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

Universiteit Antwerpen

Status: Enrolling

Conditions: Postural Balance; Accidental Fall; Gait; Aged

Treatments: Diagnostic Test: Frailty; Other: Follow up; Other: Biomechanical movement analysis; Diagnostic Test: Sensory function; Diagnostic Test: Cognition; Other: Screening

Study type: Observational

Funder types: Other

Identifiers

NCT06345625

6012 (Other Identifier)

Details and patient eligibility

About

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.

Full description

Older adults above 65 years old experience falls at a rate of 20-40% annually, with women being more affected than men. Unintentional falls are the second leading cause of accidental injury death and a major contributor to disability levels worldwide. Falls pose an even bigger burden on society in the future due to the increasing number of older adults and the higher prevalence of falls as people age. Gait and balance instability are major risk and causative factors for falls in older adults. As people age, their stability decreases. This is evident in the careful way that older adults walk. To prevent and predict falls, it is essential to understand how humans maintain their stability during locomotor activities.

Balance disruptions are typically not caused by walking itself, but rather by internal or external disturbances or the performance of multiple tasks simultaneously. In daily life, people often face complex situations that require high levels of sensory input and cognitive processing. This can be especially challenging when also trying to maintain a safe walking pattern, such as when checking the environment before crossing the street. This task requires coordinated movement of both the head and eyes to track moving objects. Gaze control requires accurate cognitive processing, including multisensory integration, attention, executive functioning, and motor responses to coordinate eye and head movements.

Older adults use different strategies than younger adults to control head movement for stabilizing their head during walking. Therefore, changes in head position may affect gait stability differently in older adults. Ageing can cause frailty, decline in sensorimotor and cognitive abilities, and a reduced capacity to adjust gait to changing environments. These changes may increase the risk of falls in older adults. However, research on these issues is currently insufficient.

Enrollment: 100 estimated patients

Sex: All

Ages: 65 to 100 years old

Volunteers: Accepts Healthy Volunteers

Inclusion criteria

• Community dwelling
• an age of 65 years or above

Exclusion criteria

• 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 design

100 participants in 2 patient groups

Fallers

Description:

Community dwelling older adults with an age above 65 years. A participant is categorized as faller in case of a history of ≥2 falls in the previous 12 months and with identified high fall risk on the TUG (i.e., completion time ≥13.5 seconds). A fall is defined as an event that results in a person coming to rest inadvertently on the ground/floor/other lower level (WHO, 2021). Asyncopal fall, identified through the report of a loss of consciousness during the fall, has a different etiology and therefore will not be counted as a fall (Ang et al., 2020).

Treatment:

Diagnostic Test: Frailty

Other: Follow up

Other: Screening

Other: Biomechanical movement analysis

Diagnostic Test: Cognition

Diagnostic Test: Sensory function

Non-Fallers

Description:

Community dwelling older adults with an age above 65 years. A participant is included as non-faller in case of a history of 0 falls in the previous 12 months and without an identified fall risk on the TUG test (i.e., completion time ≤13.5 seconds).

Treatment:

Diagnostic Test: Frailty

Other: Follow up

Other: Screening

Other: Biomechanical movement analysis

Diagnostic Test: Cognition

Diagnostic Test: Sensory function