Is walking enough, or do I really need to do strength training as well?

Walking alone has not been proven effective against falls. A large Cochrane analysis¹ shows that exercise in general reduces the number of fall incidents by 23% and the proportion of people who fall by 15%. However, walking as a standalone activity was not identified in that analysis as proven fall prevention. The evidence for that remains uncertain.

What does work strongly are balance exercises, such as Tai Chi. These reduce falls by 24%, with high certainty. Add strength training to that, and you likely arrive at around 34% fewer falls. Strength training does not need to be intense at all; what matters is the combination with balance exercises.

Do you have knee osteoarthritis? Then gentle strength training is the better choice. A large study² found that high intensity made no additional difference for knee pain after 18 months, while the heavy-training group had 53 adverse events compared with 30 in the gentle-training group and just 4 in the control group.

If you want walking to do a bit more for you, interval walking helps -- alternating between fast and slow. In people with type 2 diabetes, this improved fitness, muscle strength, and blood sugar regulation³. It does not replace targeted balance exercises, but it does make walking more effective.

In Parkinson's disease, almost any form of movement helps: motor symptoms and quality of life improve compared with doing nothing⁴. Which form is best cannot be said with certainty. The message is simple: moving helps, staying passive does not.