Two Novel Slip Training Methods Improve the Likelihood of Recovering Balance After a Laboratory-Induced Slip

Abstract

Task-specific balance training is an approach to fall prevention that has the potential to reduce the number of slip-induced falls. However, a limitation of current task-specific training methods is that they require non-trivial financial and/or equipment resources. This pilot study evaluated the efficacy of two low-cost, low-tech methods for slip recovery training in improving balance recovery ability. The two methods were: 1) repeated unexpected slip training (UST), which involved repeated unexpected slips while walking (similar to current methods of task-specific slip recovery training); and 2) volitional slip-recovery training (VST), which involved practicing a slip recovery response after volitionally stepping to induce a slip-like perturbation. Thirty-six young adults completed one training session (UST, VST, or control), followed by one unexpected, laboratory-induced slip while walking on the following day. Compared to controls, UST and VST resulted in a higher proportion of successful balance recoveries from the laboratory-induced slips. UST improved both proactive control and the reactive stepping response after slipping, while VST improved the ability to arrest the motion of the slipping foot. Based on these preliminary results, UST and VST may provide practical, cost-effective methods for slip recovery training.

Perturbation-based balance training targeting both slip- and trip-induced falls among older adults: a randomized controlled trial

“…PBT for slip training has been reported in detail elsewhere [10]. Briefly, participants repeatedly stepped onto a low-friction interface (nylon fabric placed over a 0.9 × 0.9 m polycarbonate sheet) while practicing controlling/decelerating the slipping foot and properly positioning the nonslipping foot under the pelvis by stepping (Fig.…”

“…Slips commonly occur at heel strike when the friction required for walking exceeds the friction available between the foot and floor [8], and typically result in a backwards loss of balance [9]. Examples of PBT for slipping have involved repeated exposure to slips while walking over a sliding platform [6], or a structured step-training regimen onto a low-friction surface [10]. These types of PBT have elicited slip-reducing proactive gait adaptations, and improved recovery rates and reactive balance after laboratory-induced slips.…”

A Cross-Sectional Study on Fall Direction and Lower Limb Loading in Response to a Perturbation on Laterally Inclined Platform

“…Balance in a person has been challenged and trained with different techniques/devices that require the patient to be in motion (walk) or motionless (stand). The PBT interventions used with the person in motion are motorized treadmill [10][11][12], split treadmill [13], and trip and slip walkway [14][15][16]. While a motorized treadmill perturbs both legs, a split treadmill and slip board perturb a single leg to move the center of mass away from the base of support.…”

Severity of Unconstrained Simultaneous Bilateral Slips: The Impact of Frontal Plane Feet Velocities Relative to the Center of Mass to Classify Slip-Related Falls and Recoveries

“…Treadmill-belt perturbations (13)(14)(15)(16) or sliding platforms embedded in the floor (9,15,(17)(18)(19) during over-ground locomotion restrict motion of the slipping foot to the anteroposterior direction and therefore may not reproduce the diversity of slip mechanics across both sagittal and frontal planes. Other slip simulation methods employing low friction sheets or lubricants applied unexpectedly in a person's walking path (9,10,(20)(21)(22) do produce unconstrained slips, however the location of the slip is predictable after the first occurrence, making the delivery of repeated unpredictable slips challenging. To simulate unconstrained slips that occur at unpredictable times and locations in the lab, our research group developed the Wearable Apparatus for Slipping Perturbations (WASP, Figure 1).…”