Falls are the leading cause of fatal and nonfatal injuries in the elderly. One-third of adults older than 65 and half of those older than 80 fall at least once a year, with 5% of these falls resulting in fracture or hospitalization. Several interventions are shown to be effective in reducing falls including balance training, tai chi, and treadmill exercise. 

There is reason to think that greater mindfulness while walking might also be helpful given its attentional focus to sensory experience while walking. Phoobangkerdphol et al. [Clinical Rehabilitation] tested the efficacy of walking meditation practice against conventional balance training in reducing falls in older adults with elevated fall risk.

The researchers randomly assigned 68 Thai Buddhist adults over age 60 who had fallen at least once in the past year (age range = 60-85; 85% female) to either a walking meditation or balance training intervention. Participants attended a training session and were given a brochure and instructional CD to aid practice on their own at home.

All participants were told to practice 20-30 minutes a day, 5-7 days a week and keep daily logs of their assigned practice. At 6 months, participants were given the option of continuing to practice for an additional 3 months, and most of the participants who had completed the six-month program elected to continue to practice. 

Walking meditation involved slow paced walking along a 5-meter course with attention to lifting, moving, and placing the feet, shifting weight, and breathing. Balance training included practice marching, reaching, chair standing, and sideways, backwards, and tandem walking.

Participants were assessed at baseline, 6 and 9 months on the time it took to stand up, walk 3-meters, return to the chair, and sit down, the degree they could bend at the waist while standing, and the length of time they could stand on one leg. They were also assessed on a self-report geriatric mental health screening measure and a measure of quality of life.

The results showed improvement on all physical mobility measures for both groups, and to a similar degree at both 6 and 9 months. Improvements were small and below the level of set for minimal clinically important differences.

There were no group differences on the mental health or quality of life measures. Compliance (68% vs. 48%) and program satisfaction (79% vs. 62%) were significantly higher for the balance training group. None of the participants experienced falls by 6 months, but 2 individuals in each group experienced falls by 9 months. 

The study shows walking meditation and balance training were equally effective in improving performance of balance and mobility tasks among older adults. The researchers conclude walking meditation could be an alternative to balance training in the elderly to help prevent falls. Participants were less satisfied and compliant with the walking meditation program.

Given improvements in both groups were below the minimal clinically important difference level, a no-treatment control group would have been a useful additional comparator.

Reference:

Phoobangkerdphol, C., Limampai, P., Dasri, S., & Kuptniratsaikul, V. (2021). Walking meditation versus balance training for improving balance abilities among older adults with history of fall: A randomized controlled trial. Clinical Rehabilitation.

Link to study