Neuromodulation for Exercise Adherence

Description

Lack of adherence to an exercise program is a major problem for older Veterans. Several fall prevention programs fail in the home setting due to lack of adherence. Exercise adherence is dependent on brain function among other factors. Magnetic stimulation of the front part of the brain improves brain function necessary for planning and following-through. The investigators propose a three-phase study in 106 sedentary older Veterans. Everyone will be trained on use of the exergame, Nintendo Wii-Fit, that the investigators' team has found beneficial in improving balance and gait. They will be asked to exercise using Wii-Fit at home for 45 minutes daily five days/week for 12-weeks. Those that exercise less than recommended dose and those that exercise adequately but have low executive function will receive either real or sham magnetic stimulation to the front part of their brain over ten sessions paired with exercise training. All subjects will further complete 24-weeks of Wii-Fit home exercises. Adherence, executive function, balance and gait, self-efficacy, delay discounting, and falls will be measured periodically.

Conditions

Executive Dysfunction, Poor Exercise Adherence

Study Overview

Study Details

Study overview

Lack of adherence to an exercise program is a major problem for older Veterans. Several fall prevention programs fail in the home setting due to lack of adherence. Exercise adherence is dependent on brain function among other factors. Magnetic stimulation of the front part of the brain improves brain function necessary for planning and following-through. The investigators propose a three-phase study in 106 sedentary older Veterans. Everyone will be trained on use of the exergame, Nintendo Wii-Fit, that the investigators' team has found beneficial in improving balance and gait. They will be asked to exercise using Wii-Fit at home for 45 minutes daily five days/week for 12-weeks. Those that exercise less than recommended dose and those that exercise adequately but have low executive function will receive either real or sham magnetic stimulation to the front part of their brain over ten sessions paired with exercise training. All subjects will further complete 24-weeks of Wii-Fit home exercises. Adherence, executive function, balance and gait, self-efficacy, delay discounting, and falls will be measured periodically.

Neuromodulation for Exercise Adherence in Older Veterans

Neuromodulation for Exercise Adherence

Condition
Executive Dysfunction
Intervention / Treatment

-

Contacts and Locations

North Little Rock

Central Arkansas Veterans Healthcare System Eugene J. Towbin Healthcare Center, Little Rock, AR, North Little Rock, Arkansas, United States, 72114-1706

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

For general information about clinical research, read Learn About Studies.

Eligibility Criteria

  • * Sedentary Community Dwelling Veterans age 60 years
  • * Have TV at home
  • * Subjects reporting spending long periods of time in sedentary behavior by answering affirmatively to the question: 'For most days, do you feel you sit for too long (6-8 hours or more a day)?
  • * Some examples might include when watching TV, working at the computer / laptop or when doing sitting-based hobbies such as reading and sewing' will be included
  • * Those that participate in regular physical activity for at least 30 minutes five or more days of the week
  • * Use of wheel chair for mobility
  • * Cognitive impairment \[Montreal Cognitive Assessment (MoCA \< 26)\]
  • * Weight 325 lbs. (weight restriction of the Wii-Board)
  • * Absolute contraindications to exercise per The American College of Sports Medicine guidelines
  • * Those with medical conditions that in the opinion of the study physician are likely to compromise safe participation
  • * Taking medications known to increase risk of seizures from 2012 Beers criteria such as bupropion, chlorpromazine, clozapine.
  • * Taking other medications known to increase risk of seizures such as tricyclic antidepressants.
  • * Taking ototoxic medications: Aminoglycosides, CisplatinHistory of seizures/ seizures in first degree relatives
  • * Those with implanted device
  • * History of stroke, aneurysm, or cranial neurosurgery
  • * History of bipolar disorder
  • * History of abnormal electroencephalogram (EEG)

Ages Eligible for Study

60 Years to

Sexes Eligible for Study

ALL

Accepts Healthy Volunteers

Yes

Collaborators and Investigators

VA Office of Research and Development,

Kalpana P Padala, MD MS, PRINCIPAL_INVESTIGATOR, Central Arkansas Veterans Healthcare System Eugene J. Towbin Healthcare Center, Little Rock, AR

Study Record Dates

2025-01-31