Virginia Polytechnic Institute and State University
The goal of this clinical trial is to learn if a novel balance training stepping exercise can reduce the risk of falling among adults over the age of 65. The main question it aims to answer is: * Does the novel stepping exercise improve laboratory-based measurements of balance and fall rate? * Does the novel stepping exercise improve real-world measurements of balance and fall rate? Researchers will compare the novel stepping exercise to 1) a more established stepping exercise that requires more expensive equipment, and 2) a more established general exercise program focusing on strength and standing balance without stepping. Participants will: * complete their assigned exercise intervention twice a week for three weeks, then complete booster sessions of their assigned exercise intervention once a month during months 1-5 after completing the initial three weeks of intervention * complete laboratory sessions to test their balance: a) before intervention, b) 1 week after intervention, and c) 6 months after intervention * use a wearable sensor daily for 12 months after intervention to capture any loss of balance or fall events
Inclusion Criteria: * Age ≥ 65 years * Moderate balance impairment as indicated by best unipedal stance time \<10 seconds * Able to ambulate household distances and tolerate testing and training without an assistive device * No significant cognitive impairment (telephone Montreal Cognitive Assessment \>18) * Functional vision and hearing (with correction if needed) * Comprehension of written and spoken English * Willing and able to study-required voice recorders * Limited physical activity (\<150 min/week moderate-vigorous), not in physical therapy, not presently in balance training programs…
Perturbation-based balance training without a treadmill. Initial dosage will be twice a week for three weeks. Then booster sessions will be completed once a month during months 1-5 after completing the initial three weeks of intervention.
Perturbation-based balance training with a treadmill. Initial dosage will be twice a week for three weeks. Then booster sessions will be completed once a month during months 1-5 after completing the initial three weeks of intervention.
Strength and standing balance training without stepping. Initial dosage will be twice a week for three weeks. Then booster sessions will be completed once a month during months 1-5 after completing the initial three weeks of intervention.