Proof of Concept for Perturbation-Based Balance Training in Older Adults at a High Risk for Falls

Abstract

Bieryla KA, Madigan ML. Proof of concept for perturbation-based balance training in older adults at a high risk for falls. Objective To investigate the efficacy of perturbation-based balance training (PBBT) on time to stabilization (TTS) after a nonstepping response to a postural perturbation in older adults at a high risk for falls. Design Single-subject design. Participants completed 4 baseline tests, 1 month of PBBT, and posttraining tests both 1 week and 1 month after training. Setting Assisted-living facility. Participants Older adults (N=5; mean ± SD age, 85±6.5y; residents of assisted-living facility) at a high risk for falls. Intervention PBBT involved 3 sessions a week for 4 weeks. Each session involved standing for 50 trials on a pneumatic instrumented moving platform that translated 0 to 0.08m forward or 0 to 0.13m backward in approximately 390ms (average velocity, 0.25m/s). Main Outcome Measures Time to stabilization of center of pressure (COP) after a perturbation on the moving platform. Results TTS of COP was 41.6% shorter than baseline tests ( P<.001) 1 week after completing PBBT and 46.3% shorter than baseline tests ( P<.001) 1 month after completing PBBT. Conclusions PBBT improved TTS after a postural perturbation in older adults at a high risk for falls, and these improvements were retained for 1 month.