Motor Imagery and Turning Practice to Improve Mobility: Pilot Trial
Trial statusNot yet recruiting
Trial phaseNot applicable
Trial typeInterventional
Biological sexAll
Age65+
SponsorBoise State University
About this trial
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.
Eligibility criteria
This trial accepts healthy volunteersQualifiers
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.
Disqualifiers
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.
Trial design
Design model
Parallel
Treatments tested in this trial
Motor Imagery Therapy
BehavioralMotor 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.
Stress Management Education
BehavioralStress 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.
Locomotor Turning Practice
BehavioralLocomotor 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.
Treatment groups
30 Participants
are divided into 2 treatment groupsGroup A: Loco+MITExperimental treatment 2 interventions
Group B: Loco+SMEActive comparator 2 interventions
Trial outcomes
Primary outcomes
1
Participant Retention Rate (Feasibility)
Percentage of enrolled participants who complete the 1-month post-intervention assessment.
Time frame
Post 1-Month Assessment Visit2
Participant Attendance Rate (Feasibility)
Percentage of scheduled in-person intervention sessions and home-based sessions completed by participants.
Time frame
Baseline through the 1-month post-intervention assessment (approximately 11 weeks).3
Change from Baseline of 360-Degree Turn Duration
The change in time required to complete a 360-degree turn measured using wearable inertial sensors.
Time frame
Baseline to 1-week post-intervention (approximately seven weeks between assessments)4
Change from Baseline of 180-Degree Turn Duration
The change in time required to complete a 180-degree turn measured using wearable inertial sensors.
Time frame
Baseline to 1-week post-intervention (approximately seven weeks between assessments)Secondary outcomes
1
Free-Living Physical Activity - Daily Step Count
Change in average daily step count measured using an activity monitor.
Time frame
Baseline to 1-week post-intervention2
Free-Living Physical Activity - Time Spent Sedentary
Change in average time spend sedentary measured using an activity monitor.
Time frame
Baseline to 1-week post-intervention3
Duration of Cortical Silent Period (cSP) (ms)
Cortical Silent Period (cSP) duration is a measure of cortical inhibitory function assessed using single-pulse transcranial magnetic stimulation (TMS). The cSP is defined as the duration of stimulus-induced suppression of voluntary muscle activity and is reported in milliseconds (ms).
Time frame
Change from baseline to 1-week post-intervention (approximately seven weeks after baseline)Other outcomes
1
Time Up and Go Test
Assessment measuring the time taken to rise from a seated position, walk 3 meters at a comfortable pace, turn 180-degrees, walk back to chair, and sit back down.
Time frame
Baseline and approximately 1-week after the final intervention session (+/- three days).2
TabCAT Cognitive Assessment
Participants will use an iPad to complete tests looking at different aspects of cognitive function: 1. The Flanker test will be used to assess executive function and inhibition. 2. The Running Dots test will be used to assess executive function and spatial working memory. 3. The Line Orientation test will be used to assess visuospatial function.
Time frame
Baseline and approximately 1-week after the final intervention session (+/- three days)3
Activities-Specific Balance Confidence (ABC)
The Activities-specific Balance Confidence (ABC) Scale is a 16-item self-report questionnaire that measures confidence in performing everyday ambulatory activities without losing balance or becoming unsteady. Scores range from 0 to 100, with higher scores indicating greater balance confidence.
Time frame
Change from baseline to 1-week post-intervention (approximately 7 weeks after baseline).4
Mini-BESTest, a 14-item test assessing mobility performance
The Mini-Balance Evaluation Systems Test (Mini-BESTest) is a 14-item clinical assessment of dynamic balance. Total scores range from 0 to 28, with higher scores indicating better balance performance.
Time frame
Change from baseline to 1-week post-intervention (approximately 7 weeks after baseline).Locations
Sponsors and contacts
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Boise State University
Lead sponsor
National Institute of General Medical Sciences (NIGMS)
Collaborator
Source ClinicalTrials.gov
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