Author(s): STUCKENSCHNEIDER, T., SCHMIDT, L., HACKBARTH, M., KOSCHATE, J., ZIESCHANG, T., Institution: CARL VON OSSIETZKY UNIVERSITY, Country: GERMANY, Abstract-ID: 1350

INTRODUCTION:
According to the Global Burden of Disease Reports, there are 172 million falls annually, resulting in short- or long-term health impairments. Older individuals are particularly affected, making falls prevention programs crucial to reduce nursing care and mortality. Perturbation-based balance training (PBT) has gained importance in training-based falls prevention efforts due to its task-specific nature. Moreover, assessing an individual’s reactive dynamic balance in response to perturbations may serve as both an highly relevant indicator of future fall risk and a target for interventions. Early research suggests that a single session of PBT may reduce the risk of falls. Therefore, it is imperative to ascertain the impact of a diagnostic protocol on subsequent falls, which is one aim of the SeFallED study [1].
METHODS:
The ongoing SeFallED study follows individuals aged 60 and above, who visit the emergency department after a fall without subsequent hospital admission. Participants undergo a comprehensive geriatric assessment and gait analyses in a laboratory (four weeks after the emergency department, and 6, 12, and 24 months later). Falls are monitored via fall calendar and monthly phone calls. In the laboratory, participants are randomly stratified to either walk on a treadmill at their preferred treadmill walking speed or experience nine different perturbations while walking on the treadmill (M-Gait, Motek Medical B.V., Amsterdam, the Netherlands). Fall rates were compared between groups six months after their initial assessment for reactive dynamic balance.
RESULTS:
Out of 185 eligible participants, 160 (mean age 72.2  7.7; 59 males) provided complete baseline data. Thus far, 83 participants (mean age 73.0  7.7; 36 males) have been followed up for 6 months with 29% of these individuals experiencing another fall. The number of fallers did not differ between the groups (p = 0.487). Thirteen individuals (33%) in the perturbation group experienced another fall, compared to eleven individuals (26%) in the group without perturbations.
CONCLUSION:
Preliminary findings indicate that the protocol employed in the SeFallED study does not impact future fall risk significantly. However, further analysis and extended follow-up durations are essential to comprehensively grasp the role of diagnosing reactive dynamic balance and its implications for future fall risk. Nevertheless, these initial results contribute to ongoing discussions regarding the optimal dosage of PBT. In high-risk individuals who have recently suffered a severe fall, a single session does not appear to provide an adequate training stimulus to induce relevant improvement.

References:
1. Stuckenschneider T, et al: Sentinel fall presenting to the emergency department (SeFallED) - protocol. BMC Geriatr 2022, 22(1):594.