Effect of Pilates Exercise Program versus Otago Exercise Program to Improve Balance, Strength in Postmenopausal Elderly Women to Study Fear of Fall and Quality of Life: A Research Protocol

Introduction: Elderly individuals with reduced muscle strength and lower-limb mass are more likely to fall. The frequency of age-related health problems, such as falls, is rising as the world’s population ages more rapidly. Since both fallers and non fallers frequently experience fear of falling, this may be linked to falls through shared risk factors. It has been proposed that fear of falling leads to worse balance and diminished functional ability, which in turn leads to activity limitations. These factors are thought to contribute to future falls. Due to the abrupt decrease in oestrogen and the ensuing reductions in skeletal muscle and bone density, postmenopausal women are at heightened risk for osteoporosis and fractures caused by falls. Need of the study: The Otago Exercise Program (OEP) is a tailored, home-based program of strength and balance retraining designed to prevent falls in older people living in the community. As balance disorders and falls are significant issues that may impact the functioning of an ageing population, it is important to determine how Otago may improve balance and strength in postmenopausal women. Falls resulting in fractures among postmenopausal women can seriously hinder quality of life and lead to high morbidity and mortality, as well as increased direct costs for health services. There are many studies on Otago exercise in the elderly regarding balance disorders, but no studies have been found specifically in postmenopausal women addressing balance disorders, strength and quality of life. Pilates has gained popularity recently and seems to be a practical way to improve balance and quality of life while strengthening trunk muscles. However, a direct comparison of these two methodologies for postmenopausal elderly women has not yet been conducted. Therefore, the aim is to determine the effects of the OEP and Pilates on balance, strength and quality of life in postmenopausal women. Aim: To determine the effects of the OEP and Pilates exercise, in addition to conventional exercise, on improving strength, balance and quality of life in postmenopausal elderly women. Materials and Methods: An experimental comparative, twoarm, parallel, open-label, non-blinded study will include 86 postmenopausal women aged 60 years and above. The trial will be conducted for one year from November 2024 to November 2025, meeting specific inclusion criteria. Participants will be recruited from Acharya Vinoba Bhave Rural Hospital and the Community Physiotherapy OPD Wardha, Sawangi, Maharashtra, India. Participants will be randomly assigned to two groups: Group A will receive Pilates exercises with conventional physiotherapy and Group B will undergo the OEP with conventional physiotherapy. Both groups will complete a sixweek intervention. Baseline and post intervention assessments will include the Berg Balance Scale (BBS) for balance, the 30- second Sit-to-Stand test for strength, the Falls Efficacy Scale (FES-1) for fear of falling, and the Older People’s Quality of Life (OPQoL) questionnaire for QoL. The analysis will be conducted using the free version of the R software. Differences in mean outcomes between groups at post intervention will be assessed using either the independent-samples t-test or the Mann– Whitney U test, as appropriate. Within-group comparisons (pre- to post intervention) will be conducted using either the paired t-test or the Wilcoxon signed-rank test, as appropriate. A two-sided p-value of ≤0.05 will be considered statistically significant.