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Effects of Balance Training on Balance and Fall Confidence After Hip Replacement Surgery

26 de agosto de 2026 atualizado por: Jun Deokhoon, Daegu University

Effects of Perturbation-Based Balance Training on Balance Ability and Fall Efficacy in Patients After Total Hip Arthroplasty: A Randomized Controlled Trial

This randomized controlled study aims to investigate the effects of perturbation-based balance training using pressure biofeedback on balance ability, hip function, and falls efficacy in patients after total hip arthroplasty (THA). Thirty participants who underwent THA will be randomly assigned to either a perturbation-based balance training group or a conventional balance training group. Both groups will receive intervention five times per week for 6 weeks in addition to conventional physical therapy. Outcome measures include Berg Balance Scale, Functional Reach Test, Falls Efficacy Scale, Harris Hip Score, Lower Extremity Functional Scale, and center of pressure (COP) parameters. The study is expected to provide clinical evidence for improving balance control and reducing fall risk in patients after THA.

Visão geral do estudo

Descrição detalhada

Total hip arthroplasty (THA) is commonly performed to reduce pain and improve functional mobility in patients with hip joint disorders. However, many patients continue to experience impaired balance control, decreased proprioception, muscle weakness, and fear of falling after surgery. These impairments may negatively affect gait stability, activities of daily living, and quality of life.

Traditional balance training programs mainly focus on static posture control and predictable weight-shifting tasks. However, such approaches may not adequately improve reactive postural control required for unexpected balance disturbances encountered during daily activities. Perturbation-based balance training (PBT) has recently gained attention as an intervention designed to improve reactive balance control by exposing individuals to unexpected external disturbances and encouraging adaptive postural responses.

This study aims to investigate the effects of perturbation-based balance training using pressure biofeedback in patients following total hip arthroplasty. The pressure biofeedback system provides controlled instability and real-time sensory feedback during balance tasks, allowing participants to improve postural control strategies and weight-shifting ability.

Thirty patients who underwent THA will be recruited and randomly assigned to either an experimental group or a control group. The experimental group will receive perturbation-based balance training using pressure biofeedback in addition to conventional physical therapy, while the control group will perform conventional balance training with conventional physical therapy. Interventions will be performed 5 times per week for 6 weeks.

Outcome measures will include balance performance assessed by the Berg Balance Scale (BBS), Functional Reach Test (FRT), and center of pressure (COP) parameters measured using a Wii Balance Board. Falls efficacy will be evaluated using the Falls Efficacy Scale (FES). Hip function and lower extremity function will be assessed using the Harris Hip Score (HHS) and Lower Extremity Functional Scale (LEFS).

The findings of this study may provide evidence supporting the clinical applicability of perturbation-based balance training using pressure biofeedback as an effective rehabilitation strategy for improving postural stability and reducing fall risk after THA.

Tipo de estudo

Intervencional

Inscrição (Real)

30

Estágio

  • Não aplicável

Contactos e Locais

Esta seção fornece os detalhes de contato para aqueles que conduzem o estudo e informações sobre onde este estudo está sendo realizado.

Locais de estudo

    • Gyeongsangbuk-do
      • Gyeongsan-si, Gyeongsangbuk-do, Coréia do Sul, 38453
        • Daegu University

Critérios de participação

Os pesquisadores procuram pessoas que se encaixem em uma determinada descrição, chamada de critérios de elegibilidade. Alguns exemplos desses critérios são a condição geral de saúde de uma pessoa ou tratamentos anteriores.

Critérios de elegibilidade

Idades elegíveis para estudo

  • Adulto
  • Adulto mais velho

Aceita Voluntários Saudáveis

Não

Descrição

Inclusion Criteria:

  • Patients who underwent total hip arthroplasty (THA)
  • Postoperative period between 2 weeks and 6 months
  • Ability to understand and follow therapist instructions
  • Able to stand independently with or without an assistive device
  • Berg Balance Scale (BBS) score between 21 and 45
  • Receiving inpatient rehabilitation and physical therapy

Exclusion Criteria:

  • Severe cognitive impairment (K-MMSE < 18)
  • Severe visual impairment or vestibular dysfunction
  • Any neurological or musculoskeletal disorder affecting balance other than THA
  • Unstable cardiovascular or medical conditions that could interfere with participation
  • Inability to safely participate in balance training

Plano de estudo

Esta seção fornece detalhes do plano de estudo, incluindo como o estudo é projetado e o que o estudo está medindo.

Como o estudo é projetado?

Detalhes do projeto

  • Finalidade Principal: Tratamento
  • Alocação: Randomizado
  • Modelo Intervencional: Atribuição Paralela
  • Mascaramento: Nenhum (rótulo aberto)

Armas e Intervenções

Grupo de Participantes / Braço
Intervenção / Tratamento
Experimental: Pressure Biofeedback-Based Perturbation Balance Training Group
Participants will receive perturbation-based balance training using pressure biofeedback in addition to conventional physical therapy. The intervention will be conducted for 15 minutes per session, five times per week, for six weeks.
Participants performed perturbation-based balance training using pressure biofeedback devices in addition to conventional physical therapy. During standing tasks, pressure biofeedback units were placed under both feet, and temporary instability was induced by adjusting air pressure to alter support surface stability. Participants performed progressive balance tasks including static standing, weight shifting, multidirectional reaching, and PNF-based reaching patterns. Training intensity and task difficulty were progressively increased according to participant performance. The intervention was conducted for 15 minutes per session, 5 sessions per week, for 6 weeks under therapist supervision.
Comparador Ativo: Conventional Balance Training
Participants performed traditional balance training combined with conventional physical therapy. Training included static and dynamic balance exercises, weight shifting, postural control tasks, and functional reaching activities without pressure biofeedback. The intervention was conducted for 30 minutes per session, 5 sessions per week, for 6 weeks.
Participants in the control group received traditional balance training without pressure biofeedback. The intervention included static and dynamic balance exercises, postural control training, weight-shifting tasks, and posture transition activities. The training tasks were performed in the same sequence and progression as the experimental group, but without perturbation induced by pressure biofeedback devices. Participants received training for 30 minutes per session, 5 times per week, for 6 weeks in addition to conventional physical therapy.

O que o estudo está medindo?

Medidas de resultados primários

Medida de resultado
Descrição da medida
Prazo
Berg Balance Scale (BBS)
Prazo: Baseline and after 6 weeks of intervention
Functional balance assessed with the Berg Balance Scale, a 14-item performance-based scale scored from 0 to 56, with higher scores indicating better balance.
Baseline and after 6 weeks of intervention

Medidas de resultados secundários

Medida de resultado
Descrição da medida
Prazo
Functional Reach Test (FRT)
Prazo: Baseline and after 6 weeks of intervention
Maximum forward reach distance in centimetres while standing, measured with the Functional Reach Test; greater distance indicates better dynamic balance.
Baseline and after 6 weeks of intervention
Falls Efficacy Scale (FES)
Prazo: Baseline and after 6 weeks of intervention
Fall-related self-efficacy assessed with the Falls Efficacy Scale; higher scores indicate greater confidence in performing activities without falling.
Baseline and after 6 weeks of intervention
Harris Hip Score (HHS)
Prazo: Baseline and after 6 weeks of intervention
Hip function assessed with the Harris Hip Score, covering pain, function, deformity and range of motion, scored from 0 to 100, with higher scores indicating better hip function.
Baseline and after 6 weeks of intervention
Lower Extremity Functional Scale (LEFS)
Prazo: Baseline and after 6 weeks of intervention
Lower-limb function assessed with the Lower Extremity Functional Scale, a 20-item self-report questionnaire scored from 0 to 80, with higher scores indicating better function.
Baseline and after 6 weeks of intervention

Outras medidas de resultado

Medida de resultado
Descrição da medida
Prazo
Mean COP velocity, eyes open (cm/s)
Prazo: Baseline and after 6 weeks of intervention
Mean velocity of centre-of-pressure displacement during quiet standing with eyes open, measured with a Nintendo Wii Balance Board and Balancia software; mean of three 30-second trials.
Baseline and after 6 weeks of intervention
COP root mean square distance, eyes closed (cm)
Prazo: Baseline and after 6 weeks of intervention
Root-mean-square distance of the centre-of-pressure from its mean position during quiet standing with eyes closed, measured with a Nintendo Wii Balance Board and Balancia software; mean of three 30-second trials.
Baseline and after 6 weeks of intervention
COP 95% confidence ellipse area, eyes closed (cm^2)
Prazo: Baseline and after 6 weeks of intervention
Area of the 95% confidence ellipse fitted to the centre-of-pressure distribution during quiet standing with eyes closed, measured with a Nintendo Wii Balance Board and Balancia software; mean of three 30-second trials.
Baseline and after 6 weeks of intervention
COP sway path length, eyes closed (cm)
Prazo: Baseline and after 6 weeks of intervention
Total length of the centre-of-pressure trajectory during quiet standing with eyes closed, measured with a Nintendo Wii Balance Board and Balancia software; mean of three 30-second trials.
Baseline and after 6 weeks of intervention
COP mediolateral range, eyes closed (cm)
Prazo: Baseline and after 6 weeks of intervention
Range of centre-of-pressure excursion in the mediolateral direction during quiet standing with eyes closed, measured with a Nintendo Wii Balance Board and Balancia software; mean of three 30-second trials.
Baseline and after 6 weeks of intervention
Mean COP velocity, eyes closed (cm/s)
Prazo: Baseline and after 6 weeks of intervention
Mean velocity of centre-of-pressure displacement during quiet standing with eyes closed, measured with a Nintendo Wii Balance Board and Balancia software; mean of three 30-second trials.
Baseline and after 6 weeks of intervention
COP mediolateral range, eyes open (cm)
Prazo: Baseline and after 6 weeks of intervention
Range of centre-of-pressure excursion in the mediolateral direction during quiet standing with eyes open, measured with a Nintendo Wii Balance Board and Balancia software; mean of three 30-second trials.
Baseline and after 6 weeks of intervention
COP sway path length, eyes open (cm)
Prazo: Baseline and after 6 weeks of intervention
Total length of the centre-of-pressure trajectory during quiet standing with eyes open, measured with a Nintendo Wii Balance Board and Balancia software; mean of three 30-second trials.
Baseline and after 6 weeks of intervention
COP 95% confidence ellipse area, eyes open (cm^2)
Prazo: Baseline and after 6 weeks of intervention
Area of the 95% confidence ellipse fitted to the centre-of-pressure distribution during quiet standing with eyes open, measured with a Nintendo Wii Balance Board and Balancia software; mean of three 30-second trials.
Baseline and after 6 weeks of intervention
COP root mean square distance, eyes open (cm)
Prazo: Baseline and after 6 weeks of intervention
Root-mean-square distance of the centre-of-pressure from its mean position during quiet standing with eyes open, measured with a Nintendo Wii Balance Board and Balancia software; mean of three 30-second trials.
Baseline and after 6 weeks of intervention

Colaboradores e Investigadores

É aqui que você encontrará pessoas e organizações envolvidas com este estudo.

Patrocinador

Investigadores

  • Investigador principal: Deok Hoon Jun, Daegu University

Datas de registro do estudo

Essas datas acompanham o progresso do registro do estudo e os envios de resumo dos resultados para ClinicalTrials.gov. Os registros do estudo e os resultados relatados são revisados ​​pela National Library of Medicine (NLM) para garantir que atendam aos padrões específicos de controle de qualidade antes de serem publicados no site público.

Datas Principais do Estudo

Início do estudo (Real)

28 de outubro de 2025

Conclusão Primária (Real)

1 de março de 2026

Conclusão do estudo (Real)

1 de março de 2026

Datas de inscrição no estudo

Enviado pela primeira vez

24 de agosto de 2026

Enviado pela primeira vez que atendeu aos critérios de CQ

26 de agosto de 2026

Primeira postagem (Real)

28 de agosto de 2026

Atualizações de registro de estudo

Última Atualização Postada (Real)

28 de agosto de 2026

Última atualização enviada que atendeu aos critérios de controle de qualidade

26 de agosto de 2026

Última verificação

1 de agosto de 2026

Mais Informações

Termos relacionados a este estudo

Outros números de identificação do estudo

  • 1040621-202509-HR-074

Plano para dados de participantes individuais (IPD)

Planeja compartilhar dados de participantes individuais (IPD)?

INDECISO

Descrição do plano IPD

The plan for sharing individual participant data has not yet been determined.

Informações sobre medicamentos e dispositivos, documentos de estudo

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Não

Estuda um produto de dispositivo regulamentado pela FDA dos EUA

Não

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