A Novel Multisensory-Rhythmic Intervention in Geriatric Rehabilitation

Trial statusRecruiting
Trial phaseNot applicable
Trial typeInterventional
Biological sexAll
Age18-85
SponsorNational Cheng-Kung University Hospital

About this trial

Human performance takes shape from the dynamic interaction between person, environment, and task. Goal-directed action is a complex task, which requires the elderly to adapt their motor response according to the environment constraints and task requirements to accomplish the task goal. Among age-related problems, motor control deficits are often the main problems which restricts the frail elderly from maintaining independence for activities of daily living. Therefore, to preserve the quality of life, motor function of the elderly must be taken into consideration, including early detection of motor control problems and development of appropriate intervention strategy for persons with either healthy or pathological brain aging. Rhythmic skill training which is a new mode of dual tasks using rhythmic cueing as an external agent for facilitating an automatized motor task. During training, rhythmic skill training can provide multi-component of sensory stimulation, strengthen motor planning and optimize motor execution, therefore, it will improve the motor performance for the elderly or patients with mild cognitive impairment. In addition, the neuroplastic changes related to sensory processing, selective attention, or working memory demands through music rhythm training can facilitate the cognitive function for the elderly which is a current trend of geriatric rehabilitation. Moreover, the advantage of virtual reality is that it provides important information related to knowledge of result, which can induce better motor and cognitive training effects. Therefore, this research project will focus on assessing and intervening motor adaptation of upper extremity for the healthy elderly and patients with mild cognitive impairment. The first purpose of the project will analyze the difference in efficiency of responsive and predictive grasping motor adaptation among the healthy young adults, healthy elderly and patients with mild cognitive impairment through a test of perturbation-based of pinch-holding-up-activity, and use artificial intelligence for more accurate classification for the grasp pattern of healthy young adults, elderly and patients with mild cognitive impairment. The second one is to verify the effects of virtual-reality based rhythmic skill training system on the motor adaptation capability of upper limb and cognition for the elderly and patients with mild cognitive impairment.

Eligibility criteria

This trial accepts healthy volunteers

Qualifiers

Montreal Cognitive Assessment (MoCA) score of 23 or higher,

Clinical Dementia Rating (CDR) of 0 (for normal subjects) or 1 (for mild cognitive impairment subjects),

Healthy young participants aged between 20-39 years, healthy older adults and mild cognitive impairment participants aged between 65-85 years,

No skeletal, muscular, or neurological problems in the upper limbs in the past year, and

Disqualifiers

Any subjects with significant mental illness, central nervous system disorders, or medical history

Trial design

Design model

Parallel

Treatments tested in this trial

  • virtual-reality based rhythmic skill training

    Other intervention

    Participants wear VR headsets and Oculus Touch controllers and undergo rhythm skill training for a total of 35 minutes.

  • rhythmic skill training with visual feedback

    Other intervention

    The rhythm skill training activities in this group are the same as the virtual reality-based system. Participants received 35 minutes of rhythm skill training presented through a computer interface

  • strengthening group

    Other intervention

    Participants receive an upper limb strengthening exercise program under the supervision of a therapist to ensure that the strengthening exercises are performed correctly. This includes: proprioceptive neuromuscular facilitation, resistance training, and tendon gliding exercises.

  • breathing and muscle relaxation exercises

    Other intervention

    5 minutes of breathing and muscle relaxation exercises

Treatment groups

108 Participants
are divided into 3 treatment groups
Group A: virtual-reality based rhythmic skill trainingExperimental treatment 2 interventions
Group B: rhythmic skill training with visual feedbackActive comparator 2 interventions
Group C: strengthening groupActive comparator 2 interventions

Trial outcomes

Primary outcomes

1

Change in responsive grip behavior

To evaluate change in amplitude of pinch force development or adaptation to perturbation through a test of perturbation-based of pinch-holding-up-activity

Time frame
baseline, 8 weeks and 16 weeks

Secondary outcomes

1

Change in the results of Semmes-Weinstein monofilament test

To evaluate change in touch-deep pressure threshold of hands using a set of 20 nylon monofilaments with Semmes-Weinstein monofilament test

Time frame
baseline, 8 weeks and 16 weeks
2

Change in the result of Purdue pegboard test

To evaluate change in hand dexterity of dominant hand, non-dominant and both hands with a timed-test

Time frame
baseline, 8 weeks and 16 weeks
3

Change in the result of Minnesota manual dexterity test

To evaluate change in gross motor coordination of upper limb of dominant hand and both hands with a timed placing and turning test

Time frame
baseline, 8 weeks and 16 weeks
4

Change in the result of Weber Two-Point Discrimination Test

To evaluate the change in sensibility of the hands

Time frame
baseline, 8 weeks and 16 weeks

Other outcomes

Sponsors and contacts

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