Aging and Fall Risk: Treadmill Based Perturbation Training

Slip-related falls cause severe consequences such as hip fractures and traumatic brain injuries, which can lead to prolonged hospitalization or even death in older adults. These fall-related injuries lead to a loss of mobility, causing psychological problems such as social isolation and even depression. Therefore, it is crucial to understand the age-related changes that result in falls and develop effective fall-prevention paradigms in older adults. The studies in this dissertation examined the age-related changes in the gait speed in relation to dynamic stability, which is a well-established fall risk predictor in older adults. In addition, this dissertation used a treadmill-based perturbation training paradigm in order to examine its effects on dynamic stability. Furthermore, participants were subjected to an overground slip to examine the generalization of the learned skill from treadmill-based perturbation training depending on the level of threat dosage (i.e., intensity, slip distance) and practice dosage (i.e., repetition). The study in this dissertation found that older adults, especially over the age of 85, walked significantly slower and demonstrated lower dynamic stability than those with ages below 85 years. Also, the study in this dissertation found that treadmill slip-perturbation training has a positive effect on reducing slip-related falls. Treadmill slip-perturbation training has the advantage of adjusting the training profile, thereby helping modulate the intensity and repetition depending on the health status of the older adult. Owing to the cost and space effectiveness associated with the treadmill as compared to the traditional overground walkway, such equipment can be easily translated into rehabilitation clinics. Therefore, treadmill slip-perturbation training could be quite suitable for clinical settings designed to help community-dwelling older adults improve their reactive balance and reduce their fall rate.