This is an evidence-based, internationally recognised home-based strength and balance exercise programme (known as the Otago programme). 
The programme lasts up to 24 weeks with 6 face-to-face home visits lasting an hour. There is also additional telephone support. Patients will receive resistance bands or ankle weights (where appropriate) and an exercise book illustrating the prescribed exercises. Patients are required to practice the exercises between visits and are encouraged to walk inside their home or outside where this is appropriate.

Key outcomes of the Otago programme include a reduced risk of falls, increased strength and balance and reduced fear of falling. Patients will be supported to access community-based exercise provision following Otago.  

The programme is most effective in those who: 
•    Have fallen in the last 12 months
•    Are over 75 and/or transitioning to frailty
•    Are motivated to exercise at home
•    Are unable to attend community-based exercise classes. 

 

The criteria for referral has been relaxed to include people who would normally be suitable for referral to the 24-week community-based falls prevention classes but who lack motivation, physical strength/steadiness or who lack the confidence to go to a group setting due to the effects of the lockdown and/or continued threat of infection.
 

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Eligibility criteria

Inclusions

•    Identified at risk of falls - with history of fall/s (injurious or non-injurious)
•    Over 75 
•    Deconditioned as a result of lockdown
•    Fear of attending a group setting
•    Fear of falling
•    Feeling unstable
•    Low bone density and / or family history of osteoporotic fracture.
 

Exclusions

•    Uncontrolled angina
•    Uncontrolled resting systolic blood pressure >180mmHg or resting diastolic blood  pressure >100mmHg  Uncontrolled tachycardia >100bpm
•    Uncontrolled acute systemic illness (cancer / pneumonia)
•    Uncontrolled visual or vestibular disturbance •  
•    Uncontrolled pain
•    Significant drop in blood pressure during exercise to below 100mmHg
•    Unstable or acute heart failure
•    Unable to maintain seated upright posture due to neurological deficits
•    Impaired cognition (to the extent of being unable to follow simple movement  instructions)
•    People who place themselves or others at risk
•    Participants who are unable to monitor or modify their exercise level or technique or follow advice.

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How to refer

The following clinicians can refer to this service: GPs, Nurses, Physiotherapist

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Locations

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