Trunk motion visual feedback during walking improves dynamic balance in older adults: Assessor blinded randomized controlled trial.
Study Goal
The researchers aimed to determine whether trunk motion visual feedback (VFB) during treadmill walking improves over-ground balance in older adults with self-reported balance problems.
Results Summary
The experimental group using trunk motion VFB showed significant improvements in dynamic balance (BESTest and mini-BESTest), while the control group did not. Individuals with more profound sensory impairments benefited more from the intervention.
Population
Older adults (mean age 75.8 years) with self-reported balance difficulties or a history of falling.
Effective Dosage
Treadmill walking 3 times per week for 4 weeks in 2-minute bouts separated by seated rest.
Duration
4 weeks
Interactions
None mentioned
| Intervention | Direction | Endpoint | Population | Dosage | Impact | Claim # |
|---|---|---|---|---|---|---|
trunk motion visual feedback treadmill walking | increase | BESTest | older adults with self-reported balance problems | p = 0.031 | significantly improved | #1 |
trunk motion visual feedback treadmill walking | increase | mini-BEST | older adults with self-reported balance problems | p = 0.019 | significantly improved | #2 |
control treadmill walking (looking at stationary bulls-eye) | no change | any measure | older adults with self-reported balance problems | no significant change | did not improve significantly | #3 |
trunk motion visual feedback treadmill walking | increase | dynamic balance subtests of the BESTest | individuals with more profound sensory impairments | - | had a larger improvement | #4 |
trunk motion visual feedback treadmill walking | increase | dynamic balance | older adults with self-reported balance problems | - | improve | #5 |
trunk motion visual feedback during walking | increase | - | individuals with worse sensory function | - | may benefit more | #6 |
BACKGROUND: Virtual reality and augmented feedback have become more prevalent as training methods to improve balance. Few reports exist on the benefits of providing trunk motion visual feedback (VFB) during treadmill walking, and most of those reports only describe within session changes. RESEARCH QUESTION: To determine whether trunk motion VFB treadmill walking would improve over-ground balance for older adults with self-reported balance problems. METHODS: 40 adults (75.8 years (SD 6.5)) with self-reported balance difficulties or a history of falling were randomized to a control or experimental group. Everyone walked on a treadmill at a comfortable speed 3×/week for 4 weeks in 2 min bouts separated by a seated rest. The control group was instructed to look at a stationary bulls-eye target while the experimental group also saw a moving cursor superimposed on the stationary bulls-eye that represented VFB of their walking trunk motion. The experimental group was instructed to keep the cursor in the center of the bulls-eye. Somatosensory (monofilaments and joint position testing) and vestibular function (canal specific clinical head impulses) was evaluated prior to intervention. Balance and mobility were tested before and after the intervention using Berg Balance Test, BESTest, mini-BESTest, and Six Minute Walk. RESULTS: There were no significant differences between groups before the intervention. The experimental group significantly improved on the BESTest (p = 0.031) and the mini-BEST (p = 0.019). The control group did not improve significantly on any measure. Individuals with more profound sensory impairments had a larger improvement on dynamic balance subtests of the BESTest. SIGNIFICANCE: Older adults with self-reported balance problems improve their dynamic balance after training using trunk motion VFB treadmill walking. Individuals with worse sensory function may benefit more from trunk motion VFB during walking than individuals with intact sensory function.