The Otago Exercise Program performed as group training versus home training in fall-prone older people: a randomized controlled Trial

Abstract

Background and purpose: Exercise programs targeting muscle strength and balance can reduce falls. The study aimed to compare the Otago Exercise Program (OEP), originally designed as supervised home training (HT), with the same programme performed as GT, on functional balance and muscle strength, mobility, fall efficacy and self-reported health.

Methods: A single-blind randomized controlled trial with assessments at baseline (T1), following the 12-week intervention (T2), and 3 months following intervention (T3), was performed. 125 people, mean age 82.5 (SD = 5.7) years, 73% women, referred to a Falls Outpatient Clinic, participated. 74% had fallen, and 37% had a fall-related hospital stay during the previous year. OEP supervised by physiotherapists was performed as GT twice weekly or as HT three times a week, for 12 weeks. Total exercise time was comparable between groups. The primary outcome was the Berg Balance Scale assessed at T2.

Results: From T1-T2, Berg Balance Scale improved significantly more in the GT group than in the HT group (mean group difference in change of 3.2 points, 95%CI = 0.7-5.8, p = 0.014). Of the secondary outcomes, the 30-second sit-to-stand test (p = 0.004), and physical health measured by the Short Form-36 (p = 0.004), improved significantly more for the GT group. Change in mobility measured by the Timed Up and Go test, mental health by the Short Form-36, and fall efficacy by the Fall Efficacy Scale International did not differ between groups. The 30-second sit-to-stand test and the Timed Up and Go, but not the Berg Balance Scale, was still better in the GT group at T3.

Discussion: In fall-prone home-dwelling older people, the OEP performed as GT is more effective for improving functional balance, muscle strength and physical health, but not fall efficacy and mental health than when performed as HT. The OEP provided as GT should be considered in this population.

Keywords: accidental falls; exercise; frail elderly; motor performance.