Effect of Balance Training on White Matter Tracts in Healthy Elderly Population

Postural Balance Clinical Trial

Official title:

Effect of Balance Training on White Matter Tracts in Healthy Elderly Population

Clinical Trial Details — Status: Recruiting

Administrative data

• NCT number: NCT05539690
• Other study ID #: SC22FISI0069
• Status: Recruiting
• Phase: N/A
• Start date: August 24, 2022
• Est. completion date: February 29, 2024

Study information

• Verified date: September 2022
• Source: The Catholic University of Korea
• Contact: Youngkook Kim, MD, PhD
• Phone: +8237791383
• Email: england2[@]hamail.net
• Is FDA regulated: No
• Study type: Interventional

Clinical Trial Summary

Balance impairment increases the risk of falling and is associated with a fear of falling and immobility. Balance impairment can ultimately affect the morbidity of cardiovascular disease, cognitive impairment, and mortality, especially in an older population. Among the multiple types of exercise, balance training is the most effective in preventing falls. This study aims to investigate white matter plasticity in healthy elderly population, based on stepwise balance training. Healthy elderly participants will undergo four weeks of balance training. The investigators will analyze longitudinal changes in the microstructural integrity of the white matter tracts pre- and post-training.

Description:

Balance is an essential element of daily living. Balance impairment increases the risk of falling and is associated with a fear of falling and immobility. Balance impairment can ultimately affect the morbidity of cardiovascular disease, cognitive impairment, and mortality, especially in an older population. Among the multiple types of exercise, balance training is the most effective in preventing falls. Specific structures of the brain are highly associated with balance, and the integration of functions from these structures maintains balance function.

Training-induced behavioral changes accompany white matter plasticity. White matter plasticity by practicing expert skills has been of particular interest because characteristic changes in white matter are expected to occur through repetitive and intensive motor skill training. Training-induced white matter plasticity regarding balance is less understood in the healthy adult population. Previous neuroimaging studies have focused on elucidating the cross-sectional associations between balance function and disease-specific characteristics in various clinical populations, such as patients with stroke, traumatic brain injury, Parkinson's disease, and other neurodegenerative diseases.

Developing neuroimaging biomarkers is essential to provide individualized training or rehabilitation intervention and to evaluate its efficacy. Diffusion tensor imaging is a sensitive neuroimaging tool to detect myelin change quantitatively in human white matter in vivo. DTI is used to measure water molecules' diffusion anisotropy, called fractional anisotropy (FA).

This study will explore white matter plasticity in a healthy elderly population which practices stepwise balance training for 4 weeks. The investigators adopt a longitudinal design to contrast the neuroplastic changes in white matter tracts linked to balance function. The investigators hypothesize that balance training would change the microstructural integrity of white matter tracts associated with balance improvement.

Recruitment information / eligibility

• Status: Recruiting
• Enrollment: 40
• Est. completion date: February 29, 2024
• Est. primary completion date: August 31, 2023
• Accepts healthy volunteers: Accepts Healthy Volunteers
• Gender: All
• Age group: 60 Years to 85 Years

Eligibility

Inclusion Criteria:

• Mini-mental state examination = 26

• Independent outdoor ambulator

Exclusion Criteria:

• Men/women with any metal implants in their body

• A prior history of psychopathology or a neurological disorders

• A prior history of osteoporosis, advanced osteoarthritis (K-L grade >=3), surgical history of hip or knee arthroplasty

• If any structural abnormalities are detected on their scan

Related Conditions & MeSH terms

• Elderly Population
• Neuronal Plasticity
• Postural Balance

Intervention

Behavioral:
• Balance training
Step-by-step training (5 levels) 30 minute per training 3 times per week 4 weeks

Locations

Country	Name	City	State
Korea, Republic of	Yeouido St. Mary's Hospital	Seoul	Yeongdeungpo-gu

Sponsors (1)

Lead Sponsor	Collaborator
The Catholic University of Korea

Country where clinical trial is conducted

Korea, Republic of, 

References & Publications (5)

Kim JS, Kim SH, Lim SH, Im S, Hong BY, Oh J, Kim Y. Degeneration of the Inferior Cerebellar Peduncle After Middle Cerebral Artery Stroke: Another Perspective on Crossed Cerebellar Diaschisis. Stroke. 2019 Oct;50(10):2700-2707. doi: 10.1161/STROKEAHA.119.0 — View Citation

Kim Y, Kim SH, Hong BY, Oh J, Chang SY. Integrity of the Inferior Cerebellar Peduncle Correlates with Ambulatory Function after Hemorrhagic Stroke. J Stroke Cerebrovasc Dis. 2021 Dec;30(12):106164. doi: 10.1016/j.jstrokecerebrovasdis.2021.106164. Epub 202 — View Citation

Scholz J, Klein MC, Behrens TE, Johansen-Berg H. Training induces changes in white-matter architecture. Nat Neurosci. 2009 Nov;12(11):1370-1. doi: 10.1038/nn.2412. Epub 2009 Oct 11. — View Citation

Sherrington C, Fairhall NJ, Wallbank GK, Tiedemann A, Michaleff ZA, Howard K, Clemson L, Hopewell S, Lamb SE. Exercise for preventing falls in older people living in the community. Cochrane Database Syst Rev. 2019 Jan 31;1:CD012424. doi: 10.1002/14651858. — View Citation

Surgent OJ, Dadalko OI, Pickett KA, Travers BG. Balance and the brain: A review of structural brain correlates of postural balance and balance training in humans. Gait Posture. 2019 Jun;71:245-252. doi: 10.1016/j.gaitpost.2019.05.011. Epub 2019 May 6. Rev — View Citation

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	Fractional anisotropy of the motor-related white matter tracts	Measurement of the change of DTI-derived parameter before and after balance training; Tracts of interest; Corticospinal tract (CST); Cortico-ponto-cerebellar tract (CPCT); Dentato-rubro-thalamo-cortical tract (DRTCT); Dorsal spinocerebellar tract (DSCT); Measurement of DTI-derived parameter; Fractional anisotropy (FA) values of the CST, CPCT, DRTCT, and DSCT; Units and scoring of the Measurement; FA; No unit.; The measurement ranges from 0 to 1; Higher scores indicate better microstructural integrity.	4 weeks
Primary	Community Balance & Mobility Scale	Performance measure before and after balance training; Measurement; 13 domain; Unilateral stance, Tandem walking, 180° tandem pivot, Lateral foot scooting, Hopping forward, Crouch and walk, Lateral dodging, Walking & looking, Running with controlled stop, Forward to backward walking, Walk look and carry, Descending stairs, Step-ups x 1 step; Scoring of the Measurement; No units.; The measurement ranges from 0 to 96; Higher scores indicate better postural balance and mobility.	4 weeks
Secondary	Mean diffusivity of the motor-related white matter tracts	Measurement of the change of DTI-derived parameter before and after balance training; Tracts of interest; CST; CPCT; DRTCT; DSCT; Measurement of DTI-derived parameter; Mean Diffusivity (MD) values of the CST, CPCT, DRTCT, and DSCT; Units and scoring of the Measurement; MD; mm^2/second; There is no limit on the range (usually ranges 0.00005 - 0.0001 mm^2/second).; Higher scores indicate worse microstructural integrity.	4 weeks
Secondary	Tract volume of the motor-related white matter tracts	Measurement of the change of DTI-derived parameter before and after balance training; Tracts of interest; CST; CPCT; DRTCT; DSCT; Measurement of DTI-derived parameter; Tract volume (TV) values of the CST, CPCT, DRTCT, and DSCT; Units and scoring of the Measurement; TV; mm^3; There is no limit on the range.; Higher scores indicate better microstructural integrity.	4 weeks