Does the 'Otago exercise programme' reduce mortality and falls in older adults?: a systematic review and meta-analysis

Rehabilitation and Aged Care, Flinders University, Repatriation General Hospital, Daws Road, Daw Park, Adelaide, South Australia 5041, Australia.
Age and Ageing (Impact Factor: 3.11). 11/2010; 39(6):681-7. DOI: 10.1093/ageing/afq102
Source: PubMed

ABSTRACT the 'Otago exercise programme' (OEP) is a strength and balance retraining programme designed to prevent falls in older people living in the community. The aim of this review was to evaluate the effect of the OEP on the risk of death and fall rates and to explore levels of compliance with the OEP in older adults.
a systematic review with meta-analysis. Clinical trials where the OEP was the primary intervention and participants were community-dwelling older adults (65+) were included. Outcomes of interest included risk of death, number of falls, number of injurious falls and compliance to the exercise programme.
seven trials, involving 1503 participants were included. The mean age of participants was 81.6 (±3.9) years. The OEP significantly reduced the risk of death over 12 months [risk ratio = 0.45, 95% confidence interval (CI) = 0.25-0.80], and significantly reduced fall rates (incidence rate ratio = 0.68, 95% CI = 0.56-0.79). There was no significant difference in the risk of a serious or moderate injury occurring as the result of a fall (risk ratio = 1.05, 95% CI = 0.91-1.22). Of the 747 participants who remained in the studies at 12 months, 274 (36.7%) were still exercising three or more times per week.
the OEP significantly reduces the risk of death and falling in older community-dwelling adults.

  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Falls are a common and serious risk with an aging population. Chiropractors commonly see firsthand the effects of falls and resulting injuries in their senior patients and they can reduce falls risk through active screening. Ongoing research has provided proven approaches for making falls less likely. Screening for falls should be done yearly for all patients 65 years and older or in those with a predisposing medical condition. Additional specific falls prevention professional education would enable the chiropractor to best assist these patients. Collaboration and communication with the patient's family physician offers an opportunity for improved interprofessional dialogue to enhance patient care related to falls risk. Frequently falls prevention strategies are implemented by an interprofessional team. Chiropractors increasingly contribute within multidisciplinary teams. Collaboration by the chiropractor requires both simple screening. Such awareness can permit optimal participation in the care of their patient and the best outcome.
    JCCA. Journal of the Canadian Chiropractic Association. Journal de l'Association chiropratique canadienne 09/2014; 58(3):300-311.
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Background Preventing falls is an International priority. There is a need to synthesise the highest quality falls prevention evidence in one place for clinicians. Purpose To conduct an umbrella review of meta-analyses (MA) of randomised controlled trials (RCTs) of falls prevention interventions in community dwelling older adults. Data Sources MEDLINE, EMBASE, CINAHL, AMED, BNI, PsycINFO, Cochrane Library, PubMed and the PEDro database. Study Selection MA with one pooled analysis containing ≥ 3 RCTs investigating any intervention to prevent falls in community dwelling older adults aged ≥ 60 years of age were eligible. 16 MA representing 47 pooled analyses were included. Data Extraction Two authors independently extracted data. Data Synthesis Data was narratively synthesised. The methodological quality of the MA was moderate. 3 MA defined a fall and 3 reported adverse events (although minor). There is consistent evidence that exercise reduces falls (including the rate, risk and odds of falling) with 13/14 pooled analyses (93%) from 7 MA demonstrating a significant reduction. The methodological quality of meta-analyses investigating exercise were medium/ high and effect sizes ranged from 0.87 (relative risk (RR) 95% CI 0.81–0.94, N=18, n=3568) to 0.39 (rate ratio (RaR) 95% CI 0.23 – 0.66, N=6). There is consistent evidence that multifactorial interventions reduce falls (5/6, 83% reported significant reduction). There is conflicting evidence regarding the influence of vitamin d supplementation (7/12, 58.3% reported significant reduction). Limitations MA often used different analysis and reporting of key characteristics was often lacking (e.g. participants, heterogeneity, publication bias). There may be some overlap between included MA. Conclusions There is consistent evidence that exercise and individually tailored multifactorial interventions are effective in reducing falls in the community.
    Physical Therapy 02/2015; DOI:10.2522/ptj.20140461 · 3.25 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: The objective of this study was to verify the effects of physical rehabilitation on the decline of Alzheimer's disease in Tunisian male older adult patients. We focused mainly on effects on motor functions mainly stride length, walking speed and postural stability. 21 patients carefully selected were separated into two groups. The first group of nine patients served as control. However, the second group is composed of twelve patients was submitted for six months at three sessions of 60 minutes per week in a physical training program. Our results showed that physical activity improves significantly motor functions in Alzheimer's disease patients, namely stride length, walking speed, double limb support time and postural stability. We conclude that the physical training could be an interesting approach for the control of Alzheimer's disease in Tunisian male older adult patients.
    IOSR Journal of Dental and Medical Sciences 06/2014; 13(7):71-76. DOI:10.9790/0853-16620105 · 1.58 Impact Factor