Frontiers in Sports and Active Living (Oct 2022)

Perturbation-based balance training: Principles, mechanisms and implementation in clinical practice

  • Christopher McCrum,
  • Christopher McCrum,
  • Tanvi S. Bhatt,
  • Marissa H. G. Gerards,
  • Marissa H. G. Gerards,
  • Kiros Karamanidis,
  • Mark W. Rogers,
  • Stephen R. Lord,
  • Stephen R. Lord,
  • Yoshiro Okubo,
  • Yoshiro Okubo

DOI
https://doi.org/10.3389/fspor.2022.1015394
Journal volume & issue
Vol. 4

Abstract

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Since the mid-2000s, perturbation-based balance training has been gaining interest as an efficient and effective way to prevent falls in older adults. It has been suggested that this task-specific training approach may present a paradigm shift in fall prevention. In this review, we discuss key concepts and common issues and questions regarding perturbation-based balance training. In doing so, we aim to provide a comprehensive synthesis of the current evidence on the mechanisms, feasibility and efficacy of perturbation-based balance training for researchers and practitioners. We address this in two sections: “Principles and Mechanisms” and “Implementation in Practice.” In the first section, definitions, task-specificity, adaptation and retention mechanisms and the dose-response relationship are discussed. In the second section, issues related to safety, anxiety, evidence in clinical populations (e.g., Parkinson's disease, stroke), technology and training devices are discussed. Perturbation-based balance training is a promising approach to fall prevention. However, several fundamental and applied aspects of the approach need to be further investigated before it can be widely implemented in clinical practice.

Keywords