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 volunteersQualifiers
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
Parallel
Treatments tested in this trial
Reactive balance training
BehavioralReactive 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
BehavioralOverground walking
Treatment groups
Trial outcomes
Primary outcomes
Number of reactive steps
Learning rate for number of steps to recover from 'backward fall' balance perturbations
Secondary outcomes
Step initiation time
Time from perturbation onset time to foot off time
Step execution time
Time from foot off to foot contact of the first step
Step length
Difference in foot position from foot off to foot contact
Braking impulse
Antero-posterior shear force generated over time on step contact
Other outcomes
Fall incidence
Falls in daily life
Injurious fall incidence
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
Number of participants with fear of falling
Sponsors and contacts
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Toronto Rehabilitation Institute
Lead sponsor
Canadian Institutes of Health Research (CIHR)
Collaborator