Article

Compensatory stepping and grasping reactions are prevalent responses
to sudden loss of balance and play a critical role in preventing falls. The
ability to execute these reactions effectively is impaired in older adults.
The purpose of this study was to evaluate a perturbation-based balance
training program designed to target specific age-related impairments in
compensatory stepping and grasping balance recovery reactions. DESIGN: This was a
double-blind randomized controlled trial. SETTING: The study was conducted at
research laboratories in a large urban hospital. PARTICIPANTS: Thirty
community-dwelling older adults (aged 64-80 years) with a recent history of falls
or self-reported instability participated in the study. INTERVENTION:
Participants were randomly assigned to receive either a 6-week perturbation-based
(motion platform) balance training program or a 6-week control program involving
flexibility and relaxation training. MEASUREMENTS: Features of balance reactions
targeted by the perturbation-based program were: (1) multi-step reactions, (2)
extra lateral steps following anteroposterior perturbations, (3) foot collisions
following lateral perturbations, and (4) time to complete grasping reactions. The
reactions were evoked during testing by highly unpredictable surface translation
and cable pull perturbations, both of which differed from the perturbations used
during training. RESULTS: /b> Compared with the control program, the
perturbation-based training led to greater reductions in frequency of multi-step
reactions and foot collisions that were statistically significant for surface
translations but not cable pulls. The perturbation group also showed
significantly greater reduction in handrail contact time compared with the
control group for cable pulls and a possible trend in this direction for surface
translations. LIMITATIONS: Further work is needed to determine whether a
maintenance program is needed to retain the training benefits and to assess
whether these benefits reduce fall risk in daily life. CONCLUSION:
Perturbation-based training shows promise as an effective intervention to improve
the ability of older adults to prevent themselves from falling when they lose
their balance.

Langue : ANGLAIS