Task-specific slip and trip perturbation training in healthy community-dwelling older adults
thesisposted on 06.08.2019, 00:00 by Yiru Wang
Falling is one of the most common and significant health threats faced by older adults. Over one third of the community-dwelling older adults aged above 64 years fall annually. Hence it is imperative to develop effective preventive strategies to reduce falls among older adults. Perturbation training has been recently introduced as an emerging task-specific training paradigm which involves execution of whole-body motor skills-such as stepping response to avoid falls in the forward and backward direction. A series of four experiments were included in this dissertation which respectively examined effects of adaptation, generalization and long-term retention of the task-specific perturbation training applied by an over-ground trip device and a treadmill-slip device. The results of this dissertation supplement previous perturbation studies performed in older population and suggest that healthy, community-dwelling older adults retain similar intact adaptive stability control across functional activities, such as recovering from both subject-controlled and experimenter-induced repeated slips and trips, as is retained by young adults. These results highlight the potential for using a task-specific slip- or trip-perturbation paradigm to improve immediate proactive and reactive dynamic stability control. Furthermore, the findings suggest an after-effect of reduced fall-risk in older adults as a result of short-term retention and the potential for generalization across conditions. Moreover, the studies suggest a need to refine the training intensity (i.e., larger slip distance, higher obstacle height), amount of training repetitions, and number of training sessions to better yield training-induced adaptive improvements, extend retention and generalization, and ultimately have the best success in reducing real-life falls in older adults' daily living.