Abstract
BACKGROUND: With the global elderly population growing, falls are a significant cause of injury-related harm and death, leading to physical, psychological, and economic burdens. Key modifiable risks include poor balance, leg weakness, and fear of falling. While the Otago Exercise Program (OEP) reduces fall risk and core training improves stability, their combined effect is understudied. This study aimed to evaluate the impact of a modified OEP, incorporating core stability exercises, on fall risk, balance (static and dynamic), lower limb strength, and fear of falling in older women. METHODS: This quasi-experimental comparative study involved 30 community-dwelling women aged 65 to 80 years, assigned to 3 groups (n = 10 each): modified OEP (OEP + core training), original OEP, and control. The 8-week intervention included thrice-weekly sessions. Outcome measures included the Timed Up and Go (TUG) test for fall risk, the 4-Stage Balance Test for balance, the 30-Second Sit-to-Stand test for lower limb strength, and the Falls Efficacy Scale-International (FES-I) for fear of falling. Statistical analysis involved analysis of covariance and Bonferroni post hoc tests (α = 0.05). RESULTS: After intervention, significant between-group differences were found across all outcome variables. The modified OEP group showed the most important improvements in fall risk (F(2,26) = 25.7; P < 0.001; η² = 0.497), dynamic and static balance (F = 10.6; P = 0.003; η² = 0.291), lower limb strength (F = 22; P < 0.001; η² = 0.459), and fear of falling (F = 101.4; P < 0.001; η² = 0.796). Bonferroni post hoc tests confirmed that the modified OEP group significantly outperformed both the original OEP and control groups in all measures (P < 0.05), and the original OEP group also showed significant improvements over the control. CONCLUSION: Integrating core stability exercises into the OEP enhances its effectiveness, significantly improving fall risk, balance, lower limb strength, and fear of falling in older women. These findings support the use of integrated exercise programs in fall prevention.