In:
Gerontology, S. Karger AG, Vol. 69, No. 7 ( 2023), p. 910-922
Abstract:
〈 b 〉 〈 i 〉 Introduction: 〈 /i 〉 〈 /b 〉 There is increasing evidence that perturbation-based balance training (PBT) is highly effective in preventing falls at older age. Different PBT paradigms have been presented so far, yet a systematic comparison of PBT approaches with respect to feasibility and effectiveness is missing. Two different paradigms of PBT seem to be promising for clinical implementation: (1) technology-supported training on a perturbation treadmill (PBT 〈 sub 〉 treadmill 〈 /sub 〉 ); (2) training of dynamic stability mechanisms in the presence of perturbations induced by unstable surfaces (PBT 〈 sub 〉 stability 〈 /sub 〉 ). This study aimed to compare both program's feasibility and effectiveness in fall-prone older adults. 〈 b 〉 〈 i 〉 Methods: 〈 /i 〉 〈 /b 〉 In this three-armed randomized controlled trial, seventy-one older adults (74.9 ± 6.0 years) with a verified fall risk were randomly assigned into three groups: PBT 〈 sub 〉 treadmill 〈 /sub 〉 on a motorized treadmill, PBT 〈 sub 〉 stability 〈 /sub 〉 using unstable conditions such as balance pads, and a passive control group (CG). In both intervention groups, participants conducted a 6-week intervention with 3 sessions per week. Effects were assessed in fall risk (Brief-BEST), balance ability (Stepping Threshold Test, center of pressure, limits of stability), leg strength capacity, functional performance (Timed Up and Go Test, Chair-Stand), gait (preferred walking speed), and fear of falling (Short FES-I). 〈 b 〉 〈 i 〉 Results: 〈 /i 〉 〈 /b 〉 Fifty-one participants completed the study. Training adherence was 91% for PBT 〈 sub 〉 treadmill 〈 /sub 〉 and 87% for PBT 〈 sub 〉 stability 〈 /sub 〉 , while no severe adverse events occurred. An analysis of covariance with an intention-to-treat approach revealed statistically significant group effects in favor of PBT 〈 sub 〉 stability 〈 /sub 〉 in the Brief-BEST ( 〈 i 〉 p 〈 /i 〉 = 0.009, η 〈 sup 〉 2 〈 /sup 〉 = 0.131) and the limits of stability ( 〈 i 〉 p 〈 /i 〉 = 0.020, η 〈 sup 〉 2 〈 /sup 〉 = 0.110) and in favor of PBT 〈 sub 〉 treadmill 〈 /sub 〉 in the Stepping Threshold Test ( 〈 i 〉 p 〈 /i 〉 & lt; 0.001, η 〈 sup 〉 2 〈 /sup 〉 = 0.395). The other outcomes demonstrated no significant group effects. 〈 b 〉 〈 i 〉 Conclusion: 〈 /i 〉 〈 /b 〉 Both training paradigms demonstrated high feasibility and were effective in improving specific motor performances in the fall-prone population and these effects were task specific. PBT 〈 sub 〉 treadmill 〈 /sub 〉 showed higher improvements in reactive balance, which might have been promoted by the unpredictable nature of the included perturbations and the similarity to the tested surface perturbation paradigm. PBT 〈 sub 〉 stability 〈 /sub 〉 showed more wide-ranging effects on balance ability. Consequently, both paradigms improved fall risk-associated measures. The advantages of both formats should be evaluated in light of individual needs and preferences. Larger studies are needed to investigate the effects of these paradigms on real-life fall rates.
Type of Medium:
Online Resource
ISSN:
0304-324X
,
1423-0003
Language:
English
Publisher:
S. Karger AG
Publication Date:
2023
detail.hit.zdb_id:
1482689-6
