Does modified Otago Exercise Program improves balance in older people? A systematic review

Abstract

Exercise interventions focused on strength and balance are effective for falls prevention in older people, however compliance to exercise is often a problem. Tailored intervention programs are recommended to meet the person preferences and increase compliance. Otago Exercise Program (OEP) is the most disseminated fall prevention program and is individually prescribed at home. The purpose of this study was to identify OEP modified formats and investigate their effects on balance when compared to its original form of delivering.Four electronic databases were searched, PubMed, PEDro, Science Direct and Scopus, between January and February 2017. Eligibility criteria included experimental or qualitative design studies conducted among older adults (≥50 years) at risk of falling, ongoing exercise interventions with modified formats of OEP. The primary outcome was balance. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were used.Eight studies met the inclusion criteria, five were randomized controlled trials (RCTs), two were quasi-experimental and one was a qualitative study. Therefore, a qualitative analysis was performed. Modified formats of OEP included additional vestibular or multisensory balance exercises, augmented reality, exercise in group and a DVD delivering format (in group or individual). In general, all studies using OEP modified formats reported improvements on balance and functional ability. However, it remains unclear if it is as effective as the original OEP and which modified format is more effective.

Physical therapy interventions for older people with vertigo, dizziness and balance disorders addressing mobility and participation: a systematic review

“…Effects pre-to post-treatment in both groups show the effectiveness of the Otago exercise programme on balance, mobility, quality of life and falls independently of whether delivered in the group session or, as usual at home. A recent systematic review including patients aged from 60 to 95 years confirms the effectiveness of the Otago exercise programme in every variation for an improvement in balance and functional ability [56].…”

Effects of A “Modified” Otago Exercise Program on the Functional Abilities and Social Participation of Older Adults Living in the Community—The AGA@4life Model

“…The authors of the review concluded that, in general, all studies using a "modified" OTAGO reported improvements in balance and functional abilities in general. However, whether or not these adapted formats are as effective as the original OTAGO, and which is the most effective, remains unclear, because different adaptations of the OTAGO were applied in different studies [65]. In this sense, more studies are needed to bring greater clarity to this still controversial topic.…”

Effects of dynamic exercise utilizing PNF patterns on the balance of healthy adults

“…Exercise interventions focused on strength and balance are effective for fall prevention in older people 13) . Neuromuscular training is responsible for dynamic joint stability, which is defined as training and enhancing unconscious motor responses by stimulating both afferent signals and central mechanisms 5) .…”