State-of-the-Art: Falls in older adults are considered a major health problem in our ageing society. As most falls occur due to a trip, slip, misplaced steps or a push, recent studies used controlled environmental perturbation (i.e., deviation of a body from its regular state or path) mainly during walking to identify persons at increased risk of falling. The results of these studies are promising. However, identification of increased fall risk is only the first step. To prevent falls, effective training programmes including walking and perturbation paradigms are required. There is preliminary evidence that perturbations of the walking surface leading to near-fall situations are useful to effectively train coping strategies.

Approach: The overall aim of this subproject is to test the potential of the above-mentioned perturbation paradigm by use of a newly developed dual-belt treadmill, with options for fast sway, ecologically valid trip and slip programmes, triggered by the various gait phases, to improve dynamic stability and prevent falls in older persons at risk for falls. The 6-week intervention will be intensive, personalised (i.e. focused on the key impairment) and become progressively more rigorous. Primary outcome of the study will be change in dynamic stability parameters; secondary outcomes will be changes of number of falls, near falls and fear of falling and more general parameters that will allow the integration of results into the ICF model. Outcome measures will be standardised between WP2.1 and 2.2 to allow comparisons of these different training approaches.