Effect of Adaptive Training for Balance Recovery

Study Overview
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Brief Summary
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The long-term objective of this research is a prophylactic approach that can reduce the incidence of falls and the resulting injuries among older adults at risk and thus reduce its escalating medical cost. This project explores perturbation training through the use of treadmill device and a motor learning approach, in which experience with slip-like perturbation generated by that treadmill is used to prepare the motor system to develop and then put to use fall-resisting skills outside of training environment (cross-environment transfer). The computer-controlled treadmill is portable, safe and easy to operate, thus conducive for use in clinics or community centers. The study logically builds on and complements the team's previous and current research programs, and will further test that after such a single session, older adults at risk can retain such cross-environment transfer and reduce their likelihood of falls in everyday living for the next 6 to 12 months. Finally, the study will explore that such reduction of falls does not come merely from these persons' familiarity with the training or testing setup, protocol and environments.

Official Title
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Perturbation Training for Fall-risk Reduction Among Older Adults

Conditions
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Balance, Postural, Prevention, Accident

Intervention / Treatment
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* Behavioral: treadmill slip perturbation
* Behavioral: treadmill training placebo
* Behavioral: observation training


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Subjects with no known history of musculoskeletal, neurological, cardiovascular, or pulmonary impairment that may affect their ability to perform the testing procedures will be included. Exclusion Criteria: Ultrasound calcaneus bone mineral density T score < -2.5 (osteoporotic) Mini-Mental State exam score < 25 (cognitive impairment)

Ages Eligible for Study
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Minimum Age: 65 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Prevention
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: treadmill perturbation<br>treadmill slip perturbation | Behavioral: treadmill slip perturbation<br>* Group A will receive perturbation training on a treadmill with precisely controlled slip-like displacements and then encounter an unannounced novel slip during over-ground walking.<br>|
| Placebo Comparator: treadmill placebo<br>treadmill training placebo | Behavioral: treadmill training placebo<br>* An age-matched control group (Group B) will receive only placebo training (on the same treadmill for the same duration but without perturbation) but encounter an identical novel slip during their over-ground walking.<br>|
| Sham Comparator: observation<br>observation training | Behavioral: observation training<br>* An age-matched observation-training group (Group C) will watch a training video and slides. When exposed to an identical novel slip in over-ground walking, they will know where and how the slip is going to occur and how to resist a fall.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Fall incidence |  | 1 year | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Dynamic stability | The dynamic stability will be evaluated based on the dynamic relationship of motion state (i.e., the combination of position and velocity) between the center of mass and the base of support. It will be calculated as the shortest distance from the instantaneous motion state of the center of mass to the threshold against backward fall. It is a dimensionless variable. | 6 months | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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treadmill training, generalization, retention