scholarly journals Commentary: Older adults can improve compensatory stepping with repeated postural perturbations

2016 ◽  
Vol 8 ◽  
Author(s):  
Christopher McCrum ◽  
Johannes M. N. Essers ◽  
Li-Juan Jie ◽  
Wai-Yan Liu ◽  
Kenneth Meijer
Keyword(s):  
Older Adults ◽  
Compensatory Stepping ◽  
Postural Perturbations

scholarly journals Older adults can improve compensatory stepping with repeated postural perturbations

2015 ◽  
Vol 7 ◽  
Author(s):  
Bauke W. Dijkstra ◽  
Fay B. Horak ◽  
Yvo P. T. Kamsma ◽  
Daniel S. Peterson
Keyword(s):  
Older Adults ◽  
Compensatory Stepping ◽  
Postural Perturbations

scholarly journals Promoting Generalized Learning in Balance Recovery Interventions

2021 ◽  
Vol 11 (3) ◽  
pp. 402
Author(s):  
Sara A. Harper ◽  
Anne Z. Beethe ◽  
Christopher J. Dakin ◽  
David A. E. Bolton
Keyword(s):  
Older Adults ◽  
Motor Learning ◽  
Daily Life ◽  
Balance Training ◽  
Community Dwelling ◽  
Specific Training ◽  
Balance Recovery ◽  
Parallel Streams ◽  
Postural Perturbations ◽  
Community Dwelling Older Adults

Recent studies have shown balance recovery can be enhanced via task-specific training, referred to as perturbation-based balance training (PBT). These interventions rely on principles of motor learning where repeated exposure to task-relevant postural perturbations results in more effective compensatory balance responses. Evidence indicates that compensatory responses trained using PBT can be retained for many months and can lead to a reduction in falls in community-dwelling older adults. A notable shortcoming with PBT is that it does not transfer well to similar but contextually different scenarios (e.g., falling sideways versus a forward trip). Given that it is not feasible to train all conditions in which someone could fall, this limited transfer presents a conundrum; namely, how do we best use PBT to appropriately equip people to deal with the enormous variety of fall-inducing scenarios encountered in daily life? In this perspective article, we draw from fields of research that explore how general learning can be promoted. From this, we propose a series of methods, gleaned from parallel streams of research, to inform and hopefully optimize this emerging field where people receive training to specifically improve their balance reactions.

Compensatory but not anticipatory adjustments are altered in older adults during lateral postural perturbations

2013 ◽  
Vol 124 (8) ◽  
pp. 1628-1637 ◽  
Author(s):  
Renato Claudino ◽  
Eloá C.C. dos Santos ◽  
Marcio J. Santos
Keyword(s):  
Older Adults ◽  
Postural Perturbations

Compensatory Stepping: The Biomechanics of a Preferred Response Among Older Adults

2001 ◽  
Vol 27 (4) ◽  
pp. 361-376 ◽  
Author(s):  
Jody L. Jensen ◽  
Lesley A. Brown ◽  
Marjorie H. Woollacott
Keyword(s):  
Older Adults ◽  
Compensatory Stepping

scholarly journals Effect of a Perturbation-Based Balance Training Program on Compensatory Stepping and Grasping Reactions in Older Adults: A Randomized Controlled Trial

2010 ◽  
Vol 90 (4) ◽  
pp. 476-491 ◽  
Author(s):  
Avril Mansfield ◽  
Amy L. Peters ◽  
Barbara A. Liu ◽  
Brian E. Maki
Keyword(s):  
Older Adults ◽  
Randomized Controlled Trial ◽  
Training Program ◽  
Controlled Trial ◽  
Balance Training ◽  
Control Program ◽  
Community Dwelling ◽  
Motion Platform ◽  
Randomized Controlled ◽  
Compensatory Stepping

BackgroundCompensatory 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.ObjectiveThe 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.DesignThis was a double-blind randomized controlled trial.SettingThe study was conducted at research laboratories in a large urban hospital.ParticipantsThirty community-dwelling older adults (aged 64–80 years) with a recent history of falls or self-reported instability participated in the study.InterventionParticipants 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.MeasurementsFeatures 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.ResultsCompared 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.LimitationsFurther 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.ConclusionPerturbation-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.

scholarly journals Impact of pain on reactive balance and falls in community-dwelling older adults: a prospective cohort study

2020 ◽  
Vol 49 (6) ◽  
pp. 982-988
Author(s):  
Tatsuya Hirase ◽  
Yoshiro Okubo ◽  
Jasmine Menant ◽  
Stephen R Lord ◽  
Daina L Sturnieks
Keyword(s):  
Older Adults ◽  
Neck Pain ◽  
Lower Limb ◽  
Step Length ◽  
Community Dwelling ◽  
Limb Pain ◽  
Step Initiation ◽  
Lower Limb Pain ◽  
Postural Perturbations ◽  
Reactive Balance

Abstract Background pain is associated with increased postural sway and falls in older adults. However, the impact of pain on reactive balance induced by postural perturbations and how this might predispose older adults to falls is not known. Objective to investigate whether any pain, back/neck pain and lower limb pain are associated with poor reactive balance and prospective fall outcomes in older adults. Design 12-month prospective cohort study. Setting community. Subjects 242 community-dwelling older adults aged 70+ years. Methods participants completed a questionnaire on the presence of pain and underwent force-controlled waist-pull postural perturbations while standing. Force thresholds for stepping, step initiation time, step velocity and step length were quantified. Falls were monitored with monthly falls calendars for 12-months. Results participants with lower limb pain had significantly lower force thresholds for stepping. Those with any pain or pain in the back/neck had longer step initiation time, slower step velocity and shorter step length. The three pain measures (any pain, back/neck pain, lower limb pain) were significantly associated with multiple falls when adjusted for age, sex, body mass index, use of polypharmacy, strength and walking speed. In mediation analyses, there was a significant indirect effect of reactive balance for the relationship between back/neck pain and falls with fractures. Conclusions older people with pain have impaired reactive balance and an increased risk of falls. Reactive balance partially mediated the association between pain and fall-related fractures. Further research is required to confirm the findings of this study.

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