Learning from Falling: Perturbation Balance Training to Prevent Falls in Older Adults
David Graham | Montana State University
Falls substantially contribute to mortality, morbidity and disability in older adults in general and more so in Montana and particularly those living rurally when compared to the greater US. The economic burden of falls is also notable with the overall costs of fall related injury and death reported at approximately 50 billion/year. Exercise is an important component of a health program for older adults and walking is an exercise commonly selected by older adults to improve their overall health. Walking has good compliance compared to other forms of physical activity, with numerous health benefits. Unfortunately, a complication when prescribing walking as a form of exercise is the increased risk of fall. This finding is likely due to increased exposure to falls in people with reduced capacity to respond to trips and slips while walking. Therefore, to maximize the benefits of exercise programs for older people, and particularly those with limited access to exercise facilities, it is essential to teach the skills required to recover from slips and trips to avoid falls.
Potential outcomes of improved balance recovery ability are reduction in the incidence of real world falls and a reduction of a fear of falling (FoF). Reducing FoF is important because it removes reduces concern or anxiety associated with both habitual activities and structured exercise alike. This is significant because removing barriers to exercise may lead to improved rates of activity in older adults which in turn can improve overall health and wellbeing.
Our current work demonstrates that PBT appears to be more effective and more efficient than other modes of balance recovery training. By simulating “real-world” balance challenges such as slips and trips, PBT provides a direct means for learning how to recover balance and avoid falls. It has been demonstrated that with only a few PBT sessions, older adults make rapid and dramatic improvements in balance recovery performance, retain the skills long-term and potentially suffer fewer falls over extended periods. However, we have additional questions that require consideration. Specifically, what is the association between improved balance recovery ability, fear of falling, attitudes towards physical activity and mental wellness. As such our aim is to determine the relationship between improved balance recovery ability and psychosocial indices of wellbeing.
- To determine the efficacy of balance training (BT) and perturbation-based training (PBT) and the relationship to fear of falling, perceptions of physical activity and mental wellness.
- Balance recovery performance will improve in both BT and PBT groups but will be significantly better in those completing PBT when compared to BT
- Improved balance recovery behavior will be related to reduced fear of falling, improved perceptions of activity and improved mental wellness
- Reduced fear of falling will be positively associated with increased habitual activity and participation in exercise