Lampropoulou S1,2, Kellari A3, Sakellari V3
1University of Nicosia, Department of Life and Health Sciences, Nicosia, Cyprus, 2Technological Educational Institute (TEI) of Western Greece, Physiotherapy Department, Aigio, Greece, 3Technological Educational Institute (TEI) of Sterea Ellada, MSc in Advance Physiotherapy, Physiotherapy Department, Lamia, Greece
Background: Gait and balance problems due to physiological age-related changes, such as diminished strength, poor posture, decreased sensory perception, are associated with increased risk of falls, reduced level of function and increased incidents of mortality. Otago Exercise Program (OEP) is an evidence-based fall prevention program, consisted of balance, strengthening exercises and walking activities. It has been shown to reduce the risk of falling and death among community dwelling older adults.
Purpose: The main purpose of this study, was to evaluate the changes in balance and gait characteristics following a simplified form of delivery of the OEP without verbal instructions or visual demonstration of the balance and strengthening group exercises prior to their performance. No supervised walking activities were included.
Methods: A simplified form model of a group OEP, was delivered to 12 community dwelling adults (76±7 years), 3 times per week, for 12 weeks. Participants were not given any instructions or description prior to the program or before each exercise. All visual and verbal guidance given by the physiotherapist was in parallel with the exercise execution by the elderly. Fear of falling, balance, gait and cognitive function have been evaluated at baseline, 6 and 12 weeks of the program, by using the Falls Efficacy Scale-International (FES-I), the mini-Balance Evaluation Systems Test (mini-BESTest), the Functional Gait Assessment (FGA) and the Montreal Cognitive Assessment (MoCA) test respectfully. Additionally, the ability to reach forward while standing (Functional Reach Test) and the speed of gait (Timed Up and Go test-TUG) were also assessed.
Results: The falls reduced by 11% and the participants reported less fear of falling at the FES-I questionnaire (reduction of 3 points in the total score from 24 to 21/64, F(2, 14)=5.81, p 0.05) following 12 weeks of the modified OEP. The gait performance improved by 3 points on the FGA scale (from 23 to 26/30, F(2, 14)=7.97, p 0.05). Balance was also improved by 3 points on the mini-BESTest scale (from 19 to 22/28, F(2, 14)=9.79, p 0.05) with the greatest improvement to be shown during dynamic and anticipatory balance control. The horizontal distance reached increased by 7.67cm (p 0.001) and the TUG reduced by 2.23 sec (p 0.05). The total time of the each exercise session delivery was reduced by an average of 15 min. In addition, the cognitive performance of the elderly was improved as indicated by a 3 points increase in the MoCA test scoring (from 22 to 25/30, F(2, 14)=4.89, p 0.05). Participants at a percentage of 33% were declared still following the program 3 months after its supervised termination.
Conclusion(s): The modified OEP without pre-demonstration of the exercises or additional supervised walking activity was effective in improving balance, speed and performance of gait as well as cognitive function, in parallel with the reduction of the fall incidents.
Implications: The OEP without introductory explanation or demonstration of each exercise before its execution, is effective in locomotion, balance, cognition and time saving. Clinical therapists should advice elderly taking part in such a program
Keywords: Otago-balance, gait, older adults
Funding acknowledgements: Erasmus plus, Student Mobility for Studies.
Purpose: The main purpose of this study, was to evaluate the changes in balance and gait characteristics following a simplified form of delivery of the OEP without verbal instructions or visual demonstration of the balance and strengthening group exercises prior to their performance. No supervised walking activities were included.
Methods: A simplified form model of a group OEP, was delivered to 12 community dwelling adults (76±7 years), 3 times per week, for 12 weeks. Participants were not given any instructions or description prior to the program or before each exercise. All visual and verbal guidance given by the physiotherapist was in parallel with the exercise execution by the elderly. Fear of falling, balance, gait and cognitive function have been evaluated at baseline, 6 and 12 weeks of the program, by using the Falls Efficacy Scale-International (FES-I), the mini-Balance Evaluation Systems Test (mini-BESTest), the Functional Gait Assessment (FGA) and the Montreal Cognitive Assessment (MoCA) test respectfully. Additionally, the ability to reach forward while standing (Functional Reach Test) and the speed of gait (Timed Up and Go test-TUG) were also assessed.
Results: The falls reduced by 11% and the participants reported less fear of falling at the FES-I questionnaire (reduction of 3 points in the total score from 24 to 21/64, F(2, 14)=5.81, p 0.05) following 12 weeks of the modified OEP. The gait performance improved by 3 points on the FGA scale (from 23 to 26/30, F(2, 14)=7.97, p 0.05). Balance was also improved by 3 points on the mini-BESTest scale (from 19 to 22/28, F(2, 14)=9.79, p 0.05) with the greatest improvement to be shown during dynamic and anticipatory balance control. The horizontal distance reached increased by 7.67cm (p 0.001) and the TUG reduced by 2.23 sec (p 0.05). The total time of the each exercise session delivery was reduced by an average of 15 min. In addition, the cognitive performance of the elderly was improved as indicated by a 3 points increase in the MoCA test scoring (from 22 to 25/30, F(2, 14)=4.89, p 0.05). Participants at a percentage of 33% were declared still following the program 3 months after its supervised termination.
Conclusion(s): The modified OEP without pre-demonstration of the exercises or additional supervised walking activity was effective in improving balance, speed and performance of gait as well as cognitive function, in parallel with the reduction of the fall incidents.
Implications: The OEP without introductory explanation or demonstration of each exercise before its execution, is effective in locomotion, balance, cognition and time saving. Clinical therapists should advice elderly taking part in such a program
Keywords: Otago-balance, gait, older adults
Funding acknowledgements: Erasmus plus, Student Mobility for Studies.
Topic: Older people; Disability & rehabilitation
Ethics approval required: Yes
Institution: Cyprus National Bioethics Committee
Ethics committee: Cyprus National Bioethics Committee
Ethics number: EEBK/EΠ/2017/46
All authors, affiliations and abstracts have been published as submitted.
