Otago Exercise Programme - Open Book Assessment
Accelerated Physiotherapy Course
Worksheets 1 & 2 – Revised Oct 2010
ANSWERS
Open Book Assessment Worksheet 1
1. Exercise is recommended as a tool for rehabilitation or prevention in which 5 standards
of the National Service Framework for Older People (2001)?
 Page 12 of LLT OEP manual
Standards 3 (Intermediate Care), 5 (Stroke), 6 (Falls), 7 (Mental Health)
and 8 (Promotion of Health and Active Life in Old Age)
2. The Otago Exercise Programme (OEP) is cited as a model of good practice in which
clinical guidelines in England?
 Page 22 LLTOEP manual
NICE guidelines on Falls Prevention (2004) i.e. NICE CG 21
3. Exercise brings about many physical benefits for frailer older adults. Name two physical
benefits of exercise?

Page 16 &/or page 12 of LLT OEP Manual - e.g.
 Heart & circulatory function
 Bone strength
 Muscle condition & function
 Lean body mass
 Joint function
 Ligament pliability
 Tendon elasticity
 Balance, reaction & co-ordination








Coronary heart disease
Blood pressure
Osteoporosis
Fatigue
Falls & Injury
Fat
Balance problems
Joint Stiffness
4. Exercise brings about not only physical benefits but also non-physical benefits for frailer
older adults. Name two other (non physical) benefits of exercise?

page 12 of LLT OEP Manual - e.g.
 Improves mood
 Confidence
 Self image
 Depression
 Stress
5. An inactive lifestyle may lead to or worsen certain medical conditions. Name two of
these conditions?

Page 16 &/or page 12 of LLT OEP Manual - e.g.
Osteoporosis
Non-insulin dependent diabetes
Hypertension (high blood pressure)
Deep vein thrombosis
Colon cancer
Heart disease
Stroke
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6. What percentage of women aged 70 – 74 were not confident of climbing a 30cm step
unaided?

47%
7. In terms of frequency (times per week) of exercise, what is the current ACSM
recommendation for health?
 5
8. What are the three most common sites of fracture found in frailer, older people?
 hip
 wrist
 spine
9. Name two major risk factors for falls?
 Poor muscle strength
 Poor balance
(These are the only two in the manual but if someone puts more than 4 medications,
or Parkinsons disease - or Stroke etc then we cannot really mark them down but
please comment that they should use the info from manual)
10. Name three injuries or complications that can result from falls?
Possible answers:
 Cuts and lacerations
 fractures
 Deep bruises and soft Tissue Injuries
 Dislocations and sprains
 Increase in joint pain (from old injuries)
 Long lie (being unable to get up from the floor even if there is no injury) &
complications from lying on a cold or wet floor
 Post fall syndrome (psychological outcomes such as depression and anxiety)
11. The Variables of Training can be remembered by the aide memoir FITT. What does
each letter stand for?
 Frequency
 Intensity
 Time
 Type
12. When planning exercise programmes, name the five Rs that can be altered in order to
adapt exercise for individuals?
 reps
 rate
 range
 resistance
 rest
13. Describe what is meant by reversibility (when referring to exercise)
 The benefits of exercise discussed earlier will stop as soon as the person
stops regular activity and becomes sedentary again
14. State three considerations relating to a person’s status (e.g. falls history) that need to be
taken into account when adapting OTAGO exercises for the individual?
Possible answers:
Age
Gender
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Health Status
Functional Capacity and Specific limitations
Fear of Falling
Medical/Physiotherapy/Occupational Therapy already underway
Readiness to change and adopt an exercise programme
Individual physical training response to OEP
Individual response to your feedback, you as OEP leader etc
15. How many OEP trials have been published so far and what two settings were used?
 4 - community and general practice
16. What overall percentage reduction in falls was found in these trials?
 35%
17. Was the OEP tested as a stand-alone intervention? (OEP p. 23)

Yes, however it is suggested that it could be used as part of a multi-factorial falls
prevention programme
18. Who was the OEP shown to be most effective for?
 Women over 80, and those with a previous history of falling
19. How many times per week should a participant perform the OEP strength and balance
exercises?
 3
20. In a recent trial by Liu Ambrose et al (2008), what did the OEP improve?
 Cognition or executive function
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Open Book Assessment Worksheet 2
1. List the five OEP exercises that aim to improve muscle strength
Front knee strengthening
Calf raises
Back knee strengthening
Toe raises
Side hip strengthening
2. How many repetitions of each strength exercise are recommended for effectiveness?
 10
3. State all four stages in the LaterLife Training recommended progression of the Calf
Raises Hold exercise?
 BEGIN WITH 1 SET of 5 REPETITIONS AND BUILD TO 10 REPETITIONS
 BUILD TO 2 SETS OF 10 REPETITIONS
 When reducing support progress from 2 hands, to 1 hand, to 1 finger to no
support
 Remember that foot position affects level of challenge; in this exercise feet hip
width is more challenging than feet close together because of the ankle strength
4. An effective warm up contains three types of warm up activity. Name them and for
each, describe its aim
Type= circulation-boosting
Aim= As their name suggests, these activities are needed to raise the core body
temperature
Type= Joint mobilisation
Aim= This type of movement takes a joint or joints through their full natural
range of movement at a controlled and steady speed in order
to promote the release of the joint’s natural ‘oil’, synovial fluid
Type= Stretching
Aim= The final stage of a warm up can incorporate static (non-moving) stretches
that aim to lengthen the previously warmed muscles.
5. Knee bends, one leg stand and walk and turn are three of the twelve OEP balance
exercises. Starting with the easiest, list them in order of difficulty?
 Knee bends
 One leg stand
 walk and turn
6. List five other OEP balance exercises and state how many repetitions and/or
seconds and/or steps are recommended for effectiveness
Possible Exercises:
Knee bends
Toe walking
Heel toe stand
Heel toe walk
One leg stand
Sideways walk
Heel walking
Sit to stand
Backwards walk
Heel toe walk backwards
Walk and turn
Stair walking
Reps/Secs/Steps= 10 for all
7. Give two teaching points associated with the toe walking balance exercise?
Possible teaching points:
Think of keeping the weight over the big and second toe
Stand tall, check posture throughout
Ensure the spine is neutral and the tummy muscles are pulled in
Avoid looking down at the feet
Avoid leaning against the bench or wall
Move steadily and with control
Keep the steps small initially until skills improve
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8. Give three potential problems and three solutions for the back of thigh stretch.
 The Person rounds their back and shoulders as they lean forwards
 Discomfort in back of knee
 Unable to straighten knee
 Too much weight on hands and elbows stick out
 Person places hands on straight leg
 Stretch is felt in calf rather than thigh
 SOLUTIONS: encourage bend from hips, keep back straight and neck long (don’t
look up or down); bend knee of stretching leg a little more initially – more than soft;
make sure person is sitting on front part of chair; proceed gently with stretch and with
caution
9. The OEP recommends that the person walks at least twice a week. What is the total
duration (time) of walking recommended on each day?
 30 mins
10. In the order that they are performed, list the activities of the cool down?
1. CIRCULATION LOWERER
STRETCHES
2. Back of thigh stretch
3. Calf Stretch *
11. Name the muscle targeted in the back of thigh stretch in the cool down?
 hamstrings
12. Six home visits are recommended in the original OEP study design. State when these
are scheduled.
 Week 1
 Week 2
 Week 4
 Week 8
 Month 6
 Month 12
13. LLT have added some warm up and cool down exercises to the original OEP in order to
meet current ACSM safe exercise guidelines. Name two of these exercises?
Possible answers:
CIRCULATION BOOSTER 1
Marching +/- arm swings
STRETCHES
Back of thigh stretch (Hamstrings)*
Calf Stretch (Gastrocnemius)*
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