A single session of trip-specific training modifies trunk control following treadmill induced balance perturbations in stroke survivors.
Masood Nevisipour, Mark D Grabiner, Claire F Honeycutt
PMID 30904789WHAT IT FOUND
One session of trip-specific training improved trunk control in chronic stroke survivors, but did not reduce falls.
Those who fell before training showed the most improvement, resembling non-fallers, though effects were absent at the largest perturbation level.
Key findings
01A single session of trip-specific training significantly reduced trunk flexion at smaller perturbation levels but did not change fall incidence.
02Participants classified as Fallers showed greater improvements in trunk control after training, with their post-training kinematics resembling the pre-training patterns of Non-fallers.
03No significant modifications in trunk control or fall prevention were observed at the largest perturbation level, where most falls occurred.
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
The study was a small pilot with only 16 participants, limiting generalizability. Participants were high-functioning, ambulatory individuals with stroke (high Berg Balance scores), so results may not apply to those with more severe impairments. Only short-term effects were measured; retention of any gains was not assessed. Training was limited to a single session with 15 trials, which may be an inadequate dose to affect fall outcomes. The study did not evaluate lateral perturbations or upper extremity strategies, which are common in real-world falls.
Declared interests
The study was supported by NIH grants (Extramural). No commercial conflicts of interest were declared in the provided text.
The easy way to misread this
Do not interpret the improved trunk flexion metrics as evidence that this training prevents falls. The study explicitly found that fall incidence was not reduced, particularly at the largest perturbation levels where most falls occurred.