Rehabilitation clinicians’ perspectives of reactive balance training

Jagroop, David; Houvardas, Stephanie; Danells, Cynthia; Kochanowski, Jennifer; French, Esmé; Salbach, Nancy M.; Musselman, Kristin E.; Inness, Elizabeth L.; Mansfield, Avril

doi:10.1101/2021.02.19.21252082

Cited by 2 publications

(2 citation statements)

References 38 publications

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“…This finding highlights the need to build trust between the therapist and client to alleviate these anxieties. 59 Therapists report that, as clients gradually overcome these anxieties with training, RBT can help to build self-efficacy and a sense of achievement. 59 Findings regarding adverse events should be interpreted with caution.…”

Section: Discussionmentioning

confidence: 99%

“…59 Therapists report that, as clients gradually overcome these anxieties with training, RBT can help to build self-efficacy and a sense of achievement. 59 Findings regarding adverse events should be interpreted with caution. Fifteen studies that met most of our inclusion criteria were not included in the review because they did not monitor adverse events, and six trials that were included in the current review did not monitor adverse events.…”

Section: Discussionmentioning

confidence: 99%

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The effect of reactive balance training on falls in daily life: an updated systematic review and meta-analysis

Devasahayam

Farwell

Lim

et al. 2022

Preprint

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Objective: Reactive balance training is an emerging approach to reduce falls risk in people with balance impairments. The purpose of this study was to determine the effect of reactive balance training on falls in daily life among individuals at increased risk of falls, and to document associated adverse events. Data sources: Databases searched were Ovid MEDLINE (1946-November 2020), Embase Classic and Embase (1947-November 2020), Cochrane Central Register of Controlled Trials (2014-November 2020), Physiotherapy Evidence Database (PEDro; searched on 9 November 2020). Study selection: Randomized controlled trials of reactive balance training were included. The literature search was limited to English language. Records were screened by two investigators separately. Data extraction: Outcome measures were number of participants who reported falls after training, number of falls reported after training, and the nature, frequency, and severity of adverse events. Authors of included studies were contacted to obtain additional information. Data synthesis: Twenty-five trials were included, of which 14 reported falls and 19 monitored adverse events. Participants assigned to reactive balance training groups were less likely to fall compared to control groups (fall risk ratio: 0.75, 95% confidence interval=[0.60, 0.92]; p=0.006, I2=37%) and reported fewer falls than control groups (rate ratio: 0.60, 95% confidence interval=[0.42, 0.86]; p=0.005, I2=83%). Prevalence of adverse events was higher in reactive balance training (29%) compared to control groups (19%; p=0.018). Conclusion: RBT reduces the likelihood of falls in daily life for older adults and people with balance impairments. More adverse events were reported for reactive balance training than control groups. Impact: Balance training that evokes balance reactions can reduce falls among people at increased risk of falls.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

The effect of reactive balance training on falls in daily life: an updated systematic review and meta-analysis

Devasahayam

Farwell

Lim

et al. 2022

Preprint

Self Cite

View full text Add to dashboard Cite

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Identifying priorities for balance interventions through a participatory co-design approach with end-users

Benn,

Jervis-Rademeyer,

Benson

et al. 2023

BMC Neurol

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Background Most individuals living with spinal cord injuries/diseases (SCI/D) or stroke experience at least one fall each year; hence, the development of interventions and technologies that target balance control is needed. The purpose of this study was to identify and explore the priorities for balance-focused interventions and technologies from the perspectives of end-users to assist with the design of an intervention that combines functional electrical stimulation (FES) with visual feedback training for standing balance. Methods Two individuals with SCI/D, one individual with stroke, two physical therapists (PT) and one hospital administrator were recruited. Participants attended three focus group meetings that followed a participatory co-design approach. A semi-structured interview guide, developed from the FAME (Feasibility, Appropriateness, Meaningfulness, Effectiveness, Economic Evidence) framework, was used to lead the discussion, querying participants’ experiences with balance deficits and interventions, and FES. Meetings were audio-recorded and transcribed verbatim. An iterative and reflexive inductive thematic analysis was applied to the transcripts by three researchers. Results Four themes were identified: (1) Balance is meaningful for daily life and rehabilitation. Participants acknowledged various factors influencing balance control and how balance deficits interfered with participation in activities. End-users stressed the importance of continuing to work on one’s balance after discharge from hospital-based rehabilitation. (2) Desired characteristics of balance interventions. Participants explained that balance interventions should be tailored to an individual’s unique needs and goals, relevant to their lives, balance their safety and risk, and be engaging. (3) Prior experiences with FES to inform future therapeutic use. Participants with stroke or SCI/D described initial apprehension with FES, but experienced numerous benefits that motivated them to continue with FES. Challenges with FES were mentioned, including wires, cost, and time of set up. (4) Potential role of FES in balance interventions. Participants felt that FES would complement balance interventions; however, they had not experienced this combination of therapies previously. Conclusions End-users described how their experiences with balance deficits, rehabilitation, and FES informed their priorities for balance interventions. The findings inform the design and implementation of future balance interventions for individuals with SCI/D or stroke, including an intervention involving FES and visual feedback training.

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Rehabilitation clinicians’ perspectives of reactive balance training

Cited by 2 publications

References 38 publications

The effect of reactive balance training on falls in daily life: an updated systematic review and meta-analysis

The effect of reactive balance training on falls in daily life: an updated systematic review and meta-analysis

Identifying priorities for balance interventions through a participatory co-design approach with end-users

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