Efficacy of the Otago exercise programme as a supplementary intervention to exercise classes: On falls, balance, physical function and mobility in a patient with chronic lower back pain: A case report.

Bashir Kaka,Melisha Rabilal,Sonill S Maharaj

doi:10.3329/bjms.v19i2.45020

Abstract

In the elderly, physical activity is essential in maintaining good health. In a resource constrained environment, where supervised exercise classes are conducted once a week, a suitable home exercise programme can provide the recommended weekly level of physical activity needed. The Otago Exercise Programme(OEP) is effective in the prevention of falls and increasing strength in the older adult. The efficacy of the OEP as a supplementary intervention to exercise classes; on falls, balance and health enhancing physical activity in the older adult with chronic lower back pain (CLBP) has not been reported. Mr X regularly attends the weekly land-based and aquatic exercise programme at a tertiary hospital in the public sector in Kwa Zulu-Natal. He demonstrated willingness to follow the OEP as prescribed by the Otago exercise manual as a home exercise programme and continued with other leisure, walking and activities of daily living. Post the exercise programme Mr X showed remarkable improvement in the chair to stand test, four-test balance scale and health enhanced physical activity. The OEP is effective and can be used as a supplemental programme to regular supervised exercise classes. The OEP can be beneficial for elderly patients with weakness and chronic lower back pain. Bangladesh Journal of Medical Science Vol.19(2) 2020 p.339-342

Highlights

Patients with lower back pain have been observed to have changes in lumbosacral proprioceptive alertness[1], dysfunction in trunk muscle control, altered postural balance with a potential to falling[2]
Pain could be a confounding factor for variability in postural tasks and may induce a loss of normal variability of the postural strategy in patients with chronic lower back pain (CLBP). This decrease in variability of postural strategy could create further back pathology leading to postural imbalance, decreased physical function and activities of daily living[4,5].Pain aggravates coordination of posture leading to impaired balance and increasing the risk for falling[6]
This arises as patients with chronic low back pain have variable effects on postural activation of superficial abdominal muscles and consistent effect on postural activation of the deepest abdominal muscle which could lead to muscle imbalance and poor activities of daily living[7]

Summary

Introduction

Patients with lower back pain have been observed to have changes in lumbosacral proprioceptive alertness[1], dysfunction in trunk muscle control, altered postural balance with a potential to falling[2]. Pain could be a confounding factor for variability in postural tasks and may induce a loss of normal variability of the postural strategy in patients with chronic lower back pain (CLBP) This decrease in variability of postural strategy could create further back pathology leading to postural imbalance, decreased physical function and activities of daily living[4,5].Pain aggravates coordination of posture leading to impaired balance and increasing the risk for falling[6]. This arises as patients with chronic low back pain have variable effects on postural activation of superficial abdominal muscles and consistent effect on postural activation of the deepest abdominal muscle which could lead to muscle imbalance and poor activities of daily living[7]. Falls associated with low back pain generally relate to instability of the spine leading to altered

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Conclusion