@article{ref1,
title="Comparison of lateral perturbation-induced step training and hip muscle strengthening exercise on balance and falls in community dwelling older adults: a blinded randomized controlled trial",
journal="Journals of gerontology. Series A: Biological sciences and medical sciences",
year="2021",
author="Rogers, Mark W. and Creath, Robert A. and Gray, Vicki and Abarro, Janice and McCombe Waller, Sandy and Beamer, Brock A. and Sorkin, John D.",
volume="ePub",
number="ePub",
pages="ePub-ePub",
abstract="BACKGROUND: This factorial, assessor-blinded, randomized, and controlled study compared the effects of perturbation-induced step training (lateral waist-pulls), hip muscle strengthening, and their combination, on balance performance, muscle strength, and prospective falls among older adults. <br><br>METHODS: community-dwelling older adults were randomized to four training groups. Induced-step training (IST, n=25) involved 43 progressive perturbations. Hip abduction strengthening (HST, n=25) utilized progressive resistance exercises. Combined training (CMB, n=25) included IST and HST, and the control performed seated flexibility/relaxation exercises (SFR, n=27). Training involved 36 sessions over 12-weeks. The primary outcomes were the number of recovery steps and first step length, and maximum hip abduction torque. Fall frequency during 12 months after training was determined. <br><br>RESULTS: Overall, the number of recovery steps was reduced by 31%, and depended upon the first step type. IST and CMB increased the rate of more stable single lateral steps pre-post training than HST and SFR who used more multiple crossover and sequential steps. The improved rate of lateral steps for CMB exceeded the control (CMB/SFR rate ratio 2.68). First step length was unchanged, and HST alone increased hip torque by 25%. Relative to SFR, the fall rate ratios (falls/person/year) [95% confidence interval] were: CMB 0.26 [0.07 to 0.90], IST 0.44 [0.18 to 1.08], HST 0.30 (0.10 to 0.91). <br><br>CONCLUSIONS: Balance performance through stepping was best improved by combining perturbation and strength training and not strengthening alone. The interventions reduced future falls by 56% -74% over the control. Lateral balance perturbation training may enhance traditional programs for fall prevention.<p /> <p>Language: en</p>",
language="en",
issn="1079-5006",
doi="10.1093/gerona/glab017",
url="http://dx.doi.org/10.1093/gerona/glab017"
}