Otago strength and balance training exercise programme · Otago strength and balance training. exercise ... et al. Effectiveness and economic evaluation ... A home based individually

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Otago strength and balance training

exercise programme

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An information guide for patients

2 | PI16_1285_03 OTAGO Strength Exercises

Why should you undertake this exercise programme?Welcome to the programme. The exercise programme that you will undertake has been designed specifically for you. The benefits of exercise are plentiful. By maintaining your programme, you can improve:

• Balance

• Muscle strength

• General fitness

• General well-being

You need to do the prescribed exercises three times a week. You can divide the exercises up. They do not all have to be done at the same time.

If you have any questions about the exercises, please contact your physiotherapist:

Name

Telephone number

PI16_1285_03 OTAGO Strength Exercises | 3

Walking• Walking is an excellent way to enhance your general fitness

• Try going for a walk on the days between your exercises

• Try to increase the distance you walk and the time you spend walking

• Take advantage of fine weather to go walking

Tips for walking

• Wear comfortable shoes and clothing for walking

• Start with a warm-up marching on the spot for 2 minutes

When you walk

You should make sure:

• Your shoulders are relaxed and the arms gently swing

• You look ahead not down

• With each step the heel lands first, then you push off on the toes

• Finish with a warm-down i.e. marching on the spot for 2 minutes

• Enjoy yourself!


Safety

Never exercise holding on to an object which may move, for example a chair. Always use the side of something stable like a bench or solid table unless otherwise instructed.

If illness stops you from maintaining the exercise programme contact your instructor before starting again.

Contact your doctor if while exercising you experience:

• Dizziness

• Chest pain

• Shortness of breath (you are unable to speak because you are short of breath)

These exercises are designed to grade the ease with which you can carry them out. They need to be a bit of a challenge without risk of further falls. There is an option to do most of these exercises with varying levels of support depending on your balance and confidence.

Level 1 Holding on with 2 hands

Level 2 Holding on with 1 hand

Level 3 No hands/no support

Start by holding on with 2 hands and as you progress, reduce the support to holding on with 1 hand, finger tips or no hands. Your physiotherapist will be able to advise you about the level of support you should try and achieve during the programme.


Hea

d m

ovem

ents

Sta

nd u

p ta

ll an

d lo

ok a

head

Slo

wly

tur

n yo

ur h

ead

as f

ar a

s yo

u ca

n to

the

rig

ht

Slo

wly

tur

n yo

ur h

ead

as f

ar a

s yo

u ca

n to

the

left

Rep

eat

5 tim

es t

o ea

ch s

ide


Nec

k m

ovem

ents

Sta

nd u

p ta

ll an

d lo

ok a

head

Pla

ce o

ne h

and

on y

our

chin

Gui

de y

our

head

str

aigh

t ba

ck

Rep

eat

5 tim

es


Back

ext

ensi

on

Sta

nd u

p ta

ll w

ith y

our

feet

sho

ulde

r-w

idth

apa

rt

Pla

ce y

our

hand

s on

the

sm

all o

f yo

ur b

ack

Gen

tly a

rch

your

bac

k

Rep

eat

5 tim

es


Trun

k m

ovem

ents

Sta

nd u

p ta

ll an

d pl

ace

your

han

ds o

n yo

ur h

ips

Do

not

mov

e yo

ur h

ips

Tur

n as

far

as

you

can

to t

he r

ight

, co

mfo

rtab

ly

Tur

n as

far

as

you

can

to t

he le

ft,

com

fort

ably

Rep

eat

5 tim

es t

o ea

ch s

ide


Ank

le m

ovem

ents

Eith

er s

it or

sta

nd

Poi

nt t

he f

oot

dow

n th

en p

ull t

he f

oot

back

tow

ards

you

Rep

eat

10 t

imes

for

eac

h fo

ot


Getting stronger by using weights

Strengthening your muscles is essential for maintaining healthy bones and muscles necessary for walking and being independent in your daily activities.

You should aim to do the strengthening exercises three times a week with a rest day in between.

Lift the weight slowly through the entire range of movement.

Never hold your breath while lifting. Inhale before lifting, exhale while lifting and inhale again while lowering the weight.

You may feel a bit stiff after you first start to exercise. This is quite normal. It is because you are using muscles which may not be accustomed to the exercise. It is important that you keep exercising. The stiffness will leave as your body becomes more familiar with the exercise.


Fron

t kn

ee s

tren

gthe

ning

exe

rcis

e

You

cou

ld d

o th

is w

hile

you

wat

ch T

V

Str

ap t

he w

eigh

t on

to y

our

ankl

e

Sit

on a

cha

ir w

ith y

our

back

wel

l sup

port

ed

Str

aigh

ten

your

leg

out

Low

er y

our

leg

Rep

eat

......

... t

imes

Str

ap t

he w

eigh

t on

to y

our

othe

r an

kle

Rep

eat

this

exe

rcis

e ...

......

tim

es


Back

kne

e st

reng

then

ing

exer

cise

Str

ap t

he w

eigh

t on

to y

our

ankl

e

Sta

nd u

p ta

ll fa

cing

the

ben

ch w

ith b

oth

hand

s on

the

ben

ch

Ben

d yo

ur k

nee,

brin

ging

you

r fo

ot

tow

ards

you

r bo

ttom

Ret

urn

to t

he s

tart

ing

posi

tion

Rep

eat

......

... t

imes

Str

ap t

he w

eigh

t on

to y

our

othe

r an

kle

Rep

eat

this

exe

rcis

e ...

......

tim

es


Side

hip

str

engt

heni

ng e

xerc

ise

Str

ap t

he w

eigh

t on

to y

our

ankl

e

Sta

nd u

p ta

ll be

side

the

ben

ch

Hol

d on

to t

he b

ench

Kee

p th

e ex

erci

sing

leg

stra

ight

and

the

foo

t st

raig

ht f

orw

ard

Lift

the

leg

out

to t

he s

ide

and

retu

rn

Rep

eat

......

.. tim

es

Str

ap t

he w

eigh

t on

to y

our

othe

r an

kle

Tur

n ar

ound

Rep

eat

this

exe

rcis

e ...

.....

times


Cal

f ra

ises

– h

old

supp

ort

Sta

nd u

p ta

ll fa

cing

the

ben

ch

Hol

d on

and

look

ahe

ad

You

r fe

et s

houl

d be

sho

ulde

r-w

idth

apa

rt

Com

e up

ont

o yo

ur t

oes

Low

er y

our

heel

s to

the

gro

und

Rep

eat

this

exe

rcis

e 20

tim

es


Toe

rais

es –

hol

d su

ppor

t

Sta

nd u

p ta

ll be

side

the

ben

ch

Hol

d on

and

look

ahe

ad

You

r fe

et s

houl

d be

sho

ulde

r-w

idth

apa

rt

Com

e ba

ck o

nto

your

hee

ls, r

aisi

ng t

he

fron

t fo

ot o

ff t

he fl

oor

Low

er y

our

feet

to

the

grou

nd

Rep

eat

this

exe

rcis

e 20

tim

es


Kne

e be

nds

– ho

ld s

uppo

rt

Sta

nd u

p ta

ll fa

cing

the

ben

ch w

ith b

oth

of y

our

hand

s on

the

ben

ch

Pla

ce y

our

feet

sho

ulde

r-w

idth

apa

rt

Squ

at d

own

half

way

, ben

ding

you

r kn

ees

You

r kn

ees

go o

ver

your

toe

s

Whe

n yo

u fe

el y

our

heel

s st

art

to li

ft,

stra

ight

en u

p

Rep

eat

......

... t

imes


Back

war

ds w

alki

ng –

hol

d su

ppor

t

Sta

nd u

p ta

ll an

d ho

ld o

nto

the

benc

h

Wal

k ba

ckw

ards

10

step

s

Tur

n ar

ound

and

hol

d on

with

the

oth

er h

and

Wal

k ba

ckw

ards

10

step

s to

the

beg

inni

ng

Rep

eat

this

exe

rcis

e


Wal

king

and

tur

ning

rou

nd

Wal

k at

you

r re

gula

r pa

ce

Tur

n in

a c

lock

wis

e po

sitio

n

Tur

n in

an

anti-

cloc

kwis

e po

sitio

n

The

exe

rcis

e is

a fi

gure

of

eigh

t m

ovem

ent

Rep

eat

this

mov

emen

t


Side

way

s w

alki

ng

Sta

nd u

p ta

ll an

d pl

ace

your

han

ds o

n yo

ur h

ips

Tak

e 10

sid

e st

eps

to t

he r

ight

Tak

e 10

ste

ps t

o th

e le

ft

Rep

eat


Hee

l toe

sta

ndin

g –

hold

sup

port

Sta

nd u

p ta

ll be

side

the

ben

ch

Hol

d on

to t

he b

ench

and

look

ahe

ad

Pla

ce o

ne f

oot

dire

ctly

in f

ront

of

the

othe

r

so y

our

feet

for

m a

str

aigh

t lin

e

Hol

d th

is p

ositi

on f

or 1

0 se

cond

s

Cha

nge

posi

tion

and

plac

e th

e fo

ot b

ehin

d,

dire

ctly

in f

ront

Hol

d th

is p

ositi

on f

or 1

0 se

cond

s


Hee

l toe

wal

king

– h

old

supp

ort

Sta

nd u

p ta

ll be

side

the

ben

ch

Hol

d on

to t

he b

ench

and

look

ahe

ad

Pla

ce o

ne f

oot

dire

ctly

in f

ront

of

the

othe

r

so y

our

feet

for

m a

str

aigh

t lin

e

Pla

ce t

he f

oot

behi

nd d

irect

ly in

fro

nt

Rep

eat

for

10 m

ore

step

s

Tur

n ar

ound

Rep

eat

the

exer

cise


One

leg

stan

d –

hold

sup

port

Sta

nd u

p ta

ll be

side

the

ben

ch

Hol

d on

to t

he b

ench

and

look

ahe

ad

Sta

nd o

n on

e le

g

Try

to

hold

thi

s po

sitio

n fo

r 10

sec

onds

Sta

nd o

n th

e ot

her

leg

Try

to

hold

thi

s po

sitio

n fo

r 10

sec

onds


Hee

l wal

king

– h

old

supp

ort

Sta

nd u

p ta

ll be

side

the

ben

ch

Hol

d on

to t

he b

ench

and

look

ahe

ad

Com

e ba

ck o

nto

the

heel

s, r

aisi

ng t

he f

ront

fo

ot o

ff t

he fl

oor

Wal

k 10

ste

ps o

n yo

ur h

eels

Low

er y

our

feet

to

the

grou

nd a

nd t

urn

arou

nd

Wal

k 10

ste

ps o

n yo

ur h

eels

Rep

eat


Toe

wal

king

– h

old

supp

ort

Sta

nd u

p ta

ll be

side

the

ben

ch

Hol

d on

to t

he b

ench

and

look

ahe

ad

Com

e up

ont

o yo

ur t

oes

Wal

k 10

ste

ps o

n yo

ur t

oes

Low

er y

our

heel

s to

the

gro

und

and

turn

aro

und

Wal

k 10

ste

ps o

n yo

ur t

oes

Rep

eat


Hee

l toe

wal

king

bac

kwar

ds –

hol

d su

ppor

t

Sta

nd u

p ta

ll be

side

the

ben

ch

Hol

d on

to t

he b

ench

and

look

ahe

ad

Pla

ce o

ne f

oot

dire

ctly

beh

ind

the

othe

r fo

ot

Pla

ce t

he f

oot

in f

ront

dire

ctly

beh

ind

Rep

eat

for

10 m

ore

step

s

Tur

n ar

ound

Rep

eat

the

exer

cise


Sit

to s

tand

– t

wo

hand

s

You

cou

ld d

o th

is e

xerc

ise

whi

le y

ou w

atch

TV

Sit

on a

cha

ir w

hich

is n

ot t

oo lo

w

Pla

ce t

he f

eet

behi

nd t

he k

nees

Lea

n fo

rwar

ds o

ver

your

kne

es

Pus

h of

f w

ith b

oth

hand

s to

sta

nd u

p

Rep

eat

......

... t

imes


Stai

r w

alki

ng

Hol

d on

to t

he h

and

-rai

l for

thi

s ex

erci

se

Go

up a

nd d

own

the

stai

rs f

or ..

......

.. st

eps

PI16_1285_03 UHB/PI/1285 (Edition 3) Authors: OTAGO, Ros Grant and Nicola Birch Date: February 2017 Review date: February 2019

PhysiotherapyQueen Elizabeth Hospital Birmingham

Mindelsohn Way, Edgbaston Birmingham B15 2GW

Telephone 0121 371 3466

These exercises were designed by the New Zealand Falls Prevention Group 2001. University of Otago Medical School Dunedin, New Zealand.

Copyright permission has been approved from the authors and publishers of the original OTAGO programme.

References

Robertson MC, et al. Effectiveness and economic evaluation of a nurse delivered home exercise program to prevent falls 1: A randomised controlled trial. British medical Journal 2001, Vol 322. P697-700.

Campbell J, Robertson MC. Otago exercise programme to prevent falls in older adults. A home based individually tailored strength and balance retraining programme. March 2003.

The Trust provides free monthly health talks on a variety of medical conditions and treatments. For more information visit www.uhb.nhs.uk/health-talks.htm or call 0121 371 4957.

Documents

Otago strength and balance training exercise programme · Otago strength and balance training. exercise ... et al. Effectiveness and economic evaluation ... A home based individually