ORIGINAL RESEARCH article
Front. Bioeng. Biotechnol.
Sec. Biomechanics
Volume 13 - 2025 | doi: 10.3389/fbioe.2025.1642158
This article is part of the Research TopicBiomechanics, Sensing and Bio-inspired Control in Rehabilitation and Assistive Robotics, Volume IIView all 19 articles
Effects of Single-Session Perturbation-Based Balance Training with Progressive Intensities on Resilience and Dynamic Gait Stability in Healthy Older Adults
Provisionally accepted
Ringo Tang-Long ZHU1,2,3
Friederike A. Schulte4Navrag B. Singh5
Christina Zong-Hao Ma1,2*
Chris Awai Easthope6
Deepak Kumar Ravi7- 1Department of Biomedical Engineering, The Hong Kong Polytechnic University, Kowloon, Hong Kong, SAR China
- 2Research Institute for Smart Ageing, The Hong Kong Polytechnic University, Kowloon, Hong Kong, SAR China
- 3Department of Rehabilitation, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing, China
- 4SturzZentrum Schweiz, Zurich, Switzerland
- 5Singapore-ETH Centre, Future Health Technologies Program, CREATE campus, 1 CREATE Way, #06-01, CREATE Tower, Singapore, Singapore
- 6Data Analytics & Rehabilitation Technology (DART), Lake Lucerne Institute, Vitznau, Switzerland
- 7Laboratory for Movement Biomechanics, Institute for Biomechanics, ETH Zurich, Zurich, Switzerland
Select one of your emails
You have multiple emails registered with Frontiers:
Notify me on publication
Please enter your email address:
If you already have an account, please login
You don't have a Frontiers account ? You can register here
Single-session perturbation-based balance training (PBT) has demonstrated improvements in dynamic stability during the initial step following perturbation in older adults. However, its broader effects on comprehensive balance recovery remain inconclusive. This pilot laboratory-based randomized controlled study investigated the impact of personalized single-session PBT on reactive balance control during walking, employing advanced stability analysis techniques. Ten participants in the training group (67.1 ± 2.8 years; 5 males & 5 females) underwent a single session consisting of 32 unpredictable treadmill-induced slips and trips of progressively increasing intensity, while ten participants in the control group (72.8 ± 5.2 years; 5 males & 5 females) engaged in unperturbed treadmill walking. Key outcome measures included margin of stability (MoS) parameters: minimum MoS and the number of recovery steps, and resilience parameters: peak instability and recovery time, assessed at baseline, immediately post-intervention, and three months post-intervention following an unexpected treadmill slip. In tThe training group, participants exhibited significant immediate and sustained improvements (p < 0.05) increases in minimum MoS values, immediately post-intervention (-33 ± 84 mm; p < 0.001) and three months post-intervention (-71 ± 70 mm; p < 0.01) as compared to pre-intervention (-140 ± 87 mm); they also showedalongside a notable significant reduction in peak instability (p < 0.05) immediately post-intervention (34 ± 14 mm; p = 0.019) as compared to pre-intervention (57 ± 25 mm). These changes were not observed in the control group. However, neither group demonstrated significant alterations in the number of recovery steps or recovery time across the different assessment periods. In conclusion, single-session PBT enhanced reactive balance control by improving the magnitude of post-perturbation responses, but it did not significantly influence the speed of recovery to baseline conditions.
Keywords: reactive balance training, falls, efficacy, dynamic stability, Margin of stability, resilience
Received: 06 Jun 2025; Accepted: 12 Aug 2025.
Copyright: © 2025 ZHU, Schulte, Singh, Ma, Awai Easthope and Ravi. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Christina Zong-Hao Ma, Department of Biomedical Engineering, The Hong Kong Polytechnic University, Kowloon, Hong Kong, SAR China
Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.