Background: Losing postural control ability and related injuries are of particular concern for elders living in the nursing home (NH). The Otago Exercise Program (OEP) is a multimodal exercise training program initially designed as an individually tailored home exercise for community-dwelling elders, but whether its movement characteristics and exercise intensity meet NH elders’ needs still needs to be clarified. This study aimed to determine the effects of the OEP in enhancing postural control ability among elders in the NH. Methods: A systematic literature search of English language databases (Cochrane Library, PubMed, EMBASE, CINAHL, and Web of Science) and Chinese language databases (China National Knowledge Infrastructure, Wanfang, and Chongqing VIP) until 15 April 2022 were performed by 2 reviewers on searching randomized controlled trial (RCT) and non-RCT. A meta-analysis was performed using Review Manager 5.3 software. Continuous data were expressed as mean difference (MD) with 95% confidence intervals (95% CI). Dichotomous data were presented as risk ratios (RRs) with 95% CI. Study methodological quality was assessed according to the Cochrane Handbook for Systematic Reviews of Interventions for RCTs and Risk Of Bias In Non-randomized Studies-of Interventions for non-RCTs by 3 reviewers. Results: Nine studies with 546 participants were included in this review. Two hundred and sixty-nine participants received OEP, and 277 only had conventional exercise training. Compared to the conventional exercise training group, the NH elders in the OEP group have considerably decreased in fall risk (MD = −0.84; 95% CI = −1.17, −0.51; P < .00001) and positively increased in postural balance (MD = 5.55; 95% CI = 3.60, 7.50; P < .00001), functional mobility in short-distance (MD = −6.39; 95% CI = −8.07, −4.70; P < .00001), lower-limb muscle strength (MD = 4.32; 95% CI = 3.71, 4.93; P < .00001), and health status (risk ratio = 0.35; 95% CI = 0.18, 0.66; P = .001). Conclusions: Current evidence suggests that OEP is practical and feasible in NH. The nursing personnel can receive sufficient support for maintaining and enhancing these elders’ postural control ability, especially during the COVID-19 pandemic.

Background: Functional ankle instability (FAI) is the primary classification of ankle injuries. Competitive activities have complicated movements that can result in ankle re-injury among patients with FAI. Unanticipated movement state (MS) and mental fatigue (MF) could also happen in these activities, which may further increase their joint injury risk.Objective: This study aimed to clarify the biomechanical characteristics difference of the lower extremity (LE) between the injured side and the uninjured side among patients with FAI when they perform unanticipated side-step cutting after MF.Methods: Fifteen males with unilateral FAI participated in this study (age: 20.7 ± 1.3 years, height: 173.6 ± 4.4 cm, weight: 70.1 ± 5.0 kg). They used the injured side and the uninjured side of LE to complete anticipated and unanticipated side-step cutting before and after MF. The kinematic and kinetics data were evaluated using three-way ANOVA with repeated measures.Results: During patients with FAI performed anticipated side-step cutting, the ankle stiffness of both sides showed no significant change after MF; During they performed unanticipated side-step cutting, their injured side presented significantly lower ankle stiffness after MF, while the uninjured side did not have such change. In addition, after MF, the injured side exhibited increased ankle inversion, knee valgus and LR, but the uninjured side did without these changes.Conclusion: Influenced by MF, when patients with FAI use their injured side of LE to perform side-step cutting, this side LE has a higher risk of musculoskeletal injuries such as lateral ankle sprains and anterior cruciate ligament injury. The ankle stiffness of the injured side will be further reduced when patients with FAI perform unanticipated side-step cutting, which increases ankle instability and the risk of re-injury.

Background: The ankle is prone to injury during drop landing with usual residual symptoms, and functional ankle instability (FAI) is the most common. Vision guarantees the postural stability of patients with FAI, and visual deprivation (VD) increases their risk of injury when completing various movements. This study explored injury risk during drop landing in patients with FAI under VD through the kinetics of lower extremities.Methods: A total of 12 males with FAI participated in the study (age, 23.0 ± 0.8 years; height, 1.68 ± 0.06 m; weight, and 62.2 ± 10.4 kg) completed single-leg drop landings under visual presence (VP) and VD conditions. Ground reaction force (GRF), time to peak GRF, joint torque, and vertical length variation (ΔL) were measured.Results: Significant effects were detected in the group for time to peak lateral GRF (p = 0.004), hip extensor torque (p = 0.022), ankle plantarflexion torque (p &lt; 0.001), ankle varus torque (p = 0.021), lower extremity stiffness (p = 0.035), and ankle stiffness (p &lt; 0.001). Significant effects of conditions were detected for vertical GRF, time to peak vertical and lateral GRF, loading rate, hip extensor torque, knee extensor torque, hip varus torque, knee varus torque, lower extremity stiffness, and ankle stiffness (p &lt; 0.05). ΔL was affected by VD with a significant difference (p &lt; 0.001).Conclusion: In patients with FAI, an unstable extremity has a higher injury risk than a stable extremity, and VD increases such risk. However, because the influence of the central nervous system on hip strategy is also affected, the effect on the unstable extremity is more significant and more likely to result in injury. Deepening the squat range may be an effective preventive measure for reducing injury risk of unstable extremities during drop landing.