Perturbation-based balance training of older adults and effects on physiological, cognitive and sociopsychological factors

1. Perturbation-based balance training only showed moderate physical benefits in the short term (<6 months) but no benefits in physical, cognitive, or sociopsychological measures after 6 months

Evidence Rating Level: 1 (Excellent) 

As we age, there is an increased risk of falls and fall-related injuries due to physical and cognitive deterioration. This can also cause psychological consequences such as fear of falling leading to loss of independence which can greatly reduce the quality of life for older adults. Physical exercise is currently the most effective fall-preventative intervention. Task-specificity is a principle that states training paradigms are most effective if they closely stimulate the desired task. One intervention that follows this principle for falls is called perturbation-based balance training (PBT) where participants are exposed to repeated, unexpected postural disturbances while in a harness for safety. The effect of PBT on daily life is not clear and its effects on other physical, cognitive, and sociopsychological factors are unknown. This randomized controlled trial with a 12-month follow-up aimed to evaluate the short- and long-term effects of a four-session PBT intervention on older adults aged 65 years or older and compared it with treadmill walking. A significant difference favouring PBT was seen when comparing the physical functions from pre-training to post-training. However, these differences were not seen in the 6 or 12-month follow-ups. No other differences were seen regarding physical, cognitive, or sociopsychological factors. Therefore, a four-session PBT did not lead to any improvements in physical, cognitive, or sociopsychological measures after 6 months. There was, however, short-term improvement in choice-stepping reaction time and dual-task gait speed for participants treated with PBT. 

Click to read the study in BMJ

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