One third of older adults aged over 65 years experience at least one fall annually.
A fall can have devastating consequences, such as fractures, head injuries and even death. Preventing falls is therefore key for public health and quality of life among older adults.
Most falls are caused by mechanical perturbations such as trips and slips. Conventional fall prevention training typically lacks training of task-specific recovery from such perturbations to avoid a fall.
On a treadmill, perturbations can be easily and safely applied by sudden belt accelerations or decelerations, provoking forward or backward balance loss. Recent studies have shown that perturbation training can be very effective with up to 50% reduction in daily-life falls.
We conducted a series of experiments. In the first experiment we showed that recovery from perturbations, measured by trunk kinematics, is significantly improved after a single session of training and retained over one week, but does not transfer to improved gait stability in different perturbation directions.
Subsequently, we developed a perturbation-based gait training, including 8 sessions over a 4-week period. In a randomized clinical trial, we showed that after treadmill training with or without perturbations, all participants significantly improved their balance and gait performance, but training with perturbations led to significantly more increase on physical performance, more decrease in concern of falling and a significant reduction on daily-life falls.
Physical activity and gait quality in daily life remained unchanged after the training. Further research is necessary to understand the pathways for translation of perturbation-based treadmill training effects in reducing falls.
Researchers involved in this project
- Dr. Selma Papegaaij;
- Dr. Frans Steenbrink.