Effectiveness of Otago exercise programme in reducing fall risk in stroke survivors; A case study

Introduction: Stroke is one of the leading causes of long-term disability worldwide. Depending on the affected region of the brain, a stroke can cause a wide range of functional deficits, with motor impairments being among the most prominent. Evaluating balance and gait abnormalities is crucial as post-stroke survivors often experience significant impairments in balance and gait, leading to a high risk of falls and compromised independence. The Otago exercise programme (OEP) focuses on 3 key components; muscle strengthening, balance training and walking. Therefore, this study aimed to investigate the effectiveness of the OEP on reducing the fall risk in stroke survivors. Case: A 68-year-old male patient with right sided ischemic stroke presented to the clinic with difficulties in standing with eyes closed and narrow base of support, tandem stance with eyes open and closed, single leg stance, turning around and walking on heels and toes. The patient underwent 8 weeks of rehabilitation, attending 45-minute physiotherapy sessions for 3 days per week. The OEP included 5 strengthening exercises, 12 balance exercises and walking programme. The outcome measures were taken on first day, last day of 4 ^th and 8 ^th week. The outcome measures were evaluated using 30 Second Chair Stand Test (CST), Four-Stage Balance Test (FSBT), Timed Up and Go test (TUG) and Dynamic Gait Index (DGI). Post-intervention, 30 Second CST, TUG test and DGI scores were improved by 7 points (pre-15s, post-8s), 7 points (pre-17s, post-10s) and 6 points (pre-13/24, post-19/24), respectively. Patient could perform standing with eyes closed and a narrow base of support, turning around and standing on one foot, and walk on toes, and heels after 8 weeks. Conclusion: This case study concludes that Otago exercises programme can be beneficial and safe for stroke survivors in reducing fall risk and improving balance and gait.