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Sensory-Specific Balance Training in Older Adults: Effect on Proprioceptive Reintegration and Cognitive Demands

KP Westlake, PT, PhD, MSc, is Post-Doctoral Fellow, Rehabilitation Research and Development Center, VA Palo Alto HCC, 3801 Miranda Ave, Palo Alto, CA 94304 (USA).
EG Culham, PT, PhD, is Professor and Director, School of Rehabilitation Therapy, Queen's University, Kingston, Ontario, Canada.

westlake{at}rrd.stanford.edu

Background and Purpose: Age-related changes in the ability to adjust to alterations in sensory information contribute to impaired postural stability. The purpose of this randomized controlled trial was to investigate the effect of sensory-specific balance training on proprioceptive reintegration.

Subjects: The subjects of this study were 36 older participants who were healthy.

Methods: Participants were randomly assigned to a balance exercise group (n=17) or a falls prevention education group (n=19). The primary outcome measure was the center-of-pressure (COP) velocity change score. This score represented the difference between COP velocity over 45 seconds of quiet standing and each of six 5-second intervals following proprioceptive perturbation through vibration with or without a secondary cognitive task. Clinical outcome measures included the Fullerton Advanced Balance (FAB) Scale and the Activities-specific Balance Confidence (ABC) Scale. Assessments were conducted at baseline, postintervention, and at an 8-week follow-up.

Results: Following the exercise intervention, there was less destabilization within the first 5 seconds following vibration with or without a secondary task than there was at baseline or in the falls prevention education group. These training effects were not maintained at the 8-week follow-up. Postintervention improvements also were seen on the FAB Scale and were maintained at follow-up. No changes in ABC Scale scores were identified in the balance exercise group, but ABC Scale scores indicated reduced balance confidence in the falls prevention education group postintervention.

Discussion and Conclusion: The results of this study support short-term enhanced postural responses to proprioceptive reintegration following a sensory-specific balance exercise program.

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