A 91-year-old man is brought to the office by his daughter following two recent falls. He lives independently in his own home, and both falls occurred at home while the patient was using a walker. He had no serious injuries with either fall. He cannot recall what led to the falls, but he was able to get himself up after each one. He has a known multifactorial gait disturbance and has routinely used a walker for the last 2 years. He reports that his balance has worsened in the last few months and that his activity level has been “slowing down.” He reports no lightheadedness or specific weakness. His cognition is normal. Medical history is remarkable for diffuse osteoarthritis with minimal discomfort and a small stroke 10 years ago without any residual deficits. He does not drink alcohol. Medications are daily aspirin, as-needed acetaminophen, and topical menthol ointment for occasional joint pain.
On physical examination, the patient is afebrile. Blood pressure is 138/82 mm Hg sitting and 140/84 mm Hg standing, and pulse rate is 84/min sitting and 80/min standing. His corrected vision is 20/25 in both eyes. He has a slow, wide-based gait with use of his walker. Neurologic examination is normal with no parkinsonian features. No detectable asymmetries in muscle strength are noted. He is wearing flip flops, which are his preferred footwear.
A multimodal intervention to prevent falls is initiated, and the patient is referred to physical therapy for an individualized exercise program. A home safety evaluation is ordered to optimize his home environment, and he is educated on proper footwear.
Which of the following additional treatments is most likely to decrease this patient's risk of falls?