An optimized protocol for reducing risk of fall in older adults

The aim of this study is to examine the effectiveness of a protocol based on the principles of the OPTIMAL theory as a fall-prevention program specifically designed for older adults.

After initial assessments, participants will be randomly assigned to the OPTIMAL or control group. All older adults will then complete eight weeks of Short Stick Exercises, with instructional cues provided according to group assignment. The OPTIMAL group will train under OPTIMAL conditions, while the control group will perform the exercises without these motivational and attentional cues.

The study was conducted at the Mohammad Amin Charity Center, with sessions three days per week. Both groups performed the same exercises in terms of type, intensity, number, and duration. The intervention group received additional OPTIMAL theory–based attentional and motivational instructions, while the control group did not. Instructors were not blinded; however, participants were blinded to the study objectives and instructional role, and outcome assessors and the data analyst were blinded to group assignments.

Age range: 75 to 85 years Ability to walk independently without assistive devices No visual impairments

Intervention group: Participants in this group will take part in an exercise program conducted under conditions based on the OPTIMAL theory. Control group: Participants in this group will receive the same exercise program in terms of type and intensity, as well as the number and duration of sessions; however, they will not receive instructional cues based on the OPTIMAL theory.

Static and dynamic balance, walking speed, depressive, postural sway, quality of life, intrinsic motivation, mental and physical effort, movement automaticity, positive affect, and fear of falling

Simple randomization method. For this purpose, participants are first listed in alphabetical order, and the numbers one and two are assigned to each participant on the list. The unit of randomization is the individual. Randomization is generated and implemented using Microsoft Excel by combining the SORTBY and ARRAYRAND functions. Using this method, each participant is allocated through simple randomization to either the control group or the OPTIMAL group, and the influence of all relevant and irrelevant variables on group allocation is neutralized through random assignment.

Given that the type of exercise, duration, intensity, and implementation conditions are identical in both groups, participants will not be aware of the differences in the instructional cues provided or their role as the main intervention of the study. Accordingly, participants will be blinded to the study objectives and group allocation. In addition, the outcome assessor and the data analyst will be blinded to participants’ group assignments.