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Accidental FallNCT04733222

Effect of Treadmill Perturbation Training on Falls

A study testing Perturbation training and Treadmill walking in people with Accidental Fall and Accident Prevention, run by Aalborg University Hospital at 1 site in Denmark.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

This parallel, randomized, controlled trial aims to quantify the effects of slip- and trip-perturbation training on fall rates collected over 12 months, compared to time-matched treadmill walking, among community-dwelling older adults (≥65 years). Read more about this study

Who is it for?
Ages 65 years and olderHealthy volunteers can take part
Conditions the study is for
Accidental Fall, Accident Prevention
What is being tested?
Perturbation training and Treadmill walking
Could I receive a placebo?
No, everyone receives an active treatment
How many people
140 participants
Where
1 siteDenmark
Study dates
1 Apr 2021to 15 Nov 2022
Phase
Interventional
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 65 years and older
  • All sexes
  • Healthy volunteers accepted
  • Older adult

Who may be able to join

  • ≥65 years old
  • Community-dwelling
  • Able to walk without a walking aid

Who cannot join

  • Any of the following self-reported conditions: Any orthopedic surgery within the past 12 months, osteoporosis or history of osteoporosis-related fractures (low impact hip, spine, and wrist fracture), or progressive neurological disease (e.g., Parkinson, multiple sclerosis)
  • An unstable medical condition that would prevent safe participation
  • Severe cognitive impairment (a score <8 in The Short Orientation-Memory-Concentration Test)
  • Current participation in another fall prevention trial

Trial locations and contacts

1 site in 1 country.

Denmark1 site
  • Aalborg Municipality

    Aalborg

Other trials in Denmark

About this study

Official title: Effect of Treadmill Slip- and Trip-perturbation Training on Falls Among Community-dwelling Older Adults: A Randomized, Controlled Trial

This parallel, randomized, controlled trial aims to quantify the effects of slip- and trip-perturbation training on fall rates collected over 12 months, compared to time-matched treadmill walking, among community-dwelling older adults (≥65 years).

A sample size calculation estimated that 140 older community-dwelling older adults (≥65 years) are needed. Following baseline measures, the recruited participants will randomly be assigned to either the perturbation or the walking group. The participants in the perturbation group will be assigned to four perturbation training sessions. The walking group will perform four treadmill walking matching the exercise time of the perturbation training. Assessment of the primary outcome, fall rates, will be conducted continuously in 12 months from randomization. When a fall is reported in the fall calendar, a telephone interview will be conducted to assess the circumstances and consequences (e.g., fall-related fractures, fall-related hospital admissions) of the falls. Moreover, assessment of physical, cognitive, and social-psychological outcomes will be made at baseline, post-test, six-month, and 12-months reassessment.

Read the detailed description

Approximately one-third of older adults fall at least once a year, and about 10% of these falls cause serious injuries such as head injuries and fractures. In fact, falls are the most frequent cause of injuries among older adults and often lead to disability, institutionalization, and premature death.

Multiple fall prevention interventions have been examined to reduce the fall rate, and physical exercise has continuously been proven as an effective and cost-effective approach. However, traditional exercise approaches, such as balance and muscle-strengthening training, have only shown a moderate 20-25% decrease in falls and encounters issues such as poor compliance. Recently, task-specific perturbation training using an overground walkway has been shown to produce quick motor adaptations resulting in improved pro- and reactive stability. Additionally, perturbation training delivered on such walkways has decreased both laboratory-induced and real-life falls. However, overground walkways with moveable platforms and trip-board are expensive and immobile; thus, limiting the clinical feasibility.

Contrarily, perturbation training delivered on computer-controlled treadmills may serve as a more implementable substitute. Preliminary studies have shown that treadmill perturbation training produces similar dynamic stability adaptations to overground perturbation training. Furthermore, a single session of treadmill perturbation decreases the rate of laboratory-induced falls, and the ergogenic effects were retained for up to six months. However, the effects of a brief treadmill perturbation training intervention on real-life falls in community-dwelling older adults still vastly unknown.

Being tested
Perturbation training, Treadmill walking
Keywords
Aged, Aged, 80 and over, Exercise, Perturbation training, Older adults
Medical subject headings
Motor Activity

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Perturbation trainingOther

    The treadmill perturbation training will be performed on a computer-controlled treadmill. The perturbation will be induced by fast forward (slip) or backward (trip) accelerations of the treadmill at specific gait cycle timings. The perturbations will be delivered randomly to enhance the unpredictability. A ceiling-mounted body-harness ensures the safety of the participants.

    Participants will be assigned to three initial sessions of treadmill slip- and trip-perturbation training on two days separated by a week and a "booster"-session after six months. On day 1, participants will first undergo a session 1 with 40 slip perturbations and then a session 2 with 40 trip perturbations. On day 2, participants will undergo a session 3 with 20 slip and 20 trip perturbations in random order. The "booster"-session after six months will be similar to session 3 (20 of each perturbation in random order).

  • Treadmill walkingOther

    Participants allocated to the walking group will walk at a self-selected pace on a computer-controlled treadmill for the same amount of time as the treadmill perturbation training participants.

Study groups in NCT04733222
Study groupRoleWhat they receive
Perturbation trainingExperimentalParticipants randomized to the treadmill perturbation training will initially perform three sessions performed within a week followed by a "booster"-session after six months.
Receives: Other: Perturbation training
Treadmill walkingActive comparatorParticipants randomized to the walking group will undergo three initial sessions within a week and a "booster"-session after six months.
Receives: Other: Treadmill walking

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Fall rate

    Falls are collected by daily recordings in calendar that is returned to the research group monthly

    Measured: Continuously for 12 months after the initial three training sessions

Secondary outcomes (22)
  1. Proportion of participants with at least one fall

    Falls are collected by daily recordings in calendar that is returned to the research group monthly

    Measured: Continuously for 12 months after the initial three training sessions

  2. Time to first fall

    Falls are collected by daily recordings in calendar that is returned to the research group monthly

    Measured: Continuously for 12 months after the initial three training sessions

  3. Fall-related fracture rate

    When a fall is registered in the fall calendar, a research group member will make a telephone interview to obtain information about the fall's consequences (e.g. fractures). Screening of the participants medical records for radiologically verified fractures will verify this information.

    Measured: Continuously for 12 months after the initial three training sessions

  4. Proportion of participants with at least one fall-related fractures

    When a fall is registered in the fall calendar, a research group member will make a telephone interview to obtain information about the fall's consequences (e.g. fractures). Screening of the participants medical records for radiologically verified fractures will verify this information.

    Measured: Continuously for 12 months after the initial three training sessions

  5. Number of all-cause fractures

    Screening of the participants medical records for radiologically verified fractures.

    Measured: At the 52-week follow-up

  6. Number of other fall-related injuries

    When a fall is registered in the fall calendar, a research group member will make a telephone interview to obtain information about the fall's consequences (e.g. head injuries and bruises).

    Measured: Continuously for 12 months after the initial three training sessions

  7. Fall-related hospital admission rate

    When a fall is registered in the fall calendar, a research group member will make a telephone interview to obtain information about the fall's consequences (e.g. hospital contacts). Screening of the participant's medical records will verify this information.

    Measured: Continuously for 12 months after the initial three training sessions

  8. Proportion of participants with at least one hospital admission

    When a fall is registered in the fall calendar, a research group member will make a telephone interview to obtain information about the fall's consequences (e.g. hospital contacts). Screening of the participant's medical records will verify this information.

    Measured: Continuously for 12 months after the initial three training sessions

  9. Number of all-cause hospital admissions

    Screening of the participant's medical records

    Measured: At the 52-week follow-up

  10. Laboratory-induced falls

    Falls after slips and trips induced on the treadmill. A fall is determined based on video recordings. A fall is defined as unambiguous support by the safety harness after the perturbation.

    Measured: Week 0 (Pre-training; before the first training), week 1 (Post-training; after the third training session), week 26 (26-week follow-up; before the fourth training session), and week 52 (52-week follow-up)

  11. Gait kinematics to perturbations

    Gait kinematics collected before, during and after a slip- and trip-perturbation measured by heel contacts

    Measured: Week 0 (Pre-training; before the first training), week 1 (Post-training; after the third training session), week 26 (26-week follow-up; before the fourth training session), and week 52 (52-week follow-up)

  12. Single-task gait

    8-meter walking timed by handheld stopwatch.

    Measured: Week 0 (Pre-training; before the first training), week 1 (Post-training; after the third training session), week 26 (26-week follow-up; before the fourth training session), and week 52 (52-week follow-up)

  13. Dual-task gait

    8-meter walking timed by handheld stopwatch under dual-task condition (serial subtraction of threes from a random three digit number).

    Measured: Week 0 (Pre-training; before the first training), week 1 (Post-training; after the third training session), week 26 (26-week follow-up; before the fourth training session), and week 52 (52-week follow-up)

  14. Single-task static balance

    30-seconds static balance measures on a Wii balance board.

    Measured: Week 0 (Pre-training; before the first training), week 1 (Post-training; after the third training session), week 26 (26-week follow-up; before the fourth training session), and week 52 (52-week follow-up)

  15. Dual-task static balance

    30-seconds static balance measures on a Wii balance board under dual-task conditions (verbal fluency of grocery store items).

    Measured: Week 0 (Pre-training; before the first training), week 1 (Post-training; after the third training session), week 26 (26-week follow-up; before the fourth training session), and week 52 (52-week follow-up)

  16. Choice stepping reaction time

    Choice stepping reactions test on a Wii balance board

    Measured: Week 0 (Pre-training; before the first training), week 1 (Post-training; after the third training session), week 26 (26-week follow-up; before the fourth training session), and week 52 (52-week follow-up)

  17. Lower extremity physical performance

    The Short Physical Performance Battery

    Measured: Week 0 (Pre-training; before the first training), week 1 (Post-training; after the third training session), week 26 (26-week follow-up; before the fourth training session), and week 52 (52-week follow-up)

  18. Health-related quality of life

    The EuroQoL EQ-5D-5L, Danish version

    Measured: Week 0 (Pre-training; before the first training), week 1 (Post-training; after the third training session), week 26 (26-week follow-up; before the fourth training session), and week 52 (52-week follow-up)

  19. Fear of Falling

    The Short Falls Efficacy Scale International, Danish version

    Measured: Week 0 (Pre-training; before the first training), week 1 (Post-training; after the third training session), week 26 (26-week follow-up; before the fourth training session), and week 52 (52-week follow-up)

  20. Executive function

    The trail making task Part A and B

    Measured: Week 0 (Pre-training; before the first training), week 1 (Post-training; after the third training session), week 26 (26-week follow-up; before the fourth training session), and week 52 (52-week follow-up)

  21. Frailty

    The Tilburg Frailty Indicator

    Measured: Week 0 (Pre-training; before the first training), week 1 (Post-training; after the third training session), week 26 (26-week follow-up; before the fourth training session), and week 52 (52-week follow-up)

  22. Adverse events

    Patient-reported events such as muscle soreness, discomfort, pain, or injuries

    Measured: Week 0 (Pre-training; before the first training), week 1 (Post-training; after the third training session), week 26 (26-week follow-up; before the fourth training session), and week 52 (52-week follow-up)

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted2 Feb 2021
  2. Study start1 Apr 2021
  3. Primary completion15 Nov 2022
  4. Study completion15 Nov 2022

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Prevention
Allocation
Randomised
Intervention model
Parallel groups
Model description
After the pre-training tests, participants will be randomly allocated to either the perturation or control group. To produce groups of similar size a permuted block randomization will be used. Allocation concealment will be maintained using random block sizes (4, 6, or 8) and by the randomization code only being available for non-blinded research staff. The perturbation group will undergo three initial training sessions on two days within a week, and a "booster"-session after six months. The active control group will perform treadmill walking at a preferred speed to match the training dose of the perturbations group.
Masking
None (open label)
Enrolment
140 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT04733222
Sponsor's protocol ID
N-20200089
Status last verified
Jan 2023
First submitted
22 Jan 2021
Last updated
1 Feb 2023
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No

Publications

  • Norgaard JE, Andersen S, Ryg J, Andreasen J, Oliveira ASC, Stevenson AJT, Danielsen MBB, Jorgensen MG. Perturbation-based balance training of older adults and effects on physiological, cognitive and sociopsychological factors: a secondary analysis from a randomised controlled trial with 12-month follow-up. BMJ Open. 2024 Aug 7;14(8):e080550. doi: 10.1136/bmjopen-2023-080550.

    PubMed 39117404
  • Norgaard JE, Andersen S, Ryg J, Stevenson AJT, Andreasen J, Oliveira AS, Danielsen MB, Jorgensen MG. Effect of Treadmill Perturbation-Based Balance Training on Fall Rates in Community-Dwelling Older Adults: A Randomized Clinical Trial. JAMA Netw Open. 2023 Apr 3;6(4):e238422. doi: 10.1001/jamanetworkopen.2023.8422.

    PubMed 37079305
  • Norgaard JE, Andersen S, Ryg J, Stevenson AJT, Andreasen J, Danielsen MB, Oliveira ASC, Jorgensen MG. Effects of treadmill slip and trip perturbation-based balance training on falls in community-dwelling older adults (STABILITY): study protocol for a randomised controlled trial. BMJ Open. 2022 Feb 7;12(2):e052492. doi: 10.1136/bmjopen-2021-052492.

    PubMed 35131823

Questions about this trial

What is this clinical trial studying?

A study testing Perturbation training and Treadmill walking in people with Accidental Fall and Accident Prevention, run by Aalborg University Hospital at 1 site in Denmark.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 3 inclusion and 4 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 1 Feb 2023. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in Denmark. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Fall rate (time frame: Continuously for 12 months after the initial three training sessions). It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT04733222, which also lists 3 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 1 Feb 2023.

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