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Strength and balance class (Segment 2B)

If a client has a moderate strength and balance problem but is unable to participate in an exercise programme independently, a referral to the strength and balance class at the falls clinic (Guy’s Older Person's Assessment Unit, Dulwich Day Hospital or Whittington Centre) is more appropriate:

  • The class is designed to determine the client's potential to participate in further exercise and enable referral on to appropriate exercise intervention (ideally to community exercise intervention with postural stability instructor)
  • The class is based on the Otago exercise programme. Exercise consists of warm up, strengthening (using weights), balance exercises and walking. The Otago exercise programme is adhered to as closely as possible as this will allow for appropriate participants to continue with the exercises at home once they are discharged
  • Participants attend the group twice a week
  • Each participant should attend for 8 weeks or 16 sessions
  • Classes run on 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 losing valuable spaces if group members “drop out”
  • The class is run by one physiotherapist and an assistant with a maximum of 8 participants in each class
  • All participants complete each exercise simultaneously with one instructor providing a demonstration for all participants to follow and a further instructor providing individualised guidance to allow each participant to perform and progress exercises safely and effectively
  • If certain participants require additional specific exercises, these can be added to the programme (for that participant) at the discretion of the instructor
  • 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 appropriate

Criteria for referral

  • Reaction times, muscle strength or postural sway impaired related to age reflected in moderate/marked falls risk score on PPA or moderate near tandem stand, alternate step and/or sit to stand impairment on PPA QuickScreen©
  • 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 during unsupervised exercise

Referral procedure



Please send or fax a copy of the Specialist Physiotherapy Assessment form remove hyperlink and add (full or mini) and attached new form to each, and/or OPAU referral form to:

Older Persons Assessment Unit
Guy’s Hospital
Ground Floor
Bermondsey Wing
London SE1 9RT

Telephone: 0207 188 2093
Fax: 0207 188 2095


Please send or fax a copy of the specialist physiotherapy assessment form remove hyperlink and add (full or mini) and attached new form to each, and/or Betty Alexander Suite referral form to:

Falls Clinic
Betty Alexander Suite
Golden Jubilee Wing
King's College Hospital

Tel: 020 3299 6184/6185
Fax: 020 3299 6149


Please send or fax Lambeth therapies referral form to:

Lambeth Single Point of Access (SPA)
Pulross Intermediate Care Centre
47a Pulross Road
London SE9 8AE

Tel: 020 3049 4004
Fax: 020 3049 4014