Purpose: To report the feasibility and to obtain preliminary data on the effects of using an enhanced Otago Exercise Programme to reduce fall risk in individuals with osteoarthritis (OA). Participants: Ten participants from the Johnston County Osteoarthritis Project who have OA, are at risk for falls, and are 65+ years old. Procedures (methods): All participants will receive the 6-month enhanced Otago program. The investigators will assemble data: quantifying participant adherence to and safety of the intervention, ascertaining retention of participants for 6 months, determining acceptability of the program, and other validated measures (e.g., number of falls and fall severity, balance measures).
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
PREVENTION
Masking
NONE
Enrollment
10
The Otago Exercise Programme is a falls prevention program that is successful at reducing falls in adults 65+ years of age. Briefly, this program includes flexibility, progressive lower extremity strengthening with ankle weights, and balance exercises. The investigators are replacing the Otago walking program with the evidence-based Arthritis Foundation's Walk With Ease program.
Participant Adherence to Intervention
Number of participants who adhere to the intervention.
Time frame: 6 months
Participant Safety With the Intervention
Number and type of adverse events related to the intervention.
Time frame: 6 months
Retention of Participants
Number of participants who participate in the study for the full 6 month program.
Time frame: 6 months
Acceptability of the Program
Descriptive summary of participants' reports from closing interview of what they like and do not like about the program, any challenges they experienced with doing the program, and whether they plan to continue what they learned.
Time frame: 6 months
Number of Falls
Participant will record occurrence of falls on a monthly falls calendar. Number of falls over the 6 month program will be calculated.
Time frame: Baseline to Month 6
Number of People With Severe of Falls
Participant will record whether the fall resulted in an injury and the type of injury that occurred. A fall will be considered severe if an injury occurred.
Time frame: Baseline to Month 6
Berg Balance Scale
This is 14 item scale that measures balance among older adults. The participant attempts to complete 14 different balance tests (e.g., stand unsupported with eyes closed, pick up object from floor from standing position), closely supervised by a physical therapist to prevent fall or injury. The test takes no more than 15 minutes to complete and a total score is calculated of 0-56 (high fall risk to low fall risk).
Time frame: Baseline
Four-tests Balance: Feet Together Stand
Four timed static balance tasks of increasing difficulty are completed without assistive devices: 1) feet together stand for up to 10 seconds; 2) semi-tandem stand (heel of one foot placed to the side of the big toe of the other foot) for up to 10 seconds; 3) tandem stand (one foot in front of the other, heel touching toe) for up to 10 seconds; and 4) one leg stand for up to 30 seconds. Time for each test is recorded in seconds. If the participant cannot achieve a task, this is recorded as 0 seconds.
Time frame: Baseline
Hand Grip Dynamometry Right Hand
Participant squeezes hand dynamometer with maximum strength, and force is recorded in kgs.
Time frame: Baseline
30-second Chair Stand Test
Participant rises from chair to full standing position and sits back down as quickly as possible for 30 seconds. Number of completed sit to stand to sit maneuvers is recorded.
Time frame: Baseline
Timed Up and Go Test
Participant stands up from chair, walks 3 meters, turns around, walks back to chair, and sits down. Time to complete task is recorded in seconds.
Time frame: Baseline
Stair Climb Test
Participant ascends and descends 3 stairs as quickly as possible in a safe manner, using handrail and walking aid if needed. Time to complete task is recorded in seconds.
Time frame: Baseline
Western Ontario and McMaster Universities Osteoarthritis Index
This questionnaire include 5 questions about knee or hip pain, 2 questions about knee or hip stiffness, and 17 questions about difficulty with performing daily activities that involve the lower body. Each item is scored from 0-4 (none, slight, moderate, severe, and extreme). A total score is calculated by summing the item scores and ranges from 0 (no problems) to 96 (extreme problems).
Time frame: Baseline
Activities-specific Balance Confidence Scale
Participant reports level of confidence in doing an activity without losing balance or becoming unsteady on a scale of 0-100%. The ratings are totaled and divided by 16 (the number of items) to calculate a total score.
Time frame: Baseline
Rapid Assessment of Physical Activity: Aerobic Score
Participants are asked to identify from a list of 7 items which one accurately describes their current level of aerobic physical activity. Participants who identify with items 6 or 7 are considered active. Those who identify with items 1-5 are considered to have suboptimal aerobic physical activity levels. Sedentary: 1. I rarely or never do any physical activities. Under-active: 2. I do some light or moderate physical activities, but not every week. Under-active regular - light activities: 3. I do some light physical activity every week. Under-active regular: 4. I do moderate physical activities every week, but less than 30 minutes a day or 5 days a week. 5. I do vigorous physical activities every week, but less than 20 minutes a day or 3 days a week. Active: 6. I do 30 minutes or more a day of moderate physical activities, 5 or more days a week. 7. I do 20 minutes or more a day of vigorous physical activities, 3 or more days a week.
Time frame: Baseline
Berg Balance Scale
This is 14 item scale that measures balance among older adults. The participant attempts to complete 14 different balance tests (e.g., stand unsupported with eyes closed, pick up object from floor from standing position), closely supervised by a physical therapist to prevent fall or injury. The test takes no more than 15 minutes to complete and a total score is calculated of 0-56 (high fall risk to low fall risk).
Time frame: Week 8
Berg Balance Scale
This is 14 item scale that measures balance among older adults. The participant attempts to complete 14 different balance tests (e.g., stand unsupported with eyes closed, pick up object from floor from standing position), closely supervised by a physical therapist to prevent fall or injury. The test takes no more than 15 minutes to complete and a total score is calculated of 0-56 (high fall risk to low fall risk).
Time frame: Month 6
Four-tests Balance: Feet Together Stand
Four timed static balance tasks of increasing difficulty are completed without assistive devices: 1) feet together stand for up to 10 seconds; 2) semi-tandem stand (heel of one foot placed to the side of the big toe of the other foot) for up to 10 seconds; 3) tandem stand (one foot in front of the other, heel touching toe) for up to 10 seconds; and 4) one leg stand for up to 30 seconds. Time for each test is recorded in seconds. If the participant cannot achieve a task, this is recorded as 0 seconds.
Time frame: Week 8
Four-tests Balance: Feet Together Stand
Four timed static balance tasks of increasing difficulty are completed without assistive devices: 1) feet together stand for up to 10 seconds; 2) semi-tandem stand (heel of one foot placed to the side of the big toe of the other foot) for up to 10 seconds; 3) tandem stand (one foot in front of the other, heel touching toe) for up to 10 seconds; and 4) one leg stand for up to 30 seconds. Time for each test is recorded in seconds. If the participant cannot achieve a task, this is recorded as 0 seconds.
Time frame: Month 6
Four-tests Balance: Semi-tandem Stand
Four timed static balance tasks of increasing difficulty are completed without assistive devices: 1) feet together stand for up to 10 seconds; 2) semi-tandem stand (heel of one foot placed to the side of the big toe of the other foot) for up to 10 seconds; 3) tandem stand (one foot in front of the other, heel touching toe) for up to 10 seconds; and 4) one leg stand for up to 30 seconds. Time for each test is recorded in seconds. If the participant cannot achieve a task, this is recorded as 0 seconds.
Time frame: Baseline
Four-tests Balance: Semi-tandem Stand
Four timed static balance tasks of increasing difficulty are completed without assistive devices: 1) feet together stand for up to 10 seconds; 2) semi-tandem stand (heel of one foot placed to the side of the big toe of the other foot) for up to 10 seconds; 3) tandem stand (one foot in front of the other, heel touching toe) for up to 10 seconds; and 4) one leg stand for up to 30 seconds. Time for each test is recorded in seconds. If the participant cannot achieve a task, this is recorded as 0 seconds.
Time frame: Week 8
Four-tests Balance: Semi-tandem Stand
Four timed static balance tasks of increasing difficulty are completed without assistive devices: 1) feet together stand for up to 10 seconds; 2) semi-tandem stand (heel of one foot placed to the side of the big toe of the other foot) for up to 10 seconds; 3) tandem stand (one foot in front of the other, heel touching toe) for up to 10 seconds; and 4) one leg stand for up to 30 seconds. Time for each test is recorded in seconds. If the participant cannot achieve a task, this is recorded as 0 seconds.
Time frame: Month 6
Four-tests Balance: Tandem Stand
Four timed static balance tasks of increasing difficulty are completed without assistive devices: 1) feet together stand for up to 10 seconds; 2) semi-tandem stand (heel of one foot placed to the side of the big toe of the other foot) for up to 10 seconds; 3) tandem stand (one foot in front of the other, heel touching toe) for up to 10 seconds; and 4) one leg stand for up to 30 seconds. Time for each test is recorded in seconds. If the participant cannot achieve a task, this is recorded as 0 seconds.
Time frame: Baseline
Four-tests Balance: Tandem Stand
Four timed static balance tasks of increasing difficulty are completed without assistive devices: 1) feet together stand for up to 10 seconds; 2) semi-tandem stand (heel of one foot placed to the side of the big toe of the other foot) for up to 10 seconds; 3) tandem stand (one foot in front of the other, heel touching toe) for up to 10 seconds; and 4) one leg stand for up to 30 seconds. Time for each test is recorded in seconds. If the participant cannot achieve a task, this is recorded as 0 seconds.
Time frame: Week 8
Four-tests Balance: Tandem Stand
Four timed static balance tasks of increasing difficulty are completed without assistive devices: 1) feet together stand for up to 10 seconds; 2) semi-tandem stand (heel of one foot placed to the side of the big toe of the other foot) for up to 10 seconds; 3) tandem stand (one foot in front of the other, heel touching toe) for up to 10 seconds; and 4) one leg stand for up to 30 seconds. Time for each test is recorded in seconds. If the participant cannot achieve a task, this is recorded as 0 seconds.
Time frame: Month 6
Four-tests Balance: One Leg Stand
Four timed static balance tasks of increasing difficulty are completed without assistive devices: 1) feet together stand for up to 10 seconds; 2) semi-tandem stand (heel of one foot placed to the side of the big toe of the other foot) for up to 10 seconds; 3) tandem stand (one foot in front of the other, heel touching toe) for up to 10 seconds; and 4) one leg stand for up to 30 seconds. Time for each test is recorded in seconds. If the participant cannot achieve a task, this is recorded as 0 seconds.
Time frame: Baseline
Four-tests Balance: One Leg Stand
Four timed static balance tasks of increasing difficulty are completed without assistive devices: 1) feet together stand for up to 10 seconds; 2) semi-tandem stand (heel of one foot placed to the side of the big toe of the other foot) for up to 10 seconds; 3) tandem stand (one foot in front of the other, heel touching toe) for up to 10 seconds; and 4) one leg stand for up to 30 seconds. Time for each test is recorded in seconds. If the participant cannot achieve a task, this is recorded as 0 seconds.
Time frame: Week 8
Four-tests Balance: One Leg Stand
Four timed static balance tasks of increasing difficulty are completed without assistive devices: 1) feet together stand for up to 10 seconds; 2) semi-tandem stand (heel of one foot placed to the side of the big toe of the other foot) for up to 10 seconds; 3) tandem stand (one foot in front of the other, heel touching toe) for up to 10 seconds; and 4) one leg stand for up to 30 seconds. Time for each test is recorded in seconds. If the participant cannot achieve a task, this is recorded as 0 seconds.
Time frame: Month 6
Hand Grip Dynamometry Right Hand
Participant squeezes hand dynamometer with maximum strength, and force is recorded in kgs.
Time frame: Week 8
Hand Grip Dynamometry Right Hand
Participant squeezes hand dynamometer with maximum strength, and force is recorded in kgs.
Time frame: Month 6
Hand Grip Dynamometry Left Hand
Participant squeezes hand dynamometer with maximum strength, and force is recorded in kgs.
Time frame: Baseline
Hand Grip Dynamometry Left Hand
Participant squeezes hand dynamometer with maximum strength, and force is recorded in kgs.
Time frame: Week 8
Hand Grip Dynamometry Left Hand
Participant squeezes hand dynamometer with maximum strength, and force is recorded in kgs.
Time frame: Month 6
30-second Chair Stand Test
Participant rises from chair to full standing position and sits back down as quickly as possible for 30 seconds. Number of completed sit to stand to sit maneuvers is recorded.
Time frame: Week 8
30-second Chair Stand Test
Participant rises from chair to full standing position and sits back down as quickly as possible for 30 seconds. Number of completed sit to stand to sit maneuvers is recorded.
Time frame: Month 6
Timed Up and Go Test
Participant stands up from chair, walks 3 meters, turns around, walks back to chair, and sits down. Time to complete task is recorded in seconds.
Time frame: Week 8
Timed Up and Go Test
Participant stands up from chair, walks 3 meters, turns around, walks back to chair, and sits down. Time to complete task is recorded in seconds.
Time frame: Month 6
Stair Climb Test
Participant ascends and descends 3 stairs as quickly as possible in a safe manner, using handrail and walking aid if needed. Time to complete task is recorded in seconds.
Time frame: Week 8
Stair Climb Test
Participant ascends and descends 3 stairs as quickly as possible in a safe manner, using handrail and walking aid if needed. Time to complete task is recorded in seconds.
Time frame: Month 6
Western Ontario and McMaster Universities Osteoarthritis Index
This questionnaire include 5 questions about knee or hip pain, 2 questions about knee or hip stiffness, and 17 questions about difficulty with performing daily activities that involve the lower body. Each item is scored from 0-4 (none, slight, moderate, severe, and extreme). A total score is calculated by summing the item scores and ranges from 0 (no problems) to 96 (extreme problems).
Time frame: Week 8
Western Ontario and McMaster Universities Osteoarthritis Index
This questionnaire include 5 questions about knee or hip pain, 2 questions about knee or hip stiffness, and 17 questions about difficulty with performing daily activities that involve the lower body. Each item is scored from 0-4 (none, slight, moderate, severe, and extreme). A total score is calculated by summing the item scores and ranges from 0 (no problems) to 96 (extreme problems).
Time frame: Month 6
Activities-specific Balance Confidence Scale
Participant reports level of confidence in doing an activity without losing balance or becoming unsteady on a scale of 0-100%. The ratings are totaled and divided by 16 (the number of items) to calculate a total score.
Time frame: Week 8
Activities-specific Balance Confidence Scale
Participant reports level of confidence in doing an activity without losing balance or becoming unsteady on a scale of 0-100%. The ratings are totaled and divided by 16 (the number of items) to calculate a total score.
Time frame: Month 6
Rapid Assessment of Physical Activity: Aerobic Score
Participants are asked to identify from a list of 7 items which one accurately describes their current level of aerobic physical activity. Participants who identify with items 6 or 7 are considered active. Those who identify with items 1-5 are considered to have suboptimal aerobic physical activity levels. Sedentary: 1. I rarely or never do any physical activities. Under-active: 2. I do some light or moderate physical activities, but not every week. Under-active regular - light activities: 3. I do some light physical activity every week. Under-active regular: 4. I do moderate physical activities every week, but less than 30 minutes a day or 5 days a week. 5. I do vigorous physical activities every week, but less than 20 minutes a day or 3 days a week. Active: 6. I do 30 minutes or more a day of moderate physical activities, 5 or more days a week. 7. I do 20 minutes or more a day of vigorous physical activities, 3 or more days a week.
Time frame: Week 8
Rapid Assessment of Physical Activity: Aerobic Score
Participants are asked to identify from a list of 7 items which one accurately describes their current level of aerobic physical activity. Participants who identify with items 6 or 7 are considered active. Those who identify with items 1-5 are considered to have suboptimal aerobic physical activity levels. Sedentary: 1. I rarely or never do any physical activities. Under-active: 2. I do some light or moderate physical activities, but not every week. Under-active regular - light activities: 3. I do some light physical activity every week. Under-active regular: 4. I do moderate physical activities every week, but less than 30 minutes a day or 5 days a week. 5. I do vigorous physical activities every week, but less than 20 minutes a day or 3 days a week. Active: 6. I do 30 minutes or more a day of moderate physical activities, 5 or more days a week. 7. I do 20 minutes or more a day of vigorous physical activities, 3 or more days a week.
Time frame: Month 6
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