[A good stumbler doesn't fall! : Treadmill perturbation-based balance training in geriatric rehabilitation].

Background: Treadmill perturbation-based balance training (PBT) is considered a promising approach to fall prevention in older adults. It aims to improve reactive balance control in response to unexpected disturbances-one of the most common causes of falls in everyday life.

Objective: To introduce treadmill-based perturbation training as an innovative therapeutic method in geriatric rehabilitation and to provide practical insights into its implementation.

Methods: The article combines a narrative literature analysis on the use of PBT with a report on experiences from inpatient and outpatient geriatric rehabilitation at the Agaplesion Bethesda Klinik Ulm. The training takes place on treadmills with targeted, multidirectional perturbations under therapeutic supervision.

Results: Randomized studies and meta-analyses show that even small amounts of PBT can lead to a significant reduction in the fall rate (up to -46%) and the number of people who fall (up to -29%). In clinical practice, rehabilitation patients report an increased sense of security and greater confidence in their own mobility. Integrated into interdisciplinary rehabilitation processes, a standardized protocol with 40 perturbations per unit has been established. Implementation requires a step-by-step approach, careful indication, and team coordination.

Conclusion: Treadmill PBT can be easily integrated into geriatric rehabilitation concepts. Experience shows that training under controlled conditions addresses everyday fall mechanisms and strengthens the sense of safety of rehabilitation patients.