{"title":"Domain-specific balance training reduces slip-related fall risk in young adults: A potential alternative to perturbation training","authors":"Jessica Pitts, Tanvi Bhatt","doi":"10.1016/j.humov.2024.103294","DOIUrl":null,"url":null,"abstract":"<div><h3>Background</h3><div>External, environmental perturbations (e.g., slips) account for >60% of falls and lead to severe health-related consequences. Perturbation training paradigms are known to reduce slip-related fall risk by improving two key aspects of reactive balance control: center of mass (COM) stability and limb support. However, perturbation training requires complex technology and is difficult to implement outside of the laboratory. This study examined if key reactive balance mechanisms could also be improved via more clinically translatable balance exercises targeting both volitional and reactive balance control (i.e., domain-specific balance training).</div></div><div><h3>Methods</h3><div>12 young adults completed a single session of domain-specific balance training and were exposed to a single overground slip (S1-Domain-Specific). The control group (<em>n</em> = 12) was exposed to 24 overground slips (S1–24-Control) without prior training. On the first (novel) slip, we compared reactive balance performance (rate of falls and loss of balance, margin of stability (MOS), limb support) between the training and control groups (S1-Domain-Specific vs. S1-Control). We also compared key reactive balance outcomes between S1-Domain-Specific and the final slip of the control group (S24-Control).</div></div><div><h3>Results</h3><div>There was a lower rate of backward loss of balance on S1-Domain-Specific than S1-Control, along with higher post-slip MOS and increased hip height (i.e., greater limb support) (<em>p < 0.05</em>). These improvements were associated with a more anterior COM position, greater COM velocity in the anterior direction, and reduced slip distance. Post-slip MOS and hip height were not significantly different between S1-Domain-Specific and S24-Control.</div></div><div><h3>Discussion</h3><div>A single session of domain-specific balance training improved key components of reactive balance control and could significantly reduce slip-related fall risk. Domain-specific balance training might provide similar fall prevention benefits as perturbation training, with easier transition into clinics, communities, and homes.</div></div>","PeriodicalId":55046,"journal":{"name":"Human Movement Science","volume":null,"pages":null},"PeriodicalIF":1.6000,"publicationDate":"2024-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Human Movement Science","FirstCategoryId":"102","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S0167945724001192","RegionNum":3,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"NEUROSCIENCES","Score":null,"Total":0}
引用次数: 0
Abstract
Background
External, environmental perturbations (e.g., slips) account for >60% of falls and lead to severe health-related consequences. Perturbation training paradigms are known to reduce slip-related fall risk by improving two key aspects of reactive balance control: center of mass (COM) stability and limb support. However, perturbation training requires complex technology and is difficult to implement outside of the laboratory. This study examined if key reactive balance mechanisms could also be improved via more clinically translatable balance exercises targeting both volitional and reactive balance control (i.e., domain-specific balance training).
Methods
12 young adults completed a single session of domain-specific balance training and were exposed to a single overground slip (S1-Domain-Specific). The control group (n = 12) was exposed to 24 overground slips (S1–24-Control) without prior training. On the first (novel) slip, we compared reactive balance performance (rate of falls and loss of balance, margin of stability (MOS), limb support) between the training and control groups (S1-Domain-Specific vs. S1-Control). We also compared key reactive balance outcomes between S1-Domain-Specific and the final slip of the control group (S24-Control).
Results
There was a lower rate of backward loss of balance on S1-Domain-Specific than S1-Control, along with higher post-slip MOS and increased hip height (i.e., greater limb support) (p < 0.05). These improvements were associated with a more anterior COM position, greater COM velocity in the anterior direction, and reduced slip distance. Post-slip MOS and hip height were not significantly different between S1-Domain-Specific and S24-Control.
Discussion
A single session of domain-specific balance training improved key components of reactive balance control and could significantly reduce slip-related fall risk. Domain-specific balance training might provide similar fall prevention benefits as perturbation training, with easier transition into clinics, communities, and homes.
期刊介绍:
Human Movement Science provides a medium for publishing disciplinary and multidisciplinary studies on human movement. It brings together psychological, biomechanical and neurophysiological research on the control, organization and learning of human movement, including the perceptual support of movement. The overarching goal of the journal is to publish articles that help advance theoretical understanding of the control and organization of human movement, as well as changes therein as a function of development, learning and rehabilitation. The nature of the research reported may vary from fundamental theoretical or empirical studies to more applied studies in the fields of, for example, sport, dance and rehabilitation with the proviso that all studies have a distinct theoretical bearing. Also, reviews and meta-studies advancing the understanding of human movement are welcome.
These aims and scope imply that purely descriptive studies are not acceptable, while methodological articles are only acceptable if the methodology in question opens up new vistas in understanding the control and organization of human movement. The same holds for articles on exercise physiology, which in general are not supported, unless they speak to the control and organization of human movement. In general, it is required that the theoretical message of articles published in Human Movement Science is, to a certain extent, innovative and not dismissible as just "more of the same."