Older Adults’ Perceptions of Fall-resisting Skills Training and their Stability: a Pilot Study for a Randomised Controlled Trial
Abstract
Introduction
Training fall-resisting skills can prevent falls in older adults. These skills include proactive gait adaptability, gait robustness, and reactive gait recovery, which allow people to effectively avoid, resist, and recover from balance threats, respectively.This pilot study guided the design of an RCT of fall-resisting skills training by investigating older adults’ perceptions of the training and their own stability. The aims were 1) explore older adults’ perceptions of stability during walking perturbations related to gait researcher observations; 2) investigate how task unpredictability affects anxiety during walking perturbations; and 3) check the feasibility of fall-resisting skill tasks.
Method
Eleven healthy older adults (73.5±5.5y) performed assessment and training tasks for each fall-resisting skill. For aim 1, participants experienced walking perturbations of increasing magnitude. Their self-reported perceptions of stability after each perturbation were compared to gait researcher observations. For aim 2, participants experienced large walking perturbations progressing from single to multiple directions, to adding auditory dual tasks. Anxiety was assessed with a 7-point Likert scale. Feasibility of each fall-resisting skill task was assessed with a 7-point Likert scale and open-ended questions on participants’ enjoyment, tension, and anxiety.
Results
Participants’ perception of stability did not consistently match gait researcher observations, with participants reporting instability early, at perturbation levels typically insufficient to induce instability. During large walking perturbations, participants’ anxiety scores started at 2.1±1.3 (1=low, 7=high) and progressively decreased with increasingly unpredictable perturbations. Overall, participants reported high enjoyment, and low anxiety and tension in all tasks.
Conclusions
Older adults' perceptions of their own stability cannot be relied upon for evaluating or progressing training difficulty. Fall-resisting skill tasks are feasible, and gradually increasing types of perturbations do not increase anxiety, given they are introduced in this order (i.e., repetition reduces anxiety), supporting their use in the future RCT.
Comments
Perception of stability
Thank you for this nice poster and interesting study!
Could you clarify the basis on which the gait researcher’s observations were made? Specifically, were these observations derived solely from visual gait analysis, or did they also include the outcomes of the MoS assessment? And was the assessment conducted by a single researcher, or were multiple researchers involved?
Gait researchers' observations
Thank you for your question.
The gait researchers' observations were done by watching video recordings of the trials, and evaluating after each perturbation whether an overt reactive gait response was observed. This was done by two researchers separately. The agreement between the researchers can be found in the bottom table.
The MoS was calculated for each perturbation as well, separately from the researchers' observations, and was done by evaluating whether the MoS of the first step after the perturbation fell within three standard deviations of the mean MoS of the 10 steps right before the perturbation.