Reducing Falls Risk Through Community Exercise in Multiple Sclerosis

People living with multiple sclerosis face a significantly higher risk of falls than the general population, with research suggesting that more than half will experience a fall within any six-month period. Impaired balance, muscle weakness, visual disturbances, and fatigue all contribute to this elevated risk, often leading to reduced confidence, social withdrawal, and serious injuries such as hip fractures. In Queensland, where many residents enjoy active outdoor lifestyles along the Brisbane River or in suburban parklands, maintaining mobility is central to quality of life for those managing chronic neurological conditions.

Community-based exercise programs offer a practical, evidence-supported pathway to reducing falls risk while fostering social connection. By bringing physiotherapy-led sessions into accessible local venues rather than relying solely on hospital outpatient clinics, these initiatives meet participants where they live and work. For people with MS across South East Queensland, such programs can transform daily routines, restore independence, and lower the long-term burden on families and the healthcare system.

Why falls are a common complication of MS

Multiple sclerosis disrupts communication between the brain and body, producing symptoms that directly affect postural stability. Spasticity, sensory loss in the feet, delayed reaction times, and vestibular dysfunction all undermine the automatic adjustments healthy individuals make when navigating uneven footpaths, crowded shopping centres, or slippery bathroom floors. A single fall can trigger a cascade of consequences, including hospitalisation, deconditioning from reduced activity, and a heightened fear of falling that further restricts movement.

Australian physiotherapists have long observed that falls in MS often occur during routine tasks such as stepping off a kerb in the Brisbane CBD or transferring in and out of a shower. The economic impact is substantial, with fall-related injuries contributing to rising demand for hospital beds and rehabilitation services across the metropolitan area. Addressing this issue requires proactive, sustained intervention rather than reactive treatment after an injury has already occurred.

What community-based programs offer

Community-based exercise programs differ from standard clinical rehabilitation in several meaningful ways. Sessions are typically held in accessible facilities such as community health hubs, local gyms, or hydrotherapy pools, often within a short drive of participants' homes. Group formats encourage peer support, which is particularly valuable for individuals who may otherwise feel isolated by their condition. Participants in Brisbane-based pilot schemes have reported that exercising alongside others facing similar challenges helps sustain motivation over weeks and months.

Programs generally combine supervised strength training, balance retraining, gait education, and functional task practice. Many incorporate outdoor components, taking advantage of Queensland's favourable climate to train on varied terrain. The shift away from purely clinic-based models also aligns with the goals of the National Disability Insurance Scheme, which emphasises community participation and informed choice for people living with permanent disabilities.

Core components of an effective falls prevention program

A well-designed falls prevention program for MS typically begins with a comprehensive assessment by a qualified physiotherapist. This includes evaluating leg strength, walking speed, step symmetry, and confidence using tools such as the Activities-specific Balance Confidence scale. From this baseline, an individualised plan is developed, though group sessions follow a structured curriculum that progresses over a typical ten-to-twelve-week block.

Balance training forms the cornerstone of most successful interventions. Exercises might include standing on foam surfaces, tandem walking along marked lines on a community hall floor, or practising reactive stepping when nudged gently by a partner. Strength work targets the hip abductors, ankle stabilisers, and core muscles that protect against lateral falls. Education plays an equally important role, covering topics such as appropriate footwear, managing fatigue, modifying home environments, and pacing daily activities to avoid the afternoon energy crashes common in MS.

Local examples and implementation across Queensland

Several Queensland Health initiatives and university-led projects have demonstrated how community exercise can be integrated with existing neurological services. Partnerships between Metro North Hospital and Health Service, The University of Queensland, and local councils have enabled exercise classes to be delivered in suburban venues stretching from Caboolture to Beenleigh. Some programs are co-located with diabetes or cardiac rehabilitation groups, reflecting the broader push within Australian healthcare to manage chronic disease holistically.

Funding sources vary, with some programs supported by research grants, others by the NDIS, and a growing number through Medicare-subsidised care plans arranged by general practitioners. Participants often travel to sessions via accessible transport networks, and many report that simply leaving the house regularly provides psychological benefits beyond the physical gains. The Brisbane Diamantina Health Partners network has been instrumental in connecting researchers, clinicians, and community organisations to refine these models and ensure findings reach the people who need them.

Comparing program models and outcomes

Different delivery formats suit different needs. The table below summarises three common approaches seen across Australian community settings.

Research consistently shows that programs lasting at least eight weeks with twice-weekly contact produce measurable improvements in balance scores and reductions in self-reported falls. Hydrotherapy is particularly helpful for individuals who experience heat sensitivity, a common MS symptom in Brisbane's warm summers, while home-based options widen access for those in regional areas or with limited mobility.

If you are a person living with MS, a carer, a clinician, or a community organiser interested in falls prevention, there are meaningful ways to contribute. Health translation collaboratives such as Brisbane Diamantina Health Partners bring together researchers, healthcare providers, and consumer advocates to design, test, and scale programs that work in real Australian settings. Connecting with these networks offers opportunities to participate in pilot projects, provide feedback on emerging resources, or help advocate for sustained funding. Community-based exercise is not a peripheral add-on to neurological care; it is a core strategy for keeping people with MS upright, confident, and engaged in the activities that make life worthwhile. Whether through joining an existing class, supporting a loved one's participation, or championing new initiatives in your local area, every contribution helps build a more inclusive and resilient Queensland.