Accidental Falls
Conditions
Keywords
Postural balance, Aging, Biomechanics, Rehabilitation
Brief summary
Falls in daily life are a serious risk for older adults. A new type of balance training, called reactive balance training (RBT) involves people losing balance many times so that they can practice fast balance reactions, like stepping reactions. Differences in training program features might explain differences in the results of previous RBT studies. Training intensity is the difficulty or challenge of the training program. It would be valuable to know if high-intensity RBT improves balance reactions quickly. The main goal of this study is to see if more intense RBT improves balance reactions faster than less intense RBT. The investigators will compare how quickly people improve balance reactions between high- and moderate-intensity RBT, and between RBT and a control program that does not include RBT. The investigators will also test if the improvements in balance reactions last after the training program is over. The secondary goals are to understand exactly how balance reactions improve with training, and to determine if people who complete RBT improve their general balance skills, and falls efficacy more than people who do not complete RBT.
Interventions
BEHAVIORALReactive balance training
Reactive balance training involves clients experiencing repeated balance perturbations so that they can practice and improve control of reactions to avoid falling after a loss of balance.
BEHAVIORALWalking
Overground walking
Sponsors
Canadian Institutes of Health Research (CIHR)
Toronto Rehabilitation Institute
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
PREVENTION
Masking
SINGLE (Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
65 Years to 80 Years
Healthy volunteers
Yes
Inclusion criteria
* Community-dwelling older adults (65-80 years old)
Exclusion criteria
* Unable to stand independently without upper-limb support for \>30 seconds and/or walk independently (without a gait aid) for ≥10 metres; * Diagnosed neurological condition that could affect balance control (e.g., stroke, Parkinson's disease); * Score below normative values on the Montreal Cognitive Assessment; * Score below age-matched normative values for sensory and motor function, as assessed using the FallScreen battery; * Have insufficient English language comprehension such that they cannot understand instructions; * Have contraindications to reactive balance training such as severe osteoporosis; and/or * Are currently attending physiotherapy or supervised exercise.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Number of reactive steps | Two weeks | Learning rate for number of steps to recover from 'backward fall' balance perturbations |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Step execution time | One week and 12 weeks post-training | Time from foot off to foot contact of the first step |
| Step length | One week and 12 weeks post-training | Difference in foot position from foot off to foot contact |
| Braking impulse | One week and 12 weeks post-training | Antero-posterior shear force generated over time on step contact |
| Mechanical margin of stability | One week and 12 weeks post-training | Distance between the extrapolated centre of mass (incorporating centre of mass position and velocity) and the edge of the base of support |
| Balance evaluation systems test | One week and 12 weeks post-training | Scale ranges from 0-100, with higher scores indicating better outcome |
| Falls efficacy scale - International | One week, 12 weeks, and 12 months post-training | Scale range: 10-100; higher values indicate worse outcome |
| Step initiation time | One week and 12 weeks post-training | Time from perturbation onset time to foot off time |
Other
| Measure | Time frame | Description |
|---|---|---|
| 5-level EuroQoL health status measure (EQ-5D-5L) | One week, 12 weeks, and 12 months post-training | Scale range for descriptive component: 5-25, higher values indicate worse outcome; Scale range for visual analogue scale: 0-100, higher values indicate better outcome |
| Number of participants with fear of falling | One week, 12 weeks, and 12 months post-training | — |
| Number of participants with activity curtailment due to fear of falling | One week, 12 weeks, and 12 months post-training | — |
| Injurious fall incidence | 12-months post-training | — |
| Fall incidence | 12 months post-training | Falls in daily life |
Countries
Canada
Contacts
Primary ContactAvril Mansfield, PhD
Backup ContactDavid Jagroop
Outcome results
None listed