RECRUITING

Increasing Gait Automaticity in Older Adults by Exploiting Locomotor Adaptation

Study Overview

This clinical trial focuses on testing the efficacy of different digital interventions to promote re-engagement in cancer-related long-term follow-up care for adolescent and young adult (AYA) survivors of childhood cancer.

Description

The investigators will test the following: 1) the extent of locomotor adaptation improvement in individuals aged 65 years and older; 2) the association between initial walking automaticity (i.e. less PFC activity while walking with a cognitive load) and prefrontal-subcortical function (measured via neuropsychological testing); and 3) whether improvements in locomotor adaptability result in improvements in the Functional Gait Assessment (FGA), a clinically relevant indicator of dynamic balance and mobility in older adults. To answer these questions, the investigators will combine innovative techniques from multiple laboratories at the University of Pittsburgh. Automatic motor control (Dr. Rosso's expertise) will be assessed by wireless functional near-infrared spectroscopy (fNIRS) of the PFC during challenged walking conditions (walking on an uneven surface and walking while reciting every other letter of the alphabet). fNIRS allows for real-time assessment of cortical activity while a participant is upright and moving by way of light-based measurements of changes in oxygenated and deoxygenated hemoglobin. Locomotor adaptation (Dr. Torres-Oviedo's expertise) will be evaluated with a split-belt walking protocol (i.e., legs moving at different speeds) that the investigators and others have used to robustly quantify motor adaptation capacity in older individuals and have shown to be reliant on cerebellar and basal ganglia function. The investigators will focus on two important aspects of locomotor adaptation that the investigators have quantified before: (Aim 1) rate at which individuals adapt to the new (split) walking environment and (Aim 2) capacity to transition between distinct walking patterns (i.e., the split-belt and the overground walking patterns), defined as motor switching. Adaptation rate and motor switching are quantified using step length asymmetry, which is the difference between a step length taken with one leg vs. the other. The investigators will focus on this gait parameter because it robustly characterizes gait adaptation evoked by split-belt walking protocols. Finally, the investigators will quantify participant's cognitive function (Dr. Weinstein's expertise) through neuropsychological battery sensitive to prefrontal-subcortical function. The investigators will mainly focus on evaluating 1) learning capacity reliant on cerebellar structures and 2) assessing executive function heavily reliant on PFC and, to a lesser extent, the basal ganglia.

Official Title

Locomotor Adaptability for Community Mobility of Older Adults: The Role of Gait Automaticity

Quick Facts

Study Start:2021-11-08
Study Completion:2025-06-01
Study Type:Not specified
Phase:Not Applicable
Enrollment:Not specified
Status:RECRUITING

Study ID

NCT04934956

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.

Ages Eligible for Study:65 Years
Sexes Eligible for Study:ALL
Accepts Healthy Volunteers:Yes
Standard Ages:OLDER_ADULT
Inclusion CriteriaExclusion Criteria
  1. * 65 years old or older.
  2. * Body Mass Index of 35 or less. Muscle activities will be recorded for distinct muscles in the legs and fatty tissue could interfere with these measurements.
  3. * Able to walk without a hand held device
  4. * Able to walk for 5 minutes at their self-paced speed
  1. * Any past or present history of neurological disorders, heart or respiratory disease, brain injury, seizures, spinal cord surgery, or strokes.
  2. * Pregnancy.
  3. * Unable to follow two part commands;
  4. * Uncorrected vision or severe visual impairment with visual acuity \< 20/70 with best correction;
  5. * Cognitive impairments defined as modified mini-mental score \<84;
  6. * orthopedic or pain conditions (lower extremity pain, back pain, calf pain);
  7. * refuse to walk on a treadmill;
  8. * hospitalized 6 months prior to the study for acute illness or surgery, other than minor surgical procedures;
  9. * lower extremity orthopedic surgery within 1 year;
  10. * uncontrolled hypertension (\> 190/110 mmHg);
  11. * diagnosed dementia;
  12. * dyspnea at rest or during daily leaving activities;
  13. * use supplemental oxygen, resting heart rate\> 100 or \<40 beats per minute;
  14. * fixed or fused hip, knee, or ankle joints;
  15. * progressive movement disorder such as Multiple Sclerosis (MS), Amyotrophic Lateral Sclerosis (ALS), or Parkinson's disease

Contacts and Locations

Study Contact

Gelsy Torres-Oviedo, Ph.D.
CONTACT
412-624-2660
gelsyto@pitt.edu

Principal Investigator

Gelsy Torres-Oviedo, Ph.D.
PRINCIPAL_INVESTIGATOR
University of Pittsburgh

Study Locations (Sites)

Sensorimotor Learning Laboratory, Schenley Place Suite 110
Pittsburgh, Pennsylvania, 15213
United States

Collaborators and Investigators

Sponsor: University of Pittsburgh

  • Gelsy Torres-Oviedo, Ph.D., PRINCIPAL_INVESTIGATOR, University of Pittsburgh

Study Record Dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Registration Dates

Study Start Date2021-11-08
Study Completion Date2025-06-01

Study Record Updates

Study Start Date2021-11-08
Study Completion Date2025-06-01

Terms related to this study

Additional Relevant MeSH Terms

  • Community Mobility of Older Adults
  • Locomotor Adaptability
  • Gait Automaticity