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The Otago Exercise Program with or without Motivational Interviewing for community-dwelling older adults: A 12-month follow-up of a randomized, controlled trial
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience.
School of health care and social welfare, Mälardalen University.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience.
(English)In: Article in journal (Refereed) Submitted
National Category
Medical and Health Sciences
Identifiers
URN: urn:nbn:se:uu:diva-333500OAI: oai:DiVA.org:uu-333500DiVA, id: diva2:1156840
Available from: 2017-11-14 Created: 2017-11-14 Last updated: 2017-11-20
In thesis
1. Falls and fall prevention in community-dwelling older adults
Open this publication in new window or tab >>Falls and fall prevention in community-dwelling older adults
2018 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Falls are the primary cause of injuries among older adults, and accidents that result from falls can lead to personal suffering and extensive societal burdens. The overall aims of this thesis were to explore and describe falls and fall prevention strategies in community-dwelling older adults and to evaluate a fall prevention home exercise program, the Otago Exercise Program (OEP), with or without motivational interviewing (MI).

Methods: Qualitative and quantitative research methods were uses. The designs were as follows: a cross-sectional, descriptive and comparative study (study I); a descriptive feasibility investigation (study II) and a randomized controlled trial (RCT) with two interventions, the OEP and OEP+MI, as well as a control group, with a 12-month follow-up (study III); and a prospective and descriptive study (study IV). The four studies comprised community-dwelling individuals aged 75 years or older. Study I included 262 individuals and studies II-IV had 175 participants who needed walking aids or home support. Study II also included 12 physical therapists.  Data collection was performed via self-reported questionnaires, fall calendars, exercise diaries, physical performance tests and a semi-structured questionnaire. 

Results and conclusions: Suggested actions to prevent falls significantly differed between high and low active older adults (study I). Support for self-directed behavioral strategies could be important for preventing falls in older adults who have low physical activity levels. The study protocol for the RCT had acceptable feasibility (study II), and only minor changes of the protocol were needed. There were no benefits for OEP or OEP+MI with personal support implemented nine times over the 12-month period. However, all groups maintained physical functioning and activity (study III). To increase physical functioning and reduce falls in this sub-group of older adults, more frequent personal support and/or an alternative delivery format may be required for efficient intensity and challenge in home exercises. Over 12 months, falls and fall-related injuries in the RCT sample were the most common when moving around within the home and transitioning from sitting to standing (study IV). Special attention to these activities might be important for preventing falls in community-dwelling older adults who need walking aids or home support.

 

Place, publisher, year, edition, pages
Uppsala: Acta Universitatis Upsaliensis, 2018. p. 64
Series
Digital Comprehensive Summaries of Uppsala Dissertations from the Faculty of Medicine, ISSN 1651-6206 ; 1396
Keywords
older adults, falls, fall prevention, exercise, ICF, motivational interviewing
National Category
Medical and Health Sciences
Research subject
Physiotherapy
Identifiers
urn:nbn:se:uu:diva-333507 (URN)978-91-513-0156-3 (ISBN)
Public defence
2018-01-11, A1:107a, Biomedicinskt centrum, Husargatan 3, Uppsala, 13:00 (Swedish)
Opponent
Supervisors
Available from: 2017-12-19 Created: 2017-11-20 Last updated: 2018-03-08

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