Allied Health Roles in Falls Prevention Stretch Across Screening, Assessment, and Intervention
Falls prevention in community-dwelling older adults is no longer the domain of a single profession. This scoping review mapped how allied health professionals contribute to screening, assessment, and intervention across a wide range of falls-related care, and the breadth was striking: 442 relevant sources from 34 countries described roles for 17 allied health professions. In practical terms, the review shows that falls prevention is being built from many overlapping clinical disciplines rather than one tidy pathway.
The work is important because falls in older adults carry immediate consequences for function, independence, and health system burden. A fall can trigger fractures, fear of falling, reduced mobility, and downstream deconditioning, and those effects are amplified when prevention is fragmented. The review directly addressed a long-standing gap in guideline development: allied health roles are often present in care delivery but inconsistently represented in formal recommendations. Here, the evidence base was catalogued not to prove a single intervention works better than another, but to clarify who does what, where overlap exists, and where the evidence remains thin.
Mapping 17 Professions Exposes Both Breadth and Redundancy
Screening and assessment roles extended across medical, physical capacity, environmental, education, and behavioural-psychological domains. That scope is clinically plausible because falls rarely arise from one cause alone. Gait instability, sensory loss, polypharmacy, home hazards, poor footwear, low confidence, and reduced strength can all converge in the same patient. Allied health professions are uniquely positioned to interrogate those layers because their training is often built around function, movement, communication, adaptation, and environment.
Profession-specific interventions generally tracked with each discipline’s scope of practice. Physical therapy contributions are naturally aligned with strength, balance, gait, and mobility training. Occupational therapy fits environmental modification, activity adaptation, and task-specific safety. Other allied health roles were represented in screening and support functions that address education, behavior change, or domain-specific barriers to safe mobility. The review also identified notable overlap between professions, which is not a weakness in itself; in falls care, overlap often reflects the reality that older adults present with multiple interacting risks that do not respect professional silos.
One sentence captures the clinical implication plainly: falls prevention is a team-based problem because falls themselves are a systems problem.
The review used a Joanna Briggs Institute scoping framework, with searches spanning PubMed, CINAHL, Scopus, Cochrane, Web of Science, and the Allied and Complementary Medicine Database. The initial search was completed in November 2023, and a secondary search followed in July 2025. Inclusion was broad, encompassing sources that identified or described a specific role for at least one allied health professional in falls prevention care for older adults, while excluding protocols and conference abstracts. Only English-language sources were included, which is a practical constraint for evidence mapping but also a reminder that global practice may be broader than this review can fully capture.
Evidence Gaps Are Deepest for Smaller Professions
The strongest signal from this review is not only diversity of roles, but asymmetry in the evidence supporting them. Larger and more established professions appear more consistently in the literature, while smaller allied health professions are less well represented. That creates a familiar guideline problem: when a profession contributes meaningfully in clinic but has limited formal evidence, it can be left out of recommendations even when it is already part of real-world care.
Foundational research is therefore needed for those smaller professions, not as an academic exercise, but to make their contribution visible, measurable, and easier to standardize in practice guidelines. Without that evidence, service planners may underuse available expertise or default to a narrow model of falls care that misses important behavioral, environmental, or functional drivers of risk. The review’s descriptive approach is well suited to this stage of the field because it does not force a premature hierarchy onto a complex care problem. Instead, it identifies where the literature is dense, where the edges are blurred, and where the field still lacks the most basic support for inclusion in guidance.
A second practical implication follows from the overlap between professions. Coordinated pathways may be more useful than rigid role separation, especially for older adults who need multiple interventions delivered in sequence or in parallel. A patient with gait impairment, home clutter, poor vision, and low activity tolerance does not benefit from a one-discipline solution. The challenge for guideline writers is to translate that complexity into clear referral pathways without flattening the nuance of professional expertise.
The review was also notable for its use of ChatGPT-4o during initial data extraction, followed by author cross-checking and correction of inaccuracies. In editorial terms, that signals a hybrid workflow rather than an automated review. The human verification step remains central, especially in a scoping review that is synthesizing heterogeneous sources across many professions and health systems.
What This Means for Guidelines and Day-to-Day Care
For clinicians, the message is immediate: falls prevention in older adults should be thought of as a multi-profession function, not a single referral destination. For guideline developers, the review offers a structured map of where allied health professionals already contribute and where the literature is too sparse to support firm recommendations. For service designers, it suggests that effective falls pathways will likely depend on role clarity, shared screening frameworks, and explicit recognition of overlapping responsibilities.
The most concrete limitation sits in the evidence base itself. The review found broad coverage across professions and countries, but the level of evidence varied, and smaller professions lacked the foundational studies needed to place them confidently into future practice guidelines. English-language restriction may also have shaped what was captured. Even so, the overall pattern is hard to miss: allied health professions are already embedded in falls prevention, but the research record has not kept pace with that clinical reality.