Optimal Intensity of Reactive Balance Training for Healthy Older Adults

NCT06657989 | Recruiting

• 1 other identifier: 24-5665
• Study Type: interventional
• Target: 96
• Locations: 1 country
• Sites: 1

Brief Summary

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.

Conditions

Accidental Falls

Keywords

Postural balance; Aging; Biomechanics; Rehabilitation

Outcome Measures

Primary Outcomes (1)

• Number of reactive steps

  Learning rate for number of steps to recover from 'backward fall' balance perturbations

  Two weeks

Secondary Outcomes (7)

• Step initiation time

  One week and 12 weeks post-training

• Step execution time

  One week and 12 weeks post-training

• Step length

  One week and 12 weeks post-training

• Braking impulse

  One week and 12 weeks post-training

• Mechanical margin of stability

  One week and 12 weeks post-training

Other Outcomes (5)

• Fall incidence

  12 months post-training

• Injurious fall incidence

  12-months post-training

• 5-level EuroQoL health status measure (EQ-5D-5L)

  One week, 12 weeks, and 12 months post-training

Study Arms (3)

High intensity reactive balance training

EXPERIMENTAL

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.

Behavioral: Reactive balance training

Moderate intensity reactive balance training

ACTIVE COMPARATOR

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.

Behavioral: Reactive balance training

Walking control group

SHAM COMPARATOR

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

Behavioral: Walking

Interventions

Reactive balance training BEHAVIORAL

Reactive balance training involves clients experiencing repeated balance perturbations so that they can practice and improve control of reactions to avoid falling after a loss of balance.

Also known as: Perturbation-based balance training

High intensity reactive balance training; Moderate intensity reactive balance training

Walking BEHAVIORAL

Overground walking

Walking control group

Eligibility Criteria

• Age: 65 Years - 80 Years
• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Older Adult (65+)

You may qualify if:

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

You may not qualify if:

• 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.

Sponsors & Collaborators

• Toronto Rehabilitation Institute: lead
• Canadian Institutes of Health Research (CIHR): collaborator

Study Sites (1)

University Health Network

Toronto, Ontario, M5G 2A2, Canada

RECRUITING

MeSH Terms

Interventions

Walking

Intervention Hierarchy (Ancestors)

Locomotion; Movement; Musculoskeletal Physiological Phenomena; Musculoskeletal and Neural Physiological Phenomena; Exercise; Motor Activity

Study Officials

• Avril Mansfield, PhD

  University Health Network, Toronto

  PRINCIPAL INVESTIGATOR

Central Study Contacts

Avril Mansfield, PhD

CONTACT

416-597-3422; avril.mansfield@uhn.ca

David Jagroop

CONTACT

416-597-3422; david.jagroop@uhn.ca

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: SINGLE
• Who Masked: OUTCOMES ASSESSOR
• Purpose: PREVENTION
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Senior Scientist

Study Record Dates

• First Submitted: October 23, 2024
• First Posted: October 26, 2024
• Study Start: January 21, 2025
• Primary Completion (Estimated): March 1, 2027
• Study Completion (Estimated): December 31, 2027
• Last Updated: January 27, 2025

Record last verified: 2024-10

Data Sharing

• IPD Sharing: Will not share

Locations

CA (1)