The long-term objective of this research is to develop an efficacious training paradigm to enhance older adults' defense mechanisms against falls and possibility reduce healthcare cost. The Centers for Disease Control and Prevention estimates the direct medical cost for fall related injuries to be $30 billion annually. Slips and trips combied account for more than 50% of the outdoor falls in community-dwelling older adults. These environmental perturbations are opposing in nature, with slips mainly resulting in backward falls and trips in forward falls. This project explores perturbation training through both slip and trip exposure based on the principles of motor learning. The project design consists of a randomized controlled trial to examine the ability of the central nervous system to mitigate the interference in stability control (if any) that is induced by opposing types of perturbations. It aso introduces a novel combined slip and trip perturbation training paradigm to enhance one's ability to retain and generalize the acquired fall-prevention skills to both types of falls. Slips and trip induced on an over ground walkway will be used to prepare the motor system to improve stability control and vertical limb support to resist falls. The longer-term benefits of such combined perturbation training over exclusive slip-only or trip-only perturbation training in reducing both laboratory-induced and real life falls will also be assessed. The hypothesis of this study if supported by the results will provide an evidence-supported training protocol to reduce the fall-risk among community-dwelling older adults.
The improved life expectancy over the past few decades, has led to a significant increase in falls among the older adults in the United States. Falls not only result in severe injuries but also reduce an individual's overall confidence in performing activitis of daily living independently, resulting in reduced mobility and higher chances of institutionalization. The proposed study addresses this major health care concern by targeting fall prevention via enhancing older adults' defense mechanisms to environmental perturbations encountered in daily living such as slips and trips. Reduced incidence of falls could improve mobility and quality of life among the older adults, and possibly reduce healthcare cost.