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. 2024 Jun 14;16(1):132.
doi: 10.1186/s13102-024-00917-2.

Effect of Otago exercise on fear of falling in older adults: a systematic review and meta-analysis

Jianlong Han #  1 , Hongwei Wang #  1 , Yunxin Ding  1 , Qing Li  1 , Huanqie Zhai  2 , Shuling He  3
Affiliations

Effect of Otago exercise on fear of falling in older adults: a systematic review and meta-analysis

Jianlong Han et al. BMC Sports Sci Med Rehabil. .

Abstract

Background: Approximately 40-70% of older adults who have experienced falls develop fear of falling (FOF), with the incidence rate in nursing home residents reaching as high as 79.4%. An increasing number of studies have focused on the effect of the Otago Exercise Programme (OEP) on reducing FOF among older adults, yet comprehensive analysis is lacking due to regional and demographic variations. Therefore, this study integrates the relevant literature to provide evidence supporting interventions aimed at alleviating FOF among older adults.

Objective: To evaluate the impact of OEP on FOF in older adults through meta-analysis.

Methods: We searched ten databases using computer systems, covering all records up to May 1, 2024. Two researchers independently conducted the literature screening, bias risk assessment, and data extraction. We performed data analysis using RevMan 5.3 and Stata 15.0 software, assessed result stability through sensitivity analysis, and examined publication bias with funnel plots and Egger's test.

Results: Sixteen RCTs were included. Meta-analysis revealed that the OEP significantly reduced FOF among older adults [SMD = 0.96, 95%CI (0.68, 1.23), P < 0.00001]. Subgroup analysis revealed that interventions lasting more than 16 weeks [SMD = 1.12, 95%CI (0.75, 1.49), P < 0.00001], with a frequency of more than twice a week [SMD = 0.99, 95%CI (0.64, 1.35), P < 0.00001], and for older adults in community and nursing institutions [SMD = 1.03, 95%CI (0.50, 1.57), P = 0.0002] were more effective. A comparison of the 16-week and 24-week interventions revealed that the latter had better outcomes [SMD = 0.87, 95%CI (0.66, 1.08), P = 0.0004].

Conclusion: Current evidence indicates that OEP effectively reduces FOF among older adults. It is recommended that interventions last for more than 24 weeks, occur more than twice a week, and suitable for application among older adults in community settings or elder care institutions.

Keywords: Fear of falling; Meta-analysis; Older adults; Otago exercise programme.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Literature screening flowchart
Fig. 2
Fig. 2
a Risk of bias assessment chart. b Risk of bias assessment chart (expressed as percentages)
Fig. 3
Fig. 3
Forest plot of the effect of OEP on fall fear in older adults
Fig. 4
Fig. 4
Forest plot of subgroup analysis for ≤ 16 weeks and > 16 weeks
Fig. 5
Fig. 5
Forest plot of subgroup analysis for 16 weeks and 24 weeks
Fig. 6
Fig. 6
Forest plot of subgroup analysis for intervention frequency
Fig. 7
Fig. 7
Forest plot of subgroup analysis for intervention populations
Fig. 8
Fig. 8
Publication bias test funnel plot
See this image and copyright information in PMC

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