The effect of Home-Based Otago Exercises in Maintaining the Mobility and Muscle Strength in older adults with frailty

Effect of Home-Based Otago Exercises in Maintaining the Mobility and Muscle Strength in older adults with frailty Background: The Ex-Servicemen Contributory Health Scheme (ECHS) has been providing healthcare to veterans since 2003. Frailty, a prevalent issue among the elderly, hampers physical function, muscle strength, and mobility. The Otago Exercise Program, known for its efficacy, offers a promising solution for frail individuals. Rationale: Maintaining regular physical activity is vital for elderly independence. Otago exercises, validated and simple, have shown effectiveness in improving mobility and balance. The home-based nature of these exercises makes them practical for elderly veterans in ECHS helping in limited understanding of Frailty in Veterans. Investigating the efficacy of Otago exercises in the veteran population aligns with the goal of developing sustainable and scalable healthcare solutions**.** Aim: This study aims about Effect of home-based Otago exercises on mobility and muscle strength in 60 yrs. and older veterans and their dependents within ECHS (Ex-Servicemen Contributory Health Scheme) Polyclinic. Objectives: (a)To estimate the prevalence of frailty by baseline mobility, muscle strength and frailty score in elderly population.    (b) To see the effect of home-based Otago exercises on mobility, muscle strength after 10 weeks. Methodology: Elderly veterans and their dependents attending ECHS Polyclinic & Base Hospital will be recruitedutilizing exclusion -inclusion criteria and their willingness followed by a Quasi-experimental design for pre and post assessments with Chair based Otago exercises. Sample size   Expecting the prevalence of frailty in an Indian population as 24.9 %, the sample size at 95% confidence levels, and 5% absolute precision was estimated as 288. Considering 10% non-response, the sample size was estimated as 310.  Exclusion and Inclusion criteria applied. Frail subjects planned for Pretest baseline assessments with frailty scores, questionnaire and Timed Up and Go test for mobility and muscle strength. These frail veterans and their dependents will be assessed with Fried Frail criteria, excluding pre-frail and robust individuals. A 10-week home-based Otago exercise intervention will be implemented in these selected frails, with baseline assessments of muscle strength and mobility score with Timed Up and Go Time (TUGT). Proposed exercise programme will be based on home-based Otago chair exercises**.** Planned for thrice follow up and finally will be reassessed for mobility, frailty, and muscle strength to see for any change from baseline assessments after 10 weeks. Ethical considerations include Institutional approval, consent documentation, and participant confidentiality, StationCommander permission to conduct study in ECHSPolyclinic. Expected Outcomes: Prevalence of frailty,its predictors in veterans and their dependents with changes in mobility ,muscle strength and frailty scores with chair based  Otago exercise program planned for 10 weeks. This proposal aims to contribute to the well-being of elderly veterans within ECHS by addressing frailty through evidence-based home exercises, promoting independence and overall health. Anticipated outcomes include validating Otago exercises for mobility maintenance, potential application in diverse settings, and integrating health monitoring. Study can recommend implementing Otago exercise program (OEP) as a part of routine primary service provided for Elderly population Reinforcement. Future plans involve replicating the study across different geriatric cohorts, developing digitalized fall risk protocols, and establishing nomograms for the Indian population. Replication in diverse geriatric cohorts across the country.