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The Otago Exercise Program compared to falls prevention education in Zuni elders: a randomized controlled trial
Debra L Waters1,2, Janet Popp3, Carla Herman1
1Department of Internal Medicine, School of Medicine, University of New Mexico, Albuquerque, NM, 87131, USA.
BMC Geriatrics
|August 9, 2022
Summary
This study tested a culturally adapted exercise program delivered by community health representatives to prevent falls in Zuni elders. The program showed promise in improving strength and balance, potentially reducing fall-related injuries in tribal communities.
Area of Science:
- Gerontology
- Public Health
- Exercise Science
Background:
- Zuni elders face significant challenges with fall-related injuries due to limited access to healthcare facilities and physical therapy services.
- Fall prevention is a tribal priority aimed at preserving independence and reducing healthcare disparities for aging Zuni individuals.
- Existing fall risk management strategies may not be culturally relevant or accessible to this population.
Purpose of the Study:
- To compare the effectiveness of a culturally adapted Otago Exercise Program (OEP) delivered by Community Health Representatives (CHRs) against standard education-based fall risk management for Zuni elders.
- To assess the impact of a CHR-delivered, culturally adapted OEP on fall prevention in a tribal community setting.
- To evaluate the feasibility and sustainability of a CHR-delivered fall prevention program for improving elder care in underserved rural and tribal areas.
Main Methods:
- A mixed-methods randomized controlled trial involving up to 400 Zuni elders, with 200 enrolled (1:1 allocation).
- CHRs, fluent in Zuni and knowledgeable of tribal traditions, will be trained by a physical therapist to deliver the culturally adapted OEP or standard education.
- Outcomes including strength, balance, falls incidence, and self-efficacy will be measured at baseline, 3, 6, and 12 months.
Main Results:
- The study is ongoing; primary outcomes focus on improvements in strength and balance (Timed Up and Go, Sit to Stand, 4-Stage Balance Test).
- Secondary outcomes include falls incidence, self-efficacy, and quality of life (SF-12v2).
- Data analysis will determine the effectiveness of the CHR-delivered OEP compared to the control group.
Conclusions:
- The CHR-delivered, culturally adapted OEP has the potential to be an acceptable and sustainable model for fall prevention in Zuni elders.
- This intervention could significantly improve elder care in tribal and rural areas with limited access to physical therapy.
- Successful implementation can help avert fall-related injuries, reduce healthcare disparities, and support elders in aging in place within their communities.
