Acceptability of two perturbation-based balance training paradigms: perturbation treadmill versus dynamic stability training in the presence of perturbations
Introduction: Perturbation-based balance training (PBT) is promising for fall prevention in older adults, mimicking real-life fall situations at a person’s stability thresholds to improve reactive balance. Hence, it can be associated with anxiety, but knowledge about the acceptability of PBT is scar...
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| Main Authors: | , , , |
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| Format: | Article (Journal) |
| Language: | English |
| Published: |
April 2, 2024
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| In: |
Gerontology
Year: 2024, Volume: 70, Issue: 6, Pages: 661-668 |
| ISSN: | 1423-0003 |
| DOI: | 10.1159/000538105 |
| Online Access: | Verlag, lizenzpflichtig, Volltext: https://doi.org/10.1159/000538105
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| Author Notes: | Natalie Hezel, Leon Brüll, Adamantios Arampatzis, Michael Schwenk |
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| 520 | |a Introduction: Perturbation-based balance training (PBT) is promising for fall prevention in older adults, mimicking real-life fall situations at a person’s stability thresholds to improve reactive balance. Hence, it can be associated with anxiety, but knowledge about the acceptability of PBT is scarce. Method: This is a secondary analysis of a randomized controlled trial comparing the effects of two different PBT paradigms that aims to evaluate and compare the acceptability of those training paradigms in fall-prone older adults. Participants (74.9 ± 5.7 years) who completed the training (6 weeks, 3x/week) on either a perturbation treadmill (PBTtreadmill: n = 22) or unstable surfaces in the presence of perturbations (PBTstability: n = 27) were surveyed on the acceptability of PBT using a 21-item questionnaire addressing seven domains (perceived effectiveness, tailoring, demand, safety, burden, devices, affective attitude), based on the theoretical framework of acceptability and context-specific factors. Relative scores (% of absolute maximum) for single items and domains were calculated. Results: Median domain scores of perceived effectiveness, tailoring, safety, devices, and affective attitude were all ≥70% for both paradigms. The highest scores were obtained for tailoring (both paradigms = 100% [interquartile range 80-100%]). Domain scores of demand and burden were in the medium range (40-45%) for both paradigms. No significant differences between paradigms were found for any domain score. Two single items of safety differed significantly, with PBTtreadmill perceived as needing less support (p = 0.015) and leading less often to balance loss (p = 0.026) than PBTstability. Conclusion: PBT conducted on a perturbation treadmill or unstable surfaces is well accepted in this fall-prone older sample, even though it is conducted at individual stability thresholds. Tailoring may play a key role in achieving high levels of perceived effectiveness, appropriate levels of demand and burden, and a high sense of safety. PBT delivered on treadmills might be more appropriate for more anxious persons. | ||
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