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Fall Preventive Exercise With or Without Behavior Change Support for Community-Dwelling Older Adults

A Randomized Controlled Trial With Short-Term Follow-up

Arkkukangas, Marina, PT1; Söderlund, Anne, PT, PhD1; Eriksson, Staffan, PT, PhD2,3,4; Johansson, Ann-Christin, PT, PhD1,5

Journal of Geriatric Physical Therapy: January/March 2019 - Volume 42 - Issue 1 - p 9–17
doi: 10.1519/JPT.0000000000000129
Research Reports

Background and Purpose: In Western countries, falls and fall-related injuries are a well-known threat to health in the aging population. Studies indicate that regular exercise improves strength and balance and can therefore decrease the incidence of falls and fall-related injuries. The challenge, however, is to provide exercise programs that are safe, effective, and attractive to the older population. The aim of this study was to investigate the short-term effect of a home-based exercise program with or without motivational interviewing (MI) compared with standard care on physical performance, fall self-efficacy, balance, activity level, handgrip strength, adherence to the exercise, and fall frequency.

Method: A total of 175 older adults participated in this randomized controlled study. They were randomly allocated for the Otago Exercise Program (OEP) (n = 61), OEP combined with MI (n = 58), or a control group (n = 56). The participants' mean age was 83 years. The recruitment period was from October 2012 to May 2015. Measurements of physical performance, fall self-efficacy, balance, activity level, handgrip strength, adherence to the exercise, and fall frequency were done before and 12 weeks after randomization.

Results and Discussion: A total of 161 participants were followed up, and there were no significant differences between groups after a period of 12 weeks of regular exercise. Within the OEP + MI group, physical performance, fall self-efficacy, physical activity level, and handgrip strength improved significantly; likewise, improved physical performance and fall self-efficacy were found in the control group. A corresponding difference did not occur in the OEP group. Adherence to the exercise was generally high in both exercise groups.

Conclusion: In the short-term perspective, there were no benefits of an exercise program with or without MI regarding physical performance, fall self-efficacy, activity level, handgrip strength, adherence to the exercise, and fall frequency in comparison to a control group. However, some small effects occurred within the OEP + MI group, indicating that there may be some possible value in behavioral change support combined with exercise in older adults that requires further evaluation in both short- and long-term studies.

1School of Health, Care and Social Welfare, Mälardalen University, Västerås, Sweden.

2Centre for Clinical Research Sörmland, Uppsala University, Eskilstuna, Sweden.

3Department of Community Medicine and Rehabilitation, Physiotherapy, Umeå University, Umeå, Sweden.

4Department of Neuroscience, Physiotherapy, Uppsala University, Uppsala, Sweden.

5Centre for Clinical Research, Uppsala University, Västerås, Sweden.

Address Correspondence to: Marina Arkkukangas, PT, School of Health, Care and Social Welfare, Box 883, SE-72123, Mälardalen University, Västerås, Sweden (

Source of support: The National Swedish Board of Health and Welfare, Grants for the County of Västmanland. Regional Research Fund for Uppsala and Örebro region, Sweden. Research and Development Department in the Community of Eskilstuna, Sweden.

The authors declare no conflict of interest.

Bill Andrews was the Decision Editor.

© 2019 Academy of Geriatric Physical Therapy, APTA
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