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NCT Number: NCT06657989

Optimal Intensity of Reactive Balance Training for Healthy Older Adults

Falls in daily life are a serious risk for older adults. A new type of balance training, called reactive balance training (RBT) involves people losing balance many times so that they can practice fast balance reactions, like stepping reactions. Differences in training program features might explain differences in the results of previous RBT studies. Training intensity is the difficulty or challenge of the training program. It would be valuable to know if high-intensity RBT improves balance reactions quickly. The main goal of this study is to see if more intense RBT improves balance reactions faster than less intense RBT. The investigators will compare how quickly people improve balance reactions between high- and moderate-intensity RBT, and between RBT and a control program that does not include RBT. The investigators will also test if the improvements in balance reactions last after the training program is over. The secondary goals are to understand exactly how balance reactions improve with training, and to determine if people who complete RBT improve their general balance skills, and falls efficacy more than people who do not complete RBT.

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Key information

Conditions

Age range

65 year–80 year

Sex eligibility

All sexes

Study type

Interventional

Phase

Not applicable

Primary location

University Health Network

Toronto, Ontario, M5G 2A2, Canada

Location status: Recruiting

Location contact

David Jagroop

CONTACT

[email protected]

416-597-3422 ext. 7614

Who can participate

Healthy volunteers accepted: Yes

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

  • Community-dwelling older adults (65-80 years old)

Exclusion criteria

  • Unable to stand independently without upper-limb support for >30 seconds and/or walk independently (without a gait aid) for ≥10 metres;
  • Diagnosed neurological condition that could affect balance control (e.g., stroke, Parkinson's disease);
  • Score below normative values on the Montreal Cognitive Assessment;
  • Score below age-matched normative values for sensory and motor function, as assessed using the FallScreen battery;
  • Have insufficient English language comprehension such that they cannot understand instructions;
  • Have contraindications to reactive balance training such as severe osteoporosis; and/or
  • Are currently attending physiotherapy or supervised exercise.

Treatment and study plan

Reactive balance training

Behavioral

Reactive balance training involves clients experiencing repeated balance perturbations so that they can practice and improve control of reactions to avoid falling after a loss of balance.

Other names: Perturbation-based balance training

Walking

Behavioral

Overground walking

Primary outcomes

  1. Number of reactive steps

    Time frame: Two weeks

    Learning rate for number of steps to recover from 'backward fall' balance perturbations

Secondary outcomes

  1. Step initiation time

    Time frame: One week and 12 weeks post-training

    Time from perturbation onset time to foot off time

  2. Step execution time

    Time frame: One week and 12 weeks post-training

    Time from foot off to foot contact of the first step

  3. Step length

    Time frame: One week and 12 weeks post-training

    Difference in foot position from foot off to foot contact

  4. Braking impulse

    Time frame: One week and 12 weeks post-training

    Antero-posterior shear force generated over time on step contact

  5. Mechanical margin of stability

    Time frame: One week and 12 weeks post-training

    Distance between the extrapolated centre of mass (incorporating centre of mass position and velocity) and the edge of the base of support

  6. Balance evaluation systems test

    Time frame: One week and 12 weeks post-training

    Scale ranges from 0-100, with higher scores indicating better outcome

  7. Falls efficacy scale - International

    Time frame: One week, 12 weeks, and 12 months post-training

    Scale range: 10-100; higher values indicate worse outcome

Other outcomes

  1. Fall incidence

    Time frame: 12 months post-training

    Falls in daily life

  2. Injurious fall incidence

    Time frame: 12-months post-training

  3. 5-level EuroQoL health status measure (EQ-5D-5L)

    Time frame: One week, 12 weeks, and 12 months post-training

    Scale range for descriptive component: 5-25, higher values indicate worse outcome; Scale range for visual analogue scale: 0-100, higher values indicate better outcome

  4. Number of participants with fear of falling

    Time frame: One week, 12 weeks, and 12 months post-training

  5. Number of participants with activity curtailment due to fear of falling

    Time frame: One week, 12 weeks, and 12 months post-training

Study contacts

Contact information is provided by the study sponsor or research team.

Avril Mansfield, PhD

CONTACT

[email protected]

416-597-3422 ext. 7831

David Jagroop

CONTACT

[email protected]

416-597-3422 ext. 7614

Sponsors and collaborators

Lead sponsor

Toronto Rehabilitation Institute

Other

Collaborators

  • Canadian Institutes of Health Research (CIHR)

Registry information

Important dates

Study start
2025
Primary completion
2027
Study completion
2027
First posted
Oct 26, 2024
Registry last updated
Jan 27, 2025

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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