Can a single session of treadmill-based slip training reduce daily life falls in community-dwelling older adults? A randomized controlled trial

Abstract

Background: Task-specific training with single-session overground slip simulation has shown to reduce real-life falls in older adults.

Aims: The purpose of this study was to determine if fall-resisting behavior acquired from a single-session treadmill-based gait slip training could be retained to reduce older adults' falls in everyday living over a 6-month follow-up period.

Methods: 143 community-dwelling older adults (≥ 65 years old) were randomly assigned to either the treadmill-based gait slip training group (N = 73), in which participants were exposed to 40 unpredictable treadmill slips, or the control group (N = 70), in which participants walked on a treadmill at their comfortable speed. Participants reported their falls from the preceding year (through self-report history) and over the following 6 months (through fall diaries and monitored with phone calls).

Results: There was no main effect of time (retrospective vs. prospective fall) and training (treadmill training vs. control) on fall reduction (p > 0.05 for both). The survival distributions of event of all-cause falls or slip falls were comparable between groups (p > 0.05 for both).

Discussion: Unlike overground slip training where a single training session could significantly reduce everyday falls in a 6-month follow-up period, the results indicated that one treadmill-based gait slip training session by itself was unable to produce similar effects.

Conclusion: Further modification of the training protocol by increasing training dosage (e.g., number of sessions or perturbation intensity) may be necessary to enhance transfer to daily living. This study (NCT02126488) was registered on April 30, 2014.

Keywords: Fall; Perturbation; Retention; Slip.