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Zanotto T, Chen L, Fang J, Bhattacharya SB, Alexander NB, Sosnoff JJ. Minimizing fall-related injuries in at-risk older adults: The falling safely training (FAST) study protocol. Contemp Clin Trials Commun 2023; 33:101133. [PMID: 37122489 PMCID: PMC10130595 DOI: 10.1016/j.conctc.2023.101133] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Revised: 03/22/2023] [Accepted: 04/10/2023] [Indexed: 05/02/2023] Open
Abstract
Background Falls are the leading cause of accidental injury among the elderly. Fall prevention is currently the main strategy to minimize fall-related injuries in at-risk older adults. However, the success of fall prevention programs in preventing accidental injury in elderly populations is inconsistent. An alternative novel approach to directly target fall-related injuries is teaching older adults movement patterns which reduce injury risk. The purpose of the current study will be to explore the feasibility and preliminary efficacy of teaching at-risk older adults safe-falling strategies to minimize the risk of injury. Methods/design The Falling Safely Training (FAST) study will be a prospective, single-blinded randomized controlled trial. A total of 28 participants will be randomly assigned to four weeks of FAST or to an active control group with a 1:1 allocation. People aged ≥65 years, at-risk of injurious falls, and with normal hip bone density will be eligible. The FAST program will consist of a standardized progressive training of safe-falling movement strategies. The control group will consist of evidence-based balance training (modified Otago exercise program). Participants will undergo a series of experimentally induced falls in a laboratory setting at baseline, after the 4-week intervention, and three months after the intervention. Data on head and hip movement during the falls will be collected through motion capture. Discussion The current study will provide data on the feasibility and preliminary efficacy of safe-falling training as a strategy to reduce fall impact and head motion, and potentially to reduce hip and head injuries in at-risk populations. Registration The FAST study is registered at http://Clinicaltrials.gov (NCT05260034).
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Affiliation(s)
- Tobia Zanotto
- Department of Occupational Therapy Education, School of Health Professions, University of Kansas Medical Center, Kansas City, KS, United States
- Mobility Core, University of Kansas Center for Community Access, Rehabilitation Research, Education and Service, Kansas City, KS, United States
| | - Lingjun Chen
- Department of Physical Therapy, Rehabilitation Science, and Athletic Training, School of Health Professions, University of Kansas Medical Center, Kansas City, KS, United States
| | - James Fang
- Department of Physical Therapy, Rehabilitation Science, and Athletic Training, School of Health Professions, University of Kansas Medical Center, Kansas City, KS, United States
| | - Shelley B. Bhattacharya
- Department of Family & Community Medicine, School of Medicine, University of Kansas Medical Center, Kansas City, KS, United States
| | - Neil B. Alexander
- VA Ann Arbor Healthcare System Geriatric Research, Education and Clinical Center (GRECC), Ann Arbor, MI, United States
- Division of Geriatric and Palliative Medicine, Department of Internal Medicine, University of Michigan, Ann Arbor, MI, United States
| | - Jacob J. Sosnoff
- Mobility Core, University of Kansas Center for Community Access, Rehabilitation Research, Education and Service, Kansas City, KS, United States
- Department of Physical Therapy, Rehabilitation Science, and Athletic Training, School of Health Professions, University of Kansas Medical Center, Kansas City, KS, United States
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Harper SA, Beethe AZ, Dakin CJ, Bolton DAE. Promoting Generalized Learning in Balance Recovery Interventions. Brain Sci 2021; 11:402. [PMID: 33810159 PMCID: PMC8004641 DOI: 10.3390/brainsci11030402] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2021] [Revised: 03/12/2021] [Accepted: 03/19/2021] [Indexed: 12/28/2022] Open
Abstract
Recent studies have shown balance recovery can be enhanced via task-specific training, referred to as perturbation-based balance training (PBT). These interventions rely on principles of motor learning where repeated exposure to task-relevant postural perturbations results in more effective compensatory balance responses. Evidence indicates that compensatory responses trained using PBT can be retained for many months and can lead to a reduction in falls in community-dwelling older adults. A notable shortcoming with PBT is that it does not transfer well to similar but contextually different scenarios (e.g., falling sideways versus a forward trip). Given that it is not feasible to train all conditions in which someone could fall, this limited transfer presents a conundrum; namely, how do we best use PBT to appropriately equip people to deal with the enormous variety of fall-inducing scenarios encountered in daily life? In this perspective article, we draw from fields of research that explore how general learning can be promoted. From this, we propose a series of methods, gleaned from parallel streams of research, to inform and hopefully optimize this emerging field where people receive training to specifically improve their balance reactions.
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Affiliation(s)
- Sara A. Harper
- Department of Kinesiology and Health Science, Utah State University, Logan, UT 84322, USA; (S.A.H.); (A.Z.B.); (C.J.D.)
- Sorenson Legacy Foundation Center for Clinical Excellence, Utah State University, Logan, UT 84322, USA
| | - Anne Z. Beethe
- Department of Kinesiology and Health Science, Utah State University, Logan, UT 84322, USA; (S.A.H.); (A.Z.B.); (C.J.D.)
- Sorenson Legacy Foundation Center for Clinical Excellence, Utah State University, Logan, UT 84322, USA
| | - Christopher J. Dakin
- Department of Kinesiology and Health Science, Utah State University, Logan, UT 84322, USA; (S.A.H.); (A.Z.B.); (C.J.D.)
- Sorenson Legacy Foundation Center for Clinical Excellence, Utah State University, Logan, UT 84322, USA
| | - David A. E. Bolton
- Department of Kinesiology and Health Science, Utah State University, Logan, UT 84322, USA; (S.A.H.); (A.Z.B.); (C.J.D.)
- Sorenson Legacy Foundation Center for Clinical Excellence, Utah State University, Logan, UT 84322, USA
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