Training program reduces falls in older adults, Parkinson's patients

Researchers at Neuroscience Research Australia (NeuRA) and UNSW Sydney have developed a reactive balance training program that is intended to reduce falls due to trips and slips in older adults. The program is now being replicated to help those with Parkinson’s disease, and early indicators show promising results.

The reactive balance training program works on a retraining-the-brain protocol developed from learning on a purpose-built slip-and-trip walkway, said to be the only one of its kind in the world. Participants, supported by a safety harness, walk along a pathway which has a series of unexpected booby traps — boards spring up to cause a trip and sliding tiles create a slip — to which the brain and the body need to respond quickly. The learned response mechanism helps to retrain the brain to stay agile, respond faster to potential hazards and correct its balance to prevent a fall.

Writing in the Journal of Gerontology: Medical Sciences, the researchers revealed that their training program has resulted in a 60% risk reduction in falls due to trips and slips in participants. The next step of the research was to replicate the program to reduce falls risks in people with Parkinson’s disease, in a study called SAFE-PD.

Participants in the SAFE-PD training group first work through a series of stepping exercises delivered via a video gaming system and electronic mat connected to their television or computer at home. They train for around one to two hours per week.

“The games are inspired by video games such as Tetris and Pac-Man, are fun and their difficulty can be easily adjusted,” said Dr Yoshiro Okubo, lead author on the original study. “The games are designed to stimulate the brain, muscle, balance and improve quick stepping in desired directions.”

The participants are then invited to undertake the 1-hour reactive balance training using trips and slips at NeuRA at weeks four and eight. Dr Okubo explained, “In people with Parkinson’s disease, it is important to train in the context similar to real life… Repeated exposure to trips and slips can help to ensure that their practised stepping is automatically triggered by the daily life fall hazards.”

More than 80,000 people are living with Parkinson’s disease in Australia, approximately two-thirds of which will fall each year — resulting in injuries, hospitalisations and even death. With the prevalence of Parkinson’s expected to double between 2010 and 2040, the advances in fall prevention made in the SAFE-PD study have the potential to reduce personal and financial costs to individuals, their families and healthcare resources.

“The early results are in line with the success of our published study, which is encouraging because we know that falls in people with Parkinson’s are widespread and often devastating,” said Professor Stephen Lord, a Senior Principal Research Fellow at NeuRA, indicating that there have been improvements in the balance and gait of SAFE-PD participants.

Professor Peter Schofield, CEO of NeuRA, added, “The SAFE-PD program is an important innovation developed to help reduce the risk of falling associated with Parkinson’s in Australia and can be translated using technology around the world.”

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