Feasibility and effect of supplementing a modified OTAGO intervention with multisensory balance exercises in older people who fall: a pilot randomized controlled trial.
OBJECTIVE
To investigate the feasibility and comparative effect of supplementing a modified OTAGO falls rehabilitation programme with multisensory balance exercises and informed sample size calculation for a definitive trial.


METHODS
Single-blinded randomized controlled trial with pre/postcomparisons using a per-protocol analysis.


METHODS
Secondary care-based falls clinic, London, UK.


METHODS
Community-dwelling older people (n = 21) experiencing ≥2 non-syncopal falls during previous 12 months.


METHODS
Modified OTAGO exercise classes supplemented with supervised home-based rehabilitation consisting of multisensory balance or stretching exercises. Group classes and home sessions each occurred twice-weekly for eight weeks.


METHODS
A computerised randomization was used for group allocation. A rater, blinded to intervention, performed the assessment including the Functional Gait Assessment (primary outcome), Physiological Profile Assessment, and questionnaires relating to symptoms, balance confidence, and psychological state (secondary outcomes).


RESULTS
Significant within-group improvements were noted for the Functional Gait (p < 0.01, r = -0.63) and Physiological Profile Assessments (p < 0.05, r = -0.63) in the OTAGO+multisensory rehabilitation group only and for balance confidence scores in the OTAGO+stretching group (p < 0.01, r = -0.63). Between-group differences were noted for the Functional Gait (p < 0.01, r = -0.71) and Physiological Profile (p < 0.05, r = -0.54) assessments with the OTAGO+multisensory group showing significantly greater improvement. The drop-out rate was similar for both groups (~30%). No serious adverse events were reported.


CONCLUSIONS
Supplementing the OTAGO programme with multisensory balance exercises is feasible in older people who fall and may have a beneficial effect on falls risk as measured using the Functional Gait and Short-form Physiological Profile Assessments. An adequately powered randomized controlled trial would require 36 participants to detect an effect size of 1.35 on the Functional Gait Assessment.
Centre of Human and Aerospace Physiological Sciences, King's College London, London, UK.
Matthew B
MB
Liston
Centre of Human and Aerospace Physiological Sciences, King's College London, London, UK.
Ledia
L
Alushi
Department of Neuro-Otology, National Hospital for Neurology and Neurosurgery, London, UK Ear Institute, UCL, London, UK.
Doris-Eva
DE
Bamiou
Department of Elderly Care Medicine, Guys and St Thomas' NHS Foundation Trust, London, UK.
Finbarr C
FC
Martin
Department of Elderly Care Medicine, Guys and St Thomas' NHS Foundation Trust, London, UK.
Adrian
A
Hopper
Centre of Human and Aerospace Physiological Sciences, King's College London, London, UK marousa.pavlou@kcl.ac.uk.
Marousa
M
Pavlou
Balance; falls; older adults; rehabilitation interventions