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

Trial statusRecruiting
Trial phaseNot listed
Trial typeObservational
Biological sexAll
Age65-100
SponsorUniversiteit Antwerpen

About this trial

The main aim of this study is to unravel the biomechanics of postural balance reactions during head-motion perturbed standing and walking in older adults who fall, while integrating the influence of frailty, sensory functioning and cognitive processing.

Eligibility criteria

This trial accepts healthy volunteers

Qualifiers

Community dwelling

an age of 65 years or above

Disqualifiers

age < 65 years

medical history encompassing diagnosed vestibulopathy, orthostatic hypotension, peripheral neuropathy, limb amputation, neurological or neuromuscular disorders affecting balance, diagnosed neck disorders affecting sensorimotor control, blindness, deafness

a full-time walking aid is indispensable.

Trial population

Community dwelling older adults with an age of 65 years or above

Trial design

Design model

Case-control

Time perspective

Prospective

Treatments tested in this trial

  • Cognition

    Diagnostic test

    1. The CatchU® app quantitatively and objectively measures the ability to integrate visual-somatosensory information using reaction time test data. 2. Digit Symbol Substitution test assesses processing speed and attention by requiring individuals to match symbols with corresponding numbers within a specified time frame. 3. Trail Making Test part 1 and 2: assesses cognitive flexibility, visual attention, and task-switching by having individuals connect numbered circles in sequence (part 1) and then alternate between numbers and letters (Part 2). 4. Go/No Go test measures an individual's ability to inhibit a prepotent response (No-Go) and execute a response when required (Go). This test provides insights into executive functioning, particularly inhibitory control.

  • Sensory function

    Diagnostic test

    1. Cervical Sensorimotor control will be measured through a wireless wearable sensor 3D-cervical trainer by Sensamove on the placed on the head of the participant. The 3DCT registers cervical position sense by the Head Repositioning Accuracy test where the subject must relocate the head to the previously memorized (neutral) head position with the eyes closed and the joint position error degrees are registered. Cervical movement sense is examined using 'The Fly'-test where the subject ought to follow a movement pattern displayed on the screen in front of them. The movement of the neck-head unit is there upon tracked by the 3DCT and projected on the screen. 2. Vestibular function will be assessed through 3D-video Head Impulse Testing (vHIT), examining the state of the three semicircular canals by delivering the vestibulo-ocular reflex (vor) gain and vor gain asymmetry. 3. For the assessment of static and dynamic visual acuity, functional Head Impulse Testing (fHIT) will be used.

  • Frailty

    Diagnostic test

    Frailty will be assessed using the Fried criteria, comprising 5 categories (each accounting for 1 point if scored positive): Unintentional weight loss (interview), weakness (grip strength with hand-held dynamometer), poor endurance and energy (two statements of the CES-D Depression Scale), slowness (walking speed over 15ft through gait analysis) and low physical activity level (Minnesota Leisure Time Activity questionnaire)(Fried et al., 2001).

  • Biomechanical movement analysis

    Other intervention

    Markers will be placed on the predefined anatomical locations and surface electrodes for electromyography will be applied at the predefined muscle locations following the SENIAM-guidelines. The Microsoft HoloLens 2 is fixated on the participant's head which will, on one hand, provide the cue to the participant for the head movement and on the other hand track eye and head movements. A safety harness is attached to the body and the ceiling of the lab. At the start of the trial, the subject will see a projection by the HoloLens 2 on the real environment moving to the left; right; upward; downward (cue in randomized order) which the participant is ought to follow with eyes and head. First while standing still and second while walking the 10-meter overground walkway at a self-preferred walking speed.

  • Screening

    Other intervention

    The researcher will visit the possible participants (at their home, community centre, etc.) and after written consent on screening procedure is provided, the tests for eligibility will be performed. 1. Interview: asking about age (years), gender (male/female), medical history and the number of falls in the last 12 months . 2. Timed Up-and-Go (TUG) to check walking ability. TUG is a sensitive and specific measure for identifying risk for falls (Shumway-Cook et al., 2000).

  • Follow up

    Other intervention

    Participants are followed up for 12 months. They fill in a fall diary and telephone reminders will be performed monthly to encourage participants to complete and return their diaries.

Treatment groups

100 Participants
are divided into 2 treatment groups
Group A: Fallers6 interventions
Group B: Non-Fallers6 interventions

Trial outcomes

Primary outcomes

1

Spatio-temporal parameters of gait

step length and width (cm)

Time frame
baseline
2

Foot placement estimator

measure which estimates where the foot should be placed for stable gait

Time frame
baseline
3

Onset latency

latency in msec between onset of movements and activation recorded by surface EMG of bilateral m. Erector Spinae (trunk stabilization), m. Gluteus medius (hip strategy), m. Tibialis anterior and m. Soleus (ankle strategy)

Time frame
baseline
4

Peak amplitude

peak amplitude in microvolts of the surface EMG of bilateral m. Erector Spinae (trunk stabilization), m. Gluteus medius (hip strategy), m. Tibialis anterior and m. Soleus (ankle strategy)

Time frame
baseline

Secondary outcomes

1

Multisensory integration

reaction times in visual/sensory vs. visuo-sensory conditions (ratio, in %) measured with CatchU app

Time frame
baseline
2

Digit symbol substitution test

number of correct symbol-digit pairs completed

Time frame
baseline
3

Trail making test

Time to complete part A vs. B (ratio in seconds)

Time frame
baseline
4

Go/No Go test

Accuracy (number of correct responses)

Time frame
baseline

Other outcomes

1

Age

age in years

Time frame
Screening before inclusion
2

Gender

male, female or other

Time frame
Screening before inclusion
3

Medical history

presence or absence of diagnosed vestibulopathy, orthostatic hypotension, peripheral neuropathy, limb amputation, neurological/ or neuromuscular disorders affecting balance, neck disorders affecting sensorimotor control, blindness, deafness and if a full-time walking aid is indispensable

Time frame
Screening before inclusion
4

Fall history

number of falls in last 12 months

Time frame
Screening before inclusion

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