AUTHOR=McCrum Christopher , Bhatt Tanvi S. , Gerards Marissa H. G. , Karamanidis Kiros , Rogers Mark W. , Lord Stephen R. , Okubo Yoshiro TITLE=Perturbation-based balance training: Principles, mechanisms and implementation in clinical practice JOURNAL=Frontiers in Sports and Active Living VOLUME=4 YEAR=2022 URL=https://www.frontiersin.org/journals/sports-and-active-living/articles/10.3389/fspor.2022.1015394 DOI=10.3389/fspor.2022.1015394 ISSN=2624-9367 ABSTRACT=

Since the mid-2000s, perturbation-based balance training has been gaining interest as an efficient and effective way to prevent falls in older adults. It has been suggested that this task-specific training approach may present a paradigm shift in fall prevention. In this review, we discuss key concepts and common issues and questions regarding perturbation-based balance training. In doing so, we aim to provide a comprehensive synthesis of the current evidence on the mechanisms, feasibility and efficacy of perturbation-based balance training for researchers and practitioners. We address this in two sections: “Principles and Mechanisms” and “Implementation in Practice.” In the first section, definitions, task-specificity, adaptation and retention mechanisms and the dose-response relationship are discussed. In the second section, issues related to safety, anxiety, evidence in clinical populations (e.g., Parkinson's disease, stroke), technology and training devices are discussed. Perturbation-based balance training is a promising approach to fall prevention. However, several fundamental and applied aspects of the approach need to be further investigated before it can be widely implemented in clinical practice.