TY - JOUR PY - 2017// TI - The Otago exercise program: innovative delivery models to maximize sustained outcomes for high risk, homebound older adults JO - Frontiers in public health A1 - Shubert, Tiffany E. A1 - Goto, Lavinia Spring A1 - Smith, Matthew Lee A1 - Jiang, Luohua A1 - Rudman, Holly A1 - Ory, Marcia G. SP - e54 EP - e54 VL - 5 IS - N2 - BACKGROUND: It is estimated one in two adults age 80 and over fall each year, resulting in substantial morbidity and mortality rates among this oldest-old population. The Otago Exercise program (OEP) is an evidence-based fall prevention program shown to reduce falls by 35% among high-risk older adults. The OEP was designed to be delivered in the home by physical therapists. This model has encountered multiple implementation challenges in the United States health-care system, which has resulted in the development and testing of innovative models to support a broader reach and dissemination of this program.

METHODS: The Northwest Senior and Disability Services is an Area Agency on Aging (AAA) serving a five-county region in Oregon. This AAA developed a model where a Certified Occupational Therapy Assistant (COTA) and exercise physiologist delivered the OEP with a physical therapist available to consult on all cases. Physical function assessments and self-reported perceptions about physical function were collected at baseline and 6 months.

RESULTS: Baseline measures were collected on 239 participants enrolled in the OEP, and 62 participants at 6 months. Those who completed 6 months of the OEP demonstrated significant improvements in all physical function assessments and self-perceived functional improvements. A subset of this group that demonstrated improvements in the ability to rise from a chair also reported significantly fewer falls during the 6-month intervention.

CONCLUSION: Innovative models in which the OEP exercise sessions are delivered by non-physical therapists appear to be effective in improving physical performance measures and decreasing fall risk over a 6-month period. Because these models do not require a physical therapist, they may require fewer resources to implement. These findings have implications to inform implementation and dissemination strategies to bring the OEP to scale.

Language: en

LA - en SN - 2296-2565 UR - http://dx.doi.org/10.3389/fpubh.2017.00054 ID - ref1 ER -