Abstract
Bhatt T, Yang F, Pai Y-C. Learning to resist gait-slip falls: long-term retention
in community-dwelling older adults.
Objectives
To determine whether the fall-resisting skills acquired from a single perturbation
training session can be retained for 6 months or enhanced by an intermediate ancillary
session.
Design
A randomized controlled trial.
Setting
Biomechanics research laboratory.
Participants
Community-dwelling elderly (N=48; age, >65y).
Interventions
Initial perturbation training applied to all subjects using low-friction platforms
to induce unannounced blocks of repeated right-side slips, interspersed with nonslips.
The single-session group retested with only 1 slip 6 months later. The dual-session
group received an additional slip at 3 months after the initial session, followed
by a retest of slips at 6 months.
Main Outcome Measures
Slip outcome (incidence of falls and balance loss), dynamic stability (based on the
center-of-mass position and velocity), and vertical limb support (based on hip height).
Results
Subjects in both groups significantly reduced fall and balance loss incidence from
first to last training slips, which resulted from improved stability and limb support
control. Both groups demonstrated significant retention in all outcome measures at
6 months compared with the first novel slip, although performance decay was evident
in comparison with the last training slip. The ancillary slip at 3 months led to significantly
better control of stability and, hence, reduced balance loss outcome, in the dual-session
group at 6 months than in the single-session group.
Conclusions
Motor memory could be retained for 6 months or longer after a single session of fall-resistance
training, although a single “booster” slip could further impede its decay. Through
the experience of slipping and falling, it may be possible to “inoculate” older adults
against potentially life-threatening falls.
Key Words
List of Abbreviations:
BLOB (backward loss of balance), BOS (base of support), CNS (central nervous system), COM (center of mass), R-3mo (3-month slip), R-6mo (6-month slip), S1 (1st slip of training session), S24 (last slip of training session), XCOM/BOS (anteroposterior position of the COM relative to the BOS), ẊCOM/BOS (anteroposterior velocity of the COM relative to the BOS)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: February 20, 2012
Footnotes
Supported by the National Institutes of Health (grant nos. 2R01-AG16727, R01-AG029616).
No commercial party having a direct financial interest in the results of the research supporting this article has or will confer a benefit on the authors or on any organization with which the authors are associated.
Reprints are not available from the author.
In-press corrected proof published online on Feb 20, 2012, at www.archives-pmr.org.
Identification
Copyright
© 2012 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.
