Can higher training practice dosage with treadmill slip-perturbation necessarily reduce risk of falls following overground slip?
Anna Lee, Tanvi Bhatt, Xuan Liu and 2 others
PMID 29453101WHAT IT FOUND
40 treadmill slips did not improve immediate fall resistance more than 24 slips.
Both training groups were less likely to fall or lose balance than controls, so extra slips did not add benefit.
Key findings
01Both training groups were less likely to fall than the control group, but the higher-dosage group did not differ from the lower-dosage group.
02Both training groups were less likely to lose balance than the control group, but the higher-dosage group did not differ from the lower-dosage group.
03Training improved balance control after the slip began, not before it began.
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
Participants were not randomly assigned; they were conveniently assigned to groups. The study tested only immediate response after one training session, not long-term retention or real-world fall rates. The treadmill slips were not identical to the overground slips: only 14% of treadmill slips happened during double stance, while all overground slips did. The treadmill software could not precisely control which side the slip occurred on. People with cognitive impairment, poor mobility, or symptomatic postural hypotension were excluded, so the findings do not show what would happen in frailer fall-risk patients.
Declared interests
The article is listed as receiving NIH extramural research support. The authors declare no conflict of interest.
The easy way to misread this
Do not conclude that 40 treadmill slips are better than 24. The 40-slip group and 24-slip group did not differ in falls, balance loss, or balance control after the slip began, and the study measured immediate lab slips, not long-term real-world falls.