Assessing physical therapists' knowledge in fall prevention among older adults in Saudi arabia: a cross-sectional study.

BACKGROUND: Falls among older adults remain a major global health concern, often leading to injury, disability, and loss of independence. Physical therapists are key stakeholders in fall prevention, yet their knowledge, attitudes, and practices remain underexplored in Saudi Arabia. OBJECTIVES: This study aimed to assess physical therapists' knowledge, attitudes, and confidence regarding fall prevention strategies for adults aged 65 and above and to identify factors influencing the implementation of these strategies in clinical settings. METHODS: A descriptive cross-sectional study was conducted using a validated online questionnaire distributed to licensed physical therapists across Saudi Arabia. Convenience and purposive sampling were employed to ensure diverse representation across regions and facility types. Data was analyzed using SPSS v28. Descriptive statistics described demographics and knowledge levels. Non-parametric tests (Mann-Whitney U and Kruskal-Wallis) and chi-square tests examined associations between demographic/professional factors and fall prevention practices. Multiple and robust regression models were applied to adjust for potential confounders. RESULTS: Of 384 respondents, 52.1% exhibited high knowledge of fall prevention strategies. However, only 14.8% consistently used standardized assessment tools. Education level was not significantly associated with knowledge (H = 4.05, p = 0.256); instead, frequent use of standardized tools was strongly linked to higher knowledge scores (H = 52.36, p < 0.001, ε² = 0.128). Therapists with ≥ 11 years of experience demonstrated greater tool utilization (p = 0.043). Familiarity with international guidelines such as the STEADI toolkit remained low (10.2%). Despite positive attitudes toward fall prevention (M = 4.23, SD = 1.00), self-reported confidence in applying these strategies was moderate (M = 3.60, SD = 0.94). Risk factors like urinary incontinence, polypharmacy and sensory deficits were often underrated. CONCLUSION: While theoretical knowledge is strong, practical application is inconsistent. Findings highlight the importance of structured professional development, hands-on training in standardized assessment tools, and integration of evidence-based fall-prevention frameworks into routine physiotherapy practice. Enhancing training, promoting evidence-based tools, and reinforcing interdisciplinary collaboration are essential to improving fall prevention practices among Saudi physical therapists.