Exercise Interventions for Improving Balance, Strength, and Functional Capacity in Older Adults: A Randomized...

Age-related declines in strength and balance increase fall risk in nursing home residents. This study compared the effects of the modified Otago Exercise Program and the Large-Amplitude Functional Exercise Program (LAFEP) on fall risk, balance, functional capacity, and lower-extremity strength. In this randomized controlled trial, 70 participants (aged ≥ 65) residing in nursing homes were randomly assigned to the modified Otago Exercise Program (n = 35) or the LAFEP (n = 35). Both groups received supervised group exercise three times weekly for 12 weeks. Primary outcomes were the functional reach test and the timed up-and-go test. Secondary outcomes included the Performanz Balance System, the 6-min walk test, and the five times sit-to-stand test. Both interventions led to significant within-group improvements (p < .05). However, the LAFEP group demonstrated significantly greater improvements in dynamic balance, specifically in the functional reach test (p = .03). Improvements in functional mobility outcomes, including the timed up-and-go (p = .67) and the five times sit-to-stand tests (p = .17), were also more pronounced in the LAFEP group; however, these between-group differences did not reach statistical significance. Both the modified Otago Exercise Program and the LAFEP were effective in enhancing balance and functional outcomes for older adults in residential care. The LAFEP, however, yielded superior gains specifically in dynamic balance. The findings suggest that the LAFEP, adapted from neurorehabilitation principles, may be a viable and potentially more effective alternative to conventional fall prevention exercise programs for this population.