Assessing Balance Loss and Stability Control in Older Adults Exposed to Gait Perturbations under Different Environmental Conditions: A Feasibility Study

This study investigated the feasibility of a perturbation-based balance protocol that incorporates a novel computer-controlled movable platform, the Surefooted Trainer, to induce losses of balance during overground walking under various environmental conditions. Twenty apparently healthy older adults (66.7 +/- years old) participated in this study. The acceptability and safety of the perturbation-based balance protocol were assessed by tracking adherence, adverse events, and subjective physical and mental demands after the intervention. Additionally, biomechanical variables during perturbed and non-perturbed trials were analyzed and compared with behavioral outcomes. Overall, 95% of the participants completed the study. There were no serious or non-serious adverse events. The margin of stability and step length after perturbations were significantly lower during slip-perturbations in which the environmental conditions were more challenging. For trip-perturbation conditions, the maximum trunk angle was higher during the trials that resulted in losses of balance. We conclude that the Surefooted Trainer is an acceptable and valid device for an overground walking perturbation-based assessment and training protocol in older adults.