AquaReBal - Water-based Reactive Balance Training for Older Adults: a Randomized Pilot Study

Falls are the second leading cause of accidental injury deaths worldwide, mostly in older adults. Injuries resulting from a fall are a leading cause of hospitalizations among older adults in Canada with a higher total injury cost than any other cause of injury. People must often perform rapid and complex movements to keep from falling. Reactive balance training (RBT) is a type of training that focuses on improving an individual\'s ability to perform those types of movements and respond to unexpected or sudden changes. RBT and aquatic therapy were identified as a research priority for fall prevention. There is evidence that RBT reduces the rate of falls by a half in daily life and improvements in reactive balance are maintained up to a year after the end of the program. When RBT is conducted on land, some adverse events such as fear of falling and joint pain may occur. The water environment could minimize the limitations and barriers associated with land-based RBT. To date, there are no studies showing the effects of water-based RBT on reactive balance control in older adults. Our study aims to explore if water-based RBT is a practical intervention to reduce the number of falls in older adults. Older adults will be recruited from the Greater Toronto Area and will be randomized to two groups, the water-based RBT and the land-based RBT. Both groups will receive training 2 times per week for 6 weeks. An initial sample of 30 participants will be randomly assigned to one of the two groups and will be followed for 6 months after the intervention. We will measure the main practical factors around the intervention, such as how participants adhere to the treatment and how they accept the intervention. We will also assess how the water-based and land-based RBT affect falls, balance, mobility and quality of life. With this study, we aim to inform the way for a larger study targeting falls - one of the biggest problems among older adults.