Senior Citizens Inoculated Against Falling in
Successful Research Project
Shows how brain develops fall prevention strategies
that can be generalized to variety of conditions
Feb. 4, 2009 Senior citizens may not be lining up
for this inoculation like they do flu shots, but new research shows
there is a way older people can inoculate themselves against disastrous
falls. The preventive medicine is specialized training teaching them to
react to conditions that may lead to falling.
Training people to avoid falls by repeatedly
exposing them to unstable situations in the laboratory helped them to
later maintain their balance on a slippery floor, according to this new
research from the Journal of Neurophysiology.
The study furthered the understanding of how the
brain develops fall prevention strategies that can be generalized to a
variety of conditions. The research could eventually help people,
including the elderly, for whom falling is an important health issue.
The study, "Generalization of gait adaptation for
fall prevention: from moveable platform to slippery floor," is published
online by The American Physiological Society. Tanvi Bhatt and Yi-Chung
(Clive) Pai, of the University of Illinois at Chicago carried out the
study.
Will training transfer?
The researchers used a moveable platform which
could be operated to disrupt a person's balance. Previous studies had
shown that people could quickly learn to maintain balance and avoid a
fall with a short training period on the platform. In this study, the
researchers wanted to see whether training on the platform could
transfer to prevent a fall on a slippery floor.
Dr. Pai, who teaches in the department of physical
therapy and whose work has been supported by National Institutes of
Health, National Institute on Aging, said he aims to train people to
maintain balance in the face of a situation that could cause a
slip-related fall.
In the study, eight participants trained on the
moveable platform for a total of 37 times. The low-friction platform was
set up so that it released unannounced, 24 of those times. This release
created a low-friction condition to cause a frontward or backward slip.
The platform does not allow the foot to slip from side to side, as would
be the case in a real-life fall.
The participants wore a harness to record the
amount of assistance needed to catch them when they fell. Motion capture
instruments and videos of the sessions also helped to document slip
outcomes ("skate-over", "walkover" or "loss of balance") and falls.
The participants were compared to a group of seven
controls who did not receive any training on the platform. Both groups
were later asked to walk on a vinyl surface that had one slippery spot
that they could not see. Instruments and videos were used to record the
extent of their slip. The vinyl surface represented a particular
challenge following the laboratory training, in part because it could
cause the foot to slide in any direction.
Training inoculates against falls
The researchers found:
● None of the trained participants fell on the
slippery floor and seven of the eight never lost balance.
● The control group's performance on the
slippery floor revealed their lack of training. Their performance was
akin to the trained group's first training slip on the platform.
The trained subjects were able to transfer the
skill and avoid a fall on the slippery floor because they were better at
controlling the landing foot, that is, the foot that is on the ground
during the slip. They slowed down the movement of the foot as it began
to slide forward. The landing foot of people in the untrained group went
out from under them much faster.
"Controlling this foot, which is sliding forward,
plays an important role in maintaining stability and prevents a backward
fall," Pai said.
The researchers also found that the trained group
unconsciously changed their gait. They used a flatter landing foot and
bent the landing knee more. These changes reduced the landing force and
the velocity of the slip. Interestingly, the trained group did this
while walking at their customary speed.
May help elderly
The brain is able to generalize fall training from
one situation to another by modifying gait to make loss of balance less
likely, the authors concluded. These changes give the body greater
stability when a slip begins to occur. In addition, the study found that
with one session of such training, the brain pre-programs a response to
slipping that can be drawn upon quickly to stop a slip or a fall, or
even to skate-over the slippery surface without losing balance.
Fall training may be particularly helpful for
active elderly persons who put themselves in more challenging
situations. Fall prevention training may cut down on hip fractures,
surgery, rehabilitation and pain and suffering.
So far, the research team has used younger subjects
because the experiments carry some risk of injury. But in one study also
funded by National Institutes of Health, the researchers found that
older adults were able to learn as quickly as young adults. Further
research is now being conducted to find out if older adults can retain
the training as well as the young.
Pai and Bhatt's research so far indicates that the
effects of one such training session, as with an inoculation, should
last for at least for four months, and perhaps much longer, to protect
against one of most dangerous falls, the backward falls.
Background Information
Physiology is the study of how molecules, cells,
tissues and organs function to create health or disease. The American
Physiological Society (www.The-APS.org/press)
has been an integral part of this discovery process since it was
established in 1887.
Keep up with the latest news for senior citizens, baby
boomers
Feb. 4, 2009 Senior citizens may not be lining up
for this inoculation like they do flu shots, but new research shows
there is a way older people can inoculate themselves against disastrous
falls. The preventive medicine is specialized training teaching them to
react to conditions that may lead to falling.
Dr. Pai, who teaches in the department of physical
therapy and whose work has been supported by National Institutes of
Health, National Institute on Aging, said he aims to train people to
maintain balance in the face of a situation that could cause a
slip-related fall.
The researchers found: