Backward Walking Rehabilitation to Prevent Falls in High-risk Adults Aged 75 Years and Older

Falls are a major health problem for people aged 75 or older. Backward walking may strengthen the muscles of the legs, improve posture and balance, and make walking more stable, which could help prevent new falls and improve everyday movement. This is an open-label, multicenter, randomized controlled trial that will examine whether backward walking, integrated to usual rehabilitation in a geriatric day hospital program, can help reduce the number of new falls in older adult at high risk of falling. About 300 people aged 75 years or older, living at home and at high risk of falling, will be included in this trial in 11 geriatric day hospitals in France. After receiving appropriate information, those who agree to participate will sign a written consent form and will then be randomly assigned to one of two groups. Both groups will receive standard rehabilitation care in the geriatric day hospital, with two rehabilitation sessions per week for 12 weeks. In the control group, patients will only receive usual care to prevent falls previously described above. In the intervention group, part of the usual care will be replaced, for 5 weeks, by supervised backward walking exercises, with the goal of doing two effective 10 minute backward walking sessions per week, without increasing the total time spent in rehabilitation. The trial will be conducted under the intention-to-treat principle. Participants will have a clinical visit at day 0, at week 5 and at 6 months, during which clinical information and data related to their usual care and to the study will be collected. All participants will be followed for a total of 12 months, with monthly phone calls from a study team member to record any new falls, hospitalizations, health problems, or other important events. For 10 patients in the intervention group, an individual interview will also be carried out at the 5 week visit to better understand their experience of backward walking. 2 focus groups will be held with 2 randomly