Effects of Perturbation-Based Balance Training on Fall Risk in Older Adults: A Review

Vollständiger Abstract

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Falls constitute an important source of morbidity and mortality among the elderly and are thought to be a complex problem of public health. Postural control is impaired by sensory, motor, and cognitive decline associated with aging, which contributes to an increased fall risk. In this context, poor reactive postural control, which can be defined as the capacity to react to unexpected balance challenges, is a key factor in fall occurrence. Perturbation-based balance training (PBT) is a task specific intervention that seeks to enhance reactive recovery responses by delivering sudden, unpredictable balance perturbations and is unique among balance training interventions in that it focuses on not only static balance, but also on rapid, dynamic motor responses after an initial loss of balance. Continuous practice adapting to different perturbations leads to neuromuscular and neuroplastic changes and allows for faster and more efficient balance responses in an individual. Literature-based evidence supports that perturbation-based balance training enhances reactive balance control, postural stability, and some functional performance measures in elderly people and decreases fall rates and resultant injuries. However, the extent to which these improvements can be sustained over time remains questionable, and the length and intensity of the intervention significantly influence clinical efficacy. To conclude, perturbation-based balance training seems to be a promising and efficacious task specific intervention to improve balance and reduce fall risk in older adults; nevertheless, there are required larger studies to investigate the effects in the long term and to find the optimal training parameters.