Vibrating Insoles, Perturbation Treadmills Could Reduce Fall Risk in Elderly

Photo credit: Harvard's Wyss Institute
Photo credit: Harvard’s Wyss Institute

The statistics about falls in the elderly are both startling and troubling:

  • Citing CDC data, The New York Times recently reported that in 2012 nearly 24,000 Americans aged 65 and older died after a fall, and more than 2.4 million elderly people presented to emergency departments for fall-related injuries.
  • Nearly one-quarter of seniors who fracture a hip during a fall die within 12 months.
  • By 2020, the US will spend more than $67 billion (in 2012 dollars) annually on direct and indirect costs of fall injuries.

Many researchers are working on ways to prevent falls among older people, and one of the most interesting recent developments is a simple shoe insole that provides imperceptible vibratory stimulation to the feet. A study in the Archives of Physical Medicine and Rehabilitation found that vibratory stimulation delivered via insoles to the medial arches of 12 elderly people improved their balance, reduced their gait variability, and boosted performance on a timed “get-up-and-go” test.

According to Lewis Lipsitz, MD, lead study author and director of the Institute for Aging Research, one root cause of falls in the elderly is the loss of sensation and proprioception in the feet, and small amounts of vibratory “noise” applied to the soles of the feet seem to address those sensory impairments. While these findings are promising, further research with more people and longer-term follow-up will be necessary to determine whether the gait and balance improvements measured in this small study actually translate into a reduction in falls.

In another approach to fall prevention, a randomized pilot study led by Dartmouth’s Jon Lurie, MD found that elders trained on a surface-perturbation treadmill as part of a regular exercise program were less likely to fall or be injured in a fall, relative to those who exercised without the special treadmill. This study was not sufficiently powered to reach statistical significance, but it helped promulgate the concept that if external perturbations such as tripping and slipping contribute to falls, then training people to respond to such perturbations would be beneficial. The authors conclude by calling for “longer-term studies involving larger and more diverse patient populations.”

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