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Effect of a plantar perceptual learning task on walking stability in the elderly: a randomized controlled trial [with consumer summary]
Nakano H, Nozaki M, Ueta K, Osumi M, Kawami S, Morioka S
Clinical Rehabilitation 2013 Jul;27(7):608-615
clinical trial
8/10 [Eligibility criteria: Yes; Random allocation: Yes; Concealed allocation: Yes; Baseline comparability: Yes; Blind subjects: No; Blind therapists: No; Blind assessors: Yes; Adequate follow-up: Yes; Intention-to-treat analysis: Yes; Between-group comparisons: Yes; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed*

OBJECTIVE: To determine whether the plantar perceptual learning task, using a hardness discrimination training, efficiently improves walking stability in the elderly. DESIGN: A randomized controlled trial. SETTING: Elder day-care center. PARTICIPANTS: Eighty-six elderly people (73.84 SD 5.98 years) who went to an elder day-care center were randomly assigned evenly to either an intervention or a control group. INTERVENTION: The intervention group performed a task to discriminate hardness differences while standing on sponge mats of different levels of hardness. The control group underwent the same task except that they were not instructed to discriminate hardness levels of the mats. The tasks were carried out over a four-week period for 10 days for both groups. OUTCOME MEASURES: Outcome was assessed by determining root mean squares of trunk acceleration during walking. RESULTS: Plantar perception was significantly improved in the intervention group after training (F = 26.24, p < 0.01). In addition, changes in root mean square values of acceleration were significantly greater after training in the intervention group (medial-lateral 0.36 SD 0.26; vertical 0.32 SD 0.24; anterio-posterior 0.26 SD 0.24) than in the control group (medial-lateral 0.14 SD 0.28, vertical 0.16 SD 0.35, anterio-posterior 0.12 SD 0.29) (p < 0.05). Changes in walking speed were not significantly different (p = 0.13) between the intervention (0.06 SD 0.13) and control groups (0.02 SD 0.14). CONCLUSION: The plantar perceptual learning task might efficiently stabilize postural control during walking in the elderly.

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