Perturbation training can reduce community-dwelling older adults' annual fall risk: a randomized controlled trial

J Gerontol A Biol Sci Med Sci. 2014 Dec;69(12):1586-94. doi: 10.1093/gerona/glu087. Epub 2014 Jun 24.


Background: Previous studies indicated that a single session of repeated-slip exposure can reduce over 40% of laboratory-induced falls among older adults. The purpose of this study was to determine to what degree such perturbation training translated to the reduction of older adults' annual falls risk in their everyday living.

Methods: Two hundred and twelve community-dwelling older adults (≥65 years old) were randomly assigned to either the training group (N = 109), who then were exposed to 24 unannounced repeated slips, or the control group (N = 103), who merely experienced one slip during the same walking in the same protective laboratory environment. We recorded their falls in the preceding year (through self-reported history) and during the next 12 months (through falls diary and monitored with phone calls).

Results: With this single session of repeated-slip exposure, training cut older adults' annual risk of falls by 50% (from 34% to 15%, p < .05). Those who experienced merely a single slip were 2.3 times more likely to fall during the same 12-month follow-up period (p < .05) than those who experienced the 24 repeated slips. Such training effect was especially prominent among those who had history of falls.

Conclusion: A single session of repeated-slip exposure could improve community-dwelling older adults' resilience to postural disturbances and, hence, significantly reduce their annual risk of falls.

Keywords: Generalization; Inoculation.; Learning-from-falling; Postural disturbance; Retention.

Publication types

  • Comparative Study
  • Multicenter Study
  • Randomized Controlled Trial
  • Research Support, N.I.H., Extramural

MeSH terms

  • Accidental Falls / prevention & control*
  • Accidental Falls / statistics & numerical data
  • Aged
  • Female
  • Follow-Up Studies
  • Gait / physiology*
  • Humans
  • Male
  • Patient Education as Topic / methods*
  • Postural Balance / physiology*
  • Risk Factors
  • Walking / physiology*