OTAGO Exercise Program for Fall Risk Factors

Overseen By Hiroko Kiyoshi-Teo, PhD, RN

Age: 18+

Sex: Any

Trial Phase: Academic

Sponsor: Oregon Health and Science University

Disqualifiers: Ongoing physical therapy, Acute health issues, Dementia, Other studies, Routine physical activities

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

Compensation: Varies

Number of Visits: 7

Duration: 6 months

60 Participants Needed

Trial Summary

Will I have to stop taking my current medications?

The trial information does not specify whether you need to stop taking your current medications.

What data supports the effectiveness of the OTAGO Exercise Program treatment?

Research shows that the OTAGO Exercise Program helps reduce falls and improve balance, strength, and mobility in older adults, whether they live in the community or in institutions like nursing homes. It also enhances fall confidence and quality of life, especially in elderly stroke patients. ^{1 2 3 4 5}

Is the Otago Exercise Program safe for humans?

The Otago Exercise Program, which focuses on strength and balance exercises, has been studied in older adults and is generally considered safe. It is designed to reduce falls and improve physical performance, with no significant safety concerns reported in the studies. ^{1 2 4 6 7}

How does the Otago Exercise Program treatment differ from other treatments for fall risk factors?

The Otago Exercise Program is unique because it focuses on improving strength, balance, and walking to prevent falls, specifically designed for older adults. Unlike other treatments, it is a home-based program that can be tailored to individual needs, making it accessible and practical for older adults living in various settings, including assisted living facilities. ^{1 2 6 7 8}

What is the purpose of this trial?

The goal of this study is to see if OTAGO instructors, who have been trained in a special communication method called motivational interviewing, can help older adults start and stick with the OTAGO exercise program. The results will help guide future research on how behavior change techniques can support other fall prevention strategies.

Eligibility Criteria

This trial is for older adults living in the community who are at risk of falling. Participants should be interested in starting an exercise program to reduce their fall risk and must be able to communicate with instructors.

Inclusion Criteria

I can speak and understand English clearly.

I find it hard to get around outside my home.

I can walk by myself or with help from a device.

Exclusion Criteria

6-item Callahan cognitive assessment over the phone: Patients with scores of 2 or less, positive for dementia criteria, will be excluded

Patients participating in other studies that may impact fall-related behavior change

Participants engaged in routine moderate or vigorous physical activities that require lower extremity balance and strength (e.g., >100 minutes/week for more than 3 months)

Timeline

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Treatment

Participants receive OTAGO exercise instruction and motivational interviewing during home visits

6 months

7 home visits, 2 phone-based check-ins

Follow-up

Participants are monitored for continued engagement in fall prevention behaviors

6 months

Treatment Details

Interventions

• OTAGO Exercise Program

Trial Overview The study tests if OTAGO Exercise Program instructors trained in motivational interviewing can improve adherence among older adults to a fall prevention exercise regimen, potentially enhancing its effectiveness.

Participant Groups

Group I: Intervention arm Experimental Treatment 1 Intervention

OTAGO exercise home visits will be offered 7 times with 2 phone-based check-ins during the 6-month period. As part of OTAGO home visits, participants will receive OTAGO exercise instruction and MI. Each home visit will be approximately an hour.

Who Is Running the Clinical Trial?

Oregon Health and Science University

Lead Sponsor

Trials

1,024

Recruited

7,420,000+

Oregon Wellness Network

Collaborator

Findings from Research

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 program effectively reduces falls and improves balance, strength, mobility, and health-related quality of life for older adults, whether they are living in the community or in institutions.

Group-based Otago exercise programs may yield better outcomes compared to individual sessions, highlighting the potential benefits of social interaction during exercise for older adults.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Effects of Otago Exercise Program on Physical and Psychosocial Functions Among Community-Dwelling and Institutionalized Older Adults: A Scoping Review. Mgbeojedo, UG., Akosile, CO., Okoye, EC., et al.[2023]

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 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]

References

1. United States 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. [2020]

2. United States pubmed.ncbi.nlm.nih.gov

Otago home-based strength and balance retraining improves executive functioning in older fallers: a randomized controlled trial. [2022]

3. Japan pubmed.ncbi.nlm.nih.gov

Effects of the Otago exercise program on fall efficacy, activities of daily living and quality of life in elderly stroke patients. [2020]

4. Switzerland pubmed.ncbi.nlm.nih.gov

Effects of the Otago exercise program on falls, balance, and physical performance in older nursing home residents with high fall risk: a randomized controlled trial. [2022]

5. United States pubmed.ncbi.nlm.nih.gov

Effects of Otago Exercise Program on Physical and Psychosocial Functions Among Community-Dwelling and Institutionalized Older Adults: A Scoping Review. [2023]

6. England pubmed.ncbi.nlm.nih.gov

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

7. England pubmed.ncbi.nlm.nih.gov

Effects of Otago Exercise Program on serum Interleukin-6 level in older women. [2022]

8. United States pubmed.ncbi.nlm.nih.gov

Disseminating the Otago Exercise Program in the United States: Perceived and Actual Physical Performance Improvements From Participants. [2021]