Can the control of bodily orientation be significantly improved in a groupof older adults with a history of falls?

OBJECTIVE: To determine the short-term effectiveness of a biofeedback-based , computerized intervention that applied the principles of the ecological t heory of perception and control of bodily orientation to the rehabilitation of older adults with a history of falling. PARTICIPANTS: Forty-five older adults (X = 78.5 years) with a history of fa lls were assigned to either a control (n = 21) or intervention group (n = 2 4). DESIGN: A 2 x 2 (Group X Time) mixed factorial design with repeated measure s on the second factor. SETTING: A motor control research laboratory in a university setting. MEASUREMENT: Impairments in multiple dimensions of balance (i.e., dynamic p ostural control and sensory organization) were measured before and after an 8-week balance intervention using the 100% Limits of Stability Test(R) and Sensory Organization Test(R). More functional limitations in balance and/o r mobility were measured using two clinical tests: Berg Balance Scale and T imed Up and Go test. MAIN RESULTS: Repeated measures multivariate analyses and follow-up testing indicated significant improvements in the dynamic balance and sensory inte gration capabilities in the case of the intervention group only (P < .03). Significant improvements were also observed in the two clinical measures of balance and mobility evaluated before and after the intervention for the i ntervention group only. CONCLUSIONS: Theory-driven rehabilitation programs that focus on manipulati ng individual, task, and environmental constraints concurrently can signifi cantly improve the control of bodily orientation of older adults with a pre vious history of falls in both static and dynamic action environments. More over, the significant improvements in functional performance observed for t he intervention group suggest that interventions emphasizing task-specific practice are not the only means by which an older adult's ability to perfor m daily activities requiring postural control can be improved.