Optimal Intensity of Reactive Balance Training for Healthy Older Adults

Toronto Rehabilitation Institute

Status: Enrolling

Conditions: Accidental Falls

Treatments: Behavioral: Reactive balance training; Behavioral: Walking

Study type: Interventional

Funder types: Other

Identifiers

NCT06657989

24-5665

Details and patient eligibility

About

Falls in daily life are a serious risk for older adults. A new type of balance training, called reactive balance training (RBT) involves people losing balance many times so that they can practice fast balance reactions, like stepping reactions. Differences in training program features might explain differences in the results of previous RBT studies. Training intensity is the difficulty or challenge of the training program. It would be valuable to know if high-intensity RBT improves balance reactions quickly. The main goal of this study is to see if more intense RBT improves balance reactions faster than less intense RBT. The investigators will compare how quickly people improve balance reactions between high- and moderate-intensity RBT, and between RBT and a control program that does not include RBT. The investigators will also test if the improvements in balance reactions last after the training program is over. The secondary goals are to understand exactly how balance reactions improve with training, and to determine if people who complete RBT improve their general balance skills, and falls efficacy more than people who do not complete RBT.

Enrollment: 96 estimated patients

Sex: All

Ages: 65 to 80 years old

Volunteers: Accepts Healthy Volunteers

Inclusion criteria

• Community-dwelling older adults (65-80 years old)

Exclusion criteria

• Unable to stand independently without upper-limb support for >30 seconds and/or walk independently (without a gait aid) for ≥10 metres;
• Diagnosed neurological condition that could affect balance control (e.g., stroke, Parkinson's disease);
• Score below normative values on the Montreal Cognitive Assessment;
• Score below age-matched normative values for sensory and motor function, as assessed using the FallScreen battery;
• Have insufficient English language comprehension such that they cannot understand instructions;
• Have contraindications to reactive balance training such as severe osteoporosis; and/or
• Are currently attending physiotherapy or supervised exercise.

Trial design

Primary purpose: Prevention

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Single Blind

---

96 participants in 3 patient groups

High intensity reactive balance training

Experimental group

Description:

Participants will complete 5 1-hour training sessions over 11 days. During each training session, participants will complete 36 multi-directional (left-, right-, and forward-fall) perturbations. Participants assigned to high-intensity RBT will experience perturbations at 150% of the multi-step threshold; for example, for a multi-step threshold of 2 m/s\^2 the high intensity perturbation will be 3 m/s\^2.

Treatment:

Behavioral: Reactive balance training

Moderate intensity reactive balance training

Active Comparator group

Description:

Participants will complete 5 1-hour training sessions over 11 days. During each training session, participants will complete 36 multi-directional (left-, right-, and forward-fall) perturbations. Participants assigned to moderate-intensity RBT will experience perturbations at 100% of the multi-step threshold; for example, for a multi-step threshold of 2 m/s\^2 the high intensity perturbation will be 2 m/s\^2.

Treatment:

Behavioral: Reactive balance training

Walking control group

Sham Comparator group

Description:

Participants assigned to the walking control group will complete 36 trials of unperturbed walking in each training session.

Treatment:

Behavioral: Walking