Reactive balance training to improve balance control and reduce falls in older adults: a randomized controlled trial.

Falls are a common cause of injury and hospitalization among older adults. One in three older adults aged 65 and older experience a fall each year, and a large percentage (40-73%) of older adults are afraid of falling during their daily activities. Having previously fallen significantly increases the risk of experiencing another fall in the future. Balance training can effectively reduce fall incidence in older adults. Until recently, most balance training interventions have focused on proactive balance, which is an improtant part of maintaining balance in voluntary or expected movements. However, many falls occur due to unexpected balance perturbations, forcing the individual to rely on reactive balance control. Therefore, there has been increasing interest in reactive balance training as an intervention to decrease falls in older adults. This is a form of training that specifically aims to improve reactive balance control after destabilizaing perturbations in a safe and controlled environment. Evidence for the effectiveness of this type of training as a way to reduce falls in older adults has been emerging. however, the optimal type, duration and frequency of training in a clinical setting remains unclear. This study will investigate a training protocol based on an earlier review in a clinical setting.

Objective: To investigate the effectiveness of a reactive balance training intervention to imrpove balance control and decrease prospective falls in community-dwelling older adults with a recnt history of falls, in comparison to usual care.

Reactive balance training is more effective to improve balance control in community-dwelling older adults with a recent history of falls than usual care (physical therapy).

The measurements are performed at baseline, 1 week and 3 months post-intervention. Falls incidence will be monitored from inclusion until 6 months post-intervention. Injurious falls will be checked at 24 months post-intervention through the electronic patient file.

Three weeks of reactive balance training (3x30 minutes) on the Computer Assisted Rehabilitation Environment (CAREN, Motek). The training consists of gait adaptability, and reactive balance training during standing and walking with perturbations in the anteroposterior and mediolateral directions. The control intervention is usual care, which currently consists of a referral for physical therapy. Usual care will be monitored but not influenced in this study.