Potential Implementation of Reactive Balance Training within Continuing Care Retirement Communities

Abstract

Purpose: The purpose of the study was to evaluate the feasibility of implementing reactive balance training (RBT) in continuing care retirement communities, as a part of typical practice in these facilities.

Methods: RBT, a task-specific exercise program, consisted of repeatedly exposing participants to trip-like perturbations on a modified treadmill to improve reactive balance, and subsequently reduce fall risk. Semi-structured interviews were conducted with retirement community residents (RBT participants) and administrators, to assess the organizational context, perceptions of evidence for falls prevention, and facilitation strategies that could improve the likelihood of implementing RBT as a falls-prevention program.

Results: Contextual factors such as leadership support, culture of change, evaluation capabilities, and receptivity to RBT among administrators and health leaders at the participating retirement communities could facilitate future implementation. The cost associated with RBT (e.g. equipment and personnel), resident recruitment, and accessibility of RBT for many residents were identified as primary barriers related to the intervention. Participants perceived observable health benefits after completing RBT, had increased awareness toward tripping, and greater confidence with respect to mobility. Across interviewees potential barriers for implementation regarding facilitation revolved around the compatibility and customizability for different participant capabilities that would need to be considered before adopting RBT.

Conclusion: RBT could fill a need in retirement communities and the findings provide areas of context, characteristics of the intervention, and facilitation approaches that could improve uptake.

Keywords: balance training; falls; mixed methods; older adults.

Figure 1.

CONSORT flow diagram depicting the number of participants assessed for eligibility, number that passed screening, number allocated to each intervention, and number used in analysis.

Figure 2.

Image depicting a participant successfully recovering from a perturbation during reactive balance training. The harness attached to the overhead gantry prevented a fall to the ground in case of an unsuccessful recovery.