Domain-specific balance training reduces slip-related fall risk in young adults: A potential alternative to perturbation training

Abstract

BackgroundExternal, environmental perturbations (e.g., slips) account for >60% of falls and lead to severe health-related consequences. Perturbation training paradigms are known to reduce slip-related fall risk by improving two key aspects of reactive balance control: center of mass (COM) stability and limb support. However, perturbation training requires complex technology and is difficult to implement outside of the laboratory. This study examined if key reactive balance mechanisms could also be improved via more clinically translatable balance exercises targeting both volitional and reactive balance control (i.e., domain-specific balance training). Methods12 young adults completed a single session of domain-specific balance training and were exposed to a single overground slip (S1-Domain-Specific). The control group (n = 12) was exposed to 24 overground slips (S1–24-Control) without prior training. On the first (novel) slip, we compared reactive balance performance (rate of falls and loss of balance, margin of stability (MOS), limb support) between the training and control groups (S1-Domain-Specific vs. S1-Control). We also compared key reactive balance outcomes between S1-Domain-Specific and the final slip of the control group (S24-Control). ResultsThere was a lower rate of backward loss of balance on S1-Domain-Specific than S1-Control, along with higher post-slip MOS and increased hip height (i.e., greater limb support) (p < 0.05). These improvements were associated with a more anterior COM position, greater COM velocity in the anterior direction, and reduced slip distance. Post-slip MOS and hip height were not significantly different between S1-Domain-Specific and S24-Control. DiscussionA single session of domain-specific balance training improved key components of reactive balance control and could significantly reduce slip-related fall risk. Domain-specific balance training might provide similar fall prevention benefits as perturbation training, with easier transition into clinics, communities, and homes.