Comparative Effects of Exercises on Reactive Balance and Fall Risk in Community-Dwelling Older Adults
Comparative Effects of Sensory Perturbation and Dual-Task Training in Combination With Square-Stepping Exercises on Reactive Balance and Fall Risk in Community-Dwelling Older Adults
This randomized clinical trial is comparing the effects of sensory perturbation and dual task training in combination with square-stepping exercises on reactive balance and fall risk in community-dwelling older adults. Thirty-four (34) older adults who will meet inclusion criteria will be recruited by using non-probability convenient sampling from an old age home. A complete physical history and data of demographic characteristics (age, height, weight, BMI etc.) will be collected from the participants. For intervention participants will be randomly allocated into two groups i.e., A and B. Group A will receive square-stepping exercises with sensory perturbation for 30 minutes, 3 sessions per week for 6 weeks. Group B will receive square-stepping exercises with dual task training for 30 minutes, 3 sessions per week for 6 weeks. Both groups will also receive conventional training for 30 minutes. Measurements of fall risk and reactive balance will be taken at baseline and at 6th week.
Study Overview
Status
Conditions
Study Type
Enrollment (Estimated)
Phase
- Not Applicable
Contacts and Locations
Study Locations
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Punjab Province
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Lahore, Punjab Province, Pakistan, 54000
- UMT (University of Management and Technology)
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Contact:
- Maham Khalid, M.Phil
- Phone Number: +923244467622
- Email: maham.khalid@umt.edu.pk
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Sub-Investigator:
- Memoona Bibi, MSPT
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-
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
Aged 60-85 years Both males and females Can walk independently with or without an assistive device Fall efficacy scale = 9-13 TUG =10.9 + 3.9 (20) For cognitive functions: MMSE = 24-30 Must be community-dwelling
Exclusion Criteria:
Older adults with neurological conditions and sensori-motor impairments. Severe musculoskeletal impairments e.g., recent fracture Vestibular disorders e.g., Benign Paroxysmal Positional Vertigo (BPPV). Severe visual impairment due to diabetic retinopathy or cataracts. Cardiovascular or cardiopulmonary instability. (Only if the condition could impair their ability to cooperate or is associated with rapid deterioration).
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: Single
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
|---|---|
|
Experimental: Square Stepping Exercises (SSE) with Sensory Perturbation
Participants perform square stepping exercise (SSE): stepping pattern in forward, backward, lateral, and diagonal directions on thin mat (250 cm x 100 cm) partitioned into 40 squares (25 cm x 25 cm). After instructor's demonstration, participants memorize and practice each pattern in a supervised group. For sensory perturbation, foam pieces are randomly placed under mat, hidden from participants, creating unpredictable surface that challenges somatosensory input and reactive balance. Foam positions are changed in each session. Pattern difficulty is progressed by increasing complexity of pattern. Session last 30 minutes, 3 per week for 6 weeks. Participants also receive 30 minutes of ACSM-based balance training per session: progressive reduction of base of support (two-legged to one-legged stands); dynamic movements perturbing center of gravity (tandem, toe, heel, sideways walking; raising leg with contralateral arm); heel and toe stands. An instructor supervises all sessions. |
Participants perform square stepping exercise (SSE): stepping pattern in forward, backward, lateral, and diagonal directions on thin mat (250 cm x 100 cm) partitioned into 40 squares (25 cm x 25 cm). After instructor's demonstration, participants memorize and practice each pattern in a supervised group. For sensory perturbation, foam pieces are randomly placed under mat, hidden from participants, creating unpredictable surface that challenges somatosensory input and reactive balance. Foam positions are changed in each session. Pattern difficulty is progressed by increasing complexity of pattern. Session last 30 minutes, 3 per week for 6 weeks. Participants also receive 30 minutes of ACSM-based balance training per session: progressive reduction of base of support (two-legged to one-legged stands); dynamic movements perturbing center of gravity (tandem, toe, heel, sideways walking; raising leg with contralateral arm); heel and toe stands. An instructor supervises all sessions. |
|
Experimental: Square Stepping Exercises (SSE) with Dual-Task Training
Participants perform square stepping exercise (SSE): stepping pattern in forward, backward, lateral, and diagonal directions on thin mat (250 cm x 100 cm) partitioned into 40 squares (25 cm x 25 cm). After instructor's demonstration, participants memorize and practice each pattern in a supervised group. For dual-task training, participants say aloud as many as words possible from a given category (e.g., animals, fruits) while performing one pattern, without repeating words. Categories change with each pattern and progress from general to specific; pattern complexity also increases. Session last 30 minutes, 3 per week for 6 weeks. Participants also receive 30 minutes of ACSM-based balance training per session: progressive reduction of base of support (two-legged to one-legged stands); dynamic movements perturbing center of gravity (tandem, toe, heel, sideways walking; raising leg with contralateral arm); heel and toe stands. An instructor supervises all sessions. |
Participants perform square stepping exercise (SSE): stepping pattern in forward, backward, lateral, and diagonal directions on thin mat (250 cm x 100 cm) partitioned into 40 squares (25 cm x 25 cm). After instructor's demonstration, participants memorize and practice each pattern in a supervised group. For dual-task training, participants say aloud as many as words possible from a given category (e.g., animals, fruits) while performing one pattern, without repeating words. Categories change with each pattern and progress from general to specific; pattern complexity also increases. Session last 30 minutes, 3 per week for 6 weeks. Participants also receive 30 minutes of ACSM-based balance training per session: progressive reduction of base of support (two-legged to one-legged stands); dynamic movements perturbing center of gravity (tandem, toe, heel, sideways walking; raising leg with contralateral arm); heel and toe stands. An instructor supervises all sessions. |
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Berg Balance Scale (for risk of fall)
Time Frame: Baseline and after 6 weeks
|
The Berg Balance Scale (BBS) has 14 items in daily life activities and living settings to evaluate a fall risk. Each item ranges from 0 to 4. The total score is used to classify the fall risk into 3 groups: high-risk group (0-20 points), moderate-risk group (21-40 points), and low-risk group (41-56 points). |
Baseline and after 6 weeks
|
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MiniBESTest (for Reactive Balance)
Time Frame: Baseline and after 6 weeks
|
The Balance Evaluation Systems Test1 (BESTest) was developed to identify the postural control system(s) that underly poor functional balance, enabling physiotherapists to target treatment to a person's specific balance deficit. The Mini-BESTest includes four subscales: transitions/anticipatory postural control, reactive postural control, sensory orientation and stability in gait. Each item is rated on a three-point ordinal scale (0 = severe to 2 = normal). |
Baseline and after 6 weeks
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Collaborators and Investigators
Publications and helpful links
Helpful Links
Study record dates
Study Major Dates
Study Start (Estimated)
Primary Completion (Estimated)
Study Completion (Estimated)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Actual)
Study Record Updates
Last Update Posted (Actual)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Keywords
Other Study ID Numbers
- RE-206-2026
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
IPD Plan Description
The results data collected, de-identified individual participant data will be shared.
IPD Sharing Time Frame
6 months after the publication of the manuscript.
IPD Sharing Access Criteria
The data can be requested from the corresponding author.
IPD Sharing Supporting Information Type
- STUDY_PROTOCOL
- SAP
- ICF
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
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