Additional Effects of Strength Training With Otago Exercises on Actual and Perceived Balance in Older Adults

Foundation University Islamabad

Status: Completed

Conditions: Muscle Strength; Exercise Therapy; Postural Balance; Resistance Training; Aged; Fall Prevention

Treatments: Procedure: Otago Exercise Program; Procedure: Otago Exercise with Strengthening exercise

Study type: Interventional

Funder types: Other

Identifiers

NCT07380282

FUI/CTR/2025/17

Details and patient eligibility

About

This study, titled "Additional Effects of Strength Training with Otago Exercises on Actual and Perceived Balance in Older Adults", explores strategies to reduce fall risks in the elderly. Falls are a major health concern, often causing injuries, loss of mobility, and reduced quality of life. The Otago Exercise Program (OEP) has been proven effective in improving lower-limb strength and balance, but it primarily focuses on these areas without addressing overall muscle strengthening.

The research aims to assess whether integrating additional strength training with OEP can enhance both actual balance (measured through static and dynamic stability tests) and perceived balance (confidence in avoiding falls). Using a randomized controlled trial, 34 participants aged 60 and above will be recruited and divided into two groups: one receiving OEP alone, and the other combining OEP with structured strength training. Tools such as the Berg Balance Scale, Functional Reach Test, Fall Efficacy Scale, and CONFbal Scale will measure outcomes.

The intervention will last eight weeks, with progressive resistance and balance tasks. Findings are expected to demonstrate improved mobility, reduced fear of falling, and greater confidence among participants receiving combined training. This research addresses a significant gap in geriatric rehabilitation and aims to inform cost-effective, evidence-based strategies for fall prevention, ultimately enhancing independence and quality of life in older adults.

Full description

Falls among older adults represent a critical public health issue, often resulting in injuries, loss of independence, and reduced quality of life. Globally, up to 35% of people over 65 experience falls annually, with risk increasing as age advances. The major contributors are muscle weakness and impaired balance, often linked to sarcopenia, an age-related decline in muscle mass and strength. These deficits compromise postural stability, mobility, and coordination, increasing vulnerability to recurrent falls and associated complications.

The Otago Exercise Program (OEP) is a recognized intervention for fall prevention, focusing on lower-limb strengthening and balance training. Evidence shows it reduces fall rates significantly, yet its scope remains limited to balance and limb strength, overlooking broader muscular demands. Integrating structured strength training with OEP may enhance outcomes by improving static and dynamic stability, muscle power, and confidence in daily tasks. Addressing both physical and psychological factors, such an approach can reduce fall-related injuries, foster independence, and improve quality of life in older adults.

Enrollment: 28 patients

Sex: All

Ages: 60+ years old

Volunteers: Accepts Healthy Volunteers

Inclusion criteria

• Older adults aged 60 years and above.
• Mini-Mental State Examination (MMSE) score of 24 or higher (sufficient cognitive ability to participate).
• Individuals able to ambulate independently or with minimal assistance (e.g., cane).
• Those who have not participated in a structured balance or strengthening program in the past 3 months.
• Participants able to provide informed consent and adhere to the intervention protocol.

Exclusion criteria

• Severe musculoskeletal or neurological conditions limiting mobility (e.g., advanced arthritis, stroke with significant residual deficits).
• Sensory disabilities affecting vision, hearing, or vestibular function.
• Structural defects in extremities.
• Fracture in the past year.
• Unstable systemic pathology, recent surgery, or cancer diagnosis/treatment within the past 6 months

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: None (Open label)

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28 participants in 2 patient groups

Otago with strengthening exercise

Experimental group

Description:

The Otago Exercise Program (OEP) is an evidence-based fall-prevention program designed for older adults, focusing on improving strength, balance, and mobility. It emphasizes lower-limb strengthening of key muscle groups such as the quadriceps, hamstrings, hip abductors, and ankle muscles through exercises like seated leg extensions, heel raises, sit-to-stand, and standing leg curls. The balance component includes static and dynamic activities such as tandem walking, single-leg stance, sideways walking, backward walking, and stair stepping, with gradual progression to safely challenge postural control. In this study, strengthening exercises are integrated with the OEP to enhance overall effectiveness. The program is delivered three times per week, with each session lasting 40-45 minutes over an 8-week period. This combined intervention aims to improve balance, reduce fall risk, and increase confidence during daily functional activities among older adults.

Treatment:

Procedure: Otago Exercise with Strengthening exercise

Otago

Other group

Description:

Otago exercise plan is comprisedset of 14 exercises including strengthening and balance exercises. The strenghtening exercises include strengthening of Knee Flexors, Knee Extensors, Hip-abductors Ankle dorsiflexors and ankle planter flexors and the balance exercises include following activities: Knee Bends Backward Walking, Walking and Turning Around, Sideways Walking, Tandem Stance, Tandem Walk, One Leg stance, Heel Walking, Toe Walking, Heel toe walk backwards, Sit to stand, Stair Walking These exercises will be performed for a duration 6 weeks and will be performed thrice for a period of 40/50 minutes

Treatment:

Procedure: Otago Exercise Program