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Effects of the 'ReacStep' training program on balance recovery and fall risk factors in older people: an
Shivam Sharma1,2, Carly Chaplin1, Cameron Hicks1,2
1Falls, Balance and Injury Research Centre, Neuroscience Research Australia, Randwick, New South Wales, Australia.
Background:
Reactive balance training (RBT) using repeated perturbations may reduce falls; however, training methods are not easily replicated or translatable to clinical settings. This study aimed to examine the effects of a novel RBT program on balance recovery from laboratory-induced trips and slips and fall risk factors in older people using simple and low-cost equipment.
Methods:
We conducted a randomised controlled trial involving 88 older people. An intervention group (n = 43) received the ReacStep program, which involved tether-release reactive stepping and intentional slips once a week for 6 weeks. Both the intervention and control (n = 45) groups received home-based strength training for 8 weeks. Blinded staff assessed reactive balance (laboratory-induced falls), physical functions at baseline (week 1) and post intervention (week 8). Weekly short-message service (SMS) surveys ascertained falls in daily life over 12 months.
Results:
Both groups were comparable in demographics, with a mean age of 72 years (SD = 5.6). Adherence to ReacStep sessions was high (90%). There were no significant differences between groups in laboratory-assessed reactive balance falls at post-test or daily-life falls over 1 year (P = .19). However, at post-test, the intervention group demonstrated significant improvements in maximum step length and choice stepping reaction time compared to controls (P <.05).
Conclusion:
The ReacStep program demonstrated excellent adherence, was well tolerated and improved the ability to take larger and quicker steps in older people. As these improvements did not translate to unexpected trips and slips and daily life falls, the findings highlight the need for further optimization of the program for improving reactive balance and preventing falls.
