Optimal Intensity of Reactive Balance Training for Healthy Older Adults

NCT ID: NCT06657989

Last Updated: 2025-01-27

Basic Information

• Recruitment Status: RECRUITING
• Clinical Phase: NA
• Total Enrollment: 96 participants
• Study Classification: INTERVENTIONAL
• Study Start Date: 2025-01-21
• Study Completion Date: 2027-12-31

Brief Summary

Falls in daily life are a serious risk for older adults. A new type of balance training, called reactive balance training (RBT) involves people losing balance many times so that they can practice fast balance reactions, like stepping reactions. Differences in training program features might explain differences in the results of previous RBT studies. Training intensity is the difficulty or challenge of the training program. It would be valuable to know if high-intensity RBT improves balance reactions quickly. The main goal of this study is to see if more intense RBT improves balance reactions faster than less intense RBT. The investigators will compare how quickly people improve balance reactions between high- and moderate-intensity RBT, and between RBT and a control program that does not include RBT. The investigators will also test if the improvements in balance reactions last after the training program is over. The secondary goals are to understand exactly how balance reactions improve with training, and to determine if people who complete RBT improve their general balance skills, and falls efficacy more than people who do not complete RBT.

Conditions

Accidental Falls

Study Design

• Allocation Method: RANDOMIZED
• Intervention Model: PARALLEL
• Primary Study Purpose: PREVENTION
• Blinding Strategy: SINGLE

Study Groups

High intensity reactive balance training

Participants will complete 5 1-hour training sessions over 11 days. During each training session, participants will complete 36 multi-directional (left-, right-, and forward-fall) perturbations. Participants assigned to high-intensity RBT will experience perturbations at 150% of the multi-step threshold; for example, for a multi-step threshold of 2 m/s\^2 the high intensity perturbation will be 3 m/s\^2.

Group Type: EXPERIMENTAL

Reactive balance training

Intervention Type: BEHAVIORAL

Reactive balance training involves clients experiencing repeated balance perturbations so that they can practice and improve control of reactions to avoid falling after a loss of balance.

Moderate intensity reactive balance training

Participants will complete 5 1-hour training sessions over 11 days. During each training session, participants will complete 36 multi-directional (left-, right-, and forward-fall) perturbations. Participants assigned to moderate-intensity RBT will experience perturbations at 100% of the multi-step threshold; for example, for a multi-step threshold of 2 m/s\^2 the high intensity perturbation will be 2 m/s\^2.

Group Type: ACTIVE_COMPARATOR

Reactive balance training

Intervention Type: BEHAVIORAL

Reactive balance training involves clients experiencing repeated balance perturbations so that they can practice and improve control of reactions to avoid falling after a loss of balance.

Walking control group

Participants assigned to the walking control group will complete 36 trials of unperturbed walking in each training session.

Group Type: SHAM_COMPARATOR

Walking

Intervention Type: BEHAVIORAL

Overground walking

Interventions

Reactive balance training

Reactive balance training involves clients experiencing repeated balance perturbations so that they can practice and improve control of reactions to avoid falling after a loss of balance.

Intervention Type: BEHAVIORAL

Walking

Overground walking

Intervention Type: BEHAVIORAL

Other Intervention Names

Perturbation-based balance training

Eligibility Criteria

Inclusion Criteria

• Community-dwelling older adults (65-80 years old)

Exclusion Criteria

• Unable to stand independently without upper-limb support for >30 seconds and/or walk independently (without a gait aid) for ≥10 metres;
• Diagnosed neurological condition that could affect balance control (e.g., stroke, Parkinson's disease);
• Score below normative values on the Montreal Cognitive Assessment;
• Score below age-matched normative values for sensory and motor function, as assessed using the FallScreen battery;
• Have insufficient English language comprehension such that they cannot understand instructions;
• Have contraindications to reactive balance training such as severe osteoporosis; and/or
• Are currently attending physiotherapy or supervised exercise.

• Minimum Eligible Age: 65 Years
• Maximum Eligible Age: 80 Years
• Eligible Sex: ALL
• Accepts Healthy Volunteers: Yes

Sponsors

Canadian Institutes of Health Research (CIHR)

OTHER_GOV

Sponsor Role: collaborator

Toronto Rehabilitation Institute

OTHER

Sponsor Role: lead

Responsible Party

Avril Mansfield

Senior Scientist

Responsibility Role: PRINCIPAL_INVESTIGATOR

Principal Investigators

Avril Mansfield, PhD

Role: PRINCIPAL_INVESTIGATOR

University Health Network, Toronto

Locations

University Health Network

Toronto, Ontario, Canada

Site Status: RECRUITING

Countries

Canada

Central Contacts

Avril Mansfield, PhD

Role: CONTACT

avril.mansfield@uhn.ca

416-597-3422 ext. 7831

David Jagroop

Role: CONTACT

david.jagroop@uhn.ca

416-597-3422 ext. 7614

Facility Contacts

David Jagroop

Role: primary

david.jagroop@uhn.ca

416-597-3422 ext. 7614

Other Identifiers

24-5665

Identifier Type: -

Identifier Source: org_study_id