Eleftheria Giannouli – Abstract

P08  Guidelines for the design of stepping interventions for falls prevention

Giannouli E
, Morat T and Zijlstra W

Institute of Movement and Sport Gerontology, German Sport University Cologne, Germany

To maximize effectiveness, falls-prevention exercise programs need to implement research evidence into practice. The ability to execute steps that vary in amplitude, speed, accuracy (1) in single and multi-task conditions (2) is critical for preventing accidental falls. For that reason, stepping training has been found to be particularly effective in reducing falls (3). However, to achieve optimal effects, training plans need to be specific and well dosed. Based on an analysis of age-related changes in stepping patterns, relevant ingredients for step training as well as their gradual progression are defined and a structured approach to stepping training which allows systematic manipulation of spatiotemporal aspects (e.g. stepping speed, amplitude, direction), sensory aspects (e.g. stepping on wobbly surfaces) and task complexity (single-/, dual-tasking) is presented. The proposed framework can be used for the optimal design of dose-response based exercise programs in individual or group-based training of voluntary stepping, with or without assistive technology.  An exemplary stepping training program which includes the suggested components and complies with the design principles is described in detail.  Further studies developing stepping interventions using these guidelines are encouraged.

  1. Schoene, D., Delbaere, K., & Lord, S. R. (2017). Impaired Response Selection During Stepping Predicts Falls in Older People – A Cohort Study. Journal of the American Medical Directors Association, 18(8), 719-725.
  2. Melzer, I., Kurz, I., Shahar, D., & Oddsson, L. I. (2010). Do voluntary step reactions in dual task conditions have an added value over single task for fall prediction? A prospective study. Aging clinical and experimental research, 22(5-6), 360-366.
  3. Okubo, Y., Schoene, D., & Lord, S. R. (2016). Step training improves reaction time, gait and balance and reduces falls in older people: a systematic review and meta-analysis. Br J Sports Med, bjsports-2015.