Perturbation Training to Improve Balance Recovery of Old Adults

NCT04455607 | Completed DMC

• 1 other identifier: Sor 396-16 CTIL
• Study Type: interventional
• Target: 25
• Locations: 1 country
• Sites: 3

Brief Summary

Falls are major contributors for immobility and independency. Most falls in older adults occur during walking after a sudden unexpected loss of balance. It was well-established that balance can be improved by performance of a training program that provides perturbation (unexpected perturbations of balance). The main aim of the current study is to investigate the effects of two perturbation-training methods: 1) random perturbation training; vs. 2) block (non-random) perturbation training. We also aim to explore brain area's (as measured by MRI) that are related to balance function in older adults. We hypothesize that response to an unexpected loss of balance is the balance responses will be improved in both training methods, but more in the random training method. We also hypothesize that brain function as seen in MRI will be improved in both training methods, more in the random training method. As far as we know, there is a lack of studies investigating the learning effect of random vs. block non-random training on balance recovery responses while walking and exposure to unexpected loss of balance and on brain function.

Conditions

Old Adults

Outcome Measures

Primary Outcomes (1)

• The step recovery thresholds and brain imaging (MRI)

  The stepping threshold as measured by the distance of the platform movements in centimeters will be measured. Quantitative parameters of the compensatory stepping/ and motor ability (i.e., step reaction time, step time, step length), descriptive parameters of the stepping strategy after perturbation (i.e., arm responses, upper body responses, leg step threshold and fall threshold). In addition we will be testing the correlation between brain activity using brain imaging in both to find whether improvement in motor function are correlated with brain function and anatomy.

  60 minute

Secondary Outcomes (4)

• Postural stability

  10 minutes

• Voluntary step test

  6 minutes

• Berg Balance test

  10 minutes

• kinematics of walking

  10 minutes

Study Arms (2)

experimental group

EXPERIMENTAL

Random perturbation training

Behavioral: perturbation training

control group

ACTIVE COMPARATOR

Block perturbation training

Behavioral: perturbation training

Interventions

perturbation training BEHAVIORAL

A Randomized control trial we will compare two perturbation motor learning paradigms with different challenge level of the practice condition (i.e. blocked practice vs random practice). According to motor learning theory we hypothesize that a) healthy older adults will benefit more from random practice. The purpose of this stage is to investigate the effects of task practice order (random vs blocked) on motor learning (i.e. responding to perturbations during walking) in older adults. According to motor learning theory we hypothesize that a) healthy older adults will benefit more from the random motor learning approach as compared to using blocked practice.

control group; experimental group

Eligibility Criteria

• Age: 70 Years - 120 Years
• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Older Adult (65+)

You may qualify if:

• years and older (with the young age of 20-40)
• able to walk independently (without utilities treadmill or stick);
• Be asked to invent a medical certificate which allows participation in exercise that requires walking twice a week.

You may not qualify if:

• suffering from ischaemic heart disease which limits exercise and COPD and blood pressure is not controlled;
• not suffering serious vision problems;
• does not suffer from this problem: (a score of 24 or higher on MOCA);
• a year after analyzing the type of hip replacement or knee or broken extremities;
• Does not suffer any neurological diseases or stroke.

Sponsors & Collaborators

• Soroka University Medical Center: lead

Study Sites (3)

Ben-guion University of the Negev,

Beersheba, 84105, Israel

Location

Soroka Medical Center

Beersheba, 84105, Israel

Location

SorokaUMC

Beersheba, 84105, Israel

Location

Related Publications (2)

• Paran I, Nachmani H, Salti M, Shelef I, Melzer I. Balance recovery stepping responses during walking were not affected by a concurrent cognitive task among older adults. BMC Geriatr. 2022 Apr 6;22(1):289. doi: 10.1186/s12877-022-02969-w.

  PMID: 35387589 DERIVED

• Nachmani H, Paran I, Salti M, Shelef I, Melzer I. Examining Different Motor Learning Paradigms for Improving Balance Recovery Abilities Among Older Adults, Random vs. Block Training-Study Protocol of a Randomized Non-inferiority Controlled Trial. Front Hum Neurosci. 2021 Feb 25;15:624492. doi: 10.3389/fnhum.2021.624492. eCollection 2021.

  PMID: 33716695 DERIVED

Study Officials

• ilan Shelef, MD

  Soroka University Medical Center

  STUDY CHAIR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: SINGLE
• Who Masked: OUTCOMES ASSESSOR
• Purpose: PREVENTION
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: June 29, 2020
• First Posted: July 2, 2020
• Study Start: October 1, 2017
• Primary Completion: December 31, 2021
• Study Completion: December 31, 2021
• Last Updated: April 18, 2024

Record last verified: 2020-10

Locations

IL (3)