Community-based adaptation of the Otago Exercise Programme delivered by Physiotherapy students for older adults at risk of falls

Introduction
Falls among community-dwelling older adults remain a major cause of morbidity and place a substantial burden on individuals and healthcare systems. Evidence-based exercise programmes, such as the Otago Exercise Programme (OEP), are effective in reducing fall risk. However, access to these interventions remains limited in current practice, which reduces engagement and contributes to low adherence among older adults. This project aimed to address access barriers by adapting the delivery of the OEP to better meet community needs.

Method

An intervention plan was developed to improve access to falls prevention for community-dwelling older adults identified as being at moderate or high risk of falling. Existing evidence on modified OEP delivery models and volunteer-supported exercise programmes, such as FITSKILLS, was reviewed to support our work. The adapted model pairs older adults with trained physiotherapy student volunteers residing in the same community, enabling supervised delivery of the OEP. The programme includes strength and balance training sessions three times per week and group-based community walking sessions twice a week over a three-month period.

Results

The modified OEP delivery model, supervised by physiotherapy students, is ready to be offered to older adults who have never engaged in falls prevention programmes. This approach addresses key access-related barriers identified in both current practice and the scientific literature, including lack of family support, transportation difficulties, social isolation, and restrictions in outdoor mobility. Eligible participants were identified and subsequently invited to enrol in the programme. High acceptability suggests strong participant engagement.

Conclusion

Adapting the delivery of a well-established falls prevention programme has the potential to improve access and engagement among community-dwelling older adults facing barriers to participation. Ongoing feasibility evaluation will inform service refinement and scalability, supporting a pragmatic approach to expanding falls prevention services while strengthening links between healthcare education and community-based care.