Gait, Unsteady Clinical Trial
Official title:
Home-based Motor Imagery Intervention for the Improvement of Gait Stability in Elderly Persons. A Cross-over Feasibility Study.
Gait stability is reduced as early as from age 40 to 50. Gait stability can be improved in
patients with neurological diseases or in healthy elderly persons with exercises.
There is evidence that mental practice, also called motor imagery, the imagination of
performing a movement, can also improve an activity or balance. The effective performance and
the imagination of a task activates some overlapping central areas and neural networks, which
might explain the improvements after motor imagery.
The investigators set out to test the feasibility of such a study using an open label
randomized cross-over trial including 32 persons aged 40 years or more. The primary aim is to
evaluate whether the instructions are clear, the intervention and the study procedures are
acceptable and to assess the proportion of participants withdraw from the study (drop outs).
Secondary aims are the assessment of between group differences in the changes of the gait
stability.
Gait stability is reduced as early as from age 40 to 50. Gait stability can be improved in
patients with neurological diseases or in healthy elderly persons with exercises.
There is evidence that mental practice, also called motor imagery, the imagination of
performing a movement, can also improve an activity or balance. The effective performance and
the imagination of a task activates some overlapping central areas and neural networks, which
might explain the improvements after motor imagery.
These "non-physical kind of training" modalities could be used in patients who are
immobilized temporarily (bedridden because of non-chronic disease, infection etc.), or in
those who are not allowed to charge their leg normally (e.g. postoperative phase of joint
replacement or fractures), or it can be used in combination with physical exercises, or in
the preparation of the physical exercise training (either skilling up phase or as a
preparation to increase safety of physical exercises). In persons above 40 years of age,
motor imagery could provide a sound exercise modality for tasks that are not easy to perform
with real performance. For example, walking on slippery underground such as ice, walking on a
small trail in some altitude, avoiding running dogs or cats on a sidewalk, or catching up
after stumbling can be either difficult to exercise in reality or might be too dangerous in
reality. Imaging one's performance in such difficult environments or situations might lead to
better gait stability, improved reactions in these situations and thus probably to reduced
falls frequency.
Gait stability can be estimated with the local dynamic stability, which is based on chaos
theory, i.e. the maximal Lyapunov exponent, is strongly influenced by the sensorimotor
balance system and is widely used for measuring gait stability.
In the future, the investigators plan a large scale randomized open label cross-over study to
test whether nine sessions of motor imagery improve walking stability, measured with the
Lyapunov Exponent.
To prepare this future study, the investigators set out to test the feasibility of such a
study with a feasibility study using an open label randomized cross-over trial including 32
persons aged 40 years or more. The primary aim is to evaluate whether the instructions are
clear, the intervention and the study procedures are acceptable and to assess the proportion
of participants withdraw from the study (drop outs). Secondary aims are the assessment of
between group differences in the changes of the gait stability.
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