Treadmill Training for Fall Prevention After Knee Replacement

Overseen By Study Coordinator

Age: 18+

Sex: Any

Trial Phase: Academic

Sponsor: University of Illinois at Chicago

Disqualifiers: Stroke, Multiple sclerosis, Parkinson's, others

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Compensation: Varies

Number of Visits: 6

Duration: 2 weeks

378 Participants Needed

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial aims to determine if treadmill training can prevent falls in individuals preparing for knee replacement surgery. The training involves quick speed changes on a treadmill to simulate tripping or being pushed. Researchers seek to find out if this method improves walking and reduces falls during the first year after knee surgery. Individuals diagnosed with severe knee arthritis and planning knee replacement surgery soon may be suitable for this trial. Participants will be divided into two groups: one will receive only educational materials on fall prevention, while the other will also undergo treadmill-based perturbation training. As an unphased trial, this study provides a unique opportunity to contribute to innovative research that could enhance recovery outcomes for future knee replacement patients.

Do I have to stop taking my current medications for the trial?

The trial information does not specify whether you need to stop taking your current medications. It's best to discuss this with the trial coordinators or your doctor.

What prior data suggests that treadmill-based perturbation training is safe for fall prevention after knee replacement?

Research has shown that treadmill perturbation training, which involves sudden changes in treadmill speed to improve balance, is safe for people. In past studies, participants experienced better balance and fewer falls after this training. For instance, one study found that it reduced falls by about 50% over a year. While it might feel challenging at first, many people handle it well and benefit from it.

Concerns exist with more intense training, as it can make people feel unsteady. However, the training in this trial is designed to help people gradually adapt to these changes, lowering the risk of falls. Overall, treadmill perturbation training is generally well-tolerated and has shown promising results in preventing falls after knee replacement surgery. ^{1 2 3 4 5}

Why are researchers excited about this trial?

Researchers are excited about treadmill-based perturbation training for fall prevention after knee replacement because it offers a novel approach to improving balance and stability. Unlike traditional physical therapy that often focuses on strength and range of motion, this method simulates real-life scenarios, like tripping or being pushed, directly on a treadmill. This innovative training aims to enhance the body's ability to react to sudden disturbances, potentially reducing the risk of falls. Additionally, by actively engaging patients in dynamic balance challenges, it targets underlying neural pathways to improve adaptability in everyday environments.

What evidence suggests that treadmill-based perturbation training is effective for fall prevention after knee replacement?

Research shows that treadmill training, involving unexpected movements, can improve balance and reduce falls. In this trial, participants in the Training Group will undergo treadmill-based perturbation training, simulating tripping over an obstacle or being perturbed to the side. A review of 25 studies found that this training lowered the overall fall rate by 23%, reduced the number of people who fell by 17%, and decreased falls causing injuries. Another study suggested that even a few training sessions improved balance while walking. These findings are promising for helping people recovering from knee replacement surgery avoid falls. ^{1 2 5 6 7}

Who Is on the Research Team?

Kharma Foucher, MD, PhD

Principal Investigator

University of Illinois Chicago

Are You a Good Fit for This Trial?

This trial is for people with severe knee osteoarthritis who are scheduled for total knee replacement surgery within the next two months. They must be able to attend training sessions before their surgery.

Inclusion Criteria

I need a knee replacement soon and can attend training before surgery.

Exclusion Criteria

I plan to have or had knee/hip surgery on the opposite side within 5 years.

I have conditions like stroke or MS that affect my walking and balance.

I have a history of low back pain, heart disease, vision problems, or have been institutionalized.

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Baseline Assessment

Participants complete surveys, undergo gait analysis, and are randomized into groups

1 week

1 visit (in-person)

Treatment

Participants in the training group undergo perturbation training over 2 weeks

2 weeks

4 sessions (in-person)

Post-Test Assessment

Participants undergo a post-test session to assess the effects of the perturbation training

1 week

1 visit (in-person)

Follow-up

Participants are monitored for falls and activity levels for one year post-surgery

1 year

Bi-weekly contact (virtual)

What Are the Treatments Tested in This Trial?

Interventions

• Education Control
• Treadmill-based perturbation training

Trial Overview The study tests if treadmill perturbation training can prevent falls after knee replacement surgery. Participants will either receive fall-prevention literature or the same literature plus a two-week treadmill training program, and their number of falls will be tracked for a year.

How Is the Trial Designed?

Group I: Training Group Experimental Treatment 1 Intervention

The intervention consists of disturbances delivered on a treadmill that simulates tripping over an obstacle or being perturbed to the side.

Group II: Education Group Active Control 1 Intervention

This group will receive educational materials related to fall prevention in older adults.

Who Is Running the Clinical Trial?

University of Illinois at Chicago

Lead Sponsor

Trials

653

Recruited

1,574,000+

National Institute on Aging (NIA)

Collaborator

Trials

1,841

Recruited

28,150,000+

Citations

1. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC10119738/

Effect of Treadmill Perturbation-Based Balance Training on ... In this trial of a 4-session treadmill PBT intervention, there was not a statistically significant decrease in daily-life fall rates among ...

2. ctv.veeva.com ctv.veeva.com/study/treadmill-perturbation-training-for-fall-prevention-after-total-knee-replacement

Treadmill Perturbation Training for Fall Prevention After Total ... The goal of this clinical trial is to learn about preventing falls in people who have total knee replacement surgery using treadmill perturbation training.

3. eurapa.biomedcentral.com eurapa.biomedcentral.com/articles/10.1186/s11556-025-00375-w

Dose–response relationship of treadmill perturbation-based ... Findings suggest that a low number of treadmill PBT sessions can lead to task-specific improvements in reactive balance during walking.

4. academic.oup.com academic.oup.com/ptj/article/104/1/pzad136/7295321

Effects of Perturbation-Based Treadmill Training on Balance ... A 4-week perturbation-based dual-task treadmill training program can improve self-efficacy, balance, and gait performance in a controlled setting and reduce ...

5. medrxiv.org medrxiv.org/content/10.1101/2025.07.23.25331962v1.full-text

Perturbation-based balance training improves reactive ... This systematic review and meta-analysis of 25 RCTs shows that PBT reduces fall rate (by 23%), number of fallers (by 17%), and injurious falls ( ...

6. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC10587291/

Fall prevention by reactive balance training on a ... The novel training approach of perturbation training demonstrated approximately a 50% reduction in falls over a 12-month follow-up period after ...

7. sciencedirect.com sciencedirect.com/science/article/abs/pii/S002192902400201X

Impact of standing perturbation intensities on fall and ... The results suggest that the increased perturbation intensity raises the risk of falling with larger instability and poorer reactive performance.