Efficacy of strengthening or balance exercises in a Falls & Balance Program

Group Allocation Participants will be allocated to either the strengthening group or balance group using block allocation method. The first 2 months (8 weeks) of recruitment period, patients will be allocated to the strengthening group and the subsequent 2 months (8 weeks), patients will be allocated to the balance group. The allocation method will continue until the sample size is reached. Strengthening Group Participants who are allocated to the strengthening group will receive one hour of lower limbs strengthening exercises and 30 minutes of occupational therapy session twice a week for 6 weeks in a group setting up to 6 participants. Participants will receive a home exercise program on discharge. Balance Group Participants who are allocated to the balance group will receive one hour of balance exercises and 30 minutes of the same occupational therapy session as the strengthening group twice a week for 6 weeks in a group setting up to 6 participants. Participants will receive the same home exercise program on discharge. Treatment Intervention Exercises Participants will complete sixty minutes of exercise in each session. The exercises have been prescribed based off the Otago Exercise Program (OEP). This program consists of 23 strength and balance exercises. All participants will complete the same warm up exercises for both Strengthening and Balance group. Then the main exercises will be allocated to the respective groups which include targeting the strength of knee extensors, knee flexors, hip adductors, ankle plantarflexors and the balance exercises including knee bends, walking backwards, walking and turning around, walking sideways, tandem stance, tandem walk and one leg stance. The groups will begin by being prescribed 10 repetitions as per the OEP and progressed by increasing repetitions and/or weights. The intensity of the exercises will be at low intensity between the Rate Perceived Exertion scale 3 and 5. Participants will be given a standard home exercise program on completion of the program. Participants may experience some discomfort after exercising such as delayed onset muscle soreness which is no difference to any exercise intervention. Therapists will monitor participants’ comfort in each session and will modify the dosage of the exercises if required. On completion of the program, participants will receive a home exercise program that they can continue at home. The home exercise program consists of the same exercises that they participated during program. Occupational Therapy Participants in each group will receive the same thirty minutes of occupational education session delivered by an occupational therapist. Education including pacing strategies, falls prevention strategies and relaxation techniques.