74 A Community approach to Otago Exercise: The Singapore Experience

Abstract

Background: Exercise is vital towards combating sarcopenia, frailty and falls risks. Singapore's older adults often gather at senior activity centres (SAC) for group exercises. These exercises are usually seated, low in intensity and non-progressive, posing little challenge and benefit to strength and balance. Method: Aiming to provide evidence-based exercises to these older adults, we implemented a train-the-trainer (TTT) model to upskill community staff and volunteers to conduct the Otago Exercise Programme (OEP). Our physiotherapists conducted four classroom training days using the Later Life Training OEP course as foundation, adding modules on planning, assessment and safety considerations for group exercise. Thereafter, each leader was supplemented with an average of four On-Job-Training (OJT) sessions to provide guidance to screen participants, initiate and progress the OEP exercises suitably and safely. Results: 38 centre staff and volunteers from 13 SAC's, were trained. Among 33 qualified community exercise leaders, 19 successfully conducted exercise classes while others were unable to commit due to various reasons. 174 older adults participated in the Otago exercises, conducted 1-2 times a week across 6 months. Participants' outcomes reported from five of these centres showed an average of 76% attendance rate. 77% of the participants improved or maintained their Short Physical Performance Battery (SPPB) score. Participants reported that their physical function and balance improved after the OEP, enabling them to walk and climb stairs better. The OJT helped to uphold the fidelity of OEP and supported the community exercise leaders in implementing the programme. However, challenges working with centre staffs and volunteers in the community included steep learning gradient, openness to feedback, availability and turnover. Conclusion: Community exercise leadersmay be trained to conduct OEP in a group setting for older adults safely and effectively. However, OJT is essential to guide the leaders in adhering to exercise principles and safe practices.