The effectiveness of a group-based Otago exercise program on physical function, frailty and health status in older nursing home residents: A systematic review and meta-analysis

Objectives: To explore the effects of a group-based Otago exercise program (OEP) on physical function (mobil-ity, balance, lower limb strength), frailty and health status in older nursing home residents to determine the optimal scheme and format. Methods: This systematic review and meta-analysis was conducted to estimate group-based OEP effects. Sub-group analysis was performed to identify the influences of the participant and intervention characteristics on the effects. Results: Twelve studies met the eligibility criteria and were included in this meta-analysis, and the overall quality was relatively high. The results showed that the group-based OEP significantly improved physical function, including mobility [SMD=-0.64, 95% CI (-0.83,-0.45), Z=6.55, p<0.001], balance [MD=4.72, 95% CI (3.54, 5.90), Z=7.84, p<0.001], lower limb strength [SMD=-1.09, 95% CI (-1.40,-0.79), Z=7.01, p<0.001]; frailty [SMD=-0.73, 95% CI (-1.01,-0.45), Z=5.13, p<0.001] and health status [SMD=0.47, 95% CI (0.20, 0.74), Z=3.44, p=0.0006]. Subgroup analysis revealed that 30-minute sessions were more beneficial for improving balance than >30-minute sessions (p=0.0004). The training was coordinated with physiotherapists, who were more skilled at improving mobility than providing health training education (p=0.04). Conclusions: Group-based OEP is helpful for improving physical function, frailty and health status in older nursing home residents. Specifically, 30-minute sessions and coordinating with physiotherapists may be the most appropriate and effective options. (c) 2022 The Authors. Published by Elsevier Inc. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/)

Automated summary

This systematic review and meta-analysis examined the effects of a group-based Otago exercise program on physical function, frailty, and health status in older nursing home residents. The results showed that the program significantly improved physical function, frailty, and health status. Subgroup analysis revealed that 30-minute sessions and coordination with physiotherapists were more beneficial and effective.