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The Modified Otago Exercises Prevent Grip Strength Deterioration Among Older Fallers in the Malaysian Falls Assessment and Intervention Trial (MyFAIT)

Liew, Lin Kiat MRehMed1,2; Tan, Maw Pin MD3,4; Tan, Pey June BSc3; Mat, Sumaiyah BAppScilS3; Majid, Lokman A. PT5; Hill, Keith D. PhD6; Mazlan, Mazlina MRehMed1

Journal of Geriatric Physical Therapy: July/September 2019 - Volume 42 - Issue 3 - p 123–129
doi: 10.1519/JPT.0000000000000155
Research Reports

Background and Purpose: Exercise-based interventions, such as the Otago Exercise Program (OEP), are effective in preventing falls in the older adult. Previous studies evaluating the OEP have determined falls, lower limb strength, or balance outcomes but with lack of assessment of hand grip strength. The objective of this study is to evaluate the effect of OEP on hand grip strength alongside mobility and balance outcomes.

Methods: This was a single-center, prospective, and single-blind randomized controlled trial conducted at the University Malaya Medical Centre. Patients older than 65 years presenting to the hospital emergency department or geriatric clinic with 1 injurious fall or 2 falls in the past year and with impaired functional mobility were included in the study. The intervention group received a modified OEP intervention (n = 34) for 3 months, while the control group received conventional care (n = 33). All participants were assessed at baseline and 6 months.

Results: Twenty-four participants in both OEP and control groups completed the 6-month follow-up assessments. Within-group analyses revealed no difference in grip strength in the OEP group (P = 1.00, right hand; P = .55, left hand), with significant deterioration in grip strength in the control group (P = .01, right hand; P = .005, left hand). Change in grip strength over 6 months significantly favored the OEP group (P = .047, right hand; P = .004, left hand). Significant improvements were also observed in mobility and balance in the OEP group.

Conclusions: In addition to benefits in mobility and balance, the OEP also prevents deterioration in upper limb strength. Additional benefits of exercise interventions for secondary prevention of falls in term of sarcopenia and frailty should also be evaluated in the future.

1Department of Rehabilitation Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur.

2Department of Rehabilitation Medicine, Sarawak General Hospital, Kuching, Sarawak, Malaysia.

3Ageing and Age-Associated Disorders Research Group, Faculty of Medicine, University of Malaya, Kuala Lumpur.

4Division of Geriatric Medicine, Department of Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur.

5Department of Rehabilitation Medicine, University of Malaya, Kuala Lumpur.

6School of Physiotherapy and Exercise Science, Faculty of Health Sciences, Curtin University, Sydney, Australia.

Address correspondence to: Lin Kiat Liew, MRehMed, Department of Rehabilitation Medicine, Faculty of Medicine, University Malaya, 12th Floor, Menara Selatan, University Malaya Medical Centre, Jalan Universiti, 59100 Kuala Lumpur (

All authors have made an intellectual contribution to this research. M.P.T., M.M., and K.H. were responsible identifying the research questions, design of the study, and overseeing the implementation of the study. P.J.T. and M.S. contributed to the development of support materials and recruitment of participants. L.K.L. and L.A.M. were responsible for study implementation and data collection. M.P.T. and L.K.L. conducted data analysis and interpretation. All authors were responsible for drafting the manuscript and have read and approved the final version.

The authors declare no conflicts of interest.

Bill Andrews was the Decision Editor.

© 2019 Academy of Geriatric Physical Therapy, APTA
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