Reactive Balance Training Targeting Both Slip- and Trip-Induced Falls Among Older Adults: a Pilot Randomized Controlled Trial
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 入组人数
- 34
- 试验地点
- 1
- 主要终点
- Trunk Angle at Touchdown After Tripping
研究概览
简要总结
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.
研究设计
- 研究类型
- Interventional
- 分配方式
- Non Randomized
- 干预模型
- Parallel
- 主要目的
- Prevention
- 盲法
- None
入排标准
- 年龄范围
- 60 Years 至 80 Years（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 是
入选标准
- •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
排除标准
- •were in physical therapy
- •had a self-reported fragility fracture within the last 10 years
- •had an acute lower extremity injury within the last 3 months
- •had lower extremity surgery within the last six months
- •had an ankle arthroplasty
- •had a knee or hip arthroplasty within the last 12 months
研究组 & 干预措施
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.
干预措施: Reactive balance training (Behavioral)
Control 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).
干预措施: Otago Balance Training (Behavioral)
结局指标
主要结局
Trunk Angle at Touchdown After Tripping
时间窗: 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
时间窗: during week 4, after the intervention that spanned weeks 2 and 3
highest instantaneous speed of slipping foot during actual slip
Peak Slip Speed
时间窗: during week 1, before the intervention that spanned weeks 2 and 3
highest instantaneous speed of slipping foot during actual slip
Trunk Angle at Touchdown After Tripping
时间窗: during week 1, before 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
次要结局
- Fall Incidence After a Laboratory-induced Slip(during week 4, after the intervention that spanned weeks 2 and 3)
- Recovery Step Length After Tripping(during week 4, after the intervention that spanned weeks 2 and 3)
- Slip Distance(during week 4, after the intervention that spanned weeks 2 and 3)
- Fall Incidence After a Laboratory-induced Trip(during week 4, after the intervention that spanned weeks 2 and 3)
- Recovery Step Length After Tripping(during week 1, before the intervention that spanned weeks 2 and 3)
- Slip Distance(during week 1, before the intervention that spanned weeks 2 and 3)
- Fall Incidence After a Laboratory-induced Slip(during week 1, before the intervention that spanned weeks 2 and 3)
- Fall Incidence After a Laboratory-induced Trip(during week 1, before the intervention that spanned weeks 2 and 3)
研究者
Michael Madigan
Professor
Virginia Polytechnic Institute and State University