Older Adults, Balance Clinical Trial
Official title:
Biomechanics Research in the Effects of Interactive Dynamic Balance Training on Postural and Gait Control in Older Adults
Aim 1: Determine the relationships between muscle quality and balance performance as well as
any association with fracture and fall history in older adults.
Muscle quality will be calculated from the information of muscle strength and body
composition (strength/lean muscle mass). The investigators will compute the joint torque
during functional activates using biomechanical data from the 3-D motion analysis, whereas
the lean skeletal muscle mass will be determined by the bioelectrical impedance analysis
(BIA). Clinical and functional assessments for balance performance will also be conducted.
Fracture and fall history prior to the testing will be recorded retrospectively.
Aim 2: Identify the relationships between force usages during balance perturbation in older
adults.
Lateral and forward/backward perturbation while walking will be used to elicit balance
recovery responses. The degree of necessary joint force and how this relates to a person's
functional capacity at specific joint levels will be determined by the torque demand to
capacity ratio (DCR: task demands relative to strength capacity). The DCR provides a
joint-specific unified scalar quantity representing the balance recovery demand normalized
by the maximum muscle strength capacity of an individual. It would indicate whether a person
can recover balance and to what extent of his/her maximum capacity is taxed.
Aim 3: Examine the effectiveness and long-term effects of a novel 2-month personalized
strengthening and balance training program on improving balance performance in older adults.
Personalized strengthening and balance training exercise will be personalized based on the
results of biomechanical assessments, using the Modular Interactive Tiles System (MITS) and
split-belt balance perturbation instrumented treadmill. The exercise group will receive
training 2 times a week for 2 months and the age-matched control group will maintain their
usual daily life activities. All assessments will be performed at baseline, and 1 week after
training. Follow-up telephone interviews will be conducted at 6, 9, and 12 months following
the training period.
Aging populations has become a global issue. Fall is a prevalent concern among aging adults
that can cause fracture, injury or mortality. Identifying the factors related to falls
occurring within this aging population is essential for the development of effective regimes
for fall prevention. Studies have shown that muscle quality and good posture alignments are
critical for balance control in older adults. Older adults often combining with muscles
weakness (sarcopenia), bone loss (osteoporosis) and lead to increased spine kyphosis causing
vertebral fractures and poor balance control. Therefore, the long-term objectives of this
work are to prevent fall in older adults by improving the function of degenerative muscles.
The proposed research can provide needed information regarding the processes of balance
control in this aging population, and can potentially be applied to individuals with poor
balance who at high risk of fall. Three specific aims for this 3 years research project are
described as follow:
Aim 1: Determine the relationships between muscle quality and balance performance as well as
any association with fracture and fall history in older adults.
Muscle quality will be calculated from the information of muscle strength and body
composition (strength/lean muscle mass). The investigators will compute the joint torque
during functional activates using biomechanical data from the 3-D motion analysis, whereas
the lean skeletal muscle mass will be determined by the bioelectrical impedance analysis
(BIA). Clinical and functional assessments for balance performance will also be conducted.
Fracture and fall history prior to the testing will be recorded retrospectively.
Aim 2: Identify the relationships between force usages during balance perturbation in older
adults.
Lateral and forward/backward perturbation while walking will be used to elicit balance
recovery responses. The degree of necessary joint force and how this relates to a person's
functional capacity at specific joint levels will be determined by the torque demand to
capacity ratio (DCR: task demands relative to strength capacity). The DCR provides a
joint-specific unified scalar quantity representing the balance recovery demand normalized
by the maximum muscle strength capacity of an individual. It would indicate whether a person
can recover balance and to what extent of his/her maximum capacity is taxed.
Aim 3: Examine the effectiveness and long-term effects of a novel 2-month personalized
strengthening and balance training program on improving balance performance in older adults.
Personalized strengthening and balance training exercise will be personalized based on the
results of biomechanical assessments, using the Modular Interactive Tiles System (MITS) and
split-belt balance perturbation instrumented treadmill. The exercise group will receive
training 2 times a week for 2 months and the age-matched control group will maintain their
usual daily life activities. All assessments will be performed at baseline, and 1 week after
training. Follow-up telephone interviews will be conducted at 6, 9, and 12 months following
the training period.
Translational research of this nature will contribute necessary information on the critical
factors of balance control in older adults. The research will also test clinical innovations
of exercise training to improve the long-term prognosis in this vulnerable aging population
group. The unique contribution of the proposed research lies in the integration of an
explicit physical examination and biomechanical approach to a relevant clinical problem
within a translational model. The findings will provide a new paradigm of treatment
approaches for balance control and will reduce the risk of falling and fracture. This
research can potentially be applied to individuals with poor balance who are at high risk of
falling.
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