Perturbation Training May Help Prevent Falls
Interesting research is being performed on the science behind falls and how to prevent them. We learn in childhood how to resist falls by actually experiencing a fall. There is a thought that one could possibly “inoculate” against a future fall by performing perturbation training. Perturbation training is the act of intentionally losing one’s balance.
Let’s start with some statistics.Falls are the leading cause of non-fatal and fatal injuries, as well as a major cause of disability among older adults. It is estimated that one in three adults over age 65 fall each year. Twenty to thirty percent of those that fall suffer a moderate to severe injury, which increases their risk of an early death.
The medical costs for fall-related injuries in older adults is estimated to be $30 billion in 2013. Emergency departments treated 2.4 million non-fatal fall injures in 2012, with more than 722,000 requiring hospitalization.
That is the bad news. The good news is there may be something you can do about it. Research into dynamic stability, which is the ability to maintain balance following a postural perturbation, potentially can reduce fall risk. Researchers utilized a motorized treadmill to mimic a slip or trip by fairly rapidly accelerating the treadmill belt unexpectedly. The subject was protected from falling by a safety harness. Subjects who fell on the initial recovery response were able to make modifications allowing for successful recoveries on subsequent attempts. So it seems you can learn how to recover from a slip or trip and not fall.
Other research performed in Chicago utilized low friction movable sections of a walkway to mimic a slip. Subjects walked on the walkway 24 times in one session and reduced falls from 42% on the initial slip to 0% on the 24th attempt. What is more interesting is the rate of falls on a retest remained low, with only 11.5% falling in a retest 12 months later, so the one time training results lasted for a year.
It seems perturbation training has it’s advantages in that the quick nature of the fall utilizes involuntary motion which is essential for the brain to recalibrate to learn how not to fall. What is really exciting is the process of learning only takes a few trials. The future of learning not to fall may lie in the act of falling in a controlled manner utilizing a safety harness.
-Dan Bodkin, PT
Unit Coordinator Outpatient Physical Therapy