Services

Falls Exercise Programme

Community Falls Exercise Groups

These are exercise classes designed to improve muscle strength, balance and coordination and are held in a number of leisure centres and community venues around Lambeth and Southwark.  These programmes are run by qualified instructors.

Please Click Here to see a video with examples of the exercises carried out within a class.

Exercise Venues:

• Beormund Community Centre SE1
• Darwin Court, Walworth SE17
• Dulwich Library, Dulwich SE21
• Elmcourt School, West Norwood SE27
• Ferndale Sports Centre, SW9
• Peckham Pulse, Peckham, SE15
• Streatham Leisure Centre, Streatham SW16
• West Indian Ex-Servicemen's Club- Clapham SW4

It is important that you attend the exercise sessions weekly, classes run for one hour.

Please call Falls Co-ordinator for further details:

Southwark - 020 7525 3483

Lambeth - 020 8243 2520

Exercise Segmentation

To decide whether you would benefit from joining an exercise class to improve your strength and balance, please download the segmentation chart which categories the best course of action depending on your need.

Click Here to view

Exercise Referral Form

If you would like to join an exercise class to help improve your strength and balance or you would like to refer a client, please complete the application form and send it to the SLIPS office. Please note that if you are self referring or being referred by a non-healthcare professional you will need to ask your GP to counter sign the form as we need to be certain that you are medically safe to exercise.

Referral Form (PDF file 88.6kb)

General Leisure Sector Exercise Classes for Older People

There are many other general exercise classes being run in Lambeth and Southwark.  These are not specific for improving strength and balance but will keep you fit and active.  For more information please Click Here

Exercise Programmes

If muscle weakness, poor balance and / or coordination is identified on assessment, a programme of strength and balance exercises will be recommended. There are different options for learning these exercises depending on the level of support or supervision required to carry out the exercise effectively and the choice of the individual taking part. It is important to remember that exercise must be continued for life to maintain the benefits. The following options are available in Lambeth and Southwark.

Community Exercise Groups for Strength & Balance Training

• Exercise groups in leisure and other community centres designed to improve muscle strength and balance for people who have fallen.
• The exercise programme is based on Fame project exercises (components of flexibility, muscle strengthening, balance, endurance, tai chi and practice getting up from the floor). The instructors have completed the Later life training course.
• Exercise classes are held twice a week in each centre.
• Participants attend one class a week and exercise at home twice a week.
• The programme lasts for 9 months while exercises are progressed.
• There is room for a maximum of 12 participants in each group.

Criteria for Referral

If referred from falls clinic:

• Reaction times, muscle strength or postural sway impaired related to age reflected in moderte / marked falls risk score on PPA
• Able to stand unsupported on the floor with eyes open for 30 seconds
• Memory sufficient to remember a set of exercises using the booklet as necessary
• Motivated to exercise independently
• Fear of falling does not limit ability to challenge balance appropriately in exercises
• Chosen the option of group exercise

Inclusion Criteria - If referred from falls clinics or other sources:

• Fear of falling
• Feeling unstable
• History of falls (injurous or non-injurous)
• Low bone density and / or family history of osteoporotic fracture

Exclusion Criteria - If referred from falls clinics or other sources:

• Uncontrolled angina
• Uncontrolled resting systolic blood pressure >180mmHg or resting diastolic blood pressure >100mmHg
• Uncontrolled tachycardia >100bpm
• Uncontrolled acute systemic illness (cancer / pneumonia)
• Uncontrolled visual or vestibular disturbance
• Uncontrolled pain
• Significant drop in blood pressure during exercise>100bpm
• Unstable or acute heart failure
• Unable to maintain seated upright posture due to neurological deficits
• Impaired cognition (to the extent of being unable to follow simple movement instructions
• People who place themselves or others at risk
• Participants who are unable to monitor or modify their exercise level or technique or follow advice

Otago Exercise Programme

• The programme was designed specifically to prevent falls. It consists of a set of leg muscle strengthening and balance retraining exercises progressing in difficulty, and a walking plan.
• The exercises are individually prescribed and increase in difficulty during a series of five home visits by a trained instructor
• Each person receives a booklet with instructions for each exercise prescribed and ankle cuff weights (starting at 1kg) to provide resistance for the strengthening exercises.
• The exercises take about 30 minutes to complete. Participants are expected to exercise three times a week and go for a walk at least twice a week.
• To help them adhere to the programme, participants record the days they complete the programme and the instructor telephones them each month between home visits.

Criteria for Referral

• Reaction times, muscle strength or postural sway impaired related to age reflected in moderte / marked falls risk score on PPA
• Able to stand unsupported on the floor with eyes open for 30 seconds
• Able to follow commands to carry out simple motor activities
• Memory sufficient to remember a set of exercises using the booklet as necessary
• Motivated to exercise independently
• Fear of falling does not limit ability to challenge balance appropriately in exercises
• Chosen to participate in a home exercise programme

Intermediate Care Falls Prevention Exercise

• Exercise consists of warm up, strengthening (using weights), balance exercises and walking. The actual exercises in the Otago programme should be adhered to as closely as possible as this will allow some participants to continue with the exercise at home once they are discharged.
• Participants attend the group twice a week
• Each participant should attend for 8 weeks or 16 sessions
• It is a rolling programme where spaces in the group are consecutively filled as participants complete the 8-week course. This will allow participants to start as soon as possible and prevent loosing valuable spaces if group members “drop out”.
• The class is based on the Otago exercise programme. All participants complete each exercise at the simultaneously with one instructor providing a demonstration for all participants to follow and a further instructor providing individualised guidance to allow each participant to progress exercises and perform exercises safely and effectively.
• If certain participants require other specific exercises these can be added to the programme (for that participant) at the discretion of the instructor.
• Ideally the ratio should be around 4 participants to 1 instructor. There is no need for both instructors to be physiotherapists.
• Participants who require transport will have this arranged by the centre hosting the programme.
• After the participant has attended the group for 5 –6 weeks, discharge plans should be discussed with each individual participant. Each participant should be given the choice of whether they continue the Otago programme at home or attend a community exercise group.
• If they wish to continue the Otago exercise programme at home, they should be given the exercise booklet with their specific exercises and an appropriate weight around 2 weeks before they are discharged. They can be encouraged to exercise once a week at home in between group sessions and feedback on their progress. This will allow the instructor to determine whether continuing home exercise is safe and feasible. Once the participant is discharged, they should be contacted by telephone once every month for 3 months to check on their progress.
• If they wish to attend a community exercise group, firstly ensure that they meet the referral criteria. If criteria are met, the participant should be offered a choice of location. Information on modes of transport to attend the groups should be offered at this time (Dial-a-ride / Taxicard).
• If more than one participant of the group is identified as requiring an education component, the occupational therapist (or other professional as appropriate) will arrange to see the identified individuals either before or after the exercise group. This ensures participants receive targeted intervention while recognising that working with groups is an effective use of resources.

Criteria for referral

• Reaction times, muscle strength or postural sway impaired related to age reflected in moderate / marked falls risk score on PPA.
• Able to stand unsupported on the floor with eyes open for 30 seconds.
• Difficulty following commands to carry out simple motor activities
• Memory insufficient to remember a set of exercises using the booklet as necessary.
• Poor motivation (I.e. depression)
• Fear of falling that limits ability to challenge balance appropriately in unsupervised exercise

One to one physiotherapy treatment

• Physiotherapy intervention to be carried out at the discretion of the physiotherapist.
• This option is primarily because balance is too poor to participate safely in a group or home exercise programme.
• If regular input is required, a physiotherapy assistant or healthcare assistant may be able to perform some of the exercises with the patient on a one to one basis.
• Other reasons for one to one treatment would be the need for a comprehensive assessment or treatment for other problems identified at falls assessment such as dizziness or joint pain / instability.

Criteria for referral

• Reaction times, muscle strength or postural sway impaired related to age reflected in moderate / marked falls risk score on PPA.
• Unable to stand unsupported on the floor with eyes open for 30 seconds.
• Multiple problems identified on falls specialist assessment requiring a comprehensive physiotherapy assessment.

Exercise via Leisure Sector/Voluntary Groups