Motor Imagery Intervention for Improving Gait and Cognition in the Elderly

Albert Einstein College of Medicine

Status: Completed

Conditions: Motor Activity

Treatments: Behavioral: Imagined Gait Intervention; Behavioral: Visual Imagery Intervention

Study type: Interventional

Funder types: Other; NIH

Identifiers

NCT02762604

KL2TR001071 (U.S. NIH Grant/Contract)

2014-3633

K01AG049829 (U.S. NIH Grant/Contract)

Details and patient eligibility

About

The investigators propose a single-blind randomized clinical trial to determine if seniors show improved mobility (walking speed) and cognition following motor imagery (imagined walking) training. They hypothesize that imagined walking can be used as a rehabilitative tool for improving walking speed and cognition in the elderly, because it engages and strengthens similar neural systems as actual walking and cognition.

Full description

The proposed research aims to establish the efficacy of an imagined gait protocol for improving gait and cognition in the elderly. This imagined gait protocol involves imagined gait in single (imagined walking; iW) and dual-task (imagined walking while talking; iWWT) situations. A single-blind randomized clinical trial of 58 cognitively-healthy elderly with pre-post measures of gait, cognition, and functional Magnetic Resonance Imaging (fMRI) during imagined gait is proposed. The overall hypothesis is that imagined gait can be used as a rehabilitative tool for improving gait and cognition in the elderly because it engages and strengthens similar neural systems as actual gait and cognition. The first aim of this study is to establish the efficacy of our imagined gait protocol to improve gait and cognition in the elderly. We predict that our imagined gait intervention will improve gait velocity during actual walking and walking-while-talking conditions to a greater extent than the active control (visual imagery) intervention. We also predict that our imagined gait intervention will cognitive performance during dual-task walking conditions. The second aim of this study is to determine neuroplasticity changes in response to our imagined gait protocol. We predict that the neural systems engaged during imagined gait will change following our imagined gait intervention.

Enrollment: 49 patients

Sex: All

Ages: 65 to 85 years old

Volunteers: Accepts Healthy Volunteers

Inclusion criteria

• Adults between 65 and 85 years and older, residing in the community.
• Able to speak English at a level sufficient to undergo study procedures.
• Plan to be in the area for the next 3 months.

Exclusion criteria

• Presence of dementia (telephone-based memory impairment screen < 5 or Ascertain Dementia 8-item Informant Questionnaire score > 1)
• Presence of gait disorder diagnosed by clinician (e.g. neuropathy).
• Any medical condition or chronic medication use (e.g. neuroleptics) that will compromise safety or affect cognitive functioning.
• Terminal illness with life expectancy <12 months.
• Progressive, degenerative neurologic disease (e.g. Parkinson's disease, ALS).
• Major psychiatric disorders such as Schizophrenia.
• Pacemaker or any permanent metal implants like hip prosthesis (other than tooth fillings) and claustrophobia.

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Single Blind

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49 participants in 2 patient groups

Imagined Gait Intervention

Experimental group

Description:

During the phone-based imagined gait intervention, participants will be called by the experimenter three times a week and be asked to imagine walking, imagine talking and imagine walking-while-talking. They will also be asked to rate their visual and kinesthetic qualities of their images on a 1-5 scale following each trial.

Treatment:

Behavioral: Imagined Gait Intervention

Visual Imagery Intervention

Active Comparator group

Description:

During the phone-based visual imagery intervention, participants will be called three times a week by the experimenter and be asked to imagine concrete objects (e.g. octopus, teapot, and shovel). They will also be asked to rate their visual qualities of their images on a 1-5 scale following each trial.

Treatment:

Behavioral: Visual Imagery Intervention