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Transfer and retention effects of gait training with anterior-posterior perturbations to postural responses after medio-lateral gait perturbations in older adults.
Clinical Biomechanics ( IF 1.4 ) Pub Date : 2020-03-06 , DOI: 10.1016/j.clinbiomech.2020.104988
M M Rieger 1 , S Papegaaij 2 , M Pijnappels 3 , F Steenbrink 2 , J H van Dieën 3
Affiliation  

BACKGROUND Gait perturbations, occurring in any direction in daily life, may result in a fall. In fall prevention, gait perturbation training is a promising approach. Treadmill perturbations in anterior-posterior direction can easily be applied by accelerations or decelerations of the belt, but it is unknown whether training effects transfer to reactive recovery in medio-lateral direction. We aimed to evaluate the transfer and retention effects of gait training with treadmill perturbations in anterior-posterior direction to medio-lateral reactive recovery. METHODS 30 community dwelling older adults (>65 years) participated in this study. They were randomly assigned to a treadmill training session either with 16 anterior-posterior perturbations or with treadmill walking. The assessments contained a walking trial with 4 anterior-posterior and 4 medio-lateral perturbations. Deviations in trunk velocity from unperturbed walking were summed over the first three strides after perturbation as a measure of recovery. FINDINGS An exposure to gait perturbations during the baseline assessment led to significant improvement of recovery responses. For anterior-posterior perturbations, both groups showed better recovery immediately and 1-week post-intervention, and no group x time interaction was found.. For medio-lateral perturbations, both groups showed better recovery immediately and 1-week post-intervention, and again no group × time interaction. INTERPRETATION Baseline assessment with perturbations in anterior-posterior and medio-lateral directions caused significant improvements that were retained. Short-term training can be effective in dynamic stabilization of one's trunk, but our findings do not exclude that multi-directional perturbations may be needed.

中文翻译:

步态训练与前后扰动对老年人中外侧步态扰动后姿势反应的转移和保留作用。

背景技术在日常生活中以任何方向发生的步态扰动都可能导致跌倒。在预防跌倒方面,步态摄动训练是一种很有前途的方法。跑步机在前后方向上的扰动很容易通过皮带的加速或减速来施加,但是尚不清楚训练效果是否会沿中外侧方向转移到反应性恢复状态。我们的目的是评估跑步机在前,后方向上对中外侧反应性恢复的步态训练的转移和保留效果。方法30位社区居住的老年人(> 65岁)参加了这项研究。他们被随机分配到跑步机训练班,进行16次前后扰动或跑步机行走。评估包括一项步行试验,其中有4个前后位和4个中外侧扰动。在摄动后的前三个步幅中,将未受扰动的步行造成的躯干速度偏差相加,以作为恢复的度量。研究结果在基线评估期间接触步态扰动可显着改善恢复反应。对于前后扰动,两组均在干预后和干预后1周表现出更好的恢复,并且没有发现x时间交互作用。对于中外侧扰动,两组在干预后和干预后1周表现出更好的恢复,再也没有分组×时间互动。解释基线评估前后左右方向扰动引起的明显改善得以保留。
更新日期:2020-04-20
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