Up-Training Loading Responses in Older Adults

This randomized, experimental-control group, multiple-observation study examined the ability of older adults to use center of pressure feedback to up-train the vertical loading response (LR) and the impact that such training had on changes in clinical tests of balance. Eleven community ambulators, aged at least 65 years, with no recent history of falls were recruited by convenience sampling. Each group received 6 baseline sessions and 6 control/training sessions, followed by 1 posttest session. All sessions included visual cueing about stance equilibrium followed by 30 randomly timed dynamic, toes-up perturbations (8 degrees, 66 degrees per second). Training consisted of verbal instructions with visual and auditory feedback of a 225 msec response window to shape an increase in total LR following perturbations. Subjects in the experimental group demonstrated a tendency to decrease vertical loading relative to baseline regardless of visual and verbal feedback encouraging strategies to increase it. Specifically, the T3 or 150–225 msec component of the response window showed a decline from session 7 to session 12. Up-training, however, appears to cause a faster rate of rise to the maintenance window, but this event probably occurs too late to correct for a loss of balance. No correlation was found between change in load values and change in performance on clinical balance tests.