Fear of Falling: Increase Confidence During Physical Therapy

A patient practices balancing as part of physical therapy

What is the Fear of Falling?

Ptophobia, or the fear of falling, is a phobic reaction to standing or walking after experiencing a fall injury. When someone fears falling, they may have anxiety about falling, or even avoid daily activities that could result in them falling. The fear of falling can lead to a loss of confidence, increased risks for subsequent falls, increased frailty, diminished social activity, and a lower overall quality of life. 

As we age, we are more likely to develop balancing issues. Problems with vision, the inner ear, or the sense of touch in a person’s feet often develop when we get older. Once an individual falls, they are more likely to develop a fear of falling.  Roughly one-third of elderly people develop a fear of falling after they experience a fall and this issue should be addressed in a physical therapy rehabilitation program.

Who is at Risk of the Fear of Falling?

A senior patient practices stepping up on a small box

About 40% of older adults live with a fear of falling, even more in those with ptophobia. The risk of a fear of falling is higher in females, possibly due to osteoporosis and fracture concerns. Reasons older people can have a fear of falling include: 

  • Experiencing a previous fall
  • Feeling unsteady
  • Having poor vision
  • Having a sedentary lifestyle
  • Frailty
  • Diminished health
  • And more

People who report a fear of falling show less control over their balance than people of similar ages and physical abilities. Anxiety may increase if they repeatedly face threats to their balance. 

The fear of falling may cause someone to shift their body weight incorrectly, leading them to experience more falls as they age.


Someone with a phobia of falling can experience many different symptoms, including: 

  • Anxiety
  • Headaches
  • Racing heart rate
  • Chest pain or tightness
  • Shortness of breath
  • Feeling dizzy or lightheaded
  • Tremors
  • Digestive symptoms
  • And more

The anxiety and panic of the fear of falling may cause people to avoid situations that cause their phobia. This means that the fear of falling may cause individuals to be less active. Daily tasks like grocery shopping may become difficult for someone with a fear of falling.


Several approaches can be used to treat phobias, including the fear of falling. Two important approaches are cognitive behavioral therapy (CBT) and physical therapy. 

With CBT, a therapist can help examine the negative thoughts and behaviors that may cause your fear of falling. They can help develop techniques for changing your behavior and the self-confidence to use them. 

Physical therapy is designed to restore confidence and mobility. Physical therapists may offer gait training to strengthen muscles, learn and practice good walking form, and improve posture. 

A review of CBT used in older people, alone or when combined with exercise programs, found that it can reduce the fear of falling, depression, and avoidance of activities.

How to Help Patients Cope with Their Fear of Falling

There are ways to reduce the fear of falling and risk of falls. Studies suggest improving physical and cognitive fitness and making lifestyle changes help people reclaim their confidence and reduce their fear of falling.


Man practicing balance therapy exercises

Exercise can help your patients improve their strength, coordination, stability, and self-confidence. Suggest forms of exercises that your patients may enjoy while improving their balance, like Tai Chi, Pilates, yoga, swimming, or using an exercise bike.


Correct Vision

Impaired vision can double your risk of falling. Patients should examine their eyes at least once a year, and have their prescriptions updated as needed.

Use Adaptive Equipment

Adaptive equipment may be prescribed for the short or long term. These products can help the patient remain stable and safe while performing daily tasks or during physical therapy. Types of adaptive equipment that can help reduce falls include: 

  • Grab bars
  • Tub/shower chair
  • Walkers
  • Canes
  • Ramps
  • Fall detection devices

Use the Solo-Step Overhead Track System During Physical Therapy and Rehabilitation

A woman walks under the supervision of a physical therapist

The Solo-Step Overhead Track System is a ceiling-mounted harness system designed to prevent falls during gait, strength, and balance training. Solo-Step consists of: 

  • Ceiling-mounted aluminum track
  • Smooth gliding trolley
  • Adjustable Lanyard
  • Safety Harness

Utilizing the Solo-Step Overhead Track & Harness System during physical therapy training helps take the fear out of falling for the patient because they are protected from dangerous falls while within the system. The patient will be free to perform various gait training tasks, balance exercises, and more while within the system. This gives them the confidence to improve their gait, strength, and balance! 

To learn more about the Solo-Step Overhead Track & Harness System, click the button below!


In conclusion, the fear of falling, or ptophobia, is a significant concern among older adults, affecting their physical health and overall quality of life. This fear can stem from various factors such as previous falls, frailty, diminished health, and more. However, addressing this fear head-on is essential, especially in physical therapy rehabilitation programs.

Through cognitive behavioral therapy (CBT) and physical therapy, individuals can work towards overcoming their fear of falling and regaining confidence in their mobility. CBT helps in identifying and challenging negative thoughts and behaviors associated with the fear of falling, while physical therapy focuses on restoring strength, balance, and mobility.

Various strategies can help individuals cope with and reduce their fear of falling, including exercise, supplements like vitamin D, vision correction, and the use of adaptive equipment. Additionally, incorporating innovative solutions like the Solo-Step Overhead Track System during physical therapy sessions can provide a safe environment for patients to regain their confidence in movement without the fear of falling.

By addressing the fear of falling through a comprehensive approach that combines therapy, exercise, and innovative solutions like the Solo-Step, individuals can reclaim their independence, improve their quality of life, and reduce the risk of future falls.

Learn More About Solo-Step!