Can higher training practice dosage with treadmill slip-perturbation necessarily reduce risk of falls following overground slip?

Gait Posture. 2018 Mar:61:387-392. doi: 10.1016/j.gaitpost.2018.01.037. Epub 2018 Mar 20.

Abstract

Background: Perturbation training is an emerging paradigm to reduce idiopathic falls (without clinical signs or symptoms) in older adults. While a higher threat dosage (intensity) in motor learning often directly relates to greater adaptation, retention, and generalization, little is known whether increasing the practice dosage (repetition) of slip-perturbation training would necessarily improve its outcomes.

Research question: Can higher practice dosage of treadmill slip-perturbation training lead to greater generalization to an overground slip immediately after the training?

Methods: Forty-five community-dwelling older adults (73.5 ± 5.6 years old) participated in the present study. They were conveniently assigned to three groups with equivalent treadmill walking duration: treadmill slip-perturbation training group with 40 practice dosage, 24 practice dosage, and zero practice dosage (without slip-perturbation). Later on during overground walking, all of them were exposed to the same generalization test (a novel slip on a walkway). Their recovery outcomes (fall, or no fall; balance loss, or no balance loss) and center of mass stability were compared.

Results: Higher practice dosage did not show significantly less incidence of fall, balance loss, or greater stability in comparison to lower practice dosage (p > .05). The present study showed that there was no evidence of dose-response relationship when the practice dosage was set above the 24 trials of practice dosage in treadmill slip-perturbation training.

Significance: Contrary to our hypothesis, increased practice dosage (40-slips) in treadmill slip-perturbation training from the commonly used threshold (24-slips) did not necessarily benefit immediate generalization from treadmill to overground walking among community-dwelling older adults.

Keywords: Falls; Generalization; Older adults; Practice dosage (repetition); Stability; Treadmill slip-perturbation.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Accidental Falls / prevention & control*
  • Adaptation, Physiological / physiology*
  • Aged
  • Female
  • Gait / physiology*
  • Humans
  • Independent Living*
  • Male
  • Postural Balance / physiology*
  • Walking / physiology*