Age serves as a predictor of single-leg stability, ankle dorsiflexion range, and plantar
flexor strength loss in older adults. Various factors contribute to their heightened risk
of falls, such as foot pain, reduced ankle and big toe mobility, increased pressure on
specific foot regions during stance, and greater mediolateral displacement of center of
pressure.
Exercise interventions have strong support in the field of fall prevention. In turn, foot
flexor muscle fatigue has been associated with increased displacement of the center of
pressures, so training of this muscles may be useful. While several fall prevention
strategies for older adults have shown positive outcomes, some studies face limitations
like small sample sizes or insufficient improvement in static balance, possibly due to
low exercise intensity and specificity.
The conventional use of instability devices like the BOSU, Wobble board, Airex, or Swiss
ball presents challenges in older adult contexts due to their bulkiness and
indiscriminate instability. Hence, a specific instability training approach could be
interesting to address fall risk factors.
This study proposes a Blackboard Training (BB) exercise intervention for older adults,
known for its portability, small size, and adaptability, comparable in effectiveness to
traditional devices like the BOSU or Wobble board in activating Peroneus longus muscle,
essential for single-leg stability.
Participants will be divided into control and intervention groups, both receiving their
usual conventional physiotherapy exercises. The intervention group will undergo a 5-week
program comprising 10 sessions. Measurements will be taken pre-study, one week prior,
post-study completion, and at a follow-up one month later to assess the duration of
observed changes. Each session, lasting 50 minutes, will include a warm-up, BB exercises
targeting ankle mobility and balance, and a cool-down. Safety precautions, such as
parallel bars for support, will be provided during balance exercises. Specific BB
exercises will be: 3 sets of 15 repetitions for assisted ankle dorsiflexion mobility and
5 rounds of 40-second balance exercises.
The analyzed variables will include ankle and big toe range of motion (ROM), the Lunge
test, bipedal and monopodal stabilometry, strength of ankle and foot, the Timed-Up-and-Go
test and the Single-leg Stance Test.
The hypothesis is that adding specific BB training to conventional physiotherapy for
older adults can improve foot and ankle parameters essential for fall prevention,
including ankle dorsiflexion and single-leg support. Improvement in ankle dorsiflexion
and better control of mediolateral displacement of the center of pressure are expected
outcomes.