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This study focuses on improving balance in elderly individuals (aged 60-80 years) who may experience dizziness or instability while walking or performing daily activities. Poor balance increases the risk of falls, which can lead to serious injuries and loss of independence.
The study compares two types of exercise programs:
One group performs combined cervical (neck) exercises + eye (oculomotor) exercises + Otago balance exercises The other group performs eye (oculomotor) exercises + Otago balance exercises only These exercises are done 3 times per week for 6 weeks, with each session lasting 30-45 minutes.
The goal is to determine whether combining neck and eye exercises improves balance more effectively than eye exercises alone.
This research may help:
Reduce fall risk in elderly people Improve mobility and independence Provide better rehabilitation programs for physiotherapists
Falls are a major health concern among older adults, frequently leading to serious injuries , and diminished participation in daily activities, which negatively affect overall quality of life. Therefore, designing effective, accessible, and evidence-based strategies to improve balance and prevent falls is essential for promoting healthy aging.because it introduces a novel approach that combines cervical proprioceptive exercises and oculomotor exercises alongside the Otago exercise program. While previous research has demonstrated that both cervical and oculomotor exercises independently enhance balance and reduce fall risk, their combined effects, particularly when integrated into a structured balance program like Otago, remain largely unexplored. By addressing this gap, the present study offers an innovative strategy that targets multiple systems involved in maintaining postural control., the combined intervention is designed to be practical, cost-effective, and easily implemented in various settings, including clinics, community centers, and at home., the study has the potential to guide physiotherapists and rehabilitation professionals toward adopting more holistic balance training protocols. Ultimately, the findings may contribute to reducing fall rates, promoting independence, and enhancing the overall quality of life in the elderly population.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| occulomotor exercises with otago exercises group B | Active Comparator | Frequency: 3 sessions/week | Duration: 30-45 min * Week 1-2: Eye exercises 10-12 reps, VOR x1 (30-40 sec), basic balance training, walking 5-12 min * Week 3-4: Eye exercises 12-15 reps, VOR x1→x2 (1 min), moderate balance training, walking 12-15 min * Week 5-6: Eye exercises 15-20 reps, VOR x1+x2 (1-2 min), advanced balance training, walking 15-20 min |
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| Group A (Cervical + Oculomotor + Otago) | Experimental |
Cervical ROM 10-12 reps, chin tuck 5-7 sec ×10, isometrics 5-6 sec ×5-6, eye exercises 10-12 reps, VOR x1 (30-40 sec), walking 5-12 min * Week 3-4: Cervical ROM 12-15 reps, chin tuck 8-10 sec ×12, isometrics 7-8 sec ×8-10, eye exercises 12-15 reps, VOR x1→x2 (1 min), walking 12-15 min * Week 5-6: Cervical ROM 15-20 reps, chin tuck 10-12 sec ×15, isometrics 10 sec ×10-12, eye exercises 15-20 reps, VOR x1+x2 (1-2 min), walking 15-20 min |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| occulomotor with otago exercises | Procedure | Smooth pursuit exercises, where the eyes follow a moving target horizontally, vertically, and diagonally while keeping the head still. Saccadic eye movements, involving quick shifts of gaze between two stationary targets. Gaze stability (VOR x1 and VOR x2) exercises, involving head movements while maintaining focus on a target, and moving the head and target in opposite directions. All participants will perform the Otago exercise program, a well-established, evidence-based fall prevention program focusing on lower limb strengthening and dynamic balance. It includes:
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| Measure | Description | Time Frame |
|---|---|---|
| Dynamic Balance | Berg Balance Scale (BBS) was used Cut-off Values Greater than 45 → Increased risk of falls 21-40 → Moderate balance impairment Outcome Interpretation Higher score = Better balance | 6 weeks |
| Functional Mobility | The Timed Up and Go Test (TUG) was used Cut-off Values: less than 10 seconds → Normal mobility 10-19 seconds → Good mobility 20-29 seconds → Mild impairment
Interpretation: Lower time indicates better performance | 6 weeks |
| Dynamic Balance | Four Square Step Test was used to evaluate dynamic balance Cut-off Values: < 15 seconds → Normal performance > 15 seconds → Increased risk of falls Interpretation: Lower time indicates better balance | 6 weeks |
| Dizziness related disability | 4. Dizziness Handicap was used Cut-off Values: 0-30 → Mild handicap (used in inclusion criteria) 31-60 → Moderate handicap 61-100 → Severe handicap Interpretation: Higher score indicates greater dizziness-related disability | 6 weeks |
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Inclusion Criteria:
Exclusion Criteria:
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Foundation University College of Physical Therapy | Islamabad | 44000 | Pakistan |
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| ID | Term |
|---|---|
| D004244 | Dizziness |
| ID | Term |
|---|---|
| D012678 | Sensation Disorders |
| D009461 | Neurologic Manifestations |
| D012816 | Signs and Symptoms |
| D013568 | Pathological Conditions, Signs and Symptoms |
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| Combined Cervical and Oculomotor Exercises with Otago Exercises | Procedure | Cervical range of motion exercises in flexion, extension, rotation, and side bending (gentle, controlled movements). Chin tuck exercises in supine or sitting positions to activate deep cervical flexors. Isometric neck strengthening exercises (flexion, extension, lateral flexion), focusing on controlled, static holds. Occulomotor Exercises: Smooth pursuit exercises, where the eyes follow a moving target horizontally, vertically, and diagonally while keeping the head still. Saccadic eye movements, involving quick shifts of gaze between two stationary targets. Gaze stability (VOR x1 and VOR x2) exercises, involving head movements while maintaining focus on a target, and moving the head in opposite direction Otago exercises Strengthening exercises (e.g., knee extensions, hip abduction, calf raises). Static and dynamic balance exercises (e.g., tandem stance, backward walking, sit-to-stand without using hands). A progressive walking plan to improve endurance and confidence during ambulation. |
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