Otago home-based strength and balance retraining improves executive functioning in older fallers: a randomized controlled trial.
OBJECTIVE
To primarily ascertain the effect of the Otago Exercise Program (OEP) on physiological falls risk, functional mobility, and executive functioning after 6 months in older adults with a recent history of falls and to ascertain the effect of the OEP on falls during a 1-year follow-up period.


METHODS
Randomized controlled trial.


METHODS
Dedicated falls clinics.


METHODS
Seventy-four adults aged 70 and older who presented to a healthcare professional after a fall.


METHODS
The OEP, a home-based program that consists of resistance training and balance training exercises.


METHODS
Physiological falls risk was assessed using the Physiological Profile Assessment. Functional mobility was assessed using the Timed Up and Go Test. Three central executive functions were assessed: set shifting, using the Trail Making Test Part B; updating, using the verbal digits backward test; and response inhibition, using the Stroop Color-Word Test. Falls were prospectively monitored using daily calendars.


RESULTS
At 6 months, there was no significant between-group difference in physiological falls risk or functional mobility (P>or= .33). There was a significant between-group difference in response inhibition (P=.05). A falls histogram revealed two outliers. With these cases removed, using negative binomial regression, the unadjusted incidence rate ratio of falls in the OEP group compared with the control group was 0.56. The adjusted incidence rate ratio was 0.47.


CONCLUSIONS
The OEP may reduce falls by improving cognitive performance.
Liu-Ambrose
Teresa
T
Centre for Hip Health, Vancouver Coastal Health Research Institute, University of British Columbia, Vancouver, British Columbia, Canada. teresa.ambrose@ubc.ca
Donaldson
Meghan G
MG
Ahamed
Yasmin
Y
Graf
Peter
P
Cook
Wendy L
WL
Close
Jacqueline
J
Lord
Stephen R
SR
Khan
Karim M
KM
D000058:Accidental Falls; D000368:Aged; D000369:Aged, 80 and over; D005081:Exercise Therapy; D015577:Geriatric Assessment; D006801:Humans; D008568:Memory; D008606:Mental Processes; D053580:Muscle Strength; D009483:Neuropsychological Tests; D004856:Postural Balance; D014145:Trail Making Test