® frontiers | Frontiers in Pu @ ox for updates Tevas ADM Unversity, Unites States Universo Novi Se, Semin Univesty of Worcenegre, Montenegro Tingtan Zrang sions Lue ‘This ace was subriteato ging ana Pubic He Frontiers ube Heath cup 27 May 2022 wu 9 20 October 2022 Yang Y Wang KL H, Ou 3, Wang, Chen P, Zhang ar Lue (2022) The fon the prevention o ais m older Front Pubic Heat 10953595, 1 2022 Yang, Wang. is, Qu Wan, ‘Chen, 2nang and Lue. Ths san the terme oF te create Commons ‘inutos Leense (EC BY, The ute {svieuton or reproduction nother ‘orgm authors) arate copyright Frontersin PublicHeatth Health > 20 October 2022 20.5885 tpuon. 2022 953588 The impact of Otago exercise programme on the prevention of falls in older adult: A systematic review Yi Yang’, Kun Wang}, Hengxu Liu, Jiawei Qu', Yan Wang?, Peijie Chen’, TingRan Zhang'* and Jiong Luo™* CChongaing, Chia, “Schoo of Physical estan Sichuan Agrestural Unvesty, abn, Chin Objective: To improve the quality of life of older adult in their later ‘years, by increasing the physical activity participation of older adult, the occurrence of falls accident scores in older adult can be prevented, This paper comprehensively summarizes the origin, development, participation forms, and fitness effects of the Otago exercise program (FP) Methods: Using PubMed, web of science, CNKI, dimensional spectrum, and other databases, search for research papers from 2005 to April 2021 by Using keywords such as Otago project exercise; aged, Fal: Cognitive function, Balance ability, Lower limb strength, Fall efficiency, and so on. PEDro Scale was Used to check the quality of the literatures. Results: A total of 34 papers were included after searching for kinds of literature related to the subject of this paper and after careful review by researchers. Conclusions: Otago exercise programme is beneficial to improve the cognitive function of older adult, enhance their lower limb muscle strength and dynamic and static balance abilty, and then improve the gait stability and posture control ability of older adult, which has significant positive benefits for the prevention of falls in older adult. OEP is helpful to improve the falling efficiency of older adult, help alder adult overcome the fear of falling, and form a positive emotion of “exercise improves exercise.” to reduce the harm caused by sedentary behavior and the incidence of depression and improve their subjective wellbeing. Although OEP has significant positive effects on Improving the health and physical fitness of older adult, preventing falls, and restoring clinical function, the corresponding neural mechanism for preventing falls is not very clear. At the same time, how OEP can be combined with emerging technologies to maximize its benefits needs to be further discussed inthe future. Otago exercise programme, prevent falls, balance ability, cognitive funetion, fall efficiency o frontensinorsYang etal Introduction Falling refers to filling on the ground or below the level without conscious or external force (1). It is easy to cause fracture, stroke, and limited mobility in olde adult. Inditectly, it ‘causes physical weakness, cognitive decline, sedentary behavior, social exclusion, and even death (2,3). Aging leads to the decline ‘of balance ability and posture control ability of older adult, ‘which increases th rek of falls, About 300,000 people worldwide year. Among older adult over 65 years old, 30% have fallen and 15% have fallen many times (4). Therefore, the injury caused by falls has become an important public health problem, which has a huge negative impact on the high-quality and heathy life of older adult, As we all know, human body function and neurosensory perception will weaken with age, accompanied by chronic <0.05) ep expect Feogetsl (8) Chee n= Reds OR Soscend —_Allerthelntervaton. the post et uneaiy AZ mestomin Nove standings score wa sina Tower han the preset Foursage sore (p< 005) andthe phys pefrmance snd sta balance ait were inproned AvealGs) Chie n=3 wes OEP Aer heeterventon tes. the phys ness and Ag=6 —sesnomin — BNone ‘dance eel folder incre giant, dh roupOBP ba ond aapabey heaetal 08) Choe n= 60, Res OEP Berghalane sees The static nd yamine of eal were AZO et5iin— BNone Fourstage ——_ tnproved (p< 0001). andthe physical fantion Sauocetet ——witeshaned Shubeteta (i) Amerie n=210—Eweildayls OEP soecoed Aer telnervention the giant improved AG26 —messom —— BNone standings ther phyla objet fant exit, Foursage balance ably, and slope: ai Sauces sme.) Korea nese soEP ucnal ——_-Both woups improved the mobi fle dt 6579 wet 0min BTS ‘exensan tet: whichis conduie tothe preven of female One ‘eae Lewes (5) Myth n=, week Lawerlinb_O8® computed wth th conta group he Age=6 —umes35min——BRewne sting —_Fncantest_ acta of upper gp stengih and balance ‘iy further enhanced he postr conta ity leometa.(i) Kora mamas OEP ‘OEP nprver balance and waking ped in Age 70 smes0min—BAtinabueratun tat sca pefrmance Tapers ro cate gop In the form of group OBP, older adult in the nursing center were taken as the research objects. OEP was conducted three times a ‘week for 6 months, witha total of 78 training sessions, After the intervention, the results showed that the strength of the ankle rmiuscle group and ankle dorsiflexion increased significantly. Frontersin Public Heath o ‘The muscle strength increased from 7.02 to 12.92kg before the intervention, which increased the strength of the lower limbs Compared with the pre-test and posttest data for the sitting and standing test, the number of sitting and standing in the experimental group increased from 5.11 4 257 to 933 © 5.12. fronterinorgYang etal ‘There were no falls and adverse events during the 6 months of the intervention, The exercise prescription did nat need special ‘equipment, Therefore, scholars believe that OEP isa simple, safe, And effective lower limb resistance exercise (50). In the contrast to augmented reality-based OEP and yoga, OEP effectively improved the knee flexion and ankle dorsiflesion strength of «elderly women (12). Another study also supports this view that ‘OEP improves the lower limb strength and physical tnes level, fof older adult, but the contzol group is the walking exercise ‘group, and the OEP itself nludes walking exercise, There is no significant difference between the two, but thi does not ale it positive effet (1) Similarly, OBP i efficient and safe to improve ‘the ower limb strength of oer adult under special physiological ‘conditions. Compared with Taijiquan, the OEP plan includes many resistance tesining for lower limbs to overcome self- weight, which is better than Taijiquan in improving specific lower lim strength, such as ankle strength, knee extension, and lesion strength (8). ‘The nursing home is also an effective model {or oder adult to improve heir muscle weakness and long-term, susele function (45) (Otago exercise program effectively improved the lower limb rmusele strength of patients with 2 history of falls and stroke Some scholars have discussed the positive benefits of OEP in ‘older adult with knee arthritis disease, The results show that OEP still at positive effect on the lower limb muscle strength of ‘older adult with knee arthritis, and there is no adverse effect fon knee arthritis (23). Although the research results are not fully sare to effectively reduce the fall recurrence rate of older adult with 2 special history, it can benefit older adult with ‘git disorders; older adult often euller from chronic disease, including lower limb muscle pain, which will hinder the exertion ‘of lower lim muscle function. After OEP, the pain was relieved is speculated that lower limb taining may improve musele performance (25), but tome studies have found that although ‘OEP can significantly improve the lower limb muscle strength ‘of older adult with another special medical history, st has lite effect on their self-care ability, which may be related to the special medical history. In the study on fall prevention, of stroke patients, an OEP plan can significant lower limb strength of stroke patients and reduce the # fall, with litle impact on their activities of daly living and quality of life (51). OEP can increase the lower limb strength fof dillerent groups, Due to the epidemic control, physical therapists and older adult carry out OEP exercise plans at home, The outcome indicators show that family based OEP can cfectively prevent older adult fom falling, improve the physical function and lower limb strength of family members, create a harmonious family atmosphere, and improve the subjective wellbeing of older adult (52). Walking movements in OEP projects, such as walking backward, zigrag walking, walking sideways, walking straight, climbing stairs, ee induce the activity of hip flexion muscle and isotonic flexion ‘of the ankle, which may help to improve muscle strength and continse to Frontersin PublicHeatth os 20:5509/pubh 2022.955895 coordination (1s). The research data for this part are shown in Table 3 Effect of OEP on fall efficacy in older adult Fall eficay refers tothe degree of self-efficacy that cannot be judged when participating in a certain activity. After older adult suifr from multiple all, thei fall ficiency and self-confidence decrease due to fear of ils, which inezeases the rsk of falls and a vicious circle, farther reducing the physical function of older adult, Physical exercise can improve social isolation, fer, and other related mental health problems (27). The effect of exercise therapy should nat be limited to the improvement of physiological outcome indicators psychological effect induced by exercite is also one of the important factors to reduce the risk of ills in older adult. Stodies hhave shown that the inducing effect of OEP can enhance the balance and confidence of older adult and help eliminate the shadow and fea of falling, Domestic research using Internet technology suggests that OEP can improve older adults far of| falling, encourage older adult co exercise, and reduce th risk of falling (53). After 12 weeks of OEP intervention, psychological related self-confidence problems will be effectively improved, and older adults confidence in posture control willbe enhanced 65), In addition, most ofthe fear of older adult comes from past fall history. Bjerk et a. (3) believe that in the positive benefits of OEP intervention, the psychological sel-efficacy factor eannot be ignored, which plays an important role in reducing the risk of fillsOEP enbances the self-eficacy and happiness of elder adult. The intervention of OEP indirecly improves the high-quality healthy life of older adult and meets the realistic requirements of older adult in their happy old age rather than blindly extending the lifeline, This result was also sified in the interview survey. According to their many years of practical experience, 17 physiotherapists concluded that OEP can improve older adults sense of fall efcacy, expand their social participation and promote older adult to better manage their daly life (58). An intervention study based on technical scans believes that both online group exercise and social model OBP can improve the loneliness of older adult oa certain extent and improve the level of subjective wellbeing of older adult (28). However, ome scholars believe that high cohesion group OBP is better than an individual exercise in reducing loneliness and improving subjective wellbeing, and online taining for older adv living alone does not improve their loneliness (55) Before allowing older adult to participate in OER, fist carry out observation and learning for 20min, control the actions of colder adult, and then carry ot OEP training so that older adult can conduct self-assessment according to the observation and learning content, to increase their efforts and obtain a beter sense of achievement (i). “The movement of OEP isnot complex. Hale Land other (38) with slight intellectual impairment as the The scholars took adh frontierinorgYang etal 10;5509/pubh 2022.955595 Researcher Country Sample Intervention Intervention Test task Research results sine time mode Teewtal 2) Kore, Rawls @ARORP, Digtalmanl The knee Bexon and ane dovsenon sagt iorlsomin Boge smusdetesee lathe OEP group icraed and the muscle sent flower lb in the OEP group tt ‘eer han atin he yoga 04 wets 5) Magn ‘SimprowedOEF, —Lowerlinh Telok aciny wat inproved and showed ‘Bowne manag Sdn et Band. aco ct which inproned it peng Ayana Dect tal (07) Bote DOE amy Bone denne, Thee mt a0 kfeenceinbone ine deny @Nwsing tolhers —quetonnaze einen he wo groups and tere was tee Aavetignten a bone neal dey, bt the nice erorance wa improved which wat condcve ta che prevention ffiactte henge (59) Chie aewebss OEP Do-raanding tot Aer OEP intervention the i enh the ‘wmessSmin 2 Dralyactves ——_Lowerlinb muse hae eter kee eat. and ankefesor mas eng tet gent improve IMbanpeymacal they weds OEP Seaghalance scale Af thelnterventon te numberof tend tnd © AZ messin Nove 50s standing est teincteased andthe kc fl decreed (p< 005) sonets. (0) Kore 2 ‘sour Fuctonal OEP group hs a greterinprovemeat ia lower, sk 20 min Ta Chi ‘eceson tet lbstvenghthan the Ts Chi Group, whens One conde ta th prevention aed standing tt Koei) Span aeweelss OEP Fuconal Futon acy ower ib msde stent, ‘ioesDSmin @PRevnenting independence and fanconal dependence ve sgt mewurement fect further dang the progres of the Timed xaing ability veiling tt Mace (2) Singapore alae sone Sainy tet Compared withthe contol rp. ound PRostinetrxieat Lower limb thatthe awe ib fant fe ad afer strenghtet ——thesatervenion wa eanced and thee of Pavkasdhang Korea fo) won Ener tte shor spe anand nerveon 6 imeisomin Nene ‘icencymeter tne. thesepicon take patents ie, bet aay ot ise eiseecine in preventing le Mager sta (52) Samatand sce oer Singlet Thea lee redced tenga the guy Laem et (4) Korea nwo GORP conic mate Compared withthe conte rsp the actin af Age> 70 smesS0min Act obueration dynamometer ip fexon mc nduotnic en ofthe snl nt OP group increased, and he socoth flowers icreed cede cal Sweden 1 year minh OEP Pamscaletet The tstand fn apstedy er teintervenon eo time None [fear seletest showed that OFP ees acd ewe inh pala Speman Frontersin PublicHeatth 08 frontensinorsYang etal research object and found thats nt too dificult for pacentsto "understand the content of OEP and can complete their movements Therefore, i i suggested that older adult with, «cognitive decline do not have too much paychologial pressure sand burden when completing. In addition to confirming the positive bencits of ORP for older adult, McMahon etal. (57) scholars alto dscusted the impact of interpersonal components in participating n raining, inching soil eovironment, octal support, cogative sel selCencouraging behavior change, etc these components will make older adult dare to exchange cspeticace and share knowledge when participating in exercise, ‘whieh will promote older adults self-confidence in exercise and fll efficacy. Holated elderly people inthe context af the «epidemic ate prone to negative emotions such ab depression and loneliness. OEP is used so reduce the negative effects caused by lack of exeicite and significantly improve the Aepression and physical fancion of older adult (34). In addition, in the intervention study of elderly patients after ane arthroplasty, Liu Heng and otber (25) scholars found that ‘OBE signfcenlysmproved patient fall efcency and increased patients’ selficonfdence, and the exercise program can stil ‘exercise autonomously at home alter patients are discharged ftom hospital to increase exercise benefits, However, thete ate data on OEP focusing on cogaitive fonction, and iis undeae whether OEP plays several positive benefits in other cognitive fields, From the perspective ofthe impact ofbalance ability, afer the exercise treatment of OEP, the dynamic and static balance sining ability of older adult has been significantly improved, whi improves the body posture control ability of older adult, and then reduces the fill isk of older adult who are sedentary al home or engaged in daily outdoor activites, The research data {or this part are shown in Table 4 Discussion "To sum up, the positive effects of multi-component OEP on cognitive function, balance ability lower limb muscle strength, and fll eficiency of older adult are consistent with the views ‘of most Iterature, and itis considered that OED is effective in preventing falls for older adult (10,1, 14) From the perspective fof the impact of cognitive function, it shows multifaceted positive effects on the cognitive level of older adult. OEP Jmproves the processing speed, response inhibition, and other ‘cognitive fields of older adult, and good executive function ean, predict and improve the exercise compliance of older adult, ‘make them adhere to exercise and obtain good exercise benefits. However, most studies were single OEP exercise therapy and 4d not involve the combination of multiple balance taining sethods, Research shows that taking inspiratory muscle raining a the auxiliary training method of OEP, the combination of the two therapice can better improve the balance function fof older adult and the function of the inspiratory muscle Frontersin PublicHeatth 10 10:5509/puoh 2022.955895 of older adult (58). Supplementing OEP therapy with mult sensory balance practice can also maximize the utility of balance ability (58). Therefore, OEP combined with other therapies may be more effecive in balancing ability. In terms of the impact on lower limb muscle strength, OEP mainly reduces the risk of falls im older adult by improving muscle performance and enhancing muscle strength. The muscle strength of the lower limbs of older adult patients it significantly improved, specially the muscle strength of lower limbs is improved, which is affected by the agin of older adult patients. However, the physiological mechanism of OEP improving lower limb muscle strength it not clear, and whether it wil increase bone mineral density and muscle cross-sectional area is unknown, Dut there is no doubt that it can delay muscle atrophy. From. the perspective of the impact of older adult fll efficiency, it i mainly to improve older adult’ fill efficiency, increase their self-confidence, overcome the fear of previous fills, and enable them to complete some self-management thing: independently, so that they are full of confidence in their later life (54 60), to achieve the purpose of reducing the risk of falls The long-term sedentary elderly at home can alleviate the ‘mood of depression and loneliness through OEP, expand social participation, enhance the feelings of their families and obtain the support oftheir families when exercising at home with theie families, to improve the subjective wellbeing of older adul, ‘which is very important for older adult who cannot go out of home due to physical factor. "Yo better participate in OEP exercise, practical problems {= operation also need to be further discussed, such as contraindications and exercise dose in special patiens. Shorl- term ining has Kile improvement on older adult sith a history of falls, but only improves their physical performance, Therefore, older adult with a history of falls should actively patticipate in the exercise, reduce the risk of falls in time, and adhere to it for a long time to ensute the sustainability of the exercise effect. In the research with physiotherapists as interviewees, physiotherapists believe that OEP ie an effective rane to efectively prevent falls and improve physical function in older adult (61). The main reason is that OEP has strong applicability, simple project action, and diverse participation methods, older adult have lite pressure on learning and lwaining content and have good compliance, few adverse events, and high safety, which is very Key. Therefore, the application of OEP in daily life exercise is also very feasible, not just limited to the field of clinical rehabilitation, Regardless of any sports event, the degree of exercise persistence is directly related to the exercise effect. After OEP training, telephone interviews, records, and other methods are adopted to encourage older adult to adhere to exercise, but the effet is very litle ‘which iz not enough to encourage them to adhere to exercise (©2, 62), More means are needed to ensure the effective intensity and progress of the exercige. In the future, it can bbe combined with online special psychological counseling oF fronterinorgYang etal 10;3509/puoh 2022.955895 Researcher Country Sample Intervention Intervention Test task Research results sine time mode Guests) ches nn60.Age= 2ewedls OEP SBergBaance Seale The fl efiecy index we giant amprove, 6 ‘spes0mie —@Koowledgeleaming Hae licency abd OBF could smprve he sconce of tere erat CChenetal 08) Chien, Reels Specie scty Theres bowed hal he el cone af Ag26 umes lance conence elder ada increased sgn wih as te heft overcome be fea a ing Bereta) Rania nd, Swed, Malidimensinnal Theses show tt olde aa ee pot Ag26 — umesndomse penonsliy vehi omplane and improve hie ev af qestonaace wel Pays sy ajoyment see Naima (5) Rania =H Smelt sore Physic aetvty Afr th ervenin te pet and peste A260 umeusomn None cajoymeat sede dtfound that the eve of sabjetive webeng Incense ut ad ie pact on online Leemetal (is) Korea n=30 Rel ORP eareliney sale Compued withthe conta route wang A270 umesSomn— DAdunebuevatn test ‘per step quency. sep length and stents fhe BP group increased sigan, Inde tht te sense a cy ae MeMtahn eal (7) Ameria 9=306 Remon, OEP Socal sopert__ Parting in exec can increne he oi Ag 7 etomin — BNone wetionave patton of le ada, epand ac opont mewurement and improve sey Sipe pin see Chenetal 03) Chinn Res Gee ‘OEP prover the phyial andpycalaica Ae 7 smeusOmin None Aepenion ele function folder adult wth cogatie iparment Mest Hengeta.(3) Chih m= 32 month Taner OEP Sogeitem Aer te nervention the fil eee near of Age 60 weet3Omin——DReplarenecie —peblemthad ede patent ater awe arthoplaydereed Bey een pop cognitive intervention to achieve this purpose. The traditional way of one-to-one physical therapy for older adult seems to have been unable to meet the development of a rapidly aging society, and the economic burden is also an obstacle (£2), Especially in rural areas with backward basic medical conditions it i# more difficult to implement the intervention plan, The combination of mobility organization and medical and health care, and the implementation of the OEP plan ‘based on community conditions, have improved the physical function of older adult in rural areas and reduced the risk of fall (63-55). Previous literature has confirmed the effectiveness and reliability of OEP in the form of DVDs in rural ares, and older aduk gain a sense of entertainment and happiness Frontersin Public Heath a in cocial interaction. In addition, to allow special people to participate in the exercise, we need to improve the OEP content according to the actual situation. Therefore, we should design dierent training contents according to local conditions a far possible to meet the needs of dierent patients, develop remote lsaining and online guidance based on emerging technologies, and combine the traditional one-to-one OEP treatment for special elderly needs. Population aging isan inevitable trend of social development, and the problems caused by falls of older adult seem to be not only physical injuries but also ave a great impact on the family and society. Therefore, how to effectively prevent falls of older adult ie of great significance, especialy in the postepidemic era, alter peoples special experience of frontierinorgYang etal igolation and closure, they have a deeper understanding of the ‘concept ofa healthy life Tn the fare, we will pay more attention to the integration of sports into life. Based on the need for hhealthy aging, this paper summarizes the positive effects of ‘OEP on preventing falle in older adult and effectively helping ‘older adult live a healthy fein heir later years. Therefore, this, review has practical value and significance for the development of elderly health, Conclusion Otago exercise has positive benefite im preventing falls in ‘older adult, which can improve the cogaitive function of older dull, enhance the muicle strength of lower limbs and the ability of dynamic and static balance, and then improve the ‘gait stability and posture contol ability of older adult; OEP is beneficial to improve the falling efficiency of older adult, help ‘older adult overcome the fear of filling, and form a positive ‘emotion of “exercise improve exercise” to reduce the harm ‘caused by sedentary behavior and the incidence of depression, and improve the subjective wellbeing of older adult. according to the review ofthis article, OBP exercte of 30-50 min three times a ‘weeks recommended a the exercice prescription for older adult to prevent fills tie recommended that this exercise scheme be carried out as the daily regular activities of older adull at home ‘rin the healthcare center. Ite worth noting that special elderly people need to design exclusive exercise prescriptions to prevent the occurrence of adverse events, Limitations and further research directions ‘Mast ofthe literature included inthis paper isa single OP ‘exercise prescription, which cannot draw the positive benefit of ‘OEP combined with other exercise methods to prevent falls in ‘older adult In addition, OPE lacks in-depth exploration of the ‘deep mechanism of preventing falls in older ad, Thi of the limitations of this paper. The possible mechanisms of preventing falls in older adult aze the improvement of muscle performance and cognitive function, but other mechanisms are not clear; To normalize this OEP movement in families, References | nhapeyme Kahan Koga FO, Yio, Sabin emu Akar [es ofthe Otago exe prot fs Duane aad phys parma ‘in ole uring ho reese wi igh fl side a andor contol a ur Ger Me (021) 2407-15, do 1000741998 020000081 2 Liston M, Geena G, Maser C.KikceD, Gass D, Fotis D, et a Investigating the Raby and xcept of the HOLOBsane ste ompued with adard che In older ad atk for fll dy Protos Frontersin Publi Health 2 20:5509/pubh 2022.955593 communities, and nursing homes in the post-epidemic era, and ‘promote and improve itin combination wit the actual situation of our country, it needs to be further discussed, and research in this area can be strengthened in the future Data availability statement ‘The original contributions presented in the study are included in the article/supplementary material further inquiries can be directed tothe corresponding authors, Author contributions YY collected and consulted literature and designed and ‘wrote a review, KW, HI, 1, YW, PC, 1Z, and TL provide ‘thesis writing guidance. IL is responsible forthe evaluation and revision, All authors have read and agreed to the published version of the manuscript, Funding ‘This publication was funded by the National Social Science Foundation of China (Grant No: 19ZDA352). Conflict of interest “The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed ata potential conflict of interes Publisher's note All aims expressed in thie article are solely those of the authors and do not necessarily represent those of their aliiated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article, or claim that may be made by: its manufacturer, is not guaranteed or endorsed by the publisher for ao sven Sinded pit randomied controled sy. BMI Open (2001) sist da 10 1136bmjopen 220 039258 3. Bick M, Broelé T, Skdlea DA. Bergland AA falls preventon programme fo improve qualty of le. phpcl facta andl csc fF poopie scerang heme help sence udp potcl lors ‘andomioed “orled al BMC: Tah Ser Rr 2517) 1°95. do 1O4IAKAS13.00Yang eta 4. LY. Chang Hiv D Bae, Wie, Occurence a8 inning tn of ‘ale ong let aula Daon commu Chin) Geil (2021) :265-3 5. Yang G. Yang W. Inflncing factors of compliance with fat prevention mesures eae patient Chin] ern (2050) 2046°9-8 6 Qian XX, Chay PH, Kwan CW, Lou , Leng A eM, ea Inventing tik faces for fle eaengcommuniy-dling lie adc according 1 WHO ok fiar socal for fle JN Hea Aig (201) 25425" 7. Albomoe Mie L, Morena Casha MT, Sache Pb , Bape None A Fernie Domogaes je Rud Run Me ab. Mec 0 the Otago Faecse Progen to vedue fase commu eveling ste aged 65-0 yuo trata eed se grup oe tndan nog adr or (019) E00 4: Son NK Ry YU ong HW, Jang YH, Kin HD Comparion of 2 erent ‘erie ponte Ta Ch Versus Og, in aman deg let moe Fes Ps The 6) 3851-7 do 104519 1 ouENOoDxEDOeL 9. 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