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Proof of concept for perturbation-based balance training in older adults at a high risk for falls
Kathleen A Bieryla1, Michael L Madigan
1Department of Biomedical Engineering, Bucknell University, 701 Moore Avenue, Lewisburg, PA 17837, USA. k.bieryla@bucknell.edu
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.
