Task-specific training reduces trip-related fall risk in women

Purpose: The potential of task-specific training as a fall-prevention intervention was studied. The primary purpose of the study was to determine the extent to which a task-specific training protocol decreased the number of falls by middle age and older women following a laboratoryinduced trip. Secondary purposes were to explore the ability of trunk kinematics during the initial recovery step and the length of the initial recovery step to correctly classify the trip outcome, and to quantify the extent to which the training protocol affected these variables. Methods: Healthy community dwelling women (n=52) were assigned to either a training group or control group that received no training. Training group women participated in an individually tailored, task-specific training protocol during which forward-directed stepping responses were necessary to avoid a fall following treadmill-delivered postural disturbances. Following the protocol, the ability to avoid a fall following a laboratory-induced trip was assessed. The primary outcome variable was the success (recover) or failure (fall) of the post-trip stepping response. Results: Compared to the control group, there were fewer falls by the trained women following the laboratory-induced trip (p<0.001; odds ratio = 0.13). Using logistic regression, falls and recoveries following the trip were sensitively classified by trunk flexion angle at the completion 3 of the initial recovery step and the length of the initial recovery step (sensitivity = 0.67, specificity =0.98), the former of which improved as a result of the task-specific training protocol. Conclusions: The task-specific training protocol significantly reduced the number of falls following a laboratory-induced trip. Prospective study is required to determine if this taskspecific training reduces falls in the community and, consequently, may complement currently used exercise-based fall prevention intervention methods.