Post on 18-Apr-2018
UHB is a no smoking Trust
Delivering the best in care
Otago strength and balance training
exercise programme
To see all of our current patient information leaflets please visit www.uhb.nhs.uk/patient-information-leaflets.htm
An information guide for patients
2 | PI16_1285_03 OTAGO Strength Exercises
Why should you undertake this exercise programme?Welcome to the programme. The exercise programme that you will undertake has been designed specifically for you. The benefits of exercise are plentiful. By maintaining your programme, you can improve:
• Balance
• Muscle strength
• General fitness
• General well-being
You need to do the prescribed exercises three times a week. You can divide the exercises up. They do not all have to be done at the same time.
If you have any questions about the exercises, please contact your physiotherapist:
Name
Telephone number
PI16_1285_03 OTAGO Strength Exercises | 3
Walking• Walking is an excellent way to enhance your general fitness
• Try going for a walk on the days between your exercises
• Try to increase the distance you walk and the time you spend walking
• Take advantage of fine weather to go walking
Tips for walking
• Wear comfortable shoes and clothing for walking
• Start with a warm-up marching on the spot for 2 minutes
When you walk
You should make sure:
• Your shoulders are relaxed and the arms gently swing
• You look ahead not down
• With each step the heel lands first, then you push off on the toes
• Finish with a warm-down i.e. marching on the spot for 2 minutes
• Enjoy yourself!
4 | PI16_1285_03 OTAGO Strength Exercises
Safety
Never exercise holding on to an object which may move, for example a chair. Always use the side of something stable like a bench or solid table unless otherwise instructed.
If illness stops you from maintaining the exercise programme contact your instructor before starting again.
Contact your doctor if while exercising you experience:
• Dizziness
• Chest pain
• Shortness of breath (you are unable to speak because you are short of breath)
These exercises are designed to grade the ease with which you can carry them out. They need to be a bit of a challenge without risk of further falls. There is an option to do most of these exercises with varying levels of support depending on your balance and confidence.
Level 1 Holding on with 2 hands
Level 2 Holding on with 1 hand
Level 3 No hands/no support
Start by holding on with 2 hands and as you progress, reduce the support to holding on with 1 hand, finger tips or no hands. Your physiotherapist will be able to advise you about the level of support you should try and achieve during the programme.
PI16_1285_03 OTAGO Strength Exercises | 5
Hea
d m
ovem
ents
Sta
nd u
p ta
ll an
d lo
ok a
head
Slo
wly
tur
n yo
ur h
ead
as f
ar a
s yo
u ca
n to
the
rig
ht
Slo
wly
tur
n yo
ur h
ead
as f
ar a
s yo
u ca
n to
the
left
Rep
eat
5 tim
es t
o ea
ch s
ide
6 | PI16_1285_03 OTAGO Strength Exercises
Nec
k m
ovem
ents
Sta
nd u
p ta
ll an
d lo
ok a
head
Pla
ce o
ne h
and
on y
our
chin
Gui
de y
our
head
str
aigh
t ba
ck
Rep
eat
5 tim
es
PI16_1285_03 OTAGO Strength Exercises | 7
Back
ext
ensi
on
Sta
nd u
p ta
ll w
ith y
our
feet
sho
ulde
r-w
idth
apa
rt
Pla
ce y
our
hand
s on
the
sm
all o
f yo
ur b
ack
Gen
tly a
rch
your
bac
k
Rep
eat
5 tim
es
8 | PI16_1285_03 OTAGO Strength Exercises
Trun
k m
ovem
ents
Sta
nd u
p ta
ll an
d pl
ace
your
han
ds o
n yo
ur h
ips
Do
not
mov
e yo
ur h
ips
Tur
n as
far
as
you
can
to t
he r
ight
, co
mfo
rtab
ly
Tur
n as
far
as
you
can
to t
he le
ft,
com
fort
ably
Rep
eat
5 tim
es t
o ea
ch s
ide
PI16_1285_03 OTAGO Strength Exercises | 9
Ank
le m
ovem
ents
Eith
er s
it or
sta
nd
Poi
nt t
he f
oot
dow
n th
en p
ull t
he f
oot
back
tow
ards
you
Rep
eat
10 t
imes
for
eac
h fo
ot
10 | PI16_1285_03 OTAGO Strength Exercises
Getting stronger by using weights
Strengthening your muscles is essential for maintaining healthy bones and muscles necessary for walking and being independent in your daily activities.
You should aim to do the strengthening exercises three times a week with a rest day in between.
Lift the weight slowly through the entire range of movement.
Never hold your breath while lifting. Inhale before lifting, exhale while lifting and inhale again while lowering the weight.
You may feel a bit stiff after you first start to exercise. This is quite normal. It is because you are using muscles which may not be accustomed to the exercise. It is important that you keep exercising. The stiffness will leave as your body becomes more familiar with the exercise.
PI16_1285_03 OTAGO Strength Exercises | 11
Fron
t kn
ee s
tren
gthe
ning
exe
rcis
e
You
cou
ld d
o th
is w
hile
you
wat
ch T
V
Str
ap t
he w
eigh
t on
to y
our
ankl
e
Sit
on a
cha
ir w
ith y
our
back
wel
l sup
port
ed
Str
aigh
ten
your
leg
out
Low
er y
our
leg
Rep
eat
......
... t
imes
Str
ap t
he w
eigh
t on
to y
our
othe
r an
kle
Rep
eat
this
exe
rcis
e ...
......
tim
es
12 | PI16_1285_03 OTAGO Strength Exercises
Back
kne
e st
reng
then
ing
exer
cise
Str
ap t
he w
eigh
t on
to y
our
ankl
e
Sta
nd u
p ta
ll fa
cing
the
ben
ch w
ith b
oth
hand
s on
the
ben
ch
Ben
d yo
ur k
nee,
brin
ging
you
r fo
ot
tow
ards
you
r bo
ttom
Ret
urn
to t
he s
tart
ing
posi
tion
Rep
eat
......
... t
imes
Str
ap t
he w
eigh
t on
to y
our
othe
r an
kle
Rep
eat
this
exe
rcis
e ...
......
tim
es
PI16_1285_03 OTAGO Strength Exercises | 13
Side
hip
str
engt
heni
ng e
xerc
ise
Str
ap t
he w
eigh
t on
to y
our
ankl
e
Sta
nd u
p ta
ll be
side
the
ben
ch
Hol
d on
to t
he b
ench
Kee
p th
e ex
erci
sing
leg
stra
ight
and
the
foo
t st
raig
ht f
orw
ard
Lift
the
leg
out
to t
he s
ide
and
retu
rn
Rep
eat
......
.. tim
es
Str
ap t
he w
eigh
t on
to y
our
othe
r an
kle
Tur
n ar
ound
Rep
eat
this
exe
rcis
e ...
.....
times
14 | PI16_1285_03 OTAGO Strength Exercises
Cal
f ra
ises
– h
old
supp
ort
Sta
nd u
p ta
ll fa
cing
the
ben
ch
Hol
d on
and
look
ahe
ad
You
r fe
et s
houl
d be
sho
ulde
r-w
idth
apa
rt
Com
e up
ont
o yo
ur t
oes
Low
er y
our
heel
s to
the
gro
und
Rep
eat
this
exe
rcis
e 20
tim
es
PI16_1285_03 OTAGO Strength Exercises | 15
Toe
rais
es –
hol
d su
ppor
t
Sta
nd u
p ta
ll be
side
the
ben
ch
Hol
d on
and
look
ahe
ad
You
r fe
et s
houl
d be
sho
ulde
r-w
idth
apa
rt
Com
e ba
ck o
nto
your
hee
ls, r
aisi
ng t
he
fron
t fo
ot o
ff t
he fl
oor
Low
er y
our
feet
to
the
grou
nd
Rep
eat
this
exe
rcis
e 20
tim
es
16 | PI16_1285_03 OTAGO Strength Exercises
Kne
e be
nds
– ho
ld s
uppo
rt
Sta
nd u
p ta
ll fa
cing
the
ben
ch w
ith b
oth
of y
our
hand
s on
the
ben
ch
Pla
ce y
our
feet
sho
ulde
r-w
idth
apa
rt
Squ
at d
own
half
way
, ben
ding
you
r kn
ees
You
r kn
ees
go o
ver
your
toe
s
Whe
n yo
u fe
el y
our
heel
s st
art
to li
ft,
stra
ight
en u
p
Rep
eat
......
... t
imes
PI16_1285_03 OTAGO Strength Exercises | 17
Back
war
ds w
alki
ng –
hol
d su
ppor
t
Sta
nd u
p ta
ll an
d ho
ld o
nto
the
benc
h
Wal
k ba
ckw
ards
10
step
s
Tur
n ar
ound
and
hol
d on
with
the
oth
er h
and
Wal
k ba
ckw
ards
10
step
s to
the
beg
inni
ng
Rep
eat
this
exe
rcis
e
18 | PI16_1285_03 OTAGO Strength Exercises
Wal
king
and
tur
ning
rou
nd
Wal
k at
you
r re
gula
r pa
ce
Tur
n in
a c
lock
wis
e po
sitio
n
Tur
n in
an
anti-
cloc
kwis
e po
sitio
n
The
exe
rcis
e is
a fi
gure
of
eigh
t m
ovem
ent
Rep
eat
this
mov
emen
t
PI16_1285_03 OTAGO Strength Exercises | 19
Side
way
s w
alki
ng
Sta
nd u
p ta
ll an
d pl
ace
your
han
ds o
n yo
ur h
ips
Tak
e 10
sid
e st
eps
to t
he r
ight
Tak
e 10
ste
ps t
o th
e le
ft
Rep
eat
20 | PI16_1285_03 OTAGO Strength Exercises
Hee
l toe
sta
ndin
g –
hold
sup
port
Sta
nd u
p ta
ll be
side
the
ben
ch
Hol
d on
to t
he b
ench
and
look
ahe
ad
Pla
ce o
ne f
oot
dire
ctly
in f
ront
of
the
othe
r
so y
our
feet
for
m a
str
aigh
t lin
e
Hol
d th
is p
ositi
on f
or 1
0 se
cond
s
Cha
nge
posi
tion
and
plac
e th
e fo
ot b
ehin
d,
dire
ctly
in f
ront
Hol
d th
is p
ositi
on f
or 1
0 se
cond
s
PI16_1285_03 OTAGO Strength Exercises | 21
Hee
l toe
wal
king
– h
old
supp
ort
Sta
nd u
p ta
ll be
side
the
ben
ch
Hol
d on
to t
he b
ench
and
look
ahe
ad
Pla
ce o
ne f
oot
dire
ctly
in f
ront
of
the
othe
r
so y
our
feet
for
m a
str
aigh
t lin
e
Pla
ce t
he f
oot
behi
nd d
irect
ly in
fro
nt
Rep
eat
for
10 m
ore
step
s
Tur
n ar
ound
Rep
eat
the
exer
cise
22 | PI16_1285_03 OTAGO Strength Exercises
One
leg
stan
d –
hold
sup
port
Sta
nd u
p ta
ll be
side
the
ben
ch
Hol
d on
to t
he b
ench
and
look
ahe
ad
Sta
nd o
n on
e le
g
Try
to
hold
thi
s po
sitio
n fo
r 10
sec
onds
Sta
nd o
n th
e ot
her
leg
Try
to
hold
thi
s po
sitio
n fo
r 10
sec
onds
PI16_1285_03 OTAGO Strength Exercises | 23
Hee
l wal
king
– h
old
supp
ort
Sta
nd u
p ta
ll be
side
the
ben
ch
Hol
d on
to t
he b
ench
and
look
ahe
ad
Com
e ba
ck o
nto
the
heel
s, r
aisi
ng t
he f
ront
fo
ot o
ff t
he fl
oor
Wal
k 10
ste
ps o
n yo
ur h
eels
Low
er y
our
feet
to
the
grou
nd a
nd t
urn
arou
nd
Wal
k 10
ste
ps o
n yo
ur h
eels
Rep
eat
24 | PI16_1285_03 OTAGO Strength Exercises
Toe
wal
king
– h
old
supp
ort
Sta
nd u
p ta
ll be
side
the
ben
ch
Hol
d on
to t
he b
ench
and
look
ahe
ad
Com
e up
ont
o yo
ur t
oes
Wal
k 10
ste
ps o
n yo
ur t
oes
Low
er y
our
heel
s to
the
gro
und
and
turn
aro
und
Wal
k 10
ste
ps o
n yo
ur t
oes
Rep
eat
PI16_1285_03 OTAGO Strength Exercises | 25
Hee
l toe
wal
king
bac
kwar
ds –
hol
d su
ppor
t
Sta
nd u
p ta
ll be
side
the
ben
ch
Hol
d on
to t
he b
ench
and
look
ahe
ad
Pla
ce o
ne f
oot
dire
ctly
beh
ind
the
othe
r fo
ot
Pla
ce t
he f
oot
in f
ront
dire
ctly
beh
ind
Rep
eat
for
10 m
ore
step
s
Tur
n ar
ound
Rep
eat
the
exer
cise
26 | PI16_1285_03 OTAGO Strength Exercises
Sit
to s
tand
– t
wo
hand
s
You
cou
ld d
o th
is e
xerc
ise
whi
le y
ou w
atch
TV
Sit
on a
cha
ir w
hich
is n
ot t
oo lo
w
Pla
ce t
he f
eet
behi
nd t
he k
nees
Lea
n fo
rwar
ds o
ver
your
kne
es
Pus
h of
f w
ith b
oth
hand
s to
sta
nd u
p
Rep
eat
......
... t
imes
PI16_1285_03 OTAGO Strength Exercises | 27
Stai
r w
alki
ng
Hol
d on
to t
he h
and
-rai
l for
thi
s ex
erci
se
Go
up a
nd d
own
the
stai
rs f
or ..
......
.. st
eps
PI16_1285_03 UHB/PI/1285 (Edition 3) Authors: OTAGO, Ros Grant and Nicola Birch Date: February 2017 Review date: February 2019
PhysiotherapyQueen Elizabeth Hospital Birmingham
Mindelsohn Way, Edgbaston Birmingham B15 2GW
Telephone 0121 371 3466
These exercises were designed by the New Zealand Falls Prevention Group 2001. University of Otago Medical School Dunedin, New Zealand.
Copyright permission has been approved from the authors and publishers of the original OTAGO programme.
References
Robertson MC, et al. Effectiveness and economic evaluation of a nurse delivered home exercise program to prevent falls 1: A randomised controlled trial. British medical Journal 2001, Vol 322. P697-700.
Campbell J, Robertson MC. Otago exercise programme to prevent falls in older adults. A home based individually tailored strength and balance retraining programme. March 2003.
The Trust provides free monthly health talks on a variety of medical conditions and treatments. For more information visit www.uhb.nhs.uk/health-talks.htm or call 0121 371 4957.