Trip-specific perturbation training reduces trip-related falls after laboratory-induced trips and, prospectively, in the community. Based on an emerging body of evidence, we hypothesize that using task-specific perturbation training as a stand-alone approach or in conjunction with conventional exercise-based approaches will improve the effectiveness of fall prevention interventions significantly.

The risk of falling reportedly increases almost 2.5-times in those with lower extremity osteoarthritis (OA_LE) compared with age-matched controls. However, the mechanisms underlying the increased risk are not clear. The risk factors for falls in people with OA_LE found in the literature are mostly the same as the risk factors for people without OA_LE. It is hypothesized that risk factors for falls are exacerbated by OA_LE, such that these individuals are more likely to become dynamically unstable and, once this has occurred, are less able to perform an appropriate compensatory stepping response compared with people without OA_LE. To the extent that this is true, task-specific training targeting the compensatory step, which decreases falls in middle-aged and older women, should be effective for people with OA_LE. The purpose of the present review is to provide the rationale for the above hypothesis. Furthermore, the present authors present evidence that the fall risk of people with OA_LE could be efficiently and effectively reduced using task-specific training previously shown to reduce falls in middle aged and older women.