Elderly Population, Neuronal Plasticity, Postural Balance
Conditions
Keywords
Postural Balance, White Matter, Neuronal Plasticity, Elderly Population, Rehabilitation, Diffusion Tensor Imaging
Brief 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.
Detailed 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.
Interventions
BEHAVIORALBalance training
* Step-by-step training (5 levels) * 30 minute per training * 3 times per week * 4 weeks
Sponsors
The Catholic University of Korea
Study design
Allocation
NA
Intervention model
SINGLE_GROUP
Primary purpose
BASIC_SCIENCE
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
60 Years to 85 Years
Healthy volunteers
Yes
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
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Fractional anisotropy of the motor-related white matter tracts | 4 weeks | Measurement of the change of DTI-derived parameter before and after balance training 1. Tracts of interest * Corticospinal tract (CST) * Cortico-ponto-cerebellar tract (CPCT) * Dentato-rubro-thalamo-cortical tract (DRTCT) * Dorsal spinocerebellar tract (DSCT) 2. Measurement of DTI-derived parameter * Fractional anisotropy (FA) values of the CST, CPCT, DRTCT, and DSCT 3. Units and scoring of the Measurement * FA * No unit. * The measurement ranges from 0 to 1 * Higher scores indicate better microstructural integrity. |
| Community Balance & Mobility Scale | 4 weeks | Performance measure before and after balance training 1. 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 2. Scoring of the Measurement * No units. * The measurement ranges from 0 to 96 * Higher scores indicate better postural balance and mobility. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Mean diffusivity of the motor-related white matter tracts | 4 weeks | Measurement of the change of DTI-derived parameter before and after balance training 1. Tracts of interest * CST * CPCT * DRTCT * DSCT 2. Measurement of DTI-derived parameter * Mean Diffusivity (MD) values of the CST, CPCT, DRTCT, and DSCT 3. 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. |
| Tract volume of the motor-related white matter tracts | 4 weeks | Measurement of the change of DTI-derived parameter before and after balance training 1. Tracts of interest * CST * CPCT * DRTCT * DSCT 2. Measurement of DTI-derived parameter * Tract volume (TV) values of the CST, CPCT, DRTCT, and DSCT 3. Units and scoring of the Measurement * TV * mm\^3 * There is no limit on the range. * Higher scores indicate better microstructural integrity. |
Countries
South Korea
Contacts
Primary ContactYoungkook Kim, MD, PhD
Outcome results
None listed