Motor Imagery and Turning Practice to Improve Mobility: Pilot Trial

NCT07705360 | Not Yet Recruiting

• 2 other identifiers: IRB26-0715P20GM148321
• Study Type: interventional
• Target: 30
• Locations: 0 countries
• Sites: N/A

Brief Summary

The goal of this clinical trial is to evaluate whether combining in-person turning practice with home-based Motor Imagery Therapy (MIT) is feasible and may improve mobility in community-dwelling older adults aged 65 years and older who report balance or turning-related mobility concerns. MIT involves mentally practicing movements and watching movement demonstrations without physically performing the movement. The main questions this study aims to answer are whether it is feasible for older adults to complete a combined in-person and home-based turning and motor imagery program based on attendance, retention, and activity monitor use; whether adding MIT to a turning intervention improves turning performance more than a comparison program focused on stress management education; whether MIT increases daily physical activity, increases walking intensity, and reduces sedentary time in daily life; and whether measures of brain function related to movement control predict how much participants improve following the intervention. Researchers will compare a locomotor turning intervention combined with MIT (Loco+MIT) to a locomotor turning intervention combined with stress management education (Loco+SME) to determine whether MIT leads to greater improvements in mobility and daily activity. Participants will attend five laboratory visits that include mobility testing, brain stimulation assessments, and physical activity assessments. Participants will also complete six weeks of in-person turning practice sessions held twice per week and home-based sessions three times per week consisting of either motor imagery training or stress management education. In addition, participants will wear a physical activity monitor during daily life to measure movement and sedentary behavior and will complete follow-up assessments after the intervention to evaluate changes in mobility and activity over time.

Conditions

Mobility Impairment; Community Dwelling Older Adults

Keywords

Motor Imagery; Locomotor Training; Mobility; Older Adults; Transcranial Magnetic Stimulation; Turning Performance; Physical Activity

Outcome Measures

Primary Outcomes (4)

• Participant Retention Rate (Feasibility)

  Percentage of enrolled participants who complete the 1-month post-intervention assessment.

  Post 1-Month Assessment Visit

• Participant Attendance Rate (Feasibility)

  Percentage of scheduled in-person intervention sessions and home-based sessions completed by participants.

  Baseline through the 1-month post-intervention assessment (approximately 11 weeks).

• Change from Baseline of 360-Degree Turn Duration

  The change in time required to complete a 360-degree turn measured using wearable inertial sensors.

  Baseline to 1-week post-intervention (approximately seven weeks between assessments)

• Change from Baseline of 180-Degree Turn Duration

  The change in time required to complete a 180-degree turn measured using wearable inertial sensors.

  Baseline to 1-week post-intervention (approximately seven weeks between assessments)

Secondary Outcomes (3)

• Free-Living Physical Activity - Daily Step Count

  Baseline to 1-week post-intervention

• Free-Living Physical Activity - Time Spent Sedentary

  Baseline to 1-week post-intervention

• Duration of Cortical Silent Period (cSP) (ms)

  Change from baseline to 1-week post-intervention (approximately seven weeks after baseline)

Other Outcomes (5)

• Time Up and Go Test

  Baseline and approximately 1-week after the final intervention session (+/- three days).

• TabCAT Cognitive Assessment

  Baseline and approximately 1-week after the final intervention session (+/- three days)

• Activities-Specific Balance Confidence (ABC)

  Change from baseline to 1-week post-intervention (approximately 7 weeks after baseline).

Study Arms (2)

Loco+MIT

EXPERIMENTAL

Participants assigned to this arm will receive six weeks of in-person locomotor turning practice combined with home-based Motor Imagery Therapy. In-person sessions will focus on dynamic turning, weight shifting, and head-trunk coordination. Home-based Motor Imagery Therapy sessions will include guided mental practice and action observation of movement tasks.

Behavioral: Motor Imagery Therapy; Behavioral: Locomotor Turning Practice

Loco+SME

ACTIVE COMPARATOR

Participants assigned to this arm will receive the same six weeks of in-person locomotor turning practice combined with home-based Stress Management Education. In-person sessions will focus on dynamic turning, weight shifting, and head-trunk coordination. Home-based Stress Management Education sessions will include educational content related to stress, sleep, and wellness without motor imagery or motor practice components.

Behavioral: Stress Management Education; Behavioral: Locomotor Turning Practice

Interventions

Motor Imagery Therapy BEHAVIORAL

Motor Imagery Therapy (MIT) is a home-based behavioral intervention that combines guided mental rehearsal of movement with action observation. Participants will complete sessions focused on imagining and observing functional mobility tasks and turning-related movements without physically performing the movements.

Also known as: MIT

Loco+MIT

Stress Management Education BEHAVIORAL

Stress Management Education (SME) is a home-based educational intervention designed to serve as an active comparison condition. Participants will complete sessions focused on stress management, sleep, wellness, and general health education without motor imagery or movement practice components.

Also known as: SME

Loco+SME

Locomotor Turning Practice BEHAVIORAL

Locomotor Turning Practice is an in-person mobility intervention focused on improving turning performance and dynamic mobility in older adults. Sessions will include structured practice of turning movements, weight shifting, stepping transitions, and head-trunk coordination exercises conducted twice weekly over six weeks.

Also known as: LOCO

Loco+MIT; Loco+SME

Eligibility Criteria

• Age: 65 Years+
• Sex: female
• Healthy Volunteers: Yes
• Age Groups: Older Adult (65+)

You may qualify if:

• Age 65 years or older.
• Self-report difficulty with turning, balance, or walking-related mobility tasks.
• Self-report increased fall risk, including a history of falls, fall-related injury, multiple falls within the previous year, or fear of falling due to balance or walking concerns.
• Report some difficulty with walking-related activities, such as turning, walking longer distances, climbing stairs, or completing household activities.
• Willingness to be randomized to either study group and complete all study procedures.
• Living independently in the community and able to travel to the research site.
• Ability to perform motor imagery, defined by a qualifying score on the Motor Imagery Questionnaire - Revised Second Version.
• Access to an internet-connected computer capable of playing videos with sound in a quiet environment.
• Ability to provide informed consent.

You may not qualify if:

• Diagnosis or symptoms of a neurological disorder or central nervous system injury, including Alzheimer's disease, Parkinson's disease, multiple sclerosis, or stroke.
• Contraindications to transcranial magnetic stimulation (TMS) or non-invasive brain stimulation procedures.
• Use of medications known to substantially affect central nervous system function.
• Severe arthritis or musculoskeletal impairment that would limit safe participation in mobility training.
• Severe obesity (body mass index greater than 35 kg/m²).
• Significant cardiovascular, pulmonary, renal, or other uncontrolled medical conditions that may limit safe participation.
• Myocardial infarction or major cardiac surgery within the previous year.
• Cancer treatment within the previous year, excluding nonmelanoma skin cancer or cancers with excellent prognosis.
• Uncontrolled hypertension at rest (systolic blood pressure \>180 mmHg and/or diastolic blood pressure \>100 mmHg).
• Bone fracture or joint replacement within the previous 6 months.
• Current participation in physical therapy or cardiopulmonary rehabilitation targeting lower extremity function.
• Current enrollment in another clinical trial that may interfere with study participation or outcomes.
• Inability to communicate effectively with study personnel or inability to understand English-language study procedures.
• Plans to relocate from the area during the study period.
• Any additional safety or compliance concerns identified by the investigative team.

Sponsors & Collaborators

• Boise State University: lead
• National Institute of General Medical Sciences (NIGMS): collaborator

MeSH Terms

Conditions

Motor Activity

Condition Hierarchy (Ancestors)

Behavior

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: SINGLE
• Who Masked: OUTCOMES ASSESSOR
• Masking Details: Study personnel conducting outcome assessments will be blinded to intervention assignment. Participants and intervention staff will not be blinded.
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Assistant Professor

Model Details: Participants will be randomized to one of two parallel intervention groups: locomotor turning practice combined with Motor Imagery Therapy (MIT) or locomotor turning practice combined with Stress Management Education (SME).

Study Record Dates

• First Submitted: May 26, 2026
• First Posted: July 15, 2026
• Study Start: August 1, 2026
• Primary Completion (Estimated): January 31, 2028
• Study Completion (Estimated): January 31, 2029
• Last Updated: July 15, 2026

Record last verified: 2026-07

Data Sharing

• IPD Sharing: Will share
• Shared Documents: ICF
• Time Frame: De-identified individual participant data and supporting documentation will be available beginning approximately 12 months after publication of the primary study findings and may remain available for up to 5 years following publication.
• Access Criteria: De-identified individual participant data and supporting documentation, including the informed consent form, may be made available to qualified researchers upon reasonable request for purposes of scientific research, secondary analyses, or verification of published findings. Requests will be reviewed by the investigative team and may require a data use agreement in accordance with institutional policies and ethical guidelines. Data shared will exclude direct participant identifiers.