Song Patrick Y H, Sturnieks Daina L, Davis Michael K, Lord Stephen R, Okubo Yoshiro
Falls, Balance and Injury Research Centre, Neuroscience Research Australia, Sydney, NSW, Australia.
Faculty of Medicine and Health, University of New South Wales, Sydney, NSW, Australia.
Front Sports Act Living. 2021 Aug 20;3:702320. doi: 10.3389/fspor.2021.702320. eCollection 2021.
Walkway and treadmill induced trips have contrasting advantages, for instance walkway trips have high-ecological validity whereas belt accelerations on a treadmill have high-clinical feasibility for perturbation-based balance training (PBT). This study aimed to (i) compare adaptations to repeated overground trips with repeated treadmill belt accelerations in older adults and (ii) determine if adaptations to repeated treadmill belt accelerations can transfer to an actual trip on the walkway. Thirty-eight healthy community-dwelling older adults underwent one session each of walkway and treadmill PBT in a randomised crossover design on a single day. For both conditions, 11 trips were induced to either leg in pseudo-random locations interspersed with 20 normal walking trials. Dynamic balance (e.g., margin of stability) and gait (e.g., step length) parameters from 3D motion capture were used to examine adaptations in the walkway and treadmill PBT and transfer of adaptation from treadmill PBT to a walkway trip. No changes were observed in normal (no-trip) gait parameters in both training conditions, except for a small (0.9 cm) increase in minimum toe elevation during walkway walks ( < 0.01). An increase in the margin of stability and recovery step length was observed during walkway PBT ( < 0.05). During treadmill PBT, an increased MoS, step length and decreased trunk sway range were observed ( < 0.05). These adaptations to treadmill PBT did not transfer to a walkway trip. This study demonstrated that older adults could learn to improve dynamic stability by repeated exposure to walkway trips as well as treadmill belt accelerations. However, the adaptations to treadmill belt accelerations did not transfer to an actual trip. To enhance the utility of treadmill PBT for overground trip recovery performance, further development of treadmill PBT protocols is recommended to improve ecological authenticity.
步道行走和跑步机引发的绊倒具有不同的优势，例如，步道行走具有较高的生态效度，而跑步机上的皮带加速对于基于扰动的平衡训练（PBT）具有较高的临床可行性。本研究旨在：（i）比较老年人对重复的地面绊倒与重复的跑步机皮带加速的适应性；（ii）确定对重复的跑步机皮带加速的适应性是否能转移到步道上的实际绊倒情况。38名居住在社区的健康老年人在一天内以随机交叉设计分别接受了一次步道和跑步机PBT训练。在两种情况下，在伪随机位置向每条腿诱发11次绊倒，并穿插20次正常行走试验。使用三维运动捕捉的动态平衡（如稳定极限）和步态（如步长）参数来检查步道和跑步机PBT的适应性以及从跑步机PBT到步道绊倒的适应性转移。在两种训练条件下，正常（无绊倒）步态参数均未观察到变化，但步道行走期间最小脚趾抬高有小幅（0.9厘米）增加（<0.01）。在步道PBT期间观察到稳定极限和恢复步长增加（<0.05）。在跑步机PBT期间，观察到稳定极限增加、步长增加且躯干摆动范围减小（<0.05）。这些对跑步机PBT的适应性并未转移到步道绊倒情况。本研究表明，老年人可以通过反复接触步道绊倒以及跑步机皮带加速来学习提高动态稳定性。然而，对跑步机皮带加速的适应性并未转移到实际绊倒情况。为提高跑步机PBT对地面绊倒恢复表现的效用，建议进一步开发跑步机PBT方案以提高生态真实性。
