Benefits of a novel concept of home-based exercise with the aim of preventing aspiration pneumonia and falls in frail older women: a pragmatic controlled trial

OBJECTIVES: We assessed the feasibility of delivering the Otago Exercise Programme (OEP) via an interactive DVD (ie, OEP-DVD) in combination with monthly physical therapist phone calls to older adults. DESIGN: This pre-post (baseline and 6-month follow-up) study included an intervention group (n=61) based in a rural location and a control group (n=21) based in a city. SETTING: Sechelt and Vancouver, British Columbia. PARTICIPANTS: 82 community-dwelling adults ≥75 years. INTERVENTION: Individuals in the intervention group received the OEP-DVD and were instructed to do the exercises 3 times a week after their initial home physical therapist visit for 6 months. PRIMARY AND SECONDARY OUTCOMES: Feasibility was ascertained by withdrawal rate and compliance to the OEP-DVD. The number of participants and the frequency (ie, number of times weekly) they performed the OEP exercises and walking were used to estimate compliance. The potential benefit of the OEP-DVD on falls risk profile (Physiological Profile Assessment (PPA)) and mobility were examined by comparing the change in the intervention group compared with the control group. Self-reported compliance to the exercise programme was assessed by monthly returned diary. RESULTS: Of the 82 participants, 2 withdrew from the OEP-DVD group and none withdrew from the control group. We obtained compliance data on 72% of participants in the intervention group. The mean OEP-DVD compliance was 87% and the mean walking compliance was 166%. After adjusting for baseline PPA, baseline age, sex, baseline comorbidities, baseline cognitive status and baseline falls-related self-efficacy, there was a significant between-group improvement in the overall PPA score (OEP group pre-PPA to post-PPA score: 0.79±1.2 to 0.7±0.9; p<0.05) at study completion. CONCLUSIONS: Although the OEP-DVD resulted in significant reductions in falls risk among community-dwelling older adults, there was a notable loss to follow-up limiting the feasibility of this approach. PDF Y Endnote Y Commentary: Public health system perspective on implementation of evidence-based fallprevention strategies for older adults Shubert TE, Smith ML, Schneider EC, Wilson AD, Ory MG. Front. Public Health 2016; 4: e252. Affiliation: Department of Health Promotion and Community Health Sciences, Texas A&M School of Public Health , College Station, TX , USA. Comment On: Front Public Health 2015;2:191. (Copyright © 2016, Frontiers Editorial Office) DOI 10.3389/fpubh.2016.00252 PMID 27900316 PMCID PMC5111173 Abstract [Abstract unavailable] PDF Y Endnote Y Comparison of self-reported and performance-based measures of functional ability in elderly patients in an emergency department: implications for selection of clinical outcome measures Nielsen LM, Kirkegaard H, Østergaard LG, Bovbjerg K, Breinholt K, Maribo T. BMC Geriatr. 2016; 16(1): e199.