Prevention of Slip-Related Backward Balance Loss: The Effect of Session Intensity and Frequency on Long-Term Retention

Abstract 

Bhatt T, Pai Y-C. Prevention of slip-related backward balance loss: the effect of session intensity and frequency on long-term retention.

Objective

To examine the effects of session intensity (number of slip exposures) and frequency on the retention of acquired adaptation for prevention of backward balance loss after repeated-slip training.

Design

A 4-group, randomized, and controlled study.

Setting

Biomechanics research laboratory.

Participants

Healthy young subjects (N=46; 21 men).

Interventions

Twenty-four subjects experienced a high-intensity session of 24 repeated right-side slips; 12 received additional single-slip sessions at a frequency of 1 week, 2 weeks, and 1 month, whereas the rest got no ancillary training. Another 24 subjects received a low-intensity initial session of a single slip; 12 received the same high-frequency ancillary training, whereas the rest got none. All groups were retested with a single slip 4 months after the first session.

Main Outcome Measures

The incidence of backward balance loss, gait stability, and limb support.

Results

The high-intensity groups, irrespective of ancillary training, displayed similar improvements in all 3 outcome measures. Remarkably, the low-intensity group receiving ancillary training also significantly improved in all measures, with retention comparable to that observed in the other 2 groups. A single-slip exposure without ancillary sessions was insufficient to yield a longer-term effect.

Conclusions

Frequent ancillary sessions may be unnecessary for slip-related fall prevention up to 4 months if the initial session intensity is sufficient. Furthermore, the minimum of a single slip may be as effective if the subject is exposed to frequent ancillary sessions.

Key Words: Accidental falls, Gait, Learning, Rehabiliation

Abbreviations: ANOVA, analysis of variance, BOS, base of support, COM, center of mass, CNS, central nervous system