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Reactive Balance Training for Fall Prevention

Sponsored by University of Illinois at Chicago

About this study

The objective of this pilot study is to evaluate and compare the effect of three different perturbation based training devices on the reactive balance control among healthy young adults, healthy older adults, and neurologically impaired stroke individuals. Furthermore, the project aims to determine the feasibility and tolerability of 30-minutes of perturbation training using the SureFooted Trainer. Overall, the project directs to find out the long term effect of training on fall risk reduction and fall prevention. This study investigates the effects of perturbation training (slip and trip) based on the principles of motor learning. Perturbations in the form of slips and trips induced by the three different types of perturbation devices will displace the center of mass outside the base of support and challenge the stability, thereby inducing a fall and demand compensatory strategies in order to prevent it. Such perturbation training would train the motor system to improve stability control and vertical limb support. The project design aims to examine the ability of the central nervous system to mitigate the interference in stability control (if any) that is induced by opposing types of perturbations. The hypothesis of this study if supported by the results, will provide the difference in motor learning with training on three different perturbation devices. Furthermore, it would help to determine which of the three training devices is the most effective in developing defense mechanisms necessary to reduce fall-risk among community-living older adults and the neurological population.

About 34% of the community-dwelling older population experience a detrimental fall each year. Moreover, 40% of the individuals who suffer from pathological conditions such as stroke experience falls. Age-related changes and post-stroke impairments often lead to impaired balance and gait that are highly associated with falls. Most of these falls have been reported to occur during dynamic and complex activities such as walking, reaching out for objects that are a part of daily living. There are various clinical balance tests used to evaluate the balance in individuals suffering from a stroke. However, most of the tests measure only the static balance ability while performing voluntary/ self-generated activities. Hence, these measures fail to determine the reactive balance control or compens…

Where this study is enrolling

Who can participate

Inclusion criteria

  • ✓Healthy Young participants
  • ✓Age group: 18-55 years.
  • ✓Absence of any acute or chronic neurological, cardiopulmonary, musculoskeletal or systemic diagnosis.
  • ✓No recent major surgery (\< 6 months) or hospitalization (\< 3 months)
  • ✓Not on any sedative drugs.
  • ✓Can understand and communicate in English
  • ✓Healthy older adults
  • ✓Age group: 56-90 years.
  • ✓Absence of any acute or chronic neurological, cardiopulmonary, musculoskeletal or systemic diagnosis.
  • ✓No recent major surgery (\< 6 months) or hospitalization (\< 3 months)
  • ✓Not on any sedative drugs.
  • ✓Ability to walk with or without an assistive device for 10 meters
  • ✓Can understand and communicate in English
  • ✓Berg balance scale score \<45/56.
  • ✓Persons with stroke
  • ✓Age group: 18-90 years.
  • ✓Absence of any acute or chronic neurological diagnosis except stroke (self reported)
  • ✓Onset of stroke (\> 6 months)
  • ✓Absence of any cardiopulmonary, musculoskeletal or systemic diagnosis.
  • ✓No recent major surgery (\< 6 months) or hospitalization (\< 3 months)
  • ✓Not on any sedative drugs.
  • ✓Ability to walk with or without an assistive device for 10 meters
  • ✓Can understand and communicate in English

Exclusion criteria

  • ✕Healthy subject:
  • ✕Subjects will not proceed with the test if any of the following occurs at baseline measurement: 1) HR \> 85% of age-predicted maximal heart rate (HRmax) (HRmax = 220 - age), 2) systolic blood pressure (SBP) \> 165 mmHg and/or diastolic blood pressure (DBP) \> 110 mmHg during resting), and 3) oxygen saturation (measured by pulse oximeter) during resting \< 95%.
  • ✕Body weight more than 250 lbs.
  • ✕Healthy Older adults:
  • ✕Individuals with heel bone density with a T-score \< -2, is classified as osteoporotic and will be excluded.
  • ✕Individuals with mild cognitive impairment (Mini-mental State Exam score \< 25/30) will be excluded.
  • ✕Subjects will not proceed with the test if any of the following occurs at baseline measurement: 1) HR \> 85% of age-predicted maximal heart rate (HRmax) (HRmax = 220 - age), 2) systolic blood pressure (SBP) \> 165 mmHg and/or diastolic blood pressure (DBP) \> 110 mmHg during resting), and 3) oxygen saturation (measured by pulse oximeter) during resting \< 95%.
  • ✕6 minute walk test. Subjects will also be screened out if on the 6 minute walk test they complain of shortness of breath or uncontrolled pain (\> 3/10 on VAS) or pulse oxygen drops \< 92% or are unable to achieve the age-specified minimal ambulation distance.
  • ✕Body weight more than 250 lbs.
  • ✕Persons with stroke:
  • ✕Individuals with heel bone density with a T-score \< -2, is classified as osteoporotic and will be excluded.
  • ✕Individuals with mild cognitive impairment (Mini-mental State Exam score \< 25/30) will be excluded.
  • ✕Subjects will not proceed with the test if any of the following occurs at baseline measurement: 1) HR \> 85% of age-predicted maximal heart rate (HRmax) (HRmax = 220 - age), 2) systolic blood pressure (SBP) \> 165 mmHg and/or diastolic blood pressure (DBP) \> 110 mmHg during resting), and 3) oxygen saturation (measured by pulse oximeter) during resting \< 95%.
  • ✕6 minute walk test. Subjects will also be screened out if on the 6 minute walk test they complain of shortness of breath or uncontrolled pain (\> 3/10 on VAS) or pulse oxygen drops \< 92% or are unable to achieve the age-specified minimal ambulation distance.
  • ✕Body weight more than 250 lbs.

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Trial data sourced from ClinicalTrials.gov.