Otago Exercise Program in the United States: Comparison of 2 Implementation Models

BackgroundThe Otago Exercise Program (OEP) is an evidence-based fall prevention program delivered by a physical therapist in 6 visits over a year. Despite documented effectiveness, there has been limited adoption of the OEP by physical therapists in the United States. To facilitate dissemination, 2 models have been developed: (1) the US OEP provided by a physical therapist or physical therapist assistant in the home or outpatient setting and (2) the community OEP provided by a non–physical therapist and a physical therapist consultant. It is unknown whether such modifications result in similar outcomes.ObjectiveThe aims of this study were to identify the components of these 2 models, to compare participant characteristics for those components reached by each model, and to examine outcome changes by model and between models.DesignThis was a translational cohort study with physical therapists implementing the US OEP and trained providers implementing the community OEP.MethodsData for physical performance, sociodemographic characteristics, and self-perception of function were collected at baseline and at 8 weeks.ResultsParticipants in the community OEP were significantly younger and reported more falls compared with those in US OEP. Both sites reported significant improvements in most physical and self-reported measures of function, with larger effect sizes reported by the community OEP for the Timed “Up & Go” Test. There was no significant difference in improvements in outcome measures between sites.LimitationsThis was an evaluation of a translational research project with limited control over delivery processes. The sample was 96% white, which may limit application to a more diverse population.ConclusionAlternative, less expensive implementation models of the OEP can achieve results similar to those achieved with traditional methods, especially improvements in Timed “Up & Go” Test scores. The data suggest that the action of doing the exercises may be the essential element of the OEP, providing ...