Otago Exercise Program for Fall Prevention

Overseen By Vallabh Shah, PhD

Age: 65+

Sex: Any

Trial Phase: Academic

Sponsor: University of New Mexico

Disqualifiers: Terminal cancer, Dialysis, Mini-Cog 0-1, others

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Approved in 2 Jurisdictions This treatment is already approved in other countries

Compensation: Varies

Number of Visits: 10

Duration: 12 months

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial aims to help American Indian elders, specifically those in the Zuni tribe, reduce falls and related injuries. Researchers are testing the Otago Exercise Program, delivered at home by community health representatives, to determine its effectiveness in lowering fall risks. Participants will receive either personalized exercise sessions or fall prevention education over 12 months. Elders who have experienced two or more falls in the past year or have difficulty with balance may be suitable for this trial. As an unphased trial, this study offers participants the chance to contribute to important research that may improve fall prevention strategies for their community.

Will I have to stop taking my current medications?

The trial information does not specify whether you need to stop taking your current medications. It is best to discuss this with the trial coordinators or your doctor.

What prior data suggests that the Otago Exercise Program is safe for fall prevention?

Research has shown that the Otago Exercise Program is generally safe for older adults. This program improves balance and strength while reducing the risk of falling. Studies have found that it can lower the chance of falls by 30% to 66% compared to not doing the exercises. No reports of serious problems have been linked to the program. The exercises are gentle and customized for each person, helping to prevent injuries. Overall, the Otago Exercise Program is well-received and effective in preventing falls among older adults. ^{1 2 3 4 5}

Why are researchers excited about this trial?

Researchers are excited about the Otago Exercise Program because it offers a personalized approach to preventing falls, which is different from standard options like medication or general physical therapy. This program involves community health representatives delivering tailored exercise routines directly to participants in their homes, providing convenience and personalized care. By focusing on individualized exercise regimens and consistent follow-up through home visits, the program aims to improve balance and strength more effectively than traditional methods. This hands-on approach could lead to better outcomes in reducing fall risks among older adults.

What evidence suggests that the Otago Exercise Program is effective for fall prevention?

Research has shown that the Otago Exercise Program, which participants in this trial may receive, effectively prevents falls among older adults. Studies have found that it can reduce falls by 30% to 66% compared to those not in the program. This program improves balance and fitness, crucial for fall prevention, and lowers the risk of fall-related injuries. Additionally, it can reduce the risk of death in older people living at home. Overall, strong evidence supports the Otago Exercise Program's effectiveness in reducing fall risk. ^{1 2 5 6 7}

Are You a Good Fit for This Trial?

This trial is for Zuni tribal members aged 65 or older with a high risk of falling, determined by specific tests like the Timed Up and Go or past fall history. It's not for those with terminal cancer, on dialysis, severe cognitive impairment, unwilling to consent, unable to walk even with help, or who are legally blind.

Inclusion Criteria

I am a Zuni tribal member, 65 or older, with a high risk of falling.

Exclusion Criteria

You are excluded from the study if you have recently been diagnosed with terminal cancer, currently undergoing dialysis, have severe cognitive impairment, don't want to participate, can't walk even with assistance, or have severe vision loss.

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Treatment

Participants receive the Otago Exercise Program or education-based fall risk management over 12 months

12 months

10 home visits (OEP group), 6 home visits (Education group)

Follow-up

Participants are monitored for changes in strength, balance, and fall risk

12 months

Monthly monitoring

What Are the Treatments Tested in This Trial?

Interventions

• Otago Exercise Program

Trial Overview The study tests the Otago Exercise Program delivered by Community Health Representatives in Zuni Pueblo. The goal is to see if this program can reduce falls among elders by improving their physical condition through exercises tailored to prevent falls.

How Is the Trial Designed?

Group I: Otago Exercise Program Experimental Treatment 1 Intervention

An individualized Otago Exercise Program will be delivered by community health representatives (CHR) in participants homes. There will be 10 home visits over a 12 month period.

Group II: Education Active Control 1 Intervention

The control group will receive education on fall risk reduction. This will be delivered by the CHR with 6 home visits over 12 months

Otago Exercise Program is already approved in United States for the following indications:

Approved in United States as Otago Exercise Program for:

• Fall prevention in older adults
• Used in research studies for fall prevention in tribal communities

Who Is Running the Clinical Trial?

University of New Mexico

Lead Sponsor

Trials

393

Recruited

3,526,000+

Published Research Related to This Trial

The Otago Exercise Program (OEP) delivered via DVD is a useful tool for older adults to reduce falls, but participants found it too slow and low-energy for long-term engagement, indicating a need for more dynamic content.

While the program offers flexibility, personal health issues and daily life challenges hinder adherence, highlighting the importance of social support and motivation in maintaining an exercise routine.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Understanding the Experiences of Rural Community-Dwelling Older Adults in Using a New DVD-Delivered Otago Exercise Program: A Qualitative Study. Agha, A., Liu-Ambrose, TY., Backman, CL., et al.[2023]

The Otago Exercise Program (OEP) significantly improves cognitive function, lower limb strength, and balance in older adults, which helps enhance gait stability and posture control, ultimately reducing the risk of falls.

OEP not only aids in preventing falls but also helps older adults overcome the fear of falling, promoting a positive attitude towards exercise and improving overall wellbeing, despite the unclear neural mechanisms behind its effectiveness.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

The impact of Otago exercise programme on the prevention of falls in older adult: A systematic review. Yang, Y., Wang, K., Liu, H., et al.[2023]

The Otago Exercise Program (OEP) can be effectively delivered through alternative models, such as the community OEP, which showed similar improvements in physical function compared to the traditional US OEP model, despite being implemented by non-physical therapists.

Participants in the community OEP experienced greater improvements in the Timed 'Up & Go' Test, suggesting that the exercise component is crucial for enhancing mobility and reducing fall risk, regardless of the delivery model.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Otago Exercise Program in the United States: Comparison of 2 Implementation Models. Shubert, TE., Smith, ML., Goto, L., et al.[2022]

The Otago exercise program significantly reduced the average number of falls among 30 older adults in assisted living, from 1.4 falls per person per year to 0.5 falls after the intervention.

Participants also showed a notable improvement in mobility, with Tinetti POMA scores increasing from 11.8 to 17.6, indicating enhanced balance and strength.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Examining the Effects of an Otago-Based Home Exercise Program on Falls and Fall Risks in an Assisted Living Facility. Beato, M., Dawson, N., Svien, L., et al.[2020]

The Otago exercise programme (OEP) significantly reduces the risk of death in older adults (aged 65+) living in the community, with a risk ratio of 0.45 over 12 months based on a review of seven trials involving 1503 participants.

The OEP also significantly lowers fall rates, with an incidence rate ratio of 0.68, indicating it is effective in preventing falls, although it does not significantly reduce the risk of serious injuries from falls.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Does the 'Otago exercise programme' reduce mortality and falls in older adults?: a systematic review and meta-analysis. Thomas, S., Mackintosh, S., Halbert, J.[2022]

The Otago exercise program (OEP) significantly improved physical performance and functional capacity in elderly participants, as evidenced by better scores in balance and mobility tests after six months of training.

OEP also led to a significant reduction in the incidence of falls among seniors with a history of falls, making it an effective home-based intervention for fall prevention in this population.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Randomized Control Trials on Otago Exercise Program (OEP) to Reduce Falls Among Elderly Community Dwellers in Shahroud, Iran. Dadgari, A., Aizan Hamid, T., Hakim, MN., et al.[2022]

The Otago Exercise Programme (OEP) significantly improves various aspects of balance, including static, dynamic, and proactive balance, as well as enhancing balance confidence and reducing fear of falling in older adults, based on a meta-analysis of 12 randomized controlled trials.

Group sessions of the OEP lasting more than 30 minutes are particularly effective for improving balance performance and perceived balance ability compared to shorter sessions or individual formats.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

The effects of the Otago Exercise Programme on actual and perceived balance in older adults: A meta-analysis. Chiu, HL., Yeh, TT., Lo, YT., et al.[2021]

The Otago Exercise Program (OEP) significantly improves physical function and reduces fall risk among older adults, with a study involving 239 participants showing positive outcomes after 6 months.

Innovative delivery models using Certified Occupational Therapy Assistants and exercise physiologists, rather than solely physical therapists, can effectively implement the OEP, potentially making it more accessible and resource-efficient.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

The Otago Exercise Program: Innovative Delivery Models to Maximize Sustained Outcomes for High Risk, Homebound Older Adults. Shubert, TE., Goto, LS., Smith, ML., et al.[2022]

The Otago Exercise Program (OEP) significantly improved functional mobility and balance in 210 older adults over an 8-week period, as evidenced by dramatic improvements in tests like the Timed Up-and-Go and 30-Second Chair Rise (p < .001).

Participants reported enhanced self-perceived functional performance, indicating that the OEP is effective not only in objective measures but also in how older adults feel about their mobility and balance after the program.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Disseminating the Otago Exercise Program in the United States: Perceived and Actual Physical Performance Improvements From Participants. Shubert, TE., Smith, ML., Jiang, L., et al.[2021]

Citations

1. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC9631473/

The impact of Otago exercise programme on ... Although OEP has significant positive effects on improving the health and physical fitness of older adult, preventing falls, and restoring clinical function, ...

2. bmcnurs.biomedcentral.com bmcnurs.biomedcentral.com/articles/10.1186/s12912-024-02310-3

Efficacy of the Otago-Exercise-Programme to reduce falls in ... The Otago Exercise Programme is an effective intervention for falls prevention. However, there is limited evidence in relation to studies ...

3. physio-pedia.com physio-pedia.com/Otago_Exercise_Programme

Otago Exercise Programme Falls among people participating in the Otago were reduced by 30% to 66% when compared to controls who were not doing Otago exercises. After one year, injuries ...

4. frontiersin.org frontiersin.org/journals/public-health/articles/10.3389/fpubh.2025.1522952/full

The Otago Exercise Program's effect on fall prevention High-quality evidence supports the effectiveness of the Otago Exercise Program in reducing fall risk among individuals with osteoarthritis (OA) (46). ...

5. ncbi.nlm.nih.gov ncbi.nlm.nih.gov/books/NBK78898/

Does the 'Otago exercise programme' reduce mortality ... - NCBI This review concluded that the Otago exercise programme significantly reduced risks of death and falling in older community-dwelling adults.

6. med.unc.edu med.unc.edu/aging/cgwep/wp-content/uploads/sites/865/2024/04/Otago-Guide-for-PT_April-2024-update.pdf

Tools to Implement the Otago Exercise Program Otago is one of a few fall prevention programs that improves strength and balance and reduces falls and fall related injuries among older adults. Other ...

7. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC5362608/

The Otago Exercise Program: Innovative Delivery Models ... The Otago Exercise program (OEP) is an evidence-based fall prevention program shown to reduce falls by 35% among high-risk older adults.