Effectiveness of Otago Exercise Programme on Balance and Prevention of Fall in Post-stroke Patients: A Quasi-experimental Study from Assam, India

Introduction: A stroke is the sudden loss of nerve cells caused by a shortage of oxygen due to an arterial rupture or a blockage in blood flow to the brain. Stroke occurs when the blood supply to the brain is interrupted, resulting in an abrupt loss of neurological function. The Otago Exercise Program (OEP), an evidence-based fall-prevention program composed of muscle strengthening, balance training, and walking, was implemented in this study. Aim: To determine the efficacy of OEP on balance and fall prevention in post-stroke patients. Materials and Methods: A quasi-experimental study was conducted at the Pews Group of Institution, Bonda, Guwahati, Assam, India, over the period of six months from March 2019 to August 2019. The study involved 30 post-stroke patients irrespective of the underlying vascular territory, who could walk independently without an assistive device and were classified as grade 4 on the functional ambulation category (able to ambulate independently on level surfaces but requiring supervision to negotiate). Participants had no cardiovascular disease, were at Brunnstrom recovery stage 4 (indicating voluntary movements outside synergy patterns and decreasing spasticity), and had no visual or auditory impairment, limb loss, bone impairment in the past years, or cognitive dysfunction. Patients with visual defects, vestibular dysfunction, hypertension, or an inability to follow commands and concentrate on the experiment were excluded. A two-stage sampling method was used: first stratified sampling, followed by simple random sampling. The intervention was administered for eight weeks, three times per week. The first part of the exercise program consisted of strengthening the muscles in the front and back of the knees, hip abductors, calf muscles, and toe extensors. Outcome measures—including the Berg Balance Scale (BBS), Timed Up and Go Test (TUGT), and Falls Efficacy Scale (FES)—were recorded before and after the exercise program to evaluate balance and fall prevention. Using Statistical Package for the Social Sciences (SPSS) software, statistical analyses were carried out, and results were presented in terms of mean, standard deviation (SD), and p-value. Results: A total of 30 post-stroke patients participated (23 males and 7 females). A paired t-test revealed a statistically significant improvement in all variables with a p-value <0.001. Significant differences were observed in the BBS mean and SD values (−2.400±−1.773), TUGT (1.5833±1.3646), and FES (4.233±2.315). These findings indicate that OEP improved balance ability, enhanced confidence levels, and reduced fear of falling during activities. Conclusion: The OEP helped participants maintain confidence in performing routine activities without fear of falling while also improving muscle strength and balance. The program demonstrated improvements in all three parameters—BBS, TUGT, and FES—indicating a beneficial effect of OEP on poststroke patients.