An Innovative Gait Training Program in Immersive Virtual Reality for Healthy Older Adults

NCT05915130 | Unknown

• 1 other identifier: GTPVR
• Study Type: interventional
• Target: 40
• Locations: 1 country
• Sites: 1

Brief Summary

Background Impaired gait adaptability is one of the major causes of falls among older adults by producing inappropriate gait adjustments in cluttered environments. Training programs designed to improve gait adaptability behavior in a systemic approach may prevent falls in older adults. Recently, the technology of virtual reality has appeared as a relevant gait training tool based on its training implementation potential. The present study was designed to compare the effectiveness of a virtual reality gait training program (VR group) for improving gait adaptability behavior and thus, reducing the risk of falls relative to a conventional training program of Nordic walkway (NW group). We hypothesize that the virtual reality gait training program will lead to greater gait adaptability improvements. Methods The protocol describes a randomized controlled trial with pre-tests, post-tests, retention tests and follow-up. Forty healthy independent living community dweller participants (65-80 years) will be allocated, after a general medical examination, to the VR or the NW group for a training program of six weeks. Primary outcome related to gait adaptability capacities and acceptance of the virtual reality device will be assessed in pre- and post-intervention and one month after the completion of the training program (retention). A follow-up will be done during the 12 months after the completion of the gait training program. Discussion This study will demonstrate the relative relevance of a gait training program in virtual reality versus a conventional one for improving gait adaptability behavior in healthy older adults and thus preventing falls.

Conditions

Fall; Elderly

Keywords

adaptive behavior

Outcome Measures

Primary Outcomes (5)

• Gait adaptability capacities

  Gait adaptability capacities will be assessed by a specific gait test created to assess gait parameters during goal-directed tasks. Feet positions will be measured by a seven-meter-long portable pressure-sensitive walkway GaitRite® (CIR Systems, Inc., Franklyn, NY, USA) in the real world. Firstly, participants will be instructed to walk at a normal pace on the walkway. The average preferred gait speed, step length, and step duration (with their variabilities) will be calculated over 6 trials. Afterwards, physical obstacles will be placed on the walkway. Participants will perform 3 different locomotor tasks: simple locomotor pointing, crossing-over, and stepping-over tasks (see Figure 4). They will perform 10 trials of each goal-directed task. By recording successive feet positions in relation to the obstacles, gait adaptability behavior will be analyzed through performance, inter-trials and trial-by-trial analyses.

  Pre-intervention (week 1)

• Gait adaptability capacities

  Gait adaptability capacities will be assessed by a specific gait test created to assess gait parameters during goal-directed tasks. Feet positions will be measured by a seven-meter-long portable pressure-sensitive walkway GaitRite® (CIR Systems, Inc., Franklyn, NY, USA) in the real world. Firstly, participants will be instructed to walk at a normal pace on the walkway. The average preferred gait speed, step length, and step duration (with their variabilities) will be calculated over 6 trials. Afterwards, physical obstacles will be placed on the walkway. Participants will perform 3 different locomotor tasks: simple locomotor pointing, crossing-over, and stepping-over tasks (see Figure 4). They will perform 10 trials of each goal-directed task. By recording successive feet positions in relation to the obstacles, gait adaptability behavior will be analyzed through performance, inter-trials and trial-by-trial analyses.

  Post-intervention (week 8)

• Gait adaptability capacities

  Gait adaptability capacities will be assessed by a specific gait test created to assess gait parameters during goal-directed tasks. Feet positions will be measured by a seven-meter-long portable pressure-sensitive walkway GaitRite® (CIR Systems, Inc., Franklyn, NY, USA) in the real world. Firstly, participants will be instructed to walk at a normal pace on the walkway. The average preferred gait speed, step length, and step duration (with their variabilities) will be calculated over 6 trials. Afterwards, physical obstacles will be placed on the walkway. Participants will perform 3 different locomotor tasks: simple locomotor pointing, crossing-over, and stepping-over tasks (see Figure 4). They will perform 10 trials of each goal-directed task. By recording successive feet positions in relation to the obstacles, gait adaptability behavior will be analyzed through performance, inter-trials and trial-by-trial analyses.

  Retention (week 12)

• Acceptance of the head-mounted device

  For the VR group only, VR-HMD acceptance before and after use will be assessed using the Technology Acceptance Model. According to this model, intention to use a technology is positively predicted by its perceived usefulness and its perceived ease of use. VR-HMD acceptance will be assessed through four variables: perceived usefulness, perceived ease of use, perceived enjoyment, and intention to use. (12 items with a 1-10 Likert scale; a higher score means a better outcome)

  Pre-intervention (week 1)

• Acceptance of the head-mounted device

  For the VR group only, VR-HMD acceptance before and after use will be assessed using the Technology Acceptance Model. According to this model, intention to use a technology is positively predicted by its perceived usefulness and its perceived ease of use. VR-HMD acceptance will be assessed through four variables: perceived usefulness, perceived ease of use, perceived enjoyment, and intention to use. (12 items with a 1-10 Likert scale; a higher score means a better outcome)

  Post-intervention (week 8)

Secondary Outcomes (15)

• Mobility

  Pre-intervention (week 1)

• Mobility

  Post-intervention (week 8)

• Mobility

  Retention (week 12)

• Balance

  Pre-intervention (week 1)

• Balance

  Post-intervention (week 8)

Study Arms (2)

Virtual reality training program

EXPERIMENTAL

In the VR group, participants will practice the training sessions in an experimental room. In one training session, participants will negotiate 60 trials. Participants will practice gait training sessions in a fully immersive virtual reality. They will negotiate virtual obstacles such as avoiding a rock or crossing over a tree root, thus improving their gait adaptability capacities.

Behavioral: Gait training

Nordic walking training program

EXPERIMENTAL

Participants will be instructed to walk with poles continuously around the park. Each training session will consist of a warm-up (10 min), main exercise (40 min), and cool-down (5 min) periods. Participants will adapt their locomotion to uneven terrain. They will negotiate natural obstacles such as avoiding a rock or crossing over a tree root, thus improving their gait adaptability capacities.

Behavioral: Gait training

Interventions

Gait training BEHAVIORAL

They will negotiate (natural or virtual) obstacles such as avoiding a rock or crossing over a tree root, thus improving their gait adaptability capacities.

Nordic walking training program; Virtual reality training program

Eligibility Criteria

• Age: 65 Years - 80 Years
• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Older Adult (65+)

You may qualify if:

• aged between 65 and 80
• with weekly moderate to vigorous physical activity

You may not qualify if:

• inability to practice activity at a moderate or vigorous intensity
• moderate or severe cognitive impairments
• severe non-corrected visual impairments
• uncontrolled psychiatric disorders

Sponsors & Collaborators

• Aix Marseille Université: lead

Study Sites (1)

Institute of Movement Sciences

Marseille, 13288 Marseille cedex 09, France

Location

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: NONE
• Purpose: PREVENTION
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Principal investigator

Study Record Dates

• First Submitted: May 23, 2023
• First Posted: June 22, 2023
• Study Start: July 1, 2023
• Primary Completion: October 31, 2023
• Study Completion: October 31, 2024
• Last Updated: June 23, 2023

Record last verified: 2023-06

Locations

FR (1)