Effect of computerized feedback postural training on posture and attentional demands in older adults

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Abstract
Background and aims: Previous research on various fall prevention strategies, in an effort to help the aging population has lead to inconsistent results. In this experiment, an 8-week computerized training program with a feedback fading protocol was given to 12 community-dwelling elderly subjects twice a week. Methods: Postural sway (force plate measures), attentional demands (dual-task paradigm), the Berg Balance Scale and the Activities-specific Balance Confidence Scale (ABC) were measured in pre-, post-, and retention test assessments. Results: Results indicated that the experimental group showed a significant decrease in reaction time during standing compared with the control group, and the difference remained significant even after a two-week period (retention test). Postural sway and ABC results showed no significant changes between groups in either post-test or retention test. The Berg Balance Scale scores were significantly higher in the post-test compared with the pre-test. The Berg scale is a functional mobility scale, and the increase observed may be associated with a decrease of at least 4% in the risk of falling. This study further illustrates that postural sway (mode frequency) may not be the best variable to measure the efficiency of a treatment or training protocol. Reaction time in the dual-task paradigm, which was used to measure attentional demands during posture, was found to be affected more by the training program. Conclusions: Postural training in combination with a feedback fading protocol seems to improve the automaticity of posture significantly.