Additional Effects of Strength Training With Otago Exercises on Actual and Perceived Balance in Older Adults

NCT07380282 | Completed

• 1 other identifier: FUI/CTR/2025/17
• Study Type: interventional
• Target: 28
• Locations: 1 country
• Sites: 1

Brief Summary

This study, titled "Additional Effects of Strength Training with Otago Exercises on Actual and Perceived Balance in Older Adults", explores strategies to reduce fall risks in the elderly. Falls are a major health concern, often causing injuries, loss of mobility, and reduced quality of life. The Otago Exercise Program (OEP) has been proven effective in improving lower-limb strength and balance, but it primarily focuses on these areas without addressing overall muscle strengthening. The research aims to assess whether integrating additional strength training with OEP can enhance both actual balance (measured through static and dynamic stability tests) and perceived balance (confidence in avoiding falls). Using a randomized controlled trial, 34 participants aged 60 and above will be recruited and divided into two groups: one receiving OEP alone, and the other combining OEP with structured strength training. Tools such as the Berg Balance Scale, Functional Reach Test, Fall Efficacy Scale, and CONFbal Scale will measure outcomes. The intervention will last eight weeks, with progressive resistance and balance tasks. Findings are expected to demonstrate improved mobility, reduced fear of falling, and greater confidence among participants receiving combined training. This research addresses a significant gap in geriatric rehabilitation and aims to inform cost-effective, evidence-based strategies for fall prevention, ultimately enhancing independence and quality of life in older adults.

Conditions

Aged; Postural Balance; Exercise Therapy; Muscle Strength; Resistance Training; Fall Prevention

Keywords

Older adults; Falls prevention; Otago Exercise Program; Strength training; Balance confidence; Postural stability; actual balance; perceived balance

Outcome Measures

Primary Outcomes (2)

• Actual Balance

  The 1st primary outcome is the improvement in actual balance Berg Balance Scale (BBS) Score range: 0-56 Cut-off values: * 41-56 Low fall risk * 21-40 Medium fall risk * 0-20 High fall risk \< 45 = Increased risk of falls

  8 weeks

• Functional Reach

  Functional Reach Test Measured in centimeters (cm) Cut-off values: * \> 25 cm Low fall risk * 15-25 cm Moderate fall risk * \< 15 cm High fall risk \< 18.5 cm = Increased fall risk in older adults

  8 Weeks

Secondary Outcomes (2)

• Perceived balance

  8 weeks

• Perceived Balance

  8 weeks

Study Arms (2)

Otago with strengthening exercise

EXPERIMENTAL

The Otago Exercise Program (OEP) is an evidence-based fall-prevention program designed for older adults, focusing on improving strength, balance, and mobility. It emphasizes lower-limb strengthening of key muscle groups such as the quadriceps, hamstrings, hip abductors, and ankle muscles through exercises like seated leg extensions, heel raises, sit-to-stand, and standing leg curls. The balance component includes static and dynamic activities such as tandem walking, single-leg stance, sideways walking, backward walking, and stair stepping, with gradual progression to safely challenge postural control. In this study, strengthening exercises are integrated with the OEP to enhance overall effectiveness. The program is delivered three times per week, with each session lasting 40-45 minutes over an 8-week period. This combined intervention aims to improve balance, reduce fall risk, and increase confidence during daily functional activities among older adults.

Procedure: Otago Exercise with Strengthening exercise

Otago

OTHER

Otago exercise plan is comprisedset of 14 exercises including strengthening and balance exercises. The strenghtening exercises include strengthening of Knee Flexors, Knee Extensors, Hip-abductors Ankle dorsiflexors and ankle planter flexors and the balance exercises include following activities: Knee Bends Backward Walking, Walking and Turning Around, Sideways Walking, Tandem Stance, Tandem Walk, One Leg stance, Heel Walking, Toe Walking, Heel toe walk backwards, Sit to stand, Stair Walking These exercises will be performed for a duration 6 weeks and will be performed thrice for a period of 40/50 minutes

Procedure: Otago Exercise Program

Interventions

Otago Exercise with Strengthening exercise PROCEDURE

The experimental group participated in an 8-week training program, conducted three times per week with 30-45-minute sessions. Each session began with a 5-10 minute warm-up, including dynamic stretching, marching in place, and joint mobility exercises. The program included progressive strength and balance training, starting with light or no resistance and gradually increasing to moderate-high intensity (45-75% of 1RM). Exercises included seated leg extensions, standing leg curls, sit-to-stand, heel raises, step-ups, wall push-ups, and functional movements such as sideways walking, backward walking, and obstacle walking. Balance training involved static and dynamic tasks, including tandem stance, single-leg stance, functional reach, and dynamic walking with turns. Exercise intensity and complexity progressed throughout the program while maintaining safe rest intervals. Each session concluded with a 5-10 minute cool-down, consisting of lower-limb stretching (quadriceps, hamstrings, calves

Otago with strengthening exercise

Otago Exercise Program PROCEDURE

The training program was conducted three times a week, with 30-45-minute sessions. Each session began with a 5-7 minute warm-up (marching in place, ankle circles, shoulder rolls). During Weeks 1-2, participants performed sit-to-stand, heel raises, and seated knee extensions (2 × 10), along with sideways walking (5 m, 2-3 reps) and static balance progressing from feet together to tandem stance. In Weeks 3-4, difficulty increased with sit-to-stand (3 × 10), heel-to-toe walking (5 m), backward walking (3-5 m), single-leg stance (10-15 s), and step-ups (2 × 10). During Weeks 5-6, exercises included wall push-ups, heel raises on a step, dynamic walking with 180° turns, functional reach, and eyes-closed balance tasks. In Weeks 7-8, advanced balance tasks were added, including weighted sit-to-stand, single-leg stance with arm movements, obstacle walking, higher step-ups, and dynamic tandem walking. Each session ended with a 5-7 minute cool-down of lower-limb stretching and breathing exercises

Otago

Eligibility Criteria

• Age: 60 Years+
• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Older adults aged 60 years and above.
• Mini-Mental State Examination (MMSE) score of 24 or higher (sufficient cognitive ability to participate).
• Individuals able to ambulate independently or with minimal assistance (e.g., cane).
• Those who have not participated in a structured balance or strengthening program in the past 3 months.
• Participants able to provide informed consent and adhere to the intervention protocol.

You may not qualify if:

• Severe musculoskeletal or neurological conditions limiting mobility (e.g., advanced arthritis, stroke with significant residual deficits).
• Sensory disabilities affecting vision, hearing, or vestibular function.
• Structural defects in extremities.
• Fracture in the past year.
• Unstable systemic pathology, recent surgery, or cancer diagnosis/treatment within the past 6 months

Sponsors & Collaborators

• Foundation University Islamabad: lead

Study Sites (1)

Foundation University College of Physical Therapy

Islamabad, 44000, Pakistan

Location

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: NONE
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: December 29, 2025
• First Posted: February 2, 2026
• Study Start: September 13, 2024
• Primary Completion: December 10, 2025
• Study Completion: December 10, 2025
• Last Updated: February 2, 2026

Record last verified: 2026-01

Locations

PA (1)