The objective of this dissertation was to investigate the relationship of falls efficacy and balance confidence with fall-related state anxiety, and the effectiveness of a dual-task reach-to-grasp balance perturbation intervention and the relationship between balance confidence and intervention responsiveness in older adults. First, the relationship between the falls efficacy scale-international (FES-I) and activities-specific balance confidence (ABC) scale with psychophysiological state anxiety, measured through skin conductance levels (SCLs)) during trip perturbations. Subjective fall-related state anxiety was assessed using the Subjective Units of Distress Scale (SUDS)), comparing participants with high (FES-I>23) and low (FES-I<23) fall concerns. Results indicated a positive correlation between changes in SCL from pre- to post-perturbation with FES-I and a negative correlation with ABC. SUDS scores differed between groups based on FES-I classifications. Next, the effects of a dual-task reach-to-grasp intervention on grasp responses to balance perturbations were investigated. The training involved 30 randomized walking perturbations with a handrail positioned laterally beside the dominant (trained) arm. Pre-training assessment included three unpredictable slip perturbations - two accompanied by a cognitive task and one without - with a handrail positioned for the trained reach to grasp response. Post-training assessments replicated pretest conditions and introduced two additional perturbations to evaluate the transfer and generalization of training effects (with the handrail on the non-dominant (untrained) side and without the handrail). Analyses focused on grasp accuracy (frequency of grasp errors) and grasp time (time from perturbation onset to handrail contact) for both the trained and untrained (transfer) arms. To assess generalizability, stability (i.e., distance from the center of mass to base of support at first foot touchdown) was calculated during a perturbation without a handrail. Findings showed improvements in grasp time and accuracy in the trained arm, with only grasp accuracy improvements transferring to the untrained arm. No changes were observed in stability during the no-handrail condition. Overall, results suggest that FES-I and ABC are indicative of fall-related state anxiety during balance perturbations, and that dual task reach-to-grasp training enhances performance in the trained arm, with some transfer to the untrained arm, but no generalization to stepping responses when a handrail is not present.