Treadmill-based Perturbation Training For Preventing Falls Among Young Adults

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Falls present a serious challenge not only among older adults, but for young adults, especially those whose working condition exposes them to a high fall hazard. Treadmill-based perturbation training, as a task-specific training, has emerged as a new paradigm used to prevent falls. However, the training program contained up to 30 perturbation trials in previous studies. It is unclear if a reduced number of perturbation trials could still induce positive effect in preventing falls. PURPOSE: To investigate the effect of a treadmill-based perturbation training paradigm consisting of 8 slip perturbations on reducing slip-related falls in young adults. METHODS: Thirteen healthy young adults (24 ± 4.34 years) were randomly assigned into either training (n = 6) or control (n = 7) groups. The training group underwent 8 unexpected slip trials on a special treadmill during gait while the control group received a “mock” training in which they walked on the same treadmill. After the training, both groups were subjected to an unexpected slip induced by releasing a movable platform when walking overground (OG). Subjects wore a safety harness equipped with a load cell. Body kinematics were captured and used to calculate dynamic gait stability on the OG slip. The load cell force was used to determine the OG slip outcome (fall vs. no-fall). A Chi-square test and independent t-test were used to respectively compare the fall incidents and dynamic stability between groups. RESULTS: Responding to the OG slip, 4 out of 7 (57.1%) subjects in the control group while 1 out of 6 (16.7%, p = 0.18) in the training group fell. The training group displayed a lower instability than the control at recovery foot touchdown (-0.56 ± 0.12 vs. -0.69 ± 0.07, p < 0.05). CONCLUSIONS: This study suggests that treadmill-based perturbation training with less perturbation trials could lower the risk of falls among young adults when exposed to a real-life like OG slip. Given that treadmill-based slip training is easy to use, portable, controllable, and reproducible, this training could provide a relatively novel modality to reduce falls among both young and older adults. Further studies based on a large sample size are needed to symmetrically evaluate the effectiveness of this type of training. Supported by the PiMSA Graduate Student Grant.