Reactive Balance Training Targeting Both Slip- and Trip-Induced Falls

Not Applicable

Completed

• Conditions: Accidental Fall
• Interventions: Behavioral: Reactive balance training; Behavioral: Otago Balance Training

• Registration Number: NCT04308239
• Lead Sponsor: Virginia Polytechnic Institute and State University

Brief Summary

The goal of this study was to evaluate the effects of reactive balance training (RBT) targeting slipping and tripping on laboratory-induced slips and trips. In an effort to build upon prior work, the present study included: 1) a control group receiving an alternative balance training intervention; 2) separate training and assessment sessions; 3) alternative RBT methods that may be more amenable to work outside the lab compared to prior methods, and 4) older adult participants receiving individualized training to reduce drop-out. The investigators hypothesized that slips after RBT would result in improved reactive balance kinematics, and a lower incidence of falls, compared to either initial slips before any intervention or after a control intervention. The investigators also hypothesized that trips after RBT would result in improved reactive balance kinematics, and a lower incidence of falls, compared to either initial trips before any intervention or after a control intervention. Results were intended to contribute to knowledge regarding the efficacy of alternative methods for RBT, and provide additional evidence regarding its efficacy.

Detailed Description

Not available

Study Timeline

• Study Start: 2018-06-01
• Primary Completion: 2019-07-01
• Study Completion: 2019-07-01
• Status Verified: 2020-03
• Study First Submitted: 2020-03-04
• Study First Submitted QC: 2020-03-10
• Study First Posted: 2020-03-16
• Results First Submitted: 2020-03-27
• Results First Submitted QC: 2020-05-04
• Last Update Submitted: 2020-05-04
• Results First Posted: 2020-05-18
• Last Update Posted: 2020-05-18

Recruitment & Eligibility

• Status: COMPLETED
• Sex: All
• Target Recruitment: 34

Inclusion Criteria

1. pass a medical history and screening administered by a physician that excluded participants with osteoporosis of the lumbar spine or proximal femur as assessed by Dual Energy X-ray Absorptiometry (Lunar iDXA, GE Healthcare, Chicago, IL), or any unstable or progressive medical conditions that could contribute to imbalance or falls

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Exclusion Criteria

1. smoked
2. were in physical therapy
3. had a self-reported fragility fracture within the last 10 years
4. had an acute lower extremity injury within the last 3 months
5. had lower extremity surgery within the last six months
6. had an ankle arthroplasty
7. had a knee or hip arthroplasty within the last 12 months

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Study & Design

• Study Type: INTERVENTIONAL
• Study Design: PARALLEL

Arm && Interventions

Group	Intervention	Description
Reactive balance training	Reactive balance training	Four training sessions, conducted twice a week for two weeks in groups of 1-2 participants. Each session was 0.5-1 hours, with an active training time of 30 minutes for each participant. Reactive balance training involved both slip and trip training. Slip training involved repeatedly stepping onto a low-friction interface (nylon fabric placed over a 0.9 × 0.9 meter polycarbonate sheet) while practicing controlling/decelerating the slipping foot and properly positioning the non-slipping foot under the pelvis. Trip training involved repeatedly practicing recovery from simulated trips on a modified treadmill. While standing on a modified treadmill, the treadmill belt was quickly accelerated posteriorly to elicit a forward loss of balance that mimicked a trip while walking. Participants attempted to step to avert a fall, and to establish a stable gait on the treadmill, after which the treadmill speed was slowed to zero to complete the trial.
Control balance training	Otago Balance Training	Four training sessions, conducted twice a week for two weeks in groups of 1-2 participants. Each session was 0.5-1 hours, with an active training time of 30 minutes for each participant. The control intervention involved general balance exercises adapted from the Otago Exercise program. Briefly, all four sessions involved balance exercises and strength exercises using ankle weights, and were progressively increased as performance improved by increasing ankle weights or the difficulty of the balance exercises (e.g., not holding onto a wall or support).

Primary Outcome Measures

Name	Time	Method
Trunk Angle at Touchdown After Tripping	during week 4, after the intervention that spanned weeks 2 and 3	anterior-posterior trunk angle relative to vertical at instant of touchdown of initial recovery step over tripping obstacle
Peak Slip Speed	during week 4, after the intervention that spanned weeks 2 and 3	highest instantaneous speed of slipping foot during actual slip

Secondary Outcome Measures

Name	Time	Method
Fall Incidence After a Laboratory-induced Slip	during week 4, after the intervention that spanned weeks 2 and 3	the outcome of each slip was categorized as either a: fall, recovery, or harness-assisted
Recovery Step Length After Tripping	during week 4, after the intervention that spanned weeks 2 and 3	anterior-posterior step distance of first step over tripping obstacle
Slip Distance	during week 4, after the intervention that spanned weeks 2 and 3	distance moved by slipping foot during actual slip
Fall Incidence After a Laboratory-induced Trip	during week 4, after the intervention that spanned weeks 2 and 3	the outcome of each trip was categorized as a: fall, recovery, or harness-assisted

Trial Locations

Locations (1)

Virginia Tech - Department of Industrial and Systems Engineering; 🇺🇸 Blacksburg, Virginia, United States