A pilot trial investigating feasibility and preliminary efficacy of a task-specific step training regimen to improve balance recovery among community-dwelling older adults

Abstract

While a growing number of studies have shown positive effects of perturbation-based balance training on balance recovery after tripping, this training has employed specialized equipment that may pose a barrier for wider adoption. To address this, the purpose of this pilot trial was to evaluate the feasibility and preliminary efficacy of a novel, low-resource (i.e., not requiring specialized equipment) version of perturbation-based balance training referred to here as task-specific step training. Thirty community-dwelling older adults (mean (SD) age: 71.8 (4.4) years) were recruited and allocated to either step training ( n  = 10), traditional treadmill perturbation-based balance training ( n  = 10), or a control group involving no training ( n  = 10). Participants were then exposed to two overground laboratory-induced trips while walking on a walkway. Results showed the step training group exhibited an initial recovery step that was 9.0% body height longer ( p  < 0.001) and 0.25 m/s faster ( p  = 0.011) than the control group.The step training group also exhibited a 4.8% body height longer recovery step, and a fall rate that was 39% lower ( p  = 0.037) when compared to the treadmill training group after lab-induced trips. While promising, these results should be interpreted with caution give the modest sample size and a potential bias between groups with respect to safety harness usage during laboratory-induced trips. A future trial with adequate statistical power to better evaluate efficacy and effectiveness of this step training on real-world trip and fall risk appears warranted. The study was registered on clinicaltrials.gov (NCT05734443).