falls risk. A pharmacist can deprescribe safely.
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Environmental hazard check
Loose rugs, poor lighting, bathroom grab-rails, stair handrails, footwear. Simple changes make a real difference.
Indicative pricing
What a private Otago programme costs in London.
Indicative ranges across our London network. We come back with a firm quote within one working day.
In short
Full 12-month Otago programme: £950–£1,600. Initial assessment: £250–£450.
| Service | Indicative range | Typical duration | Turnaround |
|---|---|---|---|
| Initial physiotherapy assessment | £250–£450 | 60–90 min | Report in 5 days |
| Follow-up physiotherapy visit | £120–£220 | 45–60 min | As scheduled |
| Full 12-month Otago programme | £950–£1,600 | 4–6 visits | 12 months |
| Home visit surcharge (inside M25) | £30–£80 | per visit | On request |
| Home hazard assessment (OT) | £220–£380 | 60 min | Same week |
| Medications review (pharmacist) | £120–£200 | 30–45 min | 48 hours |
Insurers we work with include Bupa, AXA Health, Vitality, Aviva, WPA, Cigna, Healix. Cover for physiotherapy varies by policy. We confirm cover in writing before booking.
Where in London
A small panel of London falls-prevention physios.
Named private physios specialising in older-adult falls prevention, at home or in clinic.
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CSP-registered older-adult physiotherapists
Chartered Society of Physiotherapy members with dedicated falls-prevention caseloads, delivering the full Otago protocol at home or in clinic across London.
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HCA Wellington - Geriatric Rehabilitation
Consultant-led geriatric rehabilitation team with in-house physiotherapy running Otago and complementary balance programmes.
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Nuffield Health physiotherapy - London sites
Older-adult physiotherapy across multiple London clinics, with home-visit options and links to strength and balance classes.
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Chelsea and Westminster - Private Falls Clinic
Multidisciplinary private falls clinic with geriatric medicine, physiotherapy, and medications review under one roof.
FAQs
The questions families actually ask.
Anything not here? Send an enquiry and we come back the same day.
- How much does Otago actually reduce my chance of falling?
- The Cochrane review of home-based exercise for older adults found Otago reduced the rate of falls by around 35 percent and fall-related injuries by around 32 percent when delivered as designed, over 12 months. The benefit is comparable to well-run structured group programmes, with the added value of being done at home.
- Who is Otago suitable for?
- Community-dwelling adults aged 65 and over, especially those with a history of falls, near-falls, fear of falling, mild frailty, or ongoing recovery after a hip fracture. It is also used alongside condition-specific rehabilitation for people with Parkinson's, stroke, peripheral neuropathy and low vision.
- What actually happens each week?
- You work through five strength and balance exercises for around 30 minutes on three days of the week, and take a walk of around 30 minutes on two other days. The physiotherapist prescribes the starting level, provides the ankle cuff weights, and progresses the programme over the year.
- How is it different from a group class?
- Otago is individually prescribed and progressed in your own home, which suits people who are house-bound, have transport difficulties, or prefer one-to-one attention. The efficacy is similar to well-run group classes. Some people move to a community group class at the end of the 12 months to keep the habit going.
- Will my insurance cover it?
- Cover for private physiotherapy varies by insurer and by policy. Most major UK insurers fund physio when referred by a consultant or GP and when medically indicated, usually as a capped number of sessions. We confirm cover in writing before booking, and offer self-pay pricing alongside.
- What happens after the 12 months are up?
- The habit is the point. We arrange a warm handover to a community strength and balance group, a Later Life Training instructor, or a maintenance physio review every 6 to 12 months. Continuing the exercises is what protects you long-term.
Ready when you are
Start the year that stops the next fall.
Send a short enquiry. We match you to a specialist physiotherapist, quote firmly across your options, and arrange the assessment within one to two weeks.