Effectiveness of Perturbation Treadmill Training on Postural Control in Older Adults with Balance Problems: A Systematic Review
Keywords:
Perturbation treadmill, Postural control, Balance problemsAbstract
Background: Technologies for gait training in individuals with balance control problems have been continuously developed, focusing on specific and repetitive training activities such as treadmill training, body weight-supported treadmill training, and robotic-assisted gait training. Based on these principles, along with the concept of adapting balance to external perturbations, the "Perturbation Treadmill" was developed. This involves walking on a treadmill with controlled perturbations applied during walking. However, as this is a novel technology, further studies are needed to assess its effectiveness. Objective: To evaluate the effectiveness of perturbation treadmill training compared to traditional training methods in older adults with balance problems. Methods: Data were retrieved from CENTRAL and MEDLINE databases (14/02/2022), focusing on randomized controlled trials (RCTs). The search yielded 40 studies from CENTRAL and 15 studies from MEDLINE. After removing duplicates and irrelevant studies, 37 studies remained, 21 were excluded after abstract screening, and 9 were excluded after full-text review, leaving 7 studies for analysis. All seven included studies were assessed for quality. Bias risks were identified, for example, some studies lacked detailed reporting on randomization methods. Results: The studies included three groups of participants. These included 4 studies on individuals with Parkinson's disease, 2 studies on older adults, and 1 study on stroke survivors. The outcomes on gait and balance varied across studies. Due to the small sample sizes and heterogeneous outcome measures, meta-analysis could not be conducted. Conclusions: This systematic review indicates that perturbation treadmill training may improve gait and balance in older adults with balance impairments. However, the differences compared to other training methods are unclear. This method may have an advantage in enhancing dynamic balance during movement. Given the small sample sizes and the variability in outcome measures, further RCTs are recommended to establish its clinical applicability.
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