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A perturbation-based balance training program for older adults: study protocol for a randomised controlled trial.
Mansfield, Avril; Peters, Amy L; Liu, Barbara A; Maki, Brian E.
Afiliación
  • Mansfield A; Institute of Medical Science, University of Toronto, Toronto, Ontario, Canada. avril.mansfield@utoronto.ca
BMC Geriatr ; 7: 12, 2007 May 31.
Article en En | MEDLINE | ID: mdl-17540020
ABSTRACT

BACKGROUND:

Previous research investigating exercise as a means of falls prevention in older adults has shown mixed results. Lack of specificity of the intervention may be an important factor contributing to negative results. Change-in-support (CIS) balance reactions, which involve very rapid stepping or grasping movements of the limbs, play a critical role in preventing falls; hence, a training program that improves ability to execute effective CIS reactions could potentially have a profound effect in reducing risk of falling. This paper describes 1) the development of a perturbation-based balance training program that targets specific previously-reported age-related impairments in CIS reactions, and 2) a study protocol to evaluate the efficacy of this new training program. METHODS/

DESIGN:

The training program involves use of unpredictable, multi-directional moving-platform perturbations to evoke stepping and grasping reactions. Perturbation magnitude is gradually increased over the course of the 6-week program, and concurrent cognitive and movement tasks are included during later sessions. The program was developed in accordance with well-established principles of motor learning, such as individualisation, specificity, overload, adaptation-progression and variability. Specific goals are to reduce the frequency of multiple-step responses, reduce the frequency of collisions between the stepping foot and stance leg, and increase the speed of grasping reactions. A randomised control trial will be performed to evaluate the efficacy of the training program. A total of 30 community-dwelling older adults (age 64-80) with a recent history of instability or falling will be assigned to either the perturbation-based training or a control group (flexibility/relaxation training), using a stratified randomisation that controls for gender, age and baseline stepping/grasping performance. CIS reactions will be tested immediately before and after the six weeks of training, using platform perturbations as well as a distinctly different method of perturbation (waist pulls) in order to evaluate the generalisability of the training effects.

DISCUSSION:

This study will determine whether perturbation-based balance training can help to reverse specific age-related impairments in balance-recovery reactions. These results will help to guide the development of more effective falls prevention programs, which may ultimately lead to reduced health-care costs and enhanced mobility, independence and quality of life.
Asunto(s)

Texto completo: 1 Banco de datos: MEDLINE Asunto principal: Postura / Accidentes por Caídas / Equilibrio Postural / Terapia por Ejercicio Tipo de estudio: Clinical_trials / Etiology_studies / Prognostic_studies / Qualitative_research / Risk_factors_studies Límite: Aged / Aged80 / Female / Humans / Male Idioma: En Revista: BMC Geriatr Asunto de la revista: GERIATRIA Año: 2007 Tipo del documento: Article País de afiliación: Canadá

Texto completo: 1 Banco de datos: MEDLINE Asunto principal: Postura / Accidentes por Caídas / Equilibrio Postural / Terapia por Ejercicio Tipo de estudio: Clinical_trials / Etiology_studies / Prognostic_studies / Qualitative_research / Risk_factors_studies Límite: Aged / Aged80 / Female / Humans / Male Idioma: En Revista: BMC Geriatr Asunto de la revista: GERIATRIA Año: 2007 Tipo del documento: Article País de afiliación: Canadá