Effects of Otago Exercise Combined With Short-Foot Exercise in Older Adults

The Otago Exercise Programme is a multicomponent exercise approach targeting strength, balance, and mobility in older adults. Short-foot exercises are designed to improve intrinsic foot muscle activation and medial longitudinal arch control. This randomized comparative study will investigate whether adding short-foot exercises to the Otago Exercise Programme provides additional benefits in older adults.

Inclusion Criteria: * Willing to participate and provide written informed consent. * Aged 65 years or older. * Residing in the nursing home where the study will be conducted for at least 3 months. * Able to understand and follow test instructions, with a Standardized Mini-Mental Test score ≥24. * Able to walk at least 30 meters without physical assistance from another person. * Able to stand with eyes open for at least 30 seconds and safely complete sit-to-stand and balance assessments. * Able to perform the target ankle dorsiflexion and plantar flexion angles without pain or marked restriction of active range of motion. * Navicular Drop Test result between 6 and 9 mm. Exclusion Criteria: * History of neurological or neurodegenerative disease that may substantially affect postural control, proprioception, or motor responses, including stroke sequelae, Parkinson's disease, multiple sclerosis, advanced dementia, or marked cerebellar disorders. * Cardiopulmonary, vestibular, or systemic disease that may prevent safe completion of the interventions or assessments. * Diagnosed peripheral neuropathy, marked lower-extremity sensory loss, or diabetic neuropathy. * Use of an assistive device. * Lower-extremity amputation, prosthesis use, or severe structural deformity interfering with foot or ankle assessment. * Pain, instability, or severe range-of-motion limitation in the ankle, knee, or hip that prevents completion of the tests. * History of lower-extremity fracture, surgery, or major trauma within the previous 6 months. * Musculoskeletal injury of the foot, ankle, or lower extremity within the previous 3 months that limits participation in functional testing. * Open wound, ulcer, active skin lesion, or infection in the foot or ankle region that interferes with sensor or measurement placement. * Recent initiation of, or dose change in, medication that may affect balance, alertness, or motor performance.