Efficacy of the Otago Exercise Program Delivered as Group Training Versus Individually Tailored Training

NCT ID: NCT03320668

Last Updated: 2022-08-03

Basic Information

• Recruitment Status: COMPLETED
• Clinical Phase: NA
• Total Enrollment: 878 participants
• Study Classification: INTERVENTIONAL
• Study Start Date: 2017-01-10
• Study Completion Date: 2022-02-28

Brief Summary

A non-inferiority controlled clinical trial using randomization for allocation at the level of general practice in 21 centers (in 8 Spanish regions), to compare a group Otago exercise program (OEP) [delivered by specifically trained instructors and supplemented by prescriptive recommendations for home exercising], with an individual OEP [also delivered by specifically trained professionals and supplemented by prescriptive recommendations for home exercising], with twelve months follow-up to determine the effectiveness of the OEP in terms of prevention of falls in a community-dwelling 65- to 80-year-old population.

Detailed Description

OBJECTIVES:

To compare the effectiveness of the Otago Exercise Program (OEP) delivered as group training versus individually tailored training in community-dwelling adults between 65 and 80 years old, on the probability of falls, improved functional balance and muscle strength and, quality of walk in the 12 months follow up.

To compare the effectiveness of both interventions to improve dynamic and static balance and gait quality in the same population.

DESIGN:

Non-inferiority clinical trial, multicentric, simple blind (blind analysis to prevent bias), with two interventions, implementation of group and individual OEP with random assign. The follow-up period will be twelve months after the OEP training.

FIELD OF STUDY:

21 Primary Health Centers (PHC) belonging to the National Health System in 8 different regions: Andalucía, Asturias, Islas Baleares, Canarias, Cataluña, Comunidad de Madrid, Región de Murcia and País Vasco

PARTICIPANTS:

Subjects who belong to primary care centers in the same health area, 65 to 80 years of age, who are not institutionalized, independent for walk (the score of the first part of the Short Physical Performance Battery scale (SPPB scale) in relation to balancing must be different from zero in any assessed position) and provide informed consent to participate in the study.

VARIABLES OF STUDY:

Principal Outcome: Percentage of falls (percentage of subjects falling)

Other Outcomes:

Safety of Intervention; Feasibility of interventions; Feasibility of the cascade training model based on the OEP; Economic analysis and added therapeutic value of both interventions.

DATA COLLECTION:

Subjects will be selected from the health centers through active recruitment by the health professionals.

The recruitment will be consecutive among the patients in the agenda in the days between 10 to 19 of each month from September 2017-December 2018.

Data will be collected at month 0, 6 and 12. Randomization will be performed by PHC and by subjects.

DATA ANALYSIS:

A descriptive analysis of sociodemographic and fall variables will be performed. The analysis to the comparative data between the two groups of the Randomize Clinical Trial will be done by protocol. In addition, an analysis will be made for the incidence density of falls, using Poisson regression models. For all a confidence level of 95% will be assumed, and the statistical software to be used to carry out the analysis will be Statistical Package for the Social Sciences version 22 (SPSS v22).

Conditions

Age Problem

Study Design

• Allocation Method: RANDOMIZED
• Intervention Model: PARALLEL
• Primary Study Purpose: PREVENTION
• Blinding Strategy: SINGLE

Study Groups

Individual OEP

Randomized subjects (65 to 80-year-old) receiving individual Otago Exercise Program (OEP) training in a total of nine Primary Care Centers.

An "OEP leader" trained nurse/physiotherapist will perform in its community consult individual education to each participant in five sessions: In the 1st, 2nd, 4th and 8th week and one reinforcement session after six months. A telephone call to each participant (following a predefined telephonic interview protocol) will be carried out in the months without training session to perform the follow-up.

Group Type: NO_INTERVENTION

No interventions assigned to this group

Group OEP

65-80 year-old randomized subjects receiving group Otago Exercise Program (OEP) training in a total of nine Primary Care Centers.

Group Type: EXPERIMENTAL

Otago Exercise Program (OEP)

Intervention Type: OTHER

A nurse/physiotherapist supported by an "instructor"-trained professional will give Otago Exercise Program (OEP) education to 10-people groups in 5 sessions (1st, 2nd, 4th and 8th week and one reinforcement session after 6 months). Telephone calls to participants will be made during non-training months (following a predefined telephonic interview protocol) to follow up. The OEP reduces the number of falls and fall-related injuries, improving balance and strength, confidence in performing everyday activities without falling. Whilst it has been shown to be effective in 4 controlled trials in New Zealand, it has not been tested in a primary care setting in Spain for feasibility, impact, acceptability and cost-effectiveness.

Interventions

Otago Exercise Program (OEP)

A nurse/physiotherapist supported by an "instructor"-trained professional will give Otago Exercise Program (OEP) education to 10-people groups in 5 sessions (1st, 2nd, 4th and 8th week and one reinforcement session after 6 months). Telephone calls to participants will be made during non-training months (following a predefined telephonic interview protocol) to follow up. The OEP reduces the number of falls and fall-related injuries, improving balance and strength, confidence in performing everyday activities without falling. Whilst it has been shown to be effective in 4 controlled trials in New Zealand, it has not been tested in a primary care setting in Spain for feasibility, impact, acceptability and cost-effectiveness.

Intervention Type: OTHER

Other Intervention Names

Usual Practice

Eligibility Criteria

Inclusion Criteria

• Subjects who belong (ascribed) to primary healthcare centers of the same health area, aged 65 to 80 years, non-institutionalized, independents for ambulation (the scores achieved from the first part of SPPB scale in relation of the balance will be different from zero in any position evaluated.) and provide their informed consent for participating in the study.

Exclusion Criteria

• Subject such residential period in the Health Basic Area of the primary health center or it life expectancies has lower 9 months. in the health area of the primary healthcare center.
• Mild and moderate cognitive impairment (according to the diagnosis from medical history).
• Sight-impairment or hearing impairment which prevent to follow the intervention (according to the diagnosis from medical history).
• Absolute contraindication to perform physical exercise (according to the diagnosis from medical history)

• Minimum Eligible Age: 65 Years
• Maximum Eligible Age: 80 Years
• Eligible Sex: ALL
• Accepts Healthy Volunteers: Yes

Sponsors

Fondo de Investigacion Sanitaria

OTHER

Sponsor Role: collaborator

Osakidetza

OTHER

Sponsor Role: collaborator

MurciaSalud

OTHER_GOV

Sponsor Role: collaborator

Instituto de Salud Carlos III

OTHER_GOV

Sponsor Role: lead

Responsible Party

Teresa Moreno Casbas

Unit Director

Responsibility Role: PRINCIPAL_INVESTIGATOR

Principal Investigators

Teresa Moreno-Cascas, Doctor

Role: STUDY_DIRECTOR

Instituto de Salud Carlos III

Locations

Osakidetza

Vitoria-Gasteiz, Araba Kalea, 45, Vitoria-Gasteiz, Spain

Universidad de Córdoba

Córdoba, Av. de Medina Azahara, 5, Spain

Servicio de Salud de Madrid

Madrid, Avenida Abrantes, 55, Spain

Servicio de Salud de Canarias

Las Palmas de Gran Canaria, Avenida Juan Xxiii,17, Spain

Servicio Murciano de Salud

Murcia, Calle Central, 7, Espinardo, Spain

Servei de Salut de Les Illes Balears

Palma de Mallorca, Carrer de La Reina Esclaramunda, 9, Palma, Spain

Institut Català de la Salut (ICS)

Barcelona, Gran Via de Les Corts Catalanes, 587-589, Spain

Institut Català de la Salut

Barcelona, Gran Via de Les Corts Catalanes, 587-589, Spain

Servicio de Salud del Principado de Asturias

Oviedo, Plaza Del Carbayón, Oviedo, Spain

Countries

Spain

References

Albornos-Munoz L, Blanco-Blanco J, Cidoncha-Moreno MA, Abad-Corpa E, Rivera-Alvarez A, Lopez-Pisa RM, Caperos JM; Otago Project Working Group Consortium; Moreno-Casbas MT. Efficacy of the Otago-Exercise-Programme to reduce falls in community-dwelling adults aged 65-80 when delivered as group or individual training: Non-inferiority-clinical-trial. BMC Nurs. 2024 Oct 1;23(1):705. doi: 10.1186/s12912-024-02310-3.

Reference Type: DERIVED

PMID: 39354514 (View on PubMed)

Angeles CM, Laura AM, Consuelo CM, Manuel RR, Eva AC, Covadonga GA; Otago Project Working Group. The effect that the Otago Exercise Programme had on fear of falling in community dwellers aged 65-80 and associated factors. Arch Gerontol Geriatr. 2022 Mar-Apr;99:104620. doi: 10.1016/j.archger.2022.104620. Epub 2022 Jan 4.

Reference Type: DERIVED

PMID: 34999543 (View on PubMed)

Other Identifiers

PI16CIII/00031

Identifier Type: -

Identifier Source: org_study_id