Optimal Intensity of Reactive Balance Training for Healthy Older Adults

Trial statusRecruiting
Trial phaseNot applicable
Trial typeInterventional
Biological sexAll
Age65-80
SponsorToronto Rehabilitation Institute

About this trial

Falls in daily life are a serious risk for older adults. A new type of balance training, called reactive balance training (RBT) involves people losing balance many times so that they can practice fast balance reactions, like stepping reactions. Differences in training program features might explain differences in the results of previous RBT studies. Training intensity is the difficulty or challenge of the training program. It would be valuable to know if high-intensity RBT improves balance reactions quickly. The main goal of this study is to see if more intense RBT improves balance reactions faster than less intense RBT. The investigators will compare how quickly people improve balance reactions between high- and moderate-intensity RBT, and between RBT and a control program that does not include RBT. The investigators will also test if the improvements in balance reactions last after the training program is over. The secondary goals are to understand exactly how balance reactions improve with training, and to determine if people who complete RBT improve their general balance skills, and falls efficacy more than people who do not complete RBT.

Eligibility criteria

This trial accepts healthy volunteers

Qualifiers

Community-dwelling older adults (65-80 years old)

Disqualifiers

Unable to stand independently without upper-limb support for >30 seconds and/or walk independently (without a gait aid) for ≥10 metres;

Diagnosed neurological condition that could affect balance control (e.g., stroke, Parkinson's disease);

Score below normative values on the Montreal Cognitive Assessment;

Score below age-matched normative values for sensory and motor function, as assessed using the FallScreen battery;

Trial design

Design model

Parallel

Treatments tested in this trial

  • Reactive balance training

    Behavioral

    Reactive balance training involves clients experiencing repeated balance perturbations so that they can practice and improve control of reactions to avoid falling after a loss of balance.

  • Walking

    Behavioral

    Overground walking

Treatment groups

96 Participants
are divided into 3 treatment groups
Group A: High intensity reactive balance trainingExperimental treatment 1 intervention
Group B: Moderate intensity reactive balance trainingActive comparator 1 intervention
Group C: Walking control groupSham comparator 1 intervention

Trial outcomes

Primary outcomes

1

Number of reactive steps

Learning rate for number of steps to recover from 'backward fall' balance perturbations

Time frame
Two weeks

Secondary outcomes

1

Step initiation time

Time from perturbation onset time to foot off time

Time frame
One week and 12 weeks post-training
2

Step execution time

Time from foot off to foot contact of the first step

Time frame
One week and 12 weeks post-training
3

Step length

Difference in foot position from foot off to foot contact

Time frame
One week and 12 weeks post-training
4

Braking impulse

Antero-posterior shear force generated over time on step contact

Time frame
One week and 12 weeks post-training

Other outcomes

1

Fall incidence

Falls in daily life

Time frame
12 months post-training
2

Injurious fall incidence

Time frame
12-months post-training
3

5-level EuroQoL health status measure (EQ-5D-5L)

Scale range for descriptive component: 5-25, higher values indicate worse outcome; Scale range for visual analogue scale: 0-100, higher values indicate better outcome

Time frame
One week, 12 weeks, and 12 months post-training
4

Number of participants with fear of falling

Time frame
One week, 12 weeks, and 12 months post-training

Sponsors and contacts

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Toronto Rehabilitation Institute

Lead sponsor

Canadian Institutes of Health Research (CIHR)

Collaborator