Effects of Dynamic Perturbation-Based Training on Balance Control of Community-Dwelling Older Adults

Abstract

Walking is one of the daily activities that may cause falling in older adults. We developed a novel dynamic balance training program using a perturbation-based training on a custom-made treadmill, which can generate forward, backward, and lateral sway perturbations during walking. The purpose of this study was to investigate the changes in the balance performance of community-dwelling older adults after 8-weeks of perturbation-based balance training. A three-dimensional motion analysis system was used to collect kinematic and kinetic data. Seventeen community-dwelling older adults performed quiet standing with and without the balance perturbation. Biomechanical parameters such as center of pressure (COP) and center of mass (COM) were calculated. A paired t-test was used to compare the difference in balance performance before and after the training. After training, the results showed that the COM control of the older adults was significantly improved during quiet standing with perturbation, while the COP control during quiet standing without perturbation was not changed. The perturbation-based balance training exerted a positive effect on dynamic balance control in older adults. This translational research offers a new paradigm of balance training and can be applied to patient populations who have a high risk of falling.

Conflict of interest statement

The authors declare no competing interests.

Figures

Figure 1

The participant’s center of mass (COM, solid blue line) displacement during the balance response in quiet standing with backward perturbation of a representative participant. (A) COM displacement before the training; (B) COM displacement after the training. The reaction phase (yellow shaded area) is defined as the time between the COM movement onset (red solid line) and treadmill movement offset (black dot line). The recovery phase (green shaded area) is defined as the time from the treadmill movement offset (black dot line) to 0.5 s after the treadmill movement offset (pink dash line). Note that there were two peaks for COM displacement during the reaction phase before training (A), while there was only one peak during the reaction phase after training (B). The two peaks of COM displacement might indicate the participant moved around their body to maintain their balance. Therefore, the variance of COM displacement was calculated to quantify both the amplitude and the variability of the COM movement.

Figure 2

Quiet standing with perturbation.