Stand Tall-A Virtual Translation of the Otago Exercise Program

Background and Purpose: The Otago Exercise Program (OEP) is effective at preventing falls and fall-related injuries. The resources and personnel required for program delivery and challenges inherent in monitoring participant adherence and compliance pose significant barriers to increasing the number of older adults participating in the OEP. Alternative delivery systems using virtual platforms may pose a solution. The purposes of this article were to (1) describe the "Stand Tall" intervention, a virtual translation of the OEP; (2) describe Stand Tall participant characteristics and fall-related risk at baseline; and (3) identify changes in physical performance measures associated with fall risk from baseline to 8-week follow-up. Methods: This was a quasi-experimental, single-group, pretest-posttest design. Forty-two older adults at risk for falls were recruited. Participants were oriented to Stand Tall by study personnel and then monitored and progressed virtually with face to face check-ins. Participants independently logged in and completed a prescribed a set of exercises 3 times a week for 30 minutes for a total of 8 weeks. Results and Discussion: The average participant age was 75.0 (9.1) years and self-reported 2.3 (1.7) chronic conditions. There were more men than women (52.4%) in the study. Participants were primarily non-Hispanic white (90.5%), had a college education (61.9), 40% reported falling in the past 6 months, and 60% screened positive for mild cognitive impairment. Participants were beginning to show decline in function with average single-leg stance less than 10 seconds and 30-second chair rise scores below normative values. Participants demonstrated high adherence rates (>88%) and significant improvements in physical performance measures associated with fall risk. These results may be limited to a less frail population and the study was not powered to demonstrate a reduction in falls. Conclusions: Results support that an avatar-delivered version of the OEP is effective, feasible, viable, and enjoyable for community-dwelling older adults. These types of platforms should be considered as potential mechanisms to increase availability of fall prevention programs.