I would think that perturbation training would be much better because you would be able to recover from balance problems and thus prevent the fall. But I know nothing, I'm not medically trained. This falls under the same category that you learn faster from your mistakes than from practicing perfection.
Originally published7 Dec 2018Stroke. 2018;0:STROKEAHA.118.022406
Abstract
Background and Purpose—
Research
has shown that balance training is effective for reducing the fear of
falling in individuals with a history of stroke. In this study, we
evaluated (1) whether cognitive behavior therapy could augment the
beneficial effects of task-oriented balance training (TOBT) in reducing
the fear of falling in chronic stroke survivors and (2) whether it
could, in turn, reduce fear-avoidance behavior and improve related
health outcomes.
Methods—
Eighty-nine
cognitively intact subjects with mildly impaired balance ability were
randomized into the following 2 groups that underwent 90-minutes
interventions 2 days per week for 8 weeks: (1) cognitive behavior
therapy + TOBT or (2) general health education + TOBT (control). The
primary outcome was the fear of falling, and the secondary outcomes were
fear-avoidance behavior, balance, fall risk, independent daily living,
community integration, and health-related quality of life. The outcomes
were assessed at baseline, after 4 and 8 weeks of intervention, and 3
and 12 months after completing the intervention.
Results—
Eighty-two
subjects completed the intervention and follow-up assessments. From
postintervention to 12 months after completing the intervention, the
cognitive behavior therapy + TOBT participants reported greater
reduction in the fear of falling and fear-avoidance behavior and greater
improvements in balance and independent daily living than the general
health education + TOBT participants.
Conclusions—
Cognitive
behavior therapy should be considered as an adjuvant therapy to
standard physiotherapy for
cognitively intact individuals(So you cherry picked participants?, I expect recovery for all. Yes that will be more difficult but leaders tackle difficult problems. Are you a mouse or a leader?) with a history
of stroke.
Clinical Trial Registration—
URL:
http://clinicaltrials.gov. Unique identifier: NCT02937532
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