None listed
Conditions
Brief summary
This research is looking at a new way to help older adults improve their balance and reduce their risk of falling. Falls are a common problem for older people and can lead to serious injuries. One way to prevent falls is through "reactive balance training" that helps people react quickly when they lose their balance—like when they slip or trip. Many current reactive balance training methods use expensive equipment and are hard to use in everyday settings. To make this kind of training more practical and accessible, we’ve developed a simple LEAP training program that uses basic items like a foam block and a plastic sheet. These exercises are designed to mimic real-life situations and help people learn how to recover their balance safely from trips and slips. We will test this program with older adults who live in the community. Participants will come to our lab once a week for six weeks. Each session will include warm-up activities and reactive balance exercises supervised by trained staff. The exercises will include both standing and walking tasks to improve balance reactions from trips and slips. To see how well the program works, we will compare two groups: one that does the LEAP training right away, and another that waits and does the same training later. We will measure how well participants can recover their balance in the lab, as well as how confident they feel about their balance and how anxious they are about falling. We’ll also look at how they move—like how fast they walk and how steady they are when standing. The results of this study will help us understand whether this simple and low-cost training method can be used more widely, especially in places that don’t have access to expensive equipment. It may also help guide future research for people with neurological conditions who are at risk of falling.
Interventions
Participants will attend the LEAP training program once per week for six weeks. Each 60-minute session includes a 5-minute warm-up followed by individually supervised balance-training exercises led by a physiotherapist or an exercise physiologist. During all exercises, participants will wear a waist transfer belt held by one or two staff members. To evaluate and ensure safety, a full-body fall-arrest harness with a load cell will also be used.
The LEAP program comprises four core exercises that
Participants will attend the LEAP training program once per week for six weeks. Each 60-minute session includes a 5-minute warm-up followed by individually supervised balance-training exercises led by a physiotherapist or an exercise physiologist. During all exercises, participants will wear a waist transfer belt held by one or two staff members. To evaluate and ensure safety, a full-body fall-arrest harness with a load cell will also be used. The LEAP program comprises four core exercises that progress from standing trips/slips to walking trips/slips with increasing challenge (e.g., from slow walking to usual gait speed; from eyes open to eyes closed). Progression will be guided by the Balance Intensity Scale to individually adjust training intensity and dosage. 1. Standing Trips: Using a manual lean-and-release technique, the participant leans forward against the therapist’s hands until the pelvis moves beyond the toes. At a random moment, support is withdrawn, prompting the participant to take a quick step over a foam obstacle to regain balance in a single step. 2. Walking Trips: Participants walk at 50% of their usual cadence, guided by a metronome app, and practice stepping over an obstacle attached to the therapist’s foot. 3. Standing Slips: Participants step onto a slippery plastic sheet and attempt to stop the slip primarily by activating the hip musculature, simulating an unexpected slip. 4. Walking Slips: Participants walk at their usual cadence and 50% of their usual step length along a 6-metre plastic mat with a concealed slip zone. A sudden slip is induced when the therapist gently pushes the participant’s foot at foot strike. Combined Walking Trips and Slips: When participants consistently demonstrate successful recovery in the above exercises (typically in sessions 4–6), a mixture of walking trips and slips may be introduced. Dual-task training: When prior exercises are performed successfully, dual-task activities will be added. These may include walking while carrying a laundry basket, answering conversational questions, counting aloud, or generating words, in combination with a slip or trip. All participants will receive a falls-education pamphlet at baseline covering standard recommendations such as medication review, general exercise, appropriate footwear. Pamphlet source: Standing Tall, Neuroscience Research Australia (NeuRA), Sydney (https://standingtall.net.au/?page_id=298) Adherence to intervention: Adherence will be monitored using REDCap software, where session attendance and completion of intervention will be recorded and stored.
Sponsors
Neuroscience Research Australia
Study design
Allocation
Randomised controlled trial
Intervention model
Parallel
Primary purpose
Prevention
Masking
Blinded (masking used) (Investigator, Outcomes Assessor)
Eligibility
Sex/Gender
All
Age
65 Years to No maximum
Healthy volunteers
Yes
Inclusion criteria
Inclusion criteria for older adults taking part in this study include: • Aged 65+ years old • Living independently in the community • Able to walk 100m unassisted and without rest • Able to communicate in the English language
Exclusion criteria
Exclusion criteria for older adults who are not eligible to participate in the study include: • Have been diagnosed with a neurological condition (e.g. multiple sclerosis, Stroke, Parkinson’s disease, Alzheimer's, dementia, etc.) • Have a history of wrist, lower limb, pelvic or vertebral fracture(s) or joint replacement(as) in the past 6 months • Have any other musculoskeletal pain (e.g. non-specific low back pain, knee pain, etc.) that can be aggravated by balance recovery movements • Have been advised against exercise by a medical practitioner • Weigh more than 120 kg • Cognitive impairment using cognitive Impairment Test (6CIT) (A score of 8 or higher on 6CIT)
Outcome results
None listed