The Sensorimotor Locus of Balance Control in Elderly Gait

Study Results

Results available

Outcome measurements, participant flow, baseline characteristics, and adverse events have been published for this study.

View full results

Basic Information

Get a concise snapshot of the trial, including recruitment status, study phase, enrollment targets, and key timeline milestones.

Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

14 participants

Study Classification

INTERVENTIONAL

Study Start Date

2017-10-30

Study Completion Date

2018-07-25

Brief Summary

Review the sponsor-provided synopsis that highlights what the study is about and why it is being conducted.

The aging population is at an exceptionally high risk of debilitating falls, contributing significantly to reduced independence and quality of life. It remains extremely challenging to screen for falls risk, and programs designed to mitigate falls risk have only modestly influenced the sizeable portion of the aging population experiencing one or more falls annually. Balance control in standing and walking depends on integrating reliable sensory feedback and on planning and executing appropriate motor responses. Walking balance control is especially dynamic, requiring active and coordinated adjustments in posture (i.e., trunk stabilization) and foot placement from step to step. Accordingly, using a custom, immersive virtual environment, the investigators have shown that sensory (i.e., optical flow) perturbations, especially when applied during walking, elicit strong and persistent motor responses to preserve balance. Exciting pilot data suggest that these motor responses are remarkably more prevalent in old age, presumably governed by an increased reliance on vision for balance control. Additional pilot data suggest that prolonged exposure to these perturbations may effectively condition successful balance control strategies. Founded on these recent discoveries, and leveraging the increase reliance on vision for balance control in old age, the investigators stand at the forefront of a potentially transformative new approach for more effectively identifying and mitigating age-related falls risk. The investigator's overarching hypothesis is that optical flow perturbations, particularly when applied during walking, can effectively identify balance deficits due to aging and falls history and can subsequently condition the neuromechanics of successful balance control via training.

Related Clinical Trials

Explore similar clinical trials based on study characteristics and research focus.

Gait and Postural Balance Analysis During Head-motion Perturbed Standing and Walking in Older Adults

NCT06345625

Aged Accidental Fall Postural Balance +1 more

RECRUITING

Motor Flexibility in Multidirectional Balance Control

NCT06076525

Falling

WITHDRAWN NA

Merging Attentional Focus and Balance Training to Reduce Fall Risk in Older Adults

NCT03776201

Accidental Fall

COMPLETED NA

Falls in Older Persons With Limb Loss

NCT03670004

Amputation Elderly

COMPLETED

Spinal Networks of Balance Learning and Retention in Older Adults

NCT06517043

Aging

RECRUITING NA

Detailed Description

Dive into the extended narrative that explains the scientific background, objectives, and procedures in greater depth.

Specific Aim 1. Investigate sensory, motor, and cognitive-motor mechanisms governing susceptibility to optical flow perturbations. Aging increases the reliance on vision for balance control. However, central and peripheral mechanisms underlying aging and falls history effects on the susceptibility to optical flow perturbations are unclear. Hypothesis 1: Entrainment to optical flow perturbations will correlate most strongly with visual dependence and decreased somatosensory function, alluding to an age-associated process of multi-sensory reweighting. Methods: Multivariate models will quantify the extent to which strategically-selected sensory (i.e., visual dependence via rod/frame test, somatosensory function), motor (i.e., rate of torque development, timed sit-to-stand) and cognitive-motor (i.e., interference) mechanisms underlie inter-individual differences in susceptibility to perturbations.

Specific Aim 2. Estimate the efficacy of prolonged optical flow perturbations to condition the neuromechanics of walking balance control in older adult fallers. Pilot data from young adults suggests that prolonged exposure to optical flow perturbations may condition reactive strategies used to successfully control walking balance. The investigator's premise is that dynamic perturbation training can improve resilience to unexpected balance disturbances. Here, the investigators conduct a preliminary test of the effects of training with optical flow perturbations on walking balance in older adult fallers. Hypothesis 2: (a) Older adults with a history of falls will adapt to prolonged exposure to perturbations, conditioning their step to step adjustments in walking balance control, and (b) improving their response to unexpected balance challenges following training. Methods: In two 20 min sessions, on different days in a randomized cross-over design, older adults with a history of falls will walk with ("treatment" session) and without ("control" session) prolonged exposure to optical flow perturbations. The investigators will assess time-dependent changes in the neuromechanics of walking balance during training and after-effects via gait variability, dynamic stability, and performance on a series of real-world like targeting and obstacle avoidance tasks.

Conditions

See the medical conditions and disease areas that this research is targeting or investigating.

Ambulation Difficulty Gait, Unsteady Fall Position Sense Disorders

Study Design

Understand how the trial is structured, including allocation methods, masking strategies, primary purpose, and other design elements.

Allocation Method

RANDOMIZED

Intervention Model

CROSSOVER

In two 20 min sessions, on different days in a randomized cross-over design, older adults will walk with ("treatment" session) and without ("control" session) prolonged exposure to optical flow perturbations.

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

No Masking

Study Groups

Review each arm or cohort in the study, along with the interventions and objectives associated with them.

Intervention, then Control

Older adults will walk during exposure to optical flow perturbations

Group Type EXPERIMENTAL

Optical flow perturbations

Intervention Type BEHAVIORAL

Continuous mediolateral (i.e., side-to-side) 20-minute perturbations of optical flow that elicit the visual perception of lateral imbalance via virtual reality during treadmill walking.

Normal walking

Intervention Type BEHAVIORAL

Usual treadmill walking without optical flow perturbations

Control, then Intervention

Older adults will walk normally (without optical flow perturbations)

Group Type EXPERIMENTAL

Optical flow perturbations

Intervention Type BEHAVIORAL

Continuous mediolateral (i.e., side-to-side) 20-minute perturbations of optical flow that elicit the visual perception of lateral imbalance via virtual reality during treadmill walking.

Normal walking

Intervention Type BEHAVIORAL

Usual treadmill walking without optical flow perturbations

Interventions

Learn about the drugs, procedures, or behavioral strategies being tested and how they are applied within this trial.

Optical flow perturbations

Continuous mediolateral (i.e., side-to-side) 20-minute perturbations of optical flow that elicit the visual perception of lateral imbalance via virtual reality during treadmill walking.

Intervention Type BEHAVIORAL

Normal walking

Usual treadmill walking without optical flow perturbations

Intervention Type BEHAVIORAL

Eligibility Criteria

Check the participation requirements, including inclusion and exclusion rules, age limits, and whether healthy volunteers are accepted.

Inclusion Criteria

* Be able to walk without an assistive aid (i.e., walker, cane)
* Have the full capacity to provide informed consent

OLDER NON-FALLERS

* Age 65+ years
* No history of falls\* in the prior 12 months

OLDER ADULTS WITH A HISTORY OF FALLS

* Age 65+ years
* History of one or more falls\* in the prior 12 months

* For the purposes of this study, falls counted towards the self-reported total will be defined as per the Kellogg International Work Group - a fall is "unintentionally coming to the ground or some lower level and other than as a consequence of sustaining a violent blow, loss of consciousness, sudden onset of paralysis as in stroke or an epileptic seizure"

Exclusion Criteria

* Current lower extremity injury or fracture
* Taking medication that causes dizziness
* Have a leg prosthesis
* Prisoners
* Individuals clearly lacking the capacity to provide informed consent

Minimum Eligible Age

65 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

Yes