Abstract
The potential of task-specific training as a fall-prevention intervention was studied. The primary purpose of the study was to determine the extent to which a task-specific training protocol decreased the number of falls by middle-age and older women after a laboratory-induced trip. Secondary purposes were to explore the ability of trunk kinematics during the initial recovery step and the length of the initial recovery step to correctly classify the trip outcome and to quantify the extent to which the training protocol affected these variables. Healthy community-dwelling women (n = 52) were assigned to either a training group or a control group that received no training. Training group women participated in an individually tailored, task-specific training protocol during which forward-directed stepping responses were necessary to avoid a fall after treadmill-delivered postural disturbances. Following the protocol, the ability to avoid a fall after a laboratory-induced trip was assessed. The primary outcome variable was the success (recover) or failure (fall) of the posttrip stepping response. Compared with the control group, there were fewer falls by the trained women after the laboratory-induced trip (P < 0.001; odds ratio = 0.13). Using logistic regression, falls and recoveries after the trip were sensitively classified by trunk flexion angle at the completion of the initial recovery step and the length of the initial recovery step (sensitivity = 0.67, specificity = 0.98), the former of which improved as a result of the task-specific training protocol. The task-specific training protocol significantly reduced the number of falls after a laboratory-induced trip. Prospective study is required to determine whether this task-specific training reduces falls in the community and, consequently, may complement currently used exercise-based fall prevention intervention methods.
Highlights
Paragraph Number 1 Exercise demonstrably reduces falls by older adults [3]
Paragraph Number 18 The results demonstrated that task-specific training decreased the number of falls by middle age and older women following a laboratory-induced trip
The 24 percent of the middle age control group women who fell is close to the 21.9% of untrained women 65+ years of age who fell after a laboratory-induced trip [10]
Summary
Paragraph Number 1 Exercise demonstrably reduces falls by older adults [3]. it may be possible to improve effectiveness of fall prevention interventions by the inclusion of taskspecific perturbation-based balance training [6]. Task-specific training that involves practicing the actual motor skill of avoiding a fall following loss of balance will possess greater specificity to falls that occur in the community The potential of this form of task-specific training to reduce trip-related falls was studied in healthy older adults who performed stepping responses to avoid falling following treadmill delivered postural disturbances [7]. Other investigators have shown that this type of task-specific training can reduce falls by frail older adults [13] and Parkinson’s disease patients [11] These studies suggest that practicing the actual motor skill of avoiding a fall following a large postural disturbance may decrease fall risk. We expected these variables to be significantly improved following the training protocol
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