The retention of fall-resisting behavior derived from treadmill slip-perturbation training in community-dwelling older adults

Liu, Xuan; Bhatt, Tanvi; Wang, Yiru; Wang, Shuaijie; Lee, Anna; Pai, Yi–Chung

doi:10.1007/s11357-020-00270-5

Cited by 15 publications

(46 citation statements)

References 51 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Evidence exists for OAs that an inter-limb transfer of backward slip-like perturbations is possible (McCrum et al, 2020 ); however, transfer to other mechanical tasks is yet to be investigated. To the knowledge of the authors, generalisation of the benefits from treadmill induced backward slips to overground backward slips has not been investigated yet, but encouraging results on forward slips show that within session and long-term generalisation of the balance improvement following treadmill-induced slips is possible, although not as efficacious as overground-slip training (Liu et al, 2020 ).…”

Section: Discussionmentioning

confidence: 99%

Biomechanical Mechanisms of Improved Balance Recovery to Repeated Backward Slips Simulated by Treadmill Belt Accelerations in Young and Older Adults

Debelle

Maganaris

O’Brien

2021

Front. Sports Act. Living

View full text Add to dashboard Cite

Aim: Exposure to repeated gait perturbations improves the balance of older adults (OAs) and decreases their risks of falling, but little is known about the underpinning mechanical adjustments. We aimed to quantify the changing temporo-spatial and kinetic characteristics of balance recovery following repeated backward slips to better understand the mechanical adjustments responsible for improved balance.Methods: We exposed 17 young adults (YAs) (25.2 ± 3.7 years) and 17 OAs (62.4 ± 6.6 years) to 10 backward slips simulated on an instrumented treadmill by unilateral backward belt accelerations. We measured the balance of the participants (margin of stability: MoS), balance recovery (nsteps: number of steps necessary to return to a steady gait for at least three consecutive steps), temporo-spatial (step length), and kinetics [ground reaction force (GRF) angle, lower limb joint moments] for 15 steps following each slip. The results were compared with baseline.Results: Participants in both groups improved their MoS and nsteps with repeated exposure to the slips, but no significant effect of age was detected. During the perturbed step, the GRF vector was directed more posteriorly during mid-stance and more anteriorly during push-off than baseline, which resulted in a longer step. These adjustments were maintained from the first (Slip01) to the last (Slip10) slip, and by Slip10 were correlated with better balance (MoS) on the second recovery step. During the first recovery step following Slip01, participants developed lower plantarflexor and larger knee extensor moments whilst taking a shorter step, these adjustments were correlated with poorer balance and were not maintained with repeated slips. Joint moments and step length of the first recovery step returned to normal levels by Slip10.Conclusion: Young adults and OAs improved their balance with repeated slips. The adjustments that were positively correlated with balance (changes in step length, GRF angle) were maintained whilst those that were not (changes in joint moments) were discarded. All the responses observed in Slip10 were observed in Slip01. The observed balance improvements were achieved by refining the initial strategy rather than by developing a new one. The underlying mechanics were correlated with step length of the first recovery steps, which was associated with balance and should be monitored in fall prevention interventions.

show abstract

Section: Discussionmentioning

confidence: 99%

Biomechanical Mechanisms of Improved Balance Recovery to Repeated Backward Slips Simulated by Treadmill Belt Accelerations in Young and Older Adults

Debelle

Maganaris

O’Brien

2021

Front. Sports Act. Living

View full text Add to dashboard Cite

show abstract

“…PBT has previously been performed using a variety of methods such as; (1) movable platforms, 28 (2) walkways with low friction platforms and/or trip boards 14 16 and (3) treadmill that produces sudden accelerations. [29][30][31][32] Among these, approaches that apply perturbations during walking are considered more task-specific as most falls occur during walking. 33 34 Moreover, perturbations delivered on walkways are considered the most realistic; however, such setups is space-consuming, expensive and immobile.…”

Section: Strengths and Limitations Of This Studymentioning

confidence: 99%

“…Moreover, perturbations delivered on walkways are considered the most realistic; however, such setups is space-consuming, expensive and immobile. Treadmills, conversely, are less space-consuming, cheaper and more portable, enabling a more straightforward implementation into fall prevention and rehabilitation clinics 12 29 35 36. An additional benefit of treadmills is the perturbations’ unpredictability, which enhances the reliance on reactive balance control strategies 23.…”

Section: Introductionmentioning

confidence: 99%

“…An additional benefit of treadmills is the perturbations’ unpredictability, which enhances the reliance on reactive balance control strategies 23. Studies have shown that treadmill-PBT improves proactive and reactive dynamic stability and decreases fall rates following laboratory-induced walkway perturbations 29 30 35 37 38. Nonetheless, the magnitude to which these adaptations translates to prevent daily life falls are still vastly unknown 31.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Effects of treadmill slip and trip perturbation-based balance training on falls in community-dwelling older adults (STABILITY): study protocol for a randomised controlled trial

et al. 2022

View full text Add to dashboard Cite

IntroductionFalls among older adults are most frequently caused by slips and trips and can have devastating consequences. Perturbation-based balance training (PBT) have recently shown promising fall preventive effects after even small training dosages. However, the fall preventive effects of PBT delivered on a treadmill are still unknown. Therefore, this parallel-group randomised controlled trial aims to quantify the effects of a four-session treadmill-PBT training intervention on falls compared with treadmill walking among community-dwelling older adults aged 65 years or more.Methods and analysis140 community-dwelling older adults will be recruited and randomised into either the treadmill-PBT or the treadmill walking group. Each group will undergo three initial training sessions within a week and an additional ‘booster’ session after 26 weeks. Participants in the treadmill-PBT group will receive 40 slip and/or trip perturbations induced by accurately timed treadmill belt accelerations at each training session. The primary outcome of interest is daily life fall rates collected using fall calendars for a follow-up period of 52 weeks. Secondary outcomes include physical, cognitive and social–psychological fall-related risk factors and will be collected at the pre-training and post-training test and the 26-week and 52-week follow-up tests. All outcomes will be analysed using the intention-to-treat approach by an external statistician. A Poisson’s regressions with bootstrapping, to account for overdispersion, will be used to compare group differences in fall rates.Ethics and disseminationThe study protocol has been approved by the North Denmark Region Committee on Health Research Ethics (N-20200089). The results will be disseminated in peer-reviewed journals and at international conferences.Trial registration numberNCT04733222.

show abstract

“…moveable platform to vinyl floor (Pai et al, 2003, Bhatt and Pai, 2009a, Yang et al, 2009); and to different perturbation types (slips to trips (Bhatt et al, 2013) and waist pull perturbations to treadmill slips (Martelli et al, 2018), though minor interference has also been reported (Bhatt et al, 2013). Generalisation between contexts (treadmill to overground slips) may also be retained over longer periods (Liu et al, 2021). Based on evidence from locomotor training studies it is postulated that when an acquired internal representation is more general (i.e.…”

Section: How Does Pbt Lead To the Retention And Generalisation Of Fal...mentioning

confidence: 99%

Perturbation-based Balance Training: Principles, Mechanisms and Implementation in Clinical Practice

McCrum¹,

Bhatt²,

Gerards³

et al. 2022

Preprint

Self Cite

View full text Add to dashboard Cite

Since the mid-2000s, perturbation-based balance training has been gaining interest as an efficient and effective way to prevent falls in older adults. It has been suggested that this task-specific training approach may present a paradigm shift in fall prevention. In this review, we discuss key concepts and common issues and questions regarding perturbation-based balance training. In doing so, we aim to provide a comprehensive synthesis of the current evidence on the mechanisms, feasibility and efficacy of perturbation-based balance training for researchers and practitioners. We address this in two sections: “Principles and Mechanisms” and “Implementation in Practice”. In the first section, definitions, task-specificity, adaptation and retention mechanisms and the dose-response relationship are discussed. In the second section, issues related to safety, anxiety, evidence in clinical populations (e.g., Parkinson’s disease, stroke), technology and training devices are discussed. Perturbation-based balance training is a promising approach to fall prevention. However, several fundamental and applied aspects of the approach need to be further investigated before it can be widely implemented in clinical practice.

show abstract

The retention of fall-resisting behavior derived from treadmill slip-perturbation training in community-dwelling older adults

Cited by 15 publications

References 51 publications

Biomechanical Mechanisms of Improved Balance Recovery to Repeated Backward Slips Simulated by Treadmill Belt Accelerations in Young and Older Adults

Biomechanical Mechanisms of Improved Balance Recovery to Repeated Backward Slips Simulated by Treadmill Belt Accelerations in Young and Older Adults

Effects of treadmill slip and trip perturbation-based balance training on falls in community-dwelling older adults (STABILITY): study protocol for a randomised controlled trial

Perturbation-based Balance Training: Principles, Mechanisms and Implementation in Clinical Practice

Contact Info

Product

Resources

About