Reactive Balance Training Involving Repeated Trips and Slips in Older Adults: Mechanisms and Long-term Retention
Overview
- Phase
- N/A
- Intervention
- Not specified
- Conditions
- Fall
- Sponsor
- Neuroscience Research Australia
- Enrollment
- 118
- Locations
- 1
- Primary Endpoint
- Laboratory induced falls
- Status
- Completed
- Last Updated
- 2 years ago
Overview
Brief Summary
Falls in older people are devastating, widespread, costly and increasing in the aging Australian population. Although falls occur in approximately one third of older adults, certain population groups such as the sarcopenic/frail present with further elevated risk of falls. Many exercise interventions have been trialled but systematic review evidence indicates such programs reduce fall rates by an average of only 20% and encounter issues such as compliance.
Reactive balance training (also called perturbation-based balance training) utilises a task-specific approach to balance training, applying repeated exposure to unpredictable perturbations that mimic balance disturbances experienced in daily life. Evidence suggests 50% reductions in falls might be achievable in a time efficient manner with reactive balance training but more evidence is required.
In this study, ecologically valid, unpredictable trips and slips will be exposed to older people in a safe environment to train their reactive balance. Three 40 min weekly training sessions will be followed by 3-monthly retraining session over one year (40 min x 6 training sessions = 4 hours of training in total). The neuromuscular, physiological, psychological, behavioural effects of the reactive balance training will be comprehensively examined.
Investigators
Eligibility Criteria
Inclusion Criteria
- •Older persons - aged 65 years and older
- •Community-dwelling
- •Ability to walk 500m without rest or use of mobility aids
Exclusion Criteria
- •Diagnosed neurological disease - eg Parkinson's disease, multiple sclerosis
- •Cognitive impairment and dementia
- •Bone fractures or joint replacement (in the past year)
- •Pre-existing medical conditions from which the medical practitioner has advised not to exercise
Outcomes
Primary Outcomes
Laboratory induced falls
Time Frame: 12 month re-assessment
Fall incidence after slips and trips in the laboratory (Okubo et al., 2019). A fall will be defined by the harness supported load when it exceeded 30% of the person's body weight (Yang et al., 2011).
Slips in daily life
Time Frame: Throughout a follow-up period (one year from randomisation)
Number of slips in daily life will be recorded using a fridge calendar and reported weekly via SMS or email.
Trips in daily life
Time Frame: Throughout a follow-up period (one year from randomisation)
Number of trips in daily life will be recorded using a fridge calendar and reported weekly via SMS or email.
Secondary Outcomes
- Margin of stability(12 month re-assessment)
- Fear of falling(12 month re-assessment)
- Fall Behavioural Scale(12 month re-assessment)
- Catch-inhibition accuracy(12 month re-assessment)
- Falls in daily life(Throughout a follow-up period (one year from randomisation))
- Anxiety(12 month re-assessment)
- Muscle activation amplitude (semitendinosus)(12 month re-assessment)
- Fall Risk(12 month re-assessment)
- Volitional Stepping Reaction time(12 month re-assessment)
- Stepping inhibition(12 month re-assessment)
- Executive function(12 month re-assessment)
- Extrapolated centre of mass(12 month re-assessment)
- Fall risk awareness and behaviours(Month 6 (middle of the follow-up period))
- Physical activity levels(12 month re-assessment)
- Range of trunk sway(12 month re-assessment)
- Muscle activation onset latency (semitendinosus)(12 month re-assessment)
- Muscle activation amplitude (rectus femoris)(12 month re-assessment)
- Step length(12 month re-assessment)
- Muscle activation onset latency (rectus femoris)(12 month re-assessment)
- Adverse events during reactive balance training(Throughout training sessions taking place at week 1, 2 and 3, and month 3, 6 and 9)
- Enjoyment of reactive balance training(Throughout training sessions taking place at week 1, 2 and 3, and month 3, 6 and 9)