Peninsula Home Care Becomes First in the Region to Offer the Otago Exercise Program to Home Care Patients

Otago; an evidence-based intervention program reduces falls among older adults

SALISBURY, MD – Young or old – everyone has fallen down before. For older adults, it isn’t always easy to get back up and brush it off. They can have serious consequences like a hip fracture or head trauma that can ultimately lead to a trip to the hospital or an early nursing home admission.

While the odds of falling increase with age, research shows that older adults who participate in prevention programs reduce their likelihood of falling.

“Patients are afraid of falling and afraid to tell their health care providers when they have fallen,” said Nancy Bagwell, area director of operations, Peninsula Home Care. “It is our job to be proactive and prevent as many falls as possible.”

Peninsula Home Care is partnering with MAC Incorporated under a grant from the US Administration for Community Living through the Department of Health and Human Services to train physical therapists in an evidence-based fall-prevention program called Otago. The Otago Exercise Program, developed and tested by the New Zealand Falls Prevention Research Group is recognized by the CDC and has been measured to reduce the rate of falls by 35 to 40%.

The rationale behind Otago is that while muscle strength, flexibility, balance and reaction time are risk factors for falls, they can easily be improved. The program includes seventeen different exercises aimed at improving strength and balance for patients.

Sample exercises prescribed three times a week include:

  • Sit to Stand
  • Knee Bends
  • Backwards Walking
  • Toe Walk

The program is broken down into different stages over a one year period. The initial evaluation and exercise prescription is done by a physical therapist followed by five to six visits from a PT over eight weeks to evaluate and individually progress the program. Upon completion, the physical therapist will discharge the patient to a self-management program with optional monthly phone calls and optional PT visits at six, nine and twelve months. Within the self-management program the individual is expected to perform a standard set of balance and strength exercises three times a week independently. A walking program is also assigned to be done three times a week (for up to 30 minutes).

“Peninsula Home Care is our go-to partner,” said Sue Lachenmayr, Programs Director, Living Well Center ofExcellence, MAC Incorporated. “When an individual is homebound, weak and frail, implementing this program in the home, one-on-one, is ideal. We are fortunate to have a home health care agency partner in our community that is dedicated to having its physical therapists trained and certified to implement the Otago program with patients.

Another local player in bringing the Otago Exercise program to the Eastern Shore of Maryland is Dennis Klima, an instructor of physical therapy at UMES. Kilma is familiar with other fall prevention programs but saw the value and measured results of the Otago program and started integrating some of the training techniques into his instruction.

“We have worked for many years with the Stepping On program but this program is geared more towards group settings,” said Klima. “Otago has the evidence and research to back up its success and we want to prepare our young professionals with the best practices possible before they venture out in the field.”


Below is a video by the National Council on Aging, NCOA. The video provides information about fall prevention programs in general. Otago is covered specifically from the 4:03 to 5:20 marks in the video.

The original video can be found here.

About Peninsula Home Care

Providing care for more than 30 years, Peninsula Home Care ensures that all patients are involved in their plan of care and strives to give them every opportunity to maintain their independence in the home. The agency has served more than 42,000 patients on Delmarva and has been named to the “Home Health Care Elite” three times in six years. For more information, visit

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