Fall risk assessment and effectiveness of home based exercise on turning ability, balance and functional mobility among older Malaysian adults aged 50 years and above.

The intervention group will participate in a tailored (individualised) home based balance exercise program. This exercise program is based on The Otago Program, a program shown to be effective in improving general balance in older people with mild to moderate balance dysfunction (Campbell, 1997), but will include additional exercises selected to improve aspects of balance impairment associated with impaired turning performance. Participants in the home based exercise group will be provided with an individualized set of exercises based on assessment findings of areas of impairment. Approximately 1-2 of the 6-8 exercises prescribed will be selected to improve turning ability. The home based exercise program is expected to take 20-30 minutes per session on average, including rests. Participants will be encouraged to continue the exercise program at least four times a week for 16 weeks. The dosage is consistent with recommendations from a meta-analysis of exercise interventions in reducing falls (Sherrington et al., 2008, 2011). At initial session, participant will be received a detailed description of exercise program,exercise booklet and explanation of the purpose of each exercise from the researcher, which will take approximately 60 to 90 minutes. Participants in the exercise intervention will return to the assessment laboratory for three occasions in the 16 week duration (one visit after 3, 6 and 9 weeks) to review the exercise program, modify exercises if required, and motivate the participant to persist with the exercises which will take approximately 45 to 60 minutes per session. Participants will receive 4 phone calls ( 5 to 10 minutes duration per call) over the 16 week period between these laboratory visit from researcher to further encourage participants to continue with the exercise program, and answer questions about the program. Strategies to support adherence in this study include provision of the exercise booklet, review and feedback on performance at the three visits during the 16 week program, encouragement at phone calls between the visits, and having participants complete and return an exercise diary.