Effects of ReacStep training program on balance recovery and fall risk factors in older people: An assessor-blinded randomised control trial

4622
Shivam Sharma 1,2, Chaplin C2, Hicks C1,2, Treacy D1, Farlie M3, Phu S2, Smith N2, Gibson H2, Ho C2, Coleman E4, Huang T1, Canning C4, Allen N4, Close J1,2, Lord S1,2, Okubo Y1,2
1 UNSW Sydney, Australia, 2 Neuroscience Research Australia (NeuRA), 3 Monash University, Australia, 4 University of Sydney, Australia
Scientific Research
SP - Education / Training
Falls
View DOI

Abstract

Background: Reactive balance training using repeated perturbations may reduce falls, however, training methods are not easily replicated or translatable to clinical settings. This study aimed to examine the effects of a novel reactive balance training program on balance recovery from laboratory induced trips and slips and fall risk factors in older people using simple and low-cost equipment.

Methods: We conducted a randomised controlled trial involving 88 older people. An intervention group (n = 43) received the ReacStep program which involved tether-release reactive stepping and intentional slips once a week for 6 weeks. Both the intervention and control (n = 45) groups received home-based strength training for 8 weeks. Blinded staff assessed reactive balance (laboratory induced falls), physical functions at baseline (week 1) and post intervention (week 8). Weekly SMS surveys ascertained falls in daily life over 12 months. 

Results: Both groups were comparable in demographics, with a mean age of 72 years (SD = 5.6). Adherence to ReacStep sessions was high (90%). There were no significant differences between groups in laboratory-assessed reactive balance falls at post-test or daily-life falls over one year (P = .19). However, at post-test, the intervention group demonstrated significant improvements in usual gait speed, maximum step length, and choice stepping reaction time compared to controls (P < .05).

Conclusion: The ReacStep program demonstrated excellent adherence, was well tolerated, and improved stepping parameters required for balance recovery following postural perturbations in older people. Nevertheless, it appears this program is not sufficient to improve reactive balance against unexpected trips and slips. 

Impact: The ReacStep program is acceptable, demonstrates excellent adherence and improves gait measures in older people, potentially reducing fall risk. However, its generalisability against unexpected trips, and slips, and falls in daily life may be limited. Future research should explore more ecological perturbations while maintaining its accessibility and acceptability.

Registration: ACTRN12622000911796

Presentation

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