On 26 June 2025, the Australian Falls Guidelines were updated by the Australian Commission on Safety and Quality in Health Care.

I was hugely excited to read  Preventing falls and harm from falls in older people: Best Practice Guidelines for Residential Aged Care Services because there is now a greater emphasis on exercise prescription in aged care, as well as balance testing.

These guidelines stipulate assessing balance with validated tools to guide exercise prescription and measure balance improvements.

It dovetails neatly with the Balance Metrix strategy of introducing balance testing to aged care facilities and partnering with exercise-focused allied health clinicians in our Better Balance Initiative.

The Guidelines mandate “multifactorial comprehensive fall risk assessment” and “tailored fall intervention plans” – in accordance with “the goals of care for the older person to minimise risk.”

That makes perfect sense and it aligns with a shift to “positive ageing” where older people retain their dignity, have more of a say about their care and are encouraged to move well and stay well for longer.

Nine years of research & development

The Balance Mat from Balance Metrix is an electronic system that can be used by residential aged care providers, healthcare providers and allied health clinicians to assess clients’ balance instability. I started developing it almost a decade ago, in 2016, based on the best falls prevention regime I could find at the time – the American Centres for Disease Control STEADI protocol.

STEADI stands for STopping Elderly Accidents, Deaths & Injuries. It grew out of the American Geriatrics Society and British Geriatrics Society Panel on Prevention of Falls in Older Persons Clinical Practice Guideline for Prevention of Falls in Older Persons (2010).

Their 4-Stage Balance Test is promoted as “the pre-eminent clinical tool used to assess static balance and fall risk in individuals, particularly older adults.” It is a manual balance testing protocol that involves testing older people’s balance for 10 seconds in each of four progressively harder stances (normal, semi-tandem, tandem, single foot).

I incorporated those four stances into the now TGA-approved Balance Mat technology and added another single leg stance to compare differences in left and right leg balance ability for rehabilitation purposes after stroke or injury. I also increased the standing time on the mat to 20 seconds per test (although if a person can’t manage standing for 20 seconds the test can be stopped at the 10-second mark).

Whether it is run for 10 or 20 seconds, the Balance Mat provides electronically recorded objective movement data that is more sensitive than time-based testing alone. Data is presented on the user’s computer or laptop in the form of a dynamic graph and score that can be saved at the end of the test and also printed out and placed on the person’s tailored fall intervention plan or emailed to a treating GP or allied health practitioner. It acts as a snapshot of the person’s balance ability on the date the test is conducted and can be repeated at a later date for comparison and monitoring of any changes.

Identifying the highest of the high

In the past six months I have spearheaded the balance testing of more than 400 people at various locations, including Hastings Medical Centre at Wauchope, Garden Village at Port Macquarie and RSL Anzac Village in Narrabeen, Sydney. This has brought the total number of people in the Balance Mat normative database to 2,200 and enabled the delineation of three clusters: low, medium and high.

In terms of the updated Australian Falls Guidelines for residential aged care where every older person is considered to have a high falls risk, the Balance Mat can help providers assess those who have a heightened risk of falling based on their “wobbliness” or degree of postural sway.

Over the years I have found the difference in postural sway from one person to the next to differ markedly. People with medium results can be 3 – 10 times more wobbly than those with low postural sway. For some people in aged care, their results can be close to zero if they are as fit and well as anyone in their older years can be. And people with high postural sway can be 20 times more wobbly than those in the low category. No wonder older people with high postural sway tend to fall more often!

The different readings on the Balance Mat give nursing and care workers a ready analytical framework that helps them recognise the highest of the high. In other words, it quantifies a group of residents’ balance instability in relation to each other’s.

The technology provides this comparative data in the form of an aggregated graph or chart that can be printed out and placed in the nurses’ station for ready reference. The system also records the number of falls the person has had.

If you ever work with older people you need to get yourself a Multimetric Balance Mat. Lately everyone I meet seems to be engaged with older people in one way or another, often through elderly parents or through their work in the healthcare or aged care sectors. They’re usually very interested when I tell them about the Balance Mat and how it can be used as a falls prevention tool.

3 ways to engage

Balance testing service

You can take advantage of our balance testing service. This is where we come to your premises and test the balance of all or as many of your residents as you wish.

Better Balance Initiative

The Better Balance Initiative is where our highly qualified allied health partners work inside a residential aged care facility to test and train residents’ balance.

Subscribe or buy

You can sign up for a low (non-refundable) one-time setup fee of $180 with a subscription of $46.50 per month. The first month of your subscription will be free and there are no lock-in contracts, so you can end the subscription at any time. You can subscribe or buy a Multimetric Balance Mat using our secure payment portal on the Shop page.

Don’t be shy!

You will find comprehensive information on this website and you can buy online using our secure payment portal or contact us via the Contact Us page.

Please feel free to reach out to me (ian@balancemetrix.com.au or mob. 0457 123 852). I’d welcome a call from you. I absolutely love talking about the Balance Mat technology!