Could Manual Therapy Help Fall Prevention

Manual therapy and mobilization are treatments that help increase joint range of motion, decrease pain, and decrease muscle spasms. They are commonly used in a therapeutic setting. They are fantastic tools and treatments for pain management.

A person is more likely to fall if they have decreased lower extremity joint range of motion and joint pain. Falling especially inthe elderly lead to very serious injuries and healthcare costs.A fall and associated surgery can severely impact an older individual’s lifestyle. Research is looking at ways to limit and prevent falling in older individuals.

Manual therapy or massage therapy is looked at as a possible treatment and preventionmethod. By keeping the muscles looser and decreasing joint pain, individuals may be less likely to fall. At this time there arevery few studies that are looking at balance and fall prevention utilizing manual therapy. Below is a study that tried to incorporate those factors and draw a conclusion. What they found was a lack of studies that have been done to investigate this question. Some of the studies that were performed did not meet the criteria for inclusion, indicating that they were not done with a high enough investigational procedure to produce a statistical conclusion.

The study can only indicate that more quality research needs to be done before we can draw any conclusions. From a clinical standpoint it does make sense. We work with many older individuals and individuals with ankle, foot, knee, and hipinjuries. When individuals are limping and experiencing more pain it is easier for them to drag their foot and fall. In addition they are less likely to be able to catch and maintain their balance preventing falling to the ground.

We believe maintaining range of motion, strength, endurance, flexibility, and proprioceptive balance are an important aspect in an older individuals care. It makes sense that these people will be less likely to experience severe injuries from falling and will probably experience less false per year. I believe we will see more of the studies in the future with our aging population.

Below isthe summary of the article.Thefollowing article discusses manual therapy and exercises for back pain. More information on exercise videos for strength and endurance to decrease risks of falling.

More information on therapeutic treatments utilizingPhysical Therapy or Chiropractic can be directed to Google+.

Journal of Manipulative and Physiological Therapeutics

Volume 35, Issue 3 , Pages 227-234, March 2012

The Effects of Manual Therapy on Balance and Falls: A Systematic Review

Kelly R. Holt, BSc (Chiro), PGDipHSc, Heidi Haavik, BSc (Chiro), PhD, Raina Elley, MBChB, PhD



The purpose of this study was to review the scientific literature on the effects of manual therapy interventions on falls and balance.


This systematic review included randomized and quasi-randomized controlled trials that investigated the effects of manual therapy interventions on falls or balance. Outcomes of interest were rate of falls, number of fallers reported, and measures of postural stability. Data sources included searches through June 2011 of Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, MEDLINE, EMBASE, CINAHL, PsycINFO, Allied and Complimentary Medicine, Current Controlled Trials, Manual Alternative and Natural Therapy Index System, Index to the Chiropractic Literature, National Institutes of Health (USA), and Google Scholar.


Eleven trials were identifiedthat met the inclusion criteria. Most trials had poor to fair methodological quality. All included trials reported outcomes of functional balance tests or tests that used a computerized balance platform. Nine of the 11 trials reported some statistically significant improvements relating to balance after an intervention that included a manual therapy component. The ability to draw conclusions from a number of the studies was limited by poor methodological quality or very low participant numbers. A meta-analysis was not performed due to heterogeneity of interventions andoutcomes. Only 2 small trials included falls as an outcome measure, but as a feasibility study and a pilot study, no meaningfulconclusions could be drawn about the effects of the intervention on falls.


A limited amount of research has been published that supports a role for manual therapy in improving postural stability and balance. More well-designed controlled trials with sufficient participant numbers are required to draw meaningful clinical conclusions about the role that manual therapies may play in preventing falls or improving postural stability and balance.

© 2012 National University of Health Sciences. Published by Elsevier Inc. All rights reserved. PubMed