From Fall Prevention to Injury Prevention: The Role of Martial Arts-Derived Training in Older Adults—A Narrative Review

1. Introduction

The ongoing ageing of the population means that preventing falls among older people is becoming one of the most important challenges facing contemporary gerontology, public health and physical education. Falls are among the most common adverse events in the elderly population and are the leading cause of injury, loss of functional independence, hospitalisation and premature mortality in this age group [1,2,3]. It is estimated that at least one third of people over the age of 65 experience at least one fall per year, and the incidence of this phenomenon increases with age and the level of functional dependence [2,4].

The consequences of falls extend far beyond the immediate physical effects. In addition to fractures, head injuries and soft tissue damage, which incur significant costs for treatment and rehabilitation, falls lead to the development of what is known as ‘post-fall syndrome’, comprising a fear of falling again, reduced physical activity, social isolation and a decline in quality of life [5,6,7]. Paradoxically, the avoidance of physical activity caused by the fear of falling contributes to a further decline in muscle strength, balance and mobility, which in turn further increases the risk of subsequent incidents [7].

Contemporary prevention strategies indicate that one of the most effective methods of reducing the risk of falls is systematic and appropriately tailored physical activity [8,9]. Research shows that exercise programmes improve muscle strength, postural control, motor coordination and gait quality, leading to a significant reduction in the number of falls amongst older adults [10,11,12]. Interventions focusing on balance and functional exercises, which simultaneously engage the cognitive processes responsible for planning, controlling and modifying movement, are particularly effective [9,13].

In recent years, exercises inspired by sports and martial arts have attracted increasing interest from researchers; due to their multidimensional nature, they may serve as a valuable tool for the prevention of falls. Unlike traditional training programmes, which focus mainly on building strength or endurance, exercises derived from martial arts integrate motor, sensory and cognitive components. These include control of the centre of gravity, multi-planar body movement, responses to balance disturbances, spatial orientation and the rapid adaptation of movement strategies to changing environmental conditions [13,14,15].

A particularly valuable feature of exercises inspired by hand-to-hand combat systems is their ability to develop motor and cognitive functions simultaneously. A growing body of evidence suggests that deficits observed during dual-task performance, which requires simultaneous cognitive and motor control, are among the most significant risk factors for falls in both older adults and patients with neurological conditions [16,17,18]. Training incorporating elements characteristic of combat sports, such as changes in direction of movement, postural transitions, reactions to external stimuli or movement sequences requiring rapid decision-making, can effectively support the mechanisms responsible for maintaining postural stability and adapting to sudden destabilising situations [13,19].

At the same time, it should be emphasised that most modern fall prevention programmes focus on preventing the fall itself, whilst overlooking the issue of minimising its consequences. However, it is impossible to completely eliminate falls, particularly amongst the elderly. Consequently, increasing attention is being paid to the need to incorporate the art of falling safely into prevention programmes, a discipline whose roots lie mainly in martial arts and selected self-defence systems [20,21,22]. Research conducted within the framework of the ‘susceptibility to bodily injuries during a fall’ (SFI) concept indicates that appropriately developed movement patterns can significantly reduce the risk of head, upper limb and hip injuries upon contact with the ground [22,23,24].

From a public health perspective, exercises inspired by combat sports may therefore represent a particularly valuable form of physical activity for older people. Their potential effectiveness stems not only from improved physical fitness, but also from the development of adaptive abilities, increased body awareness, improved postural control and the development of safe responses in situations where balance is lost [25,26,27]. This approach is consistent with the modern model of primary, secondary and tertiary prevention, aimed at both reducing the incidence of falls and minimising their adverse health consequences.

However, analyses to date have focused primarily on reducing the incidence of falls, while the potential role of martial arts-derived exercises in simultaneously reducing fall risk and mitigating the consequences of unavoidable falls has received much less attention.

The aim of this paper is to present ways of preventing falls among older people through the use of physical exercises modelled on martial arts, with particular emphasis on their impact on balance, functional fitness, cognitive-motor abilities and learning how to fall safely as part of a comprehensive gerontological prevention programme.

2. Materials and Methods

This study was conducted as a narrative review to identify and synthesize current evidence regarding the use of exercise programs derived from martial arts and combat sports for the prevention of falls and injuries in older adults. The review focused on interventions including elements of boxing, judo, wrestling, aikido, tai chi, self-defence training, fall safety education, and cognitive-motor training relevant to healthy aging.

A literature search was conducted between May and August 2026 using the electronic databases PubMed, Scopus, Web of Science, and Google Scholar. The following keywords and their combinations were used: older adults, healthy aging, fall prevention, injury prevention, safe falls, martial arts, combat sports, boxing training, judo, tai chi, dual-modality training, postural stability, balance training, cognitive-motor skills, INNOAGON, and susceptibility to fall-related injuries.

The search primarily included articles published in English between 2000 and 2026. Previous publications were also considered if they represented seminal work on martial arts pedagogy, safe falls education, or injury prevention models. Additional references were identified through manual bibliographic analysis of relevant publications.

Studies were included if they: (1) involved older adults or populations with functional characteristics relevant to aging; (2) examined physical activity programs incorporating elements from martial arts or combat sports; (3) addressed fall prevention, injury prevention, balance, mobility, cognitive-motor skills, or fall safety skills; and (4) were published in peer-reviewed academic journals or books. Studies not directly related to physical activity, fall prevention, or healthy aging were excluded. Due to the heterogeneity of study designs, intervention protocols, and outcome measures, a quantitative synthesis was not conducted. The selected literature was analysed narratively, paying particular attention to the mechanisms potentially linking martial arts-based training to fall risk reduction, injury mitigation, functional independence, and healthy aging.

3. Results and Discussion

3.1. Physical Activity Inspired by Martial Arts and Healthy Ageing

Physical activity is one of the most important factors in maintaining health and functional ability as we age. In recent years, physical activity programmes incorporating selected elements of sport and martial arts have attracted increasing interest from researchers and practitioners; when appropriately adapted, these programmes can also be used effectively with older people. Such exercises simultaneously engage the musculoskeletal system, cognitive processes and postural control mechanisms, creating a multidimensional training stimulus that promotes the maintenance of functional independence [15,19].

The modern understanding of hand-to-hand combat encompasses both combat sports and martial arts. Despite cultural and organisational differences, these disciplines utilise similar movement patterns relating to the shifting of the centre of gravity, maintaining balance, changing direction of movement, and multi-segmental body coordination. In a health context, particular importance is attached to those elements of training that develop motor and cognitive abilities without the need to participate in competitive sport [25,26].

Research indicates that regular practice of exercises inspired by combat sports helps to improve muscle strength, motor coordination, reaction speed and balance. A key benefit of these exercises is their functional nature, stemming from the need to perform movements in different planes and to frequently change body position. As a result, these exercises better reflect situations encountered in everyday life than traditional training of isolated muscle groups [13,19].

Table 1. Potential contributions of selected martial arts and combat sport disciplines to fall and injury prevention in older adults.

Discipline	Key training components	Functional and cognitive benefits	Potential contribution to fall and injury prevention
Boxing, Kickboxing, Muay Thai (non-contact forms)	Footwork, reaction drills, hand-eye coordination, multidirectional movement, stimulus-response exercises	Improved reaction time, gait adaptability, executive function, dual-task performance, coordination	Enhanced mobility and obstacle avoidance; improved ability to respond rapidly to balance disturbances and environmental hazards
Judo	Ukemi (safe-falling techniques), postural transitions, rolling, getting up from the floor, dynamic balance exercises	Improved body awareness, functional strength, movement control, confidence in mobility	Reduced susceptibility to fall-related injuries through development of protective responses and impact-distribution strategies
Wrestling	Body positioning, centre-of-gravity control, functional strength, dynamic stability exercises	Enhanced neuromuscular coordination, core stability, postural control	Better recovery after perturbations and improved maintenance of stability during daily activities
Aikido	Balance redirection, controlled body movements, rotational techniques, spatial awareness	Improved proprioception, coordination, movement fluidity and postural adjustment	Enhanced ability to regain balance and adapt to unexpected destabilising situations
Tai Chi	Slow controlled movements, weight shifting, postural alignment, breathing control	Improved balance, lower-limb strength, concentration and motor control	Reduction in fall risk through enhanced postural stability and gait control
Self-defence-based exercise programmes	Situational awareness, defensive movement patterns, rapid decision-making, multidirectional locomotion	Improved cognitive-motor integration, attention, adaptability and confidence	Better management of unexpected environmental challenges and reduction of fall risk in everyday situations

Table 1. Potential contributions of selected martial arts and combat sport disciplines to fall and injury prevention in older adults.

Discipline	Key training components	Functional and cognitive benefits	Potential contribution to fall and injury prevention
Boxing, Kickboxing, Muay Thai (non-contact forms)	Footwork, reaction drills, hand-eye coordination, multidirectional movement, stimulus-response exercises	Improved reaction time, gait adaptability, executive function, dual-task performance, coordination	Enhanced mobility and obstacle avoidance; improved ability to respond rapidly to balance disturbances and environmental hazards
Judo	Ukemi (safe-falling techniques), postural transitions, rolling, getting up from the floor, dynamic balance exercises	Improved body awareness, functional strength, movement control, confidence in mobility	Reduced susceptibility to fall-related injuries through development of protective responses and impact-distribution strategies
Wrestling	Body positioning, centre-of-gravity control, functional strength, dynamic stability exercises	Enhanced neuromuscular coordination, core stability, postural control	Better recovery after perturbations and improved maintenance of stability during daily activities
Aikido	Balance redirection, controlled body movements, rotational techniques, spatial awareness	Improved proprioception, coordination, movement fluidity and postural adjustment	Enhanced ability to regain balance and adapt to unexpected destabilising situations
Tai Chi	Slow controlled movements, weight shifting, postural alignment, breathing control	Improved balance, lower-limb strength, concentration and motor control	Reduction in fall risk through enhanced postural stability and gait control
Self-defence-based exercise programmes	Situational awareness, defensive movement patterns, rapid decision-making, multidirectional locomotion	Improved cognitive-motor integration, attention, adaptability and confidence	Better management of unexpected environmental challenges and reduction of fall risk in everyday situations

A key feature of physical activity modelled on combat sports is the simultaneous engagement of cognitive functions. Many exercises require memorising movement sequences, rapid information processing and adapting motor responses to changing conditions. These mechanisms are of particular importance in the prevention of falls, as the majority of falls occur whilst performing simultaneous motor and cognitive tasks. The ability to function effectively under dual-task conditions is now recognised as one of the key factors in reducing the risk of losing balance [16,18,27].

In practice, classes for older people primarily utilise non-contact elements of boxing, judo, aikido and self-defence exercises. These include, amongst other things, lunges, evasive steps, changes of direction, transitions to low stances, exercises for getting up from the ground, and controlled shifts of the centre of gravity. Such programmes can be easily adapted to participants’ health and fitness levels, whilst developing the skills necessary to respond effectively to sudden loss of balance [13,28].

The skill of safe falling holds a special place amongst the elements derived from martial arts. Unlike most fall prevention programmes, which focus exclusively on preventing the fall itself, training in safe falling prepares participants to minimise the consequences of situations that cannot be avoided. Research conducted by Kalina and colleagues indicates that appropriately developed movement patterns can reduce the risk of injuries to the head, upper limbs and hip area by developing effective mechanisms for cushioning contact with the ground [21,23,29].

From the perspective of gerontology and public health, physical activity based on elements of hand-to-hand combat can be regarded as a comprehensive form of preventive intervention. It combines training in balance, coordination, functional fitness and cognitive abilities with learning safe response strategies in situations where stability is lost. This approach is consistent with the modern model of primary, secondary and tertiary fall prevention and can serve as an important tool in supporting active and healthy ageing [25,26,27].

3.2. Martial Arts-Based Interventions for the Prevention of Falls

Falls are one of the most significant health problems affecting older people, and their aetiology is multifactorial. The most commonly identified risk factors include balance disorders, reduced muscle strength, cognitive decline, slowed reaction times and difficulties in adapting movement to changing environmental conditions [2,4]. Consequently, modern prevention programmes should address multiple aspects of human functioning simultaneously. In this context, interventions based on selected elements of sport and martial arts, which integrate motor, cognitive and behavioural training within a single physical activity, are of particular interest (table 2).

Not all studies were conducted in older adults; selected studies were included due to their relevance to mechanisms associated with fall and injury prevention.

A distinctive feature of exercises derived from hand-to-hand combat is the performance of movements that require constant control of the centre of gravity, the maintenance of dynamic balance, and rapid responses to changing stimuli. Unlike many traditional physical activity programmes, these exercises engage participants in situations resembling everyday life, during which it is essential to simultaneously process sensory information, plan movements and control body posture. As a result, they develop adaptive abilities that play a key role in preventing falls [13,14].

A growing number of studies indicate that the risk of falling is strongly linked to impairments in dual-task performance, which requires simultaneous cognitive and motor activity. These deficits are particularly evident in older people and neurological patients, especially those with Parkinson’s disease. Exercises inspired by hand-to-hand combat, involving the memorisation of movement sequences, responding to external cues and performing movements of varying structure, effectively develop the ability to integrate cognitive and motor processes. Research by Shearin et al. [16] showed that a boxing training programme improved gait parameters and the performance of cognitive-motor tasks in people with Parkinson’s disease, whilst Staniszewski et al. [18] reported an improvement in balance abilities following the Rock Steady Boxing programme.

Interventions incorporating elements of boxing are currently among the most frequently studied programmes based on combat sports. They include footwork exercises, changes of direction, coordination of the upper and lower limbs, reactions to auditory or visual stimuli, and tasks requiring concentration. Domingos et al. [14] emphasise that boxing training can effectively improve functional mobility, balance and the ability to move safely in everyday situations. For older adults, the ability to eliminate contact elements whilst retaining coordination and cognitive stimuli is of particular importance. Evidence from Parkinson's disease populations may not be directly transferable to community-dwelling older adults and should be interpreted with caution.

Exercises based on elements of judo and other hand-to-hand combat systems also demonstrate significant practical value. These include postural transitions, rolling exercises, controlled changes in the position of the centre of gravity, getting up from the ground, and locomotion exercises in various positions. These activities develop both functional strength and the ability to regain balance following a loss of stability. According to Kalina [20] and Kalina et al. [30], they provide a natural foundation for learning safe movement behaviours to be used when losing balance.

The component of safe falling training is of particular importance in fall prevention. Most contemporary prevention programmes focus on reducing the number of falls, whilst they address the issue of minimising their consequences much less frequently. However, it is not possible to completely eliminate falls amongst the elderly population. Kalina et al. [21] point out that learning to fall safely may be one of the most effective elements of injury prevention, regardless of the participants’ age or gender. Gąsienica-Walczak and Klimczak [23], on the other hand, describe education on safe falling as the ‘missing pillar’ of the injury prevention measures recommended by the WHO [31].

The results of the latest research carried out within the INNOAGON framework and based on the Susceptibility to Fall Injuries (SFI) concept indicate that appropriately designed interventions can lead to a significant reduction in susceptibility to injuries resulting from falls. In studies carried out amongst residents of care homes, beneficial cognitive and behavioural effects were observed, along with an improvement in the quality of motor responses associated with body contact with the ground [27]. The authors emphasise that it is not only the exercises themselves that are crucial, but also the process of learning new movement strategies and modifying unfavourable motor habits.

Current scientific evidence also suggests that the effectiveness of interventions based on combat sports stems not so much from the high intensity of the exercise as from their motor and cognitive complexity. The greatest benefits are observed when exercises require decision-making, spatial awareness, anticipation of movement and rapid adaptation of responses to changing situations. Such conditions are characteristic of exercises derived from hand-to-hand combat systems and constitute their advantage over simple forms of physical activity [16,27,28].

Interventions based on forms of hand-to-hand combat represent a promising direction for the development of modern fall prevention programmes. They combine training in balance, functional strength, coordination and cognitive function with learning how to react safely when stability is lost. In light of the available scientific evidence, they can be regarded as a comprehensive tool that helps both to reduce the risk of falls and to minimise their health consequences.

3.3. Safe Fall Learning: the Missing Link in Injury Prevention

Modern fall prevention programmes for older people focus mainly on reducing the incidence of falls themselves by improving balance, muscle strength, motor coordination and functional ability. Despite the documented effectiveness of such interventions, they are unable to completely eliminate the risk of a fall, particularly in older people with multiple co-morbidities, balance disorders or cognitive impairments. Consequently, there is a growing recognition of the need to expand the traditional prevention model to include measures aimed at mitigating the consequences of a fall in situations where the event itself becomes unavoidable. This is the role played by safe fall training, which may represent the missing link in modern injury prevention [21,23].

Safe fall learning is defined as the process of developing motor skills that enable the risk of physical injury to be minimised when one loses their balance and comes into contact with the ground. It comprises a set of conscious and partially automated motor responses that allow the body’s movement to be controlled during a fall, protect particularly vulnerable anatomical structures, and distribute the impact energy over as large an area of the body as possible [20,21]. This concept derives primarily from judo, jujitsu and other hand-to-hand combat systems, in which falling techniques (ukemi) form a fundamental part of training and are regarded as a prerequisite for safe participation in training [30].

From a biomechanical point of view, the injury sustained during a fall results from the sudden transfer of the body’s kinetic energy to a small area of contact with the ground. The magnitude of the load acting on the tissues depends on body weight, speed of movement and the time taken to come to a halt. The shorter the time taken to stop moving, the greater the forces acting on the musculoskeletal system and soft tissues. The fundamental mechanism of a safe fall is therefore to prolong the energy absorption time by adopting an appropriate body position, increasing the contact area with the ground, and utilising rolling movements that allow energy to be dispersed across successive body segments [21,32]. In practice, this means avoiding rigid support with an extended upper limb, lowering the centre of gravity, controlled flexion of the lower limbs, and protecting the head through appropriate positioning of the cervical spine. These strategies reduce the risk of upper limb fractures, hip injuries and head injuries, which are among the most serious consequences of falls in older people [21,33].

Significant support for the concept of safe fall is provided by research conducted within the framework of the Susceptibility to Bodily Injuries during a Fall (SFI) model, developed by Kalina and colleagues. The SFI concept posits that the risk of injury is determined not only by the mere fact of a fall occurring, but also by the quality of the motor responses that occur when the body comes into contact with the ground [34,35]. Studies using the STBIDF test and its modified versions have shown that many people exhibit unfavourable movement patterns that increase susceptibility to injuries to the head, upper limbs and hip region. At the same time, it has been demonstrated that these patterns can be modified through appropriately planned educational interventions and motor training [24,28].

The results of studies conducted amongst residents of care homes are particularly interesting. Klimczak et al. [27] demonstrated that innovative cognitive-behavioural interventions led to a reduction in the risk of injury during falls and an improvement in the quality of motor responses associated with loss of balance. The authors emphasised that a key role is played not only by improving physical fitness, but also by developing the cognitive abilities responsible for movement control, anticipating the consequences of actions and modifying ingrained movement habits. These findings are consistent with the principles of modern preventive medicine, which highlight the need to integrate motor and cognitive components into preventive programmes.

Further evidence is provided by studies of people who practise combat sports. Boguszewski et al. [33] demonstrated that combat sports athletes are less susceptible to certain fall-related injuries than non-athletes. This may be due to many years of honing their body control skills, absorbing external forces and developing automatic protective responses characteristic of hand-to-hand combat training.

An important issue remains the feasibility of teaching safe fall techniques to older people. Contrary to popular belief, such training does not need to involve the full range of techniques used in competitive sport. For older people, it is recommended to use exercises with a gradually increasing level of difficulty, carried out on a soft surface and with appropriate safety measures in place. Such programmes may include learning how to move safely into a sitting or lying position, body rolling exercises, learning how to get up after a fall, training in protective reactions, and controlled forms of falls inspired by judo and jujitsu [21,23]. Exercises that integrate elements of balance, spatial orientation and dual-task challenges are particularly valuable, as they reflect the conditions in which falls most commonly occur in everyday life [27].

From a public health perspective, learning safe fall may represent one of the most important areas of development in injury prevention amongst older people. It combines elements of primary, secondary and tertiary prevention, whilst enabling the development of functional ability and the reduction of the consequences of incidents that cannot be completely eliminated. Incorporating safe fall training into physical activity programmes based on appropriately modified elements of martial arts may help both to reduce the number of injuries and to lower the social and economic costs associated with falls among older people.

3.4. The INNOAGON Model in the Context of Contemporary Fall Prevention Models

In recent years, there has been a trend towards the development of interdisciplinary models for the prevention of falls, which go beyond the traditional approach focused solely on identifying risk factors and improving physical fitness. One such proposal is the INNOAGON (Innovative Agonology) concept developed by Kalina and colleagues, which integrates the areas of physical activity, health education, personal safety, rehabilitation and defensive behaviours [36,37,38]. In this framework, the individual is viewed as an agent constantly taking action in response to various environmental threats, amongst which unintentional falls are among the most common and most costly health-related events in the older population.

The central concept of the INNOAGON model is the ‘practical error’, defined as an action or omission that increases the likelihood of an injury occurring. In the context of falls, this implies shifting the focus from the event itself to the cognitive, decision-making and motor processes that precede a loss of balance or determine how the body behaves during a fall [36]. This approach is consistent with recent findings indicating that the risk of falls depends not only on the condition of the musculoskeletal system, but also on executive functions, divided attention and the ability to respond adaptively to changing environmental conditions [9,16].

Despite its originality, however, the INNOAGON model remains relatively little known in the international literature. Most of the publications elaborating on its principles originate from a single academic community centred around the journals *Archives of Budo* and *Archives of Budo: Journal of Innovative Agonology* [26,37]. The limited number of independent research teams utilising this concept makes it difficult to assess its universality and reduces the model’s level of internationalisation. Consequently, the position of INNOAGON in global academia currently remains more conceptual than empirically grounded.

To better understand the potential of this concept, it is worth relating it to models recognised within the scientific community that describe motor behaviour and injury prevention. A comparison with the ‘ecological dynamics’ approach is particularly interesting, as this is currently one of the most influential schools of thought in sports and motor sciences [39,40]. This concept posits that motor behaviour results from dynamic interactions between an individual’s capabilities, the task being performed and the environment. In the context of fall prevention, this implies the need to develop the ability to adapt to unpredictable situations through exposure to a variety of motor challenges. Exercises inspired by combat sports, involving changes in direction of movement, balance disturbances or reactions to external stimuli, align with many of the principles of ecological dynamics. However, INNOAGON extends this perspective to include the conscious shaping of protective behaviours and the analysis of the consequences of practical errors.

Similarities can also be found in relation to contemporary theories of motor learning. Approaches such as Newell’s constraints theory, the constraints-led approach and non-linear pedagogy emphasise the importance of motor exploration, variation in exercises and the learner’s independent resolution of motor problems [41,42]. In contrast to traditional programmes based on repetitive, isometric training, these models aim to develop adaptive abilities through exposure to a variety of motor situations. In this respect, the principles of INNOAGON are consistent with the modern understanding of motor learning, as they emphasise the ability to adapt responses to the changing conditions of everyday life. However, there is still a lack of experimental research allowing for a comparison of this model’s effectiveness with more established theories of motor learning.

Another point of reference is contemporary models of injury prevention. Of particular significance here are van Mechelen’s injury prevention sequence (1992), Finch’s TRIPP translational model for sports injury research [43], and the multifactorial approach by Bahr and Krosshaug [44]. These models focus on identifying risk factors, analysing injury mechanisms and evaluating the effectiveness of the interventions implemented. In comparison, INNOAGON adopts a more pedagogical and behavioural perspective, emphasising the importance of preparing individuals to act effectively in hazardous situations. Its strength lies in taking into account protective behaviours and reactions already undertaken during the fall itself. At the same time, there is still a lack of high-quality prospective studies confirming the superiority of this approach over classical models of injury epidemiology.

The principles of INNOAGON can also be analysed in relation to the World Health Organisation’s (WHO) Healthy Ageing model. The WHO defines healthy ageing as the process of developing and maintaining functional abilities that enable well-being in older age [31]. In this model, physical abilities, cognitive functions, autonomy, social participation and the ability to adapt to the environment are of key importance. Exercises inspired by martial arts and learning safe fall can support all these areas by developing balance, functional fitness, cognitive-motor skills and a sense of agency. Unlike INNOAGON, however, the WHO model has a much stronger evidence base and is more widely accepted in international health policy.

From a gerontological perspective, the INNOAGON model offers a new perspective on the issue of falls. Instead of an approach focused solely on reducing risk factors, it proposes developing adaptive skills that enable effective responses to hazards encountered in everyday life. Of particular importance here are exercises inspired by martial arts, which simultaneously help to develop balance, spatial awareness, reaction speed, postural control and the ability to fall safely. Appropriately modified forms of such exercises can be successfully incorporated into physical activity programmes for older adults, becoming an important tool for supporting active ageing and maintaining functional independence.

In light of the principles of innovative agonology, effective fall prevention should not be limited solely to attempts to eliminate the event itself. It is equally important to prepare people to cope with situations that cannot be entirely avoided. The INNOAGON model suggests that a combination of health education, cognitive-motor training and learning safe fall can form the basis of modern prevention programmes, particularly in relation to ageing populations.

Although the INNOAGON model offers an original perspective on the prevention of falls and injuries by integrating motor, cognitive, educational and behavioural dimensions, its scientific dissemination remains limited compared with internationally recognised models such as ecological dynamics, constraint-based motor learning, the TRIPP model and the WHO ‘Healthy Ageing’ model. Most of the empirical evidence stems from a relatively small group of researchers, which highlights the need for independent validation studies across different countries, healthcare systems and cultural contexts. Therefore, the INNOAGON model should currently be regarded as a promising conceptual model rather than an established, evidence-based model.

Limitations

When interpreting the results of this narrative review, several limitations should be taken into account. Firstly, the review methodology did not adhere to a systematic review protocol and may therefore be subject to selection bias. Secondly, the available evidence on martial arts-based interventions in older adults remains heterogeneous in terms of training protocols, participant characteristics and outcome measures. Thirdly, the scientific evidence supporting the INNOAGON model is still evolving and derives largely from studies conducted by a limited number of research groups. Consequently, caution should be exercised when generalising these findings to wider populations. Future randomised controlled trials and multicentre studies are warranted to establish the effectiveness of these approaches.

4. Conclusions

Physical activity incorporating appropriately adapted elements of sport and martial arts is a promising tool for preventing falls in older people. These exercises combine the development of balance, coordination, functional strength and cognitive-motor abilities, which are key factors determining the safety of mobility and functional independence in older people.

Learning safe fall is of particular value, as it complements traditional prevention programmes focused exclusively on preventing falls. Available research findings indicate that developing appropriate protective responses can reduce the risk of injury even in situations where the fall itself is unavoidable.

The INNOAGON concept expands on the traditional approach to prevention by integrating measures from the fields of primary, secondary and tertiary prevention. It emphasises the importance of education, the development of motor and cognitive skills, and the elimination of practical errors leading to injuries.

Practical Implications

Fall prevention programmes should include not only balance and muscle strength training, but also safe fall training.

Exercises inspired by martial arts should be adapted to the participants’ age, fitness level and state of health, eliminating elements of competition and physical contact.

Exercises that integrate motor and cognitive tasks (dual-task exercises) are particularly recommended, as they reflect everyday situations in which falls most commonly occur.

Elements of safe fall can be implemented in day centres, universities of the third age, long-term care facilities and geriatric physiotherapy programmes.

Training for physiotherapists, coaches and instructors of activities for older adults should include the basics of teaching safe falling and the use of exercises derived from martial arts.

Further research is needed to assess the long-term impact of safe fall training on the incidence of fractures, hospitalisations and loss of independence in the older population.