COMMUNITY-BASED POWER TRAINING IN FALLER AND NON-FALLER OLDER ADULTS: A FEASIBILITY AND FALL RISK STUDY.

NCT07369440 | Recruiting

• 2 other identifiers: Ethics committee: 160/20232023.04264.BD
• Study Type: interventional
• Target: 120
• Locations: 1 country
• Sites: 1

Brief Summary

Aging leads to substantial alterations in the nervous and skeletal muscle systems that ultimately lead to a reduction in "neural drive" and motor performance. While maximal strength starts declining as early as 50 years of age, aging brings even greater reductions in rate of force development and muscle power, that has been shown to be a stronger predictor of functional independence and balance impairments. Falls are a major health concern as one third of adults over 65 years loses balance and falls every year, and based on a published report, the estimated health care costs associated with falls in the European Union is €25 billion. The ability to recover balance declines with aging, where older individuals often recover balance with a greater number of balance recovery steps and non-optimal stepping strategies. In addition, older adults have more difficulty recovering balance in the medio-lateral direction. The hip abductors are fundamental in controlling the motion of the body centre of mass in this direction during weight transfers of standing, stepping, and walking. Furthermore, these muscles appear to be more susceptible to age-related composition and performance declines than other muscles of the lower limbs, especially in individuals at a higher risk for falls. Unfortunately, common balance interventions, such as, functional balance training, Tai-Chi, or dance, have a very limited capacity to reduce the risk of falls in older adults. Interestingly, resistance training is relatively better than the mentioned interventions at reducing this problem. This may come about through mitigating the agerelated neuromuscular performance deficits. However, traditional resistance training lacks the emphasis in high velocity movements required for adequate fall prevention protective stepping strategies. Muscle power training is a safe and effective alternative to traditional resistance training. By emphasizing in maximum speed of execution, its results are often better than with traditional resistance training, especially in functional outcomes, with the potential to enhance balance recovery. However, there is little and inconsistent evidence on the optimal exercise parameters (such as velocity) for prevention of falls. Community-based multi-component exercise programs are often used to promote health and functional benefits in the older adult population. These programs not only have a positive impact in a larger number of communitydwelling individuals, but can also lead to significant improvements. Nonetheless, these programs limited in reducing the risk for falls. Considering the robust effects of muscle power training in the older population, it is conceivable that a multi-component community-based exercise intervention, that focuses on developing muscle power and reduce fall risk, can improve the older individuals' ability to recover balance and consequently, bring greater benefits to the older adult community. However, there is no information on the feasibility of conducting an exercise program to develop muscle power and reduce fall risk in a community-based setting. Furthermore, it is generally unknown if such an exercise intervention can improve function, balance, and reduce the occurrence of falls in older adults especially, among those that have fallen in the past- which are the most relevant target population for both clinical studies and practice.

Conditions

Fall Prevention; Muscle Power Performance; Functional Mobility; Balance Control in Elderly

Keywords

Older adults; Fallers; Power Training; Functional mobility; Balance

Outcome Measures

Primary Outcomes (8)

• Neuromuscular Assessments

  Handgrip strength was assessed through sustained isometric maximal voluntary contractions (IMVC) using a digital handgrip dynamometer (Gripwisetech, PT). Participants were seated with the shoulder adducted, elbow flexed at 90°, forearm in neutral position and wrist in slight extension. Three maximal isometric contractions of 15 seconds were performed with the dominant hand, with 2 minutes of rest between trials. Maximal force was defined as the highest peak force achieved during the contraction. Rate of force development (RFD) was calculated as the slope of the force-time curve during the initial phase of contraction (0-200 ms). The best trial was used for analysis.

  12 weeks

• Neuromuscular Assessments

  Maximal isometric strength of the knee extensors, hip extensors, and hip abductors was assessed using isometric maximal voluntary contractions (IMVC) with a computer-controlled dynamometer (DESMOTEC, IT). All contractions were performed at the joint neutral position (0°) defined for each test. Participants performed the tests in a seated position for knee extension and in a standing position for hip extension and hip abduction, using standardized testing positions. For each muscle group, three maximal isometric contractions of 15 seconds were performed, with 2 minutes of rest between trials. Maximal force was defined as the highest peak torque achieved during the contraction. Rate of force development (RFD) was calculated from the slope of the torque-time curve during the initial phase of the contraction (0-200 ms). The best trial was used for analysis. Data were sampled at 100 Hz.

  12 weeks

• Functional Mobility and Balance

  Time to complete four meters at the preferred gait speed (4MWT).

  12 weeks

• Functional Mobility and Balance

  Time to complete the Four Square Step Test (FSST).

  12 weeks

• Functional Mobility and Balance

  Time to stand up and sit down five times (5STS) as quickly as possible.

  12 weeks

• Functional Mobility and Balance

  Total score of the Mini-BESTest (0-28 points).

  12 weeks

• Functional Mobility (TUG).

  Time to complete the Timed Up and Go test (seconds).

  12 weeks

• Functional Mobility under Dual Task

  Time to complete the Timed Up and Go test under dual-task conditions (seconds).

  12 weeks

Secondary Outcomes (4)

• Feasibility (Recruitment Rate)

  12 weeks

• Feasibility (Intervention Adherence)

  12 weeks

• Safety (Adverse Events)

  12 weeks

• Prospective falls incidence

  6 months

Study Arms (4)

Traditional Resistance Training in Older Fallers

EXPERIMENTAL

Retrospective falls incidence of the 12 months prior to enrollment will be used to divide participants into non\_fallers (n=60) and fallers (n=60) In this arm of the study, 30 older fallers will perform a multicomponent exercise program focusing on traditional resistance training.

Behavioral: Multi-component exercise program focused on traditional resistance training

Traditional Resistance Training in Older Non-Fallers

EXPERIMENTAL

Retrospective falls incidence of the 12 months prior to enrollment will be used to divide participants into non\_fallers (n=60) and fallers (n=60) In this arm of the study, 30 older non-fallers will perform a multicomponent exercise program focusing on traditional resistance training.

Behavioral: Multi-component exercise program focused on traditional resistance training

Power Training in Older Fallers

EXPERIMENTAL

Retrospective falls incidence of the 12 months prior to enrollment will be used to divide participants into non\_fallers (n=60) and fallers (n=60) In this arm of the study, 30 older fallers will perform a multicomponent exercise program focusing on power training.

Behavioral: Multi-component exercise program focused on muscle power

Power Training in Older Non-Fallers

EXPERIMENTAL

Retrospective falls incidence of the 12 months prior to enrollment will be used to divide participants into non\_fallers (n=60) and fallers (n=60) In this arm of the study, 30 older non-fallers will perform a multicomponent exercise program focusing on power training.

Behavioral: Multi-component exercise program focused on muscle power

Interventions

Multi-component exercise program focused on muscle power BEHAVIORAL

The intervention will be applied for 12 weeks, with a frequency of 3 times per week. Each session will have 45 minutes, and the participants will be instructed to perform a warm-up on a treadmill or other cardiofitness equipment, power training, and balance exercise. Participants in the power training groups (30 non-fallers and 30 fallers) will perform knee extension, hip extension and hip abduction exercises, in a regimen of 3 sets of 10 repetitions at 50% of the participant's 1 repetition maximum (1RM), performing each repetition as fast as possible on variable resistance machines. The 1RM estimation will be determined using a 10RM protocol and applying Brzycki's equation. The 1RM assessment will be conducted during the first training session and will be reassessed every 3 weeks to progressively adjust resistance training loads. The progression on the balance exercise (stepping and manipulation of the centre of mass over the base of support) will be equally performed every 3 weeks.

Also known as: Power Training

Power Training in Older Fallers; Power Training in Older Non-Fallers

Multi-component exercise program focused on traditional resistance training BEHAVIORAL

The intervention will be applied for 12 weeks, 3 times per week. Each session will have 45 minutes, and the participants will be instructed to perform a warm-up on a cardiofitness equipment, resistance exercise, and balance exercise. Participants in the traditional resistance training groups (30 non-fallers and 30 fallers) will perform knee extension, hip extension and hip abduction exercises, in a regimen of 3 sets of 10 repetitions at 60-75% of the participant's 1 repetition maximum (1RM), at a cadence of 2s concentric and 2s eccentric on variable resistance machines. The 1RM estimation will be determined using a 10RM protocol and applying Brzycki's equation. The 1RM assessment will be conducted during the first training session and will be reassessed every 3 weeks to progressively adjust resistance training loads. The progression on the balance exercise (stepping and manipulation of the centre of mass over the base of support) will be equally performed every 3 weeks.

Also known as: Traditional Resistance Exercise

Traditional Resistance Training in Older Fallers; Traditional Resistance Training in Older Non-Fallers

Eligibility Criteria

• Age: 65 Years+
• Sex: all
• Healthy Volunteers: No
• Age Groups: Older Adult (65+)

You may qualify if:

• Age between 65-85 years;
• Fall history over the 12 months prior to enrollment (fallers group).

You may not qualify if:

• Any existing medical conditions or injuries which would affect the ability or safety to perform exercise;
• Taking medication affecting balance (such as sedatives, anti-depressives);
• Regular (more than 1d/week) participation in resistance training with loading greater than bodyweight during the last year;
• BMI greater than 32 kg/m2.

Sponsors & Collaborators

• University of Maia: lead
• Research Center in Sports Sciences, Health Sciences and Human Development: collaborator

Study Sites (1)

Maia Municipal Sports Hall

Maia, Porto District, Portugal

RECRUITING

Related Publications (21)

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Related Links

• Strength Testing-Predicting a One-Rep Max from Reps-to-Fatigue
• The Loss of Power and Need for Power Training in Older Adults

Central Study Contacts

Óscar J Ribeiro, Master's Degree

CONTACT

+351 911-529-487; oscarjr23scp@gmail.com

Óscar J Ribeiro, Master's Degree

CONTACT

+351 911-529-487; a032229@umaia.pt

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: TRIPLE
• Who Masked: PARTICIPANT, CARE PROVIDER, INVESTIGATOR
• Purpose: PREVENTION
• Intervention Model: FACTORIAL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Doctoral Student

Model Details: The present project will have a randomized study design with delayed onset with an equal number of elderly individuals with and without a history of falls distributed across the intervention groups. Participants will be tested initially (PRE\_Control), after 12 weeks of control period (PRE\_Intervention), after 12 weeks of intervention (POST\_Intervention), and after 6 months of follow-up (RET).

Study Record Dates

• First Submitted: September 17, 2024
• First Posted: January 27, 2026
• Study Start: September 1, 2024
• Primary Completion (Estimated): March 31, 2027
• Study Completion (Estimated): August 30, 2027
• Last Updated: January 27, 2026

Record last verified: 2026-01

Data Sharing

• IPD Sharing: Will not share

Locations

PT (1)