None listed
Conditions
Brief summary
Falls among older adults cause serious challenges for the individual and health care systems, including bone fractures. Our recent systematic review and meta-analysis has shown that reactive step training (repeated exposure to balance perturbations) can reduce falls by approximately 50% (Okubo et al., 2016). However, the methods to generate perturbations (e.g. slips) in previous studies have been considerably heterogeneous and have limitations to training reactive balance control. We have developed a novel overground perturbation system which can generate both slips and trips in random locations. Since this system can provide unpredictable slips and trips, it is theoretically possible to train specifically reactive balance control (as opposed to proactive balance control or prediction). This randomized controlled trial will examine the effectiveness of the reactive step training using this perturbation system in older adults.
Interventions
The intervention (reactive step training) group will walk along a 10-m walkway consisting of 50cm x 50cm wooden decking tiles. They will be asked to step onto step-length black and white vinyl target tiles placed on the walkway with the accompaniment of music with a beat reflecting the desired cadence. Slips will be induced by a movable tile on two hidden low-friction rails with linear bearings that can slide upon foot contact (20cm, 30cm or 40cm). A friction plat will be applied to slow down th
The intervention (reactive step training) group will walk along a 10-m walkway consisting of 50cm x 50cm wooden decking tiles. They will be asked to step onto step-length black and white vinyl target tiles placed on the walkway with the accompaniment of music with a beat reflecting the desired cadence. Slips will be induced by a movable tile on two hidden low-friction rails with linear bearings that can slide upon foot contact (20cm, 30cm or 40cm). A friction plat will be applied to slow down the slip speed until a participant learns to respond well. Trips are induced using a tripping board (7cm or 14cm height) that flips up from the walkway at mid-swing using a wireless controller. The tripping board and the slipping tile are concealed and can be moved to various locations along the walkway so that proactive adaptation (e.g. changing gait with prediction) will be minimized and reactive stepping response can be specifically trained. Gait speed (40% to 90% of individual's normal gait), slip distance (20cm, 30cm or 40cm) and speed (with/without the friction plate) will be adjusted by a Health Fitness Programmer according to participant's anxiety level and perceived difficulty. Reactive step training will be conducted in three 40-minute sessions (120 minutes in total). Session 1 will train recovery from trips, session 2 will train recovery from slips and session 3 will train recovery from a mix of trips and slips. The 3 individual sessions will be held in 2 days (1st day: training sessions 1 and 2 with lunch break, 2nd day: training session 3) within a week. Attendance of and actual training contents (e.g. gait speed, slip distance and trip height) used for each participant will be recorded.
Sponsors
Neuroscience Research Australia
Study design
Allocation
Randomised controlled trial
Intervention model
Parallel
Primary purpose
Prevention
Masking
Blinded (masking used) (Subject, Outcomes Assessor)
Eligibility
Sex/Gender
All
Age
65 Years to 90 Years
Healthy volunteers
Yes
Inclusion criteria
Older adults living independently in the community or retirement village. Exercising for 90 minutes per week (e.g. fitness class, walking specifically for exercise, strength training, Tai Chi, etc) for the past 3 months.
Exclusion criteria
Osteoporosis, neurological impairment and a history of fractures in the last 3 years, or joint replacement in the past 12 months.
Outcome results
None listed