The effect of group-based Otago exercise program on fear of falling and physical function among older adults living in nursing homes: A pilot trial

Feasibility of a Small Group Otago Exercise Program for Older Adults Living with Dementia

“…In comparison to other studies of group OEP administration [ 19 , 20 , 21 , 22 ], our participants were more cognitively impaired (diagnosis of dementia, mean MMSE of 16), and notably, the most physically impaired (forcing 1:1 supervision for safety) were the most cognitively capable. This contributed to our increased staff requirements.…”

“…The need for four staff members to provide an optimal challenge and engagement of five participants was not sustainable. Maximizing the challenge did not appear to be a priority in recent published studies, which either do not comment on efforts to individualize the intervention [ 21 , 22 ] or allude to progressing the group as a whole [ 23 ]. Chen et al [ 20 ] mention that physiotherapists “guided” participants to modify their exercise level, but the weights used were consistent at 0.5 kg and nurses “led” the intervention, so it is not clear how often physiotherapists may have guided these changes.…”

“…This contributed to our increased staff requirements. Existing studies, without commenting on efforts to maximize engagement and challenge of participants, identify beneficial outcomes of group OEP [ 20 , 21 , 22 , 23 ]. In reconsidering the feasibility of group administration of OEP, clear prioritization of safety over maximizing challenge may decrease the need for staff supervision.…”

“…), and Kovàcs et al delivered the program with two physiotherapists for groups of 2–4 participants [ 19 ]. Recently, a series of studies in nursing home settings has supported the feasibility of group OEP with residents with physical and cognitive frailty [ 20 , 21 , 22 , 23 ]. While the mean MMSE scores of participants represent cognitive impairment (21–22/30) [ 20 , 21 ], a diagnosis of dementia was not in the inclusion criteria of any of these studies.…”

“…While the mean MMSE scores of participants represent cognitive impairment (21–22/30) [ 20 , 21 ], a diagnosis of dementia was not in the inclusion criteria of any of these studies. The strategy for group administration of OEP in two of these studies was to initiate the program in small groups (6 participants to 3 staff [ 21 ] or 4–7 participants to 1 staff [ 22 ]) and after 4 weeks, to combine all small groups into one larger group with 3 staff providing oversight to groups of 18 and 29, respectively. The mechanics of group OEP administration in the other studies (i.e., size of group and number of staff) was not presented [ 20 , 23 ].…”