The effect of perturbation-based balance training on balance control and fear of falling in older adults: a single-blind randomised controlled trial

BMC Geriatrics

Research

Rob de Bie¹  Kenneth Meijer²  Rik Marcellis³  Antoine Lenssen³  Rachel Senden³  Marissa Gerards⁴  Martijn Poeze⁵ 

[1]Department of Epidemiology, Maastricht University, Maastricht, The Netherlands

[2]Care and Public Health Institute (CAPHRI), Maastricht University, Maastricht, The Netherlands

[3]Department of Nutrition and Movement Sciences, Maastricht University, Maastricht, The Netherlands

[4]School of Nutrition and Translational Research in Metabolism (NUTRIM), Maastricht University, Maastricht, The Netherlands

[5]Department of Physiotherapy, Maastricht University Medical Center (MUMC+), Maastricht, The Netherlands

[6]Department of Physiotherapy, Maastricht University Medical Center (MUMC+), Maastricht, The Netherlands

[7]Department of Epidemiology, Maastricht University, Maastricht, The Netherlands

[8]Care and Public Health Institute (CAPHRI), Maastricht University, Maastricht, The Netherlands

[9]Department of Surgery, division of Trauma Surgery, MUMC+, Maastricht, The Netherlands

[10]School of Nutrition and Translational Research in Metabolism (NUTRIM), Maastricht University, Maastricht, The Netherlands

关键词: Accidental Falls;    Aging;    Balance;    Perturbation;    Prevention;    Older adults;   

DOI  :  10.1186/s12877-023-03988-x

 received in 2022-04-27, accepted in 2023-04-22,  发布年份 2023

来源: Springer

【 摘 要 】

BackgroundPerturbation-based balance training (PBT) is an emerging intervention shown to improve balance recovery responses and reduce falls in everyday life in older adults. However, perturbation interventions were heterogeneous in nature and need improvement. This study aims to investigate the effects of a PBT protocol that was designed to address previously identified challenges of PBT, in addition to usual care, on balance control and fear of falling in older adults at increased risk of falling.MethodsCommunity-dwelling older adults (age ≥ 65 years) who visited the hospital outpatient clinic due to a fall incident were included. Participants received PBT in addition to usual care (referral to a physiotherapist) versus usual care alone. PBT consisted of three 30-minute sessions in three weeks. Unilateral treadmill belt accelerations and decelerations and platform perturbations (shifts and tilts) were applied during standing and walking on the Computer Assisted Rehabilitation Environment (CAREN, Motek Medical BV). This dual-belt treadmill embedded in a motion platform with 6 degrees of freedom is surrounded by a 180° screen on which virtual reality environments are projected. Duration and contents of the training were standardised, while training progression was individualised. Fear of falling (FES-I) and balance control (Mini-BESTest) were assessed at baseline and one week post-intervention. Primary analysis compared changes in outcome measures between groups using Mann-Whitney U tests.ResultsEighty-two participants were included (PBT group n = 39), with a median age of 73 years (IQR 8 years). Median Mini-BESTest scores did not clinically relevantly improve and were not significantly different between groups post-intervention (p = 0.87). FES-I scores did not change in either group.ConclusionsParticipation in a PBT program including multiple perturbation types and directions did not lead to different effects than usual care on clinical measures of balance control or fear of falling in community-dwelling older adults with a recent history of falls. More research is needed to explore how to modulate PBT training dose, and which clinical outcomes are most suitable to measure training effects on balance control.Trial registrationNederlands Trial Register NL7680. Registered 17-04-2019 – retrospectively registered. https://www.trialregister.nl/trial/7680.

【 授权许可】

CC BY   
© The Author(s) 2023

【 图 表 】

Fig. 1

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