Transfer and retention effects of gait training with anterior-posterior perturbations to postural responses after medio-lateral gait perturbations in older adults

Rieger, S. Papegaaij, M. Pijnappels, F. Steenbrink, J. H. van Dieën*

*Corresponding author for this work

Research output: Contribution to JournalArticleAcademicpeer-review


Background: Gait perturbations, occurring in any direction in daily life, may result in a fall. In fall prevention, gait perturbation training is a promising approach. Treadmill perturbations in anterior-posterior direction can easily be applied by accelerations or decelerations of the belt, but it is unknown whether training effects transfer to reactive recovery in medio-lateral direction. We aimed to evaluate the transfer and retention effects of gait training with treadmill perturbations in anterior-posterior direction to medio-lateral reactive recovery. Methods: 30 community dwelling older adults (>65 years) participated in this study. They were randomly assigned to a treadmill training session either with 16 anterior-posterior perturbations or with treadmill walking. The assessments contained a walking trial with 4 anterior-posterior and 4 medio-lateral perturbations. Deviations in trunk velocity from unperturbed walking were summed over the first three strides after perturbation as a measure of recovery. Findings: An exposure to gait perturbations during the baseline assessment led to significant improvement of recovery responses. For anterior-posterior perturbations, both groups showed better recovery immediately and 1-week post-intervention, and no group x time interaction was found. For medio-lateral perturbations, both groups showed better recovery immediately and 1-week post-intervention, and again no group × time interaction. Interpretation: Baseline assessment with perturbations in anterior-posterior and medio-lateral directions caused significant improvements that were retained. Short-term training can be effective in dynamic stabilization of one's trunk, but our findings do not exclude that multi-directional perturbations may be needed.

Original languageEnglish
Article number104988
Pages (from-to)1-7
Number of pages7
JournalClinical Biomechanics
Early online date5 Mar 2020
Publication statusPublished - May 2020



  • Accidental falls
  • Aging
  • Exercise test
  • Postural balance
  • Treadmill
  • Walking

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