Efficacy of a Multicomponent Occupational Therapy Intervention on Balance, Functional Mobility, and Proprioception in Institutionalized Older Adults: A Randomized Controlled Pilot Trial.

Abstract

Background: With the progressive aging of the in institutionalized settings population, functional decline-manifested as reduced proprioception, joint stiffness, and muscle loss-poses a growing threat to the autonomy and quality of life of older adults. Occupational therapy plays a central role in addressing these challenges through targeted, evidence-based interventions. Objectives: This clinical trial evaluates the effectiveness of a multicomponent occupational therapy intervention that integrates balance and postural stability exercises, proprioceptive stimulation, and lower-limb strengthening with conventional gerontogymnastics. The program was designed to improve gait performance, reduce fall risk, and promote independence in institutionalized older adults. Methods: A total of 35 community-dwelling older adults were randomly assigned to three groups: gerontogymnastics intervention (n = 13), multicomponent intervention (n = 13), and control (n = 9). Participants underwent a 6-week intervention comprising two 45 min sessions per week. Pre- and post-intervention assessments focused on postural stability and balance-related functional outcomes. Results: The multicomponent group exhibited trends toward improvement in balance, proprioception, and functional mobility, although these did not reach statistical significance. Clinically meaningful improvements were defined using minimally clinically important differences (MCIDs) for functional measures such as Timed UP and Go (TUG) (>1.3 s) and Performance-Oriented Mobility Assessment (POMA) (≥3 points). The multicomponent group showed a 22.1% improvement in proprioceptive accuracy and a 13.9% improvement in mobility (TUG). Additionally, this trend may indicate a potential protective effect against age-related functional decline. Conclusions: These findings suggest that a multicomponent occupational therapy intervention may help maintain mobility and reduce functional decline in institutionalized older adults. Statistically significant gains were observed in lower-limb strength, while other improvements-such as proprioception and balance-did not reach significance but approached clinical relevance. These preliminary results support further investigation into balance-specific training within occupational therapy to promote independence and reduce fall risk. Interpretation should remain cautious due to the small sample size (n = 35) and short intervention duration, which limit statistical power and generalizability.