Improved balance in middle-aged adults after 8 weeks of a modified version of Otago Exercise Program: A randomized controlled trial

Rana Almarzouki, Gurinder Bains, Everett Lohman, Bruce Bradley, Todd Nelson, Samiah Alqabbani, Asma Alonazi, Noha Daher, Rana Almarzouki, Gurinder Bains, Everett Lohman, Bruce Bradley, Todd Nelson, Samiah Alqabbani, Asma Alonazi, Noha Daher

Abstract

Objective: The objective of this randomized controlled trial was to examine dynamic balance changes (reach distance) in middle-aged adults using the Y Balance Test (YBT) following 8 weeks of home-based exercise program adapted from the Otago Exercise Program (OEP).

Methods: Fifty-two healthy middle-aged adults with mean age of 54.4±5.4 years and body mass index of 27.7±5.7 kg/m2 were randomly assigned into either the exercise group (a modification of the Otago Exercise Program, that consisted of home-based balance and strength exercises) or the non-exercise group (continuation of usual lifestyle) by having the participants select a paper from a sealed envelope. The YBT was used to measure participants' dynamic balance in the right and left anterior (RA, LA), posteromedial (RPM, LPM), and posterolateral (RPL, LPL) directions.

Results: The outcome in this trial was reach distance (cm). There was a significant group by time interaction in terms of reach distance for all directions (p<0.05, η2 ranged from 0.06 to 0.20). In the exercise group, results of the repeated measures analysis of variance (ANOVA) showed significant improvements in the reach distance in all the directions (p<0.001). In contrast, the non-exercise group had significant difference only in the left posterolateral direction (p = 0.009). Participants in the exercise group achieved significantly greater reach distance (cm) (95% confidence interval (CI)) for RA[(2.8, 0.4 to 5.2), p = 0.023]; LA[(3.2, 0.9 to 5.6), p = 0.008]; RPM[(4.0, 1.0 to 7.9), p = 0.046]; LPM[(5.8,1.3 to 10.3), p = 0.013]; RPL[(7.6, 2.6 to 12.6), p = 0.003]; and LPL[(4.2, 0.3 to 8.2), p = 0.035].

Conclusion: The modified version of OEP appears to be effective in improving parameters of dynamic balance in the middle-aged adult population. The improvements in YBT reach distance in the exercise group are indicative of the significance of performing balance and strength exercises regularly for this population.

Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Fig 1. Consort flow diagram of participants’…
Fig 1. Consort flow diagram of participants’ recruitment and retention.

References

    1. Caban-Martinez AJ, Courtney TK, Chang W-R, Lombardi DA, Huang Y-H, Brennan MJ, et al. Leisure-time physical activity, falls, and fall injuries in middle-aged adults. American journal of preventive medicine. 2015;49(6):888–901. 10.1016/j.amepre.2015.05.022
    1. . Falls are leading cause of injury and death in older Americans 2016, September 22 [Available from:
    1. Talbot LA, Musiol RJ, Witham EK, Metter EJ. Falls in young, middle-aged and older community dwelling adults: perceived cause, environmental factors and injury. BMC public health. 2005;5(1):86.
    1. . 10 leading causes of death and injury [PDF]. 2019, [updated 2019, February 7. Available from: .
    1. . Nonfatal Hospitalized Injuries, Both Sexes, Ages 65 to 85+, United States, 2010 [updated 2014, Septenber 18. Available from: .
    1. . Nonfatal Hospitalized Injuries, Both Sexes, Ages 45 to 64, United States, 2010 2014 [updated 2014, September 18. Available from: .
    1. Toraman A, Yıldırım NÜ. The falling risk and physical fitness in older people. Archives of gerontology and geriatrics. 2010;51(2):222–6. 10.1016/j.archger.2009.10.012
    1. Daly RM, Rosengren BE, Alwis G, Ahlborg HG, Sernbo I, Karlsson MK. Gender specific age-related changes in bone density, muscle strength and functional performance in the elderly: a-10 year prospective population-based study. BMC geriatrics. 2013;13(1):71.
    1. Ferreira ML, Sherrington C, Smith K, Carswell P, Bell R, Bell M, et al. Physical activity improves strength, balance and endurance in adults aged 40–65 years: a systematic review. Journal of physiotherapy. 2012;58(3):145–56. 10.1016/S1836-9553(12)70105-4
    1. Lee D-K, Kang M-H, Lee T-S, Oh J-S. Relationships among the Y balance test, Berg Balance Scale, and lower limb strength in middle-aged and older females. Brazilian journal of physical therapy. 2015;19(3):227–34. 10.1590/bjpt-rbf.2014.0096
    1. Aslan UB, Cavlak U, Yagci N, Akdag B. Balance performance, aging and falling: a comparative study based on a Turkish sample. Archives of gerontology and geriatrics. 2008;46(3):283–92. 10.1016/j.archger.2007.05.003
    1. Ribeiro F, Oliveira J. Aging effects on joint proprioception: the role of physical activity in proprioception preservation. European review of aging and physical activity. 2007;4(2):71.
    1. Campbell A, Robertson MC. Otago exercise programme to prevent falls in older adults. Wellington: ACC Thinksafe; 2003.
    1. Liu‐Ambrose T, Donaldson MG, Ahamed Y, Graf P, Cook WL, Close J, et al. Otago home‐based strength and balance retraining improves executive functioning in older fallers: a randomized controlled trial. Journal of the american geriatrics society. 2008;56(10):1821–30. 10.1111/j.1532-5415.2008.01931.x
    1. Yoo Ha-na, Chung E, Lee B-H. The effects of augmented reality-based Otago exercise on balance, gait, and falls efficacy of elderly women. Journal of physical therapy science. 2013;25(7):797–801. 10.1589/jpts.25.797
    1. Jaber H, Lohman E, Daher N, Bains G, Nagaraj A, Mayekar P, et al. Neuromuscular control of ankle and hip during performance of the star excursion balance test in subjects with and without chronic ankle instability. PloS one. 2018;13(8):e0201479 10.1371/journal.pone.0201479
    1. Plisky PJ, Gorman PP, Butler RJ, Kiesel KB, Underwood FB, Elkins B. The reliability of an instrumented device for measuring components of the star excursion balance test. North American journal of sports physical therapy: NAJSPT. 2009;4(2):92–9.
    1. Freund JE, Stetts DM, Oostindie A, Shepherd J, Vallabhajosula S. Lower Quarter Y-Balance Test in healthy women 50–79 years old. Journal of women & aging. 2018:1–17.
    1. Lee D-K, Kim G-M, Ha S-M, Oh J-S. Correlation of the Y-balance test with lower-limb strength of adult women. Journal of physical therapy science. 2014;26(5):641–3. 10.1589/jpts.26.641
    1. Smith CA, Chimera NJ, Warren M. Association of y balance test reach asymmetry and injury in division I athletes. Medicine and science in sports and exercise. 2015;47(1):136–41. 10.1249/MSS.0000000000000380
    1. Vega-López S, Chavez A, Farr KJ, Ainsworth BE. Validity and reliability of two brief physical activity questionnaires among Spanish-speaking individuals of Mexican descent. BMC research notes. 2014;7(1):29.
    1. McCoy CE. Understanding the intention-to-treat principle in randomized controlled trials. West journal of emergency medicine. 2017;18(6):1075.
    1. Granacher U, Wick C, Rueck N, Esposito C, Roth R, Zahner L. Promoting balance and strength in the middle-aged workforce. International journal of sports medicine. 2011;32(01):35–44.
    1. Teoman N, Özcan A, Acar B. The effect of exercise on physical fitness and quality of life in postmenopausal women. Maturitas. 2004;47(1):71–7. 10.1016/s0378-5122(03)00241-x
    1. Nitz J, Choy NL, Isles R. Medial–lateral postural stability in communitydwelling women over 40 years of age. Clinical rehabilitation. 2003;17(7):765–7. 10.1191/0269215503cr675oa
    1. Hafström A, Malmström E-M, Terdèn J, Fransson P-A, Magnusson M. Improved balance confidence and stability for elderly after 6 weeks of a multimodal self-administered balance-enhancing exercise program: a randomized single arm crossover study. Gerontology and geriatric medicine. 2016;2:2333721416644149 10.1177/2333721416644149
    1. Cadore EL, Izquierdo M, Pinto SS, Alberton CL, Pinto RS, Baroni BM, et al. Neuromuscular adaptations to concurrent training in the elderly: effects of intrasession exercise sequence. Age. 2013;35(3):891–903. 10.1007/s11357-012-9405-y

Source: PubMed

Sponsors en medewerkers

Medische omstandigheden

Geneesmiddelinterventies

3
Abonneren