Citation

Pai YC, Bhatt TS. Phys. Ther. 2007; 87(11): 1478-1491.

Affiliation

Department of Physical Therapy, University of Illinois at Chicago, 1919 W Taylor St, Room 426 (M/C 898), Chicago, IL 60612 (USA).

Copyright

(Copyright © 2007, American Physical Therapy Association)

DOI

10.2522/ptj.20060326

PMID

17712033

PMCID

PMC2826275

Abstract

Falls frequently cause injury-related hospitalization or death among older adults. This article reviews a new conceptual framework on dynamic stability and weight support in reducing the risk for falls resulting from a forward slip, based on the principles of motor control and learning, in the context of adaptation and longer-term retention induced by repeated-slip training. Although an unexpected slip is severely destabilizing, a recovery step often is adequate for regaining stability, regardless of age. Consequently, poor weight support (quantified by reduction in hip height), rather than instability, is the major determinant of slip-related fall risk. Promisingly, a single session of repeated-slip training can enhance neuromechanical control of dynamic stability and weight support to prevent falls, which can be retained for several months or longer. These principles provide the theoretical basis for establishing task-specific adaptive training that facilitates the development of protective strategies to reduce falls among older adults.

Language: en