Effect of the Otago Exercises on Postural balance and Fear of falling among Older fallers with knee OA Sumaiyah Mat1, Ng Chin Teck2, Tan Maw Pin1 1Department of Medicine, Faculty of Medicine, University of Malaya, Malaysia, 2Singapore General Hospital, Singapore, Singapore Introduction Methods Tables & Graphs Total elderly fallers enrolled and randomized into MyFAIT, N=229 One in every three adults age 65 and older and almost 50% of those over 80, experience at least one fall each year. Osteoarthritis (OA) has been reported as an important risk factor for falls . However very few studies conduct intervention trial on reducing falls risk among older adults with OA. While Tai Chi and aerobic studies had shown significant positive effect in improving balance and falls risk, none of the previous studies includes falls outcome. Balance; TUG OA determination: X-ray Psychological Vision Initial Assessments OEP Control group, n=33 OEP Intervention group, n=34 Maximal Excursion Directional Control Fear of falling Objective Subjects with OA (followed-up) Intervention: 17 Control: 24 Figure 4: Mean difference changes at 6- month within group Table 2: Mean changes preceding 6-months in both group To evaluate the effect of an individualized home-based exercise program to improve postural balance, falls risk and fear of falling in older fallers with knee osteoarthritis (OA). Group Test Mean difference (95% CI) Sig. Control (n=24) Standing Sway, mCTSIB 0.15 (-0.03-0.32) 0.096 Sway velocity, STS -0.18 (-0.65-0.30) 0.458 Reaction time, LOS -0.03 (-0.1- 0.04) 0.395 End Point, LOS -0.39 (-5.64-4.85) 0.878   Maximal Excursion, LOS -4.35 (-10.55-1.85) 0.160 Directional control, LOS -3.36 (-3.13-12.56) 0.111 Short FES-I score 3.42 (-1.64-8.47) 0.175 Intervention (n=17) -0.33 (-0.79-0.14) 0.161 0.42 (-0.09-0.93) 0.101 -0.15 (-0.29- -0.001) 0.048 3.63 (-1.21-8.46) 0.131 6.88 (0.69-13.06) 0.032 10.13 (2.55-17.70) 0.012 -3.12 (-5.94- -0.30) Figure 2: Flow chart for Otago Exercise Intervention in myFAIT study Results Results from 41 participants (exercise= 17; control= 24) were included. Methods A sub-study of the single blind (assessor) randomized controlled trial study “Malaysian Falls Assessment and Intervention Trial (MyFAIT)”. Selection criteria: Had two history of fallers or one injurious fall in the past 12 months (Faller) Timed Up and Go (TUG) test score>13.5s Diagnosed with radiological knee OA (KL-grade 2-4) Intervention: Otago exercise programme (OEP), 6-months home-based exercise balance & strength retraining program which consists of 17 exercises Assessment: Baseline and after 6 months Outcome measured: Posturagraphy test, Knee Injury and Osteoarthritis outcome score (KOOS) and short FES-I were completed at baseline and 6 months. Falls recurrence (Monthly diary), Table 1: Baseline and after 6months performance score    Baseline  After 6 months* Variable Control Intervention Adj diff† Postural control Standing sway, mCTSIB 1.23 (0.34) 1.64 (0.86) 1.38 (0.49) 1.32 (0.83) 0.206 Sway velocity , STS 3.59 (0.97) 3.53 (1.23) 3.77 (1.26) 3.12 (1.14) 0.107 Reaction time, LOS 0.85 (0.15) 0.91 (0.16) 0.82 (0.13) 0.77 (0.19) 0.251 End Point, LOS 56.83 (11.88) 44.44 (13.86) 56.43 (13.10) 48.06 (11.60) 0.824 Maximal Excursion, LOS 73.39 (14.99) 56.50 (13.61) 69.04 (13.26) 63.38 (11.12) 0.647 Directional control, LOS 64.82 (10.15) 53.38 (11.19) 61.45 (14.14) 63.50 (9.22) 0.044 KOOS score Symptoms 75.85 (18.84) 70.53 (17.95) 80.56 (13.83) 80.35 (18.80) 0.790 Pain 80.25 (17.65) 73.29 (20.12) 79.95 (15.38) 81.18 (22.12) 0.463 Function 79.67 (17.41) 65.07 (24.88) 80.44 (15.77) 75.00 (21.93) 0.751 Sport 57.08 (30.85) 33.82 (29.24) 62.34 (30.21) 44.12 (38.58) 0.616 QoL 53.58 (26.63) 40.90 (27.80) 61.96 (26.10) 55.88 (31.85) 0.951 Short FES-I score 12.42 (5.04) 17.00 (5.55) 15.83 (11.20) 13.88 (4.91) 0.326 Conclusion Home-based strengthening exercise benefited older fallers with OA and gait and balance disorders in improving their directional control. It also helped in reducing fear of falling and improving postural balance. Our study was not powered for falls outcomes. Future research should therefore consider evaluating targeted exercise interventions in fallers with OA and gait and balance disorders in a larger randomized-controlled study. Literature Cited Mat S, Tan MP, Kamaruzzaman SB, Ng CT. Physical therapies for improving balance and reducing falls risk in osteoarthritis of the knee: a systematic review. Age Ageing. 2015; 44(1):16–24. Epub 2014/08/26. doi: 10.1093/ageing/afu112 PMID: 25149678. Arms Mean of days for remaining fall-free Intervention 130 days Control 133 days E-mail: mayasue89@gmail.com Contact information Figure 1 (a) the modified mCTSIB Figure 1 (b) Sit to stand test Figure 3: Kaplan Meier plots showing the probability of remaining fall-free preceding 6-months (180 days)