Primary Objective: To determine if spinal and cortical balance control mechanisms mediate the age-associated decline inbalance skills.Secondary Objective: To determine the reliability of TMS and H-reflex measures in the soleus muscle in different…
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Brief title
Condition
- Other condition
Synonym
Health condition
Veroudering
Research involving
Sponsors and support
Intervention
Outcome measures
Primary outcome
The main study parameters are the size of the short-interval intracortical
inhibition (SICI), the amount of EMG suppression after subthreshold TMS and
Hmax/Mmax ratio. SICI is the inhibition of the test motor evoked potential
(MEP), when the suprathreshold TMS pulse (the test stimulus) is preceded by a
few milliseconds with a subthreshold TMS pulse (the conditioning stimulus).
SICI and EMG suppression are measures of motor cortical inhibition, and can
thus be used to examine cortical influences. The Hmax/Mmax ratio, on the
contrary, is a measure of the spinal influences.
Secondary outcome
The secondary study parameters is the Multiscale Entropy (MSE) complexity index
of the CoP.
Background summary
Over 1/3 of individuals age 65 and older falls each year. A better
understanding of neural, especially cortical and corticospinal,
mechanisms of balance control would help to design more accurate balance
assessments and treatments. With the combination
of H-reflex and transcranial magnectic stimulataion (TMS) measures it is now
possible to determine the role of cortical and spinal
control of balance. For example, Tokuno et al. (2009) have shown that motor
cortical excitability increases, while the excitability
of the spinal motor neuron pool decreases, in normal versus supported standing.
We are interested in how age affects cortical
and spinal control mechanisms of balance.
Study objective
Primary Objective: To determine if spinal and cortical balance control
mechanisms mediate the age-associated decline in
balance skills.
Secondary Objective: To determine the reliability of TMS and H-reflex measures
in the soleus muscle in different standing
postures.
.
Study design
The primary objective will be investigated using a cross-sectional design,
comparing young versus older adults. Reliability will be
investigated with a test-retest design.
Intervention
During the experiment participants undergo TMS and peripheral nerve
stimulation, while they are standing in different postures.
These different postures are:
- Leaning forward 80% of the maximum with feedback of the center of pressure
position
- Leaning forward 80% of the maximum with support of a wall while contracting
the soleus muscle
- Sitting while contracting the soleus muscle
- Standing on a rigid platform with eyes open
- Standing on a rigid platform with eyes closed
- Standing on a platform that gently tilts forward with eyes open
- Standing on a platform that gently tilts forward with eyes closed
Study burden and risks
Subjects have to visit the Center for Human Movement Sciences one or two times
within one week (dependent on the study).
One testing session will last for maximal two hours, in which they will have to
stand for a total of about one hour. Resting periods
of 2-3 minutes are given as needed. A longer resting period of 10 minutes is
built in between the TMS and H-reflex data
collection. Participation in this study comprises electrical stimulation of the
tibial nerve and magnetic stimulation of the motor
cortex during standing. The TMS may cause slight discomfort lasting less than a
second on the scalp near the coil. It may also
cause some twitching of the muscles, the face and jaw, which may be unpleasant
and surprising but not painful. Peripheral nerve
stimulation causes the muscles to twitch that can be more surprising than
painful. It can cause some momentary burning and
tingling sensation. There are no known long-term risks of peripheral nerve or
magnetic brain stimulation. Subjects wear a
harness that is attached to the ceiling to minimize any risk of falling.
Electromyography (EMG) of the soleus and tibialis anterior
muscles will be recorded. Therefore the skin underneath the three electrodes
will be shaved and cleaned. This may cause some
light irritation of the skin.
Antonius Deuslinglaan 1
Groningen 9700AD
NL
Antonius Deuslinglaan 1
Groningen 9700AD
NL
Listed location countries
Age
Inclusion criteria
Young group:
(1) Age 18 - 35 years ;Older group:
(1) Age 65 years or older
Exclusion criteria
(1) Neurological disorders
(2) Not able to stand independently for 10 minutes without rest
(3) Pro-epileptogenic medications or medications known to affect balance
(4) Epilepsy
(5) Any metal in the brain/skull
(6) Pregnancy or suspicion of pregnancy (self-reported)
Design
Recruitment
Followed up by the following (possibly more current) registration
No registrations found.
Other (possibly less up-to-date) registrations in this register
No registrations found.
In other registers
| Register | ID |
|---|---|
| CCMO | NL40988.042.12 |