Can Treadmill Slip-Perturbation Training Reduce Longer-Term Fall Risk Upon Overground Slip Exposure?

Abstract

The purpose was to examine and compare the longer-term generalization between 2 different practice dosages for a single-session treadmill slip-perturbation training when reexposed to an overground slip 6 months later. A total of 45 older adults were conveniently assigned to either 24 or 40 slip-like treadmill perturbation trials or a third control group. Overground slips were given immediately after initial training, and at 6 months after initial training in order to examine immediate and longer-term effects. The performance (center of mass stability and vertical limb support) and fall percentage from the laboratory-induced overground slips (at initial posttraining and at 6 mo) were measured and compared between groups. Both treadmill slip-perturbation groups showed immediate generalization at the initial posttraining test and longer-term generalization at the 6-month retest. The higher-practice-dosage group performed significantly better than the control group (P < .05), with no difference between the lower-practice-dosage and the control groups at the 6-month retest (P > .05). A single session of treadmill slip-perturbation training showed a positive effect for reducing older adults’ fall risk for laboratory-induced overground slips. A higher-practice dosage of treadmill slip perturbations could be more beneficial for further reducing fall risk.

Small directional treadmill perturbations induce differential gait stability adaptation

“…These large magnitude perturbations are less frequent and often require recovery steps to regain balance. Currently, there is no clear optimal frequency and magnitude for perturbation-based balance training during walking ( 12 , 13 ), but more frequent exposure to perturbations seems to be beneficial for developing long-term fall-resisting skills ( 14 , 15 ). Small magnitude perturbations are also more easily navigated by older adults ( 16 , 17 ).…”

Small Directional Treadmill Perturbations Induce Differential Gait Stability Adaptation

“…4 (MOS ap, ltodecreased, p = 0.001, Cohen's d = 1.44; MOS ml, lto increased, p = 0.02, Cohen's d = 0.96) and the Slip0.4 (MOS ml, lto14 increased, p = 0.004, Cohen's d = 1.20) perturbations. Subjects also took wider steps for both perturbations (pre to early catch: BOS ml, lto increased, p's < 0.003, Cohen's d's > 1.25) and shifted their XCOM forward and rightward at left toe off for the Stick0.4 perturbation (pre to early catch: XCOM ap, lto increased, p = 0.02, Cohen's d = 0.99; XCOM ml, lto increased, p = 0.009, Cohen's d = 1.07).…”

Effect of Multisession Progressive Gait-Slip Training on Fall-Resisting Skills of People with Chronic Stroke: Examining Motor Adaptation in Reactive Stability

“…Providing greater training dosage to induce adaptive changes might be beneficial in PwCS, given their slower rate of locomotor adaptation compared to neurologically healthy controls [ 45 ]. Previous studies in healthy older adults are suggestive of training with more trials (40 vs. 24) to enhance motor learning and retention [ 46 ]. Similarly, our training consisted of 40 slips per session, which aimed to intentionally overtrain a task (overlearning) for better retention effects [ 47 , 48 ].…”