Walkway and treadmill induced trips have contrasting advantages, for instance walkway trips have high-ecological validity whereas belt accelerations on a treadmill have high-clinical feasibility for perturbation-based balance training (PBT). This study aimed to (i) compare adaptations to repeated overground trips with repeated treadmill belt accelerations in older adults and (ii) determine if adaptations to repeated treadmill belt accelerations can transfer to an actual trip on the walkway. Thirty-eight healthy community-dwelling older adults underwent one session each of walkway and treadmill PBT in a randomised crossover design on a single day. For both conditions, 11 trips were induced to either leg in pseudo-random locations interspersed with 20 normal walking trials. Dynamic balance (e.g., margin of stability) and gait (e.g., step length) parameters from 3D motion capture were used to examine adaptations in the walkway and treadmill PBT and transfer of adaptation from treadmill PBT to a walkway trip. No changes were observed in normal (no-trip) gait parameters in both training conditions, except for a small (0.9 cm) increase in minimum toe elevation during walkway walks ( < 0.01). An increase in the margin of stability and recovery step length was observed during walkway PBT ( < 0.05). During treadmill PBT, an increased MoS, step length and decreased trunk sway range were observed ( < 0.05). These adaptations to treadmill PBT did not transfer to a walkway trip. This study demonstrated that older adults could learn to improve dynamic stability by repeated exposure to walkway trips as well as treadmill belt accelerations. However, the adaptations to treadmill belt accelerations did not transfer to an actual trip. To enhance the utility of treadmill PBT for overground trip recovery performance, further development of treadmill PBT protocols is recommended to improve ecological authenticity.
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http://dx.doi.org/10.3389/fspor.2021.702320 | DOI Listing |
IEEE Trans Neural Syst Rehabil Eng
October 2024
Treadmill-based repeated perturbation training (PBT) induces motor adaptation in reactive balance responses, thus lowering the risk of slip-induced falls. However, little evidence exists regarding intervention-induced changes in neuromuscular control underlying motor adaptation. Examining neuromuscular changes could be an important step in identifying key elements of adaptation and evaluating treadmill training protocols for fall prevention.
View Article and Find Full Text PDFHum Mov Sci
October 2024
Falls, Balance and Injury Research Centre, Neuroscience Research Australia, Randwick, NSW, Australia; School of Population Health - Faculty of Medicine and Health, The University of New South Wales, Randwick, NSW, Australia. Electronic address:
Background: This study examined (i) adaptations in muscle activity following perturbation-based balance training (PBT) using treadmill belt-accelerations or PBT using walkway trips and (ii) whether adaptations during treadmill PBT transfer to a walkway trip.
Methods: Thirty-eight older people (65+ years) undertook two PBT sessions, including 11 treadmill belt-accelerations and 11 walkway trips. Surface electromyography (EMG) was measured bilaterally on the rectus femoris (RF), tibialis anterior (TA), semitendinosus (ST) and gastrocnemius medial head (GM) during the first (T1) and eleventh (T11) perturbations.
Motor Control
January 2025
Faculty of Medicine of Ribeirão Preto, University of São Paulo, Ribeirão Preto, SP, Brazil.
Aim: To assess the adaptive response of older adults with a history of falls in a single Perturbation-Based Balance Training (PBT) session by examining the margin of stability (MoS) and the number of falls.
Methods: Thirty-two older adults with a history of falls underwent a treadmill walking session lasting 20-25 min. During the PBT protocol, participants experienced 24 unexpected perturbations delivered in two ways: acceleration or deceleration of the treadmill belt, with 12 perturbations in each direction.
BMJ Open
August 2024
Department of Geriatric Medicine, Aalborg University Hospital, Aalborg, Denmark
Background: Perturbation-based balance training (PBT) has shown promising, although diverging, fall-preventive effects; however, the effects on important physical, cognitive and sociopsychological factors are currently unknown. The study aimed to evaluate these effects on PBT at three different time points (post-training, 6-months and 12-months) in community-dwelling older adults compared with regular treadmill walking.
Methods: This was a preplanned secondary analysis from a randomised, controlled trial performed in Aalborg, Denmark, between March 2021 and November 2022.
Gerontology
June 2024
Network Aging Research (NAR), Heidelberg University, Heidelberg, Germany.
Introduction: Perturbation-based balance training (PBT) is promising for fall prevention in older adults, mimicking real-life fall situations at a person's stability thresholds to improve reactive balance. Hence, it can be associated with anxiety, but knowledge about the acceptability of PBT is scarce.
Method: This is a secondary analysis of a randomized controlled trial comparing the effects of two different PBT paradigms that aims to evaluate and compare the acceptability of those training paradigms in fall-prone older adults.
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