Spinal Networks of Balance Learning and Retention in Older Adults
Upregulating Spinal Circuits to Enhance Balance and Walking and to Increase Spinal Excitability in Older Adults
University of Florida
30 participants
Jan 22, 2025
INTERVENTIONAL
Conditions
Summary
Age-related balance and walking issues increase fall risks, leading to injuries, higher healthcare costs, reduced quality of life, and increased morbidity/mortality rates. Preserving functional ability is a crucial public health priority, with the potential to reduce healthcare costs and enhance older adults' quality of life. Declines in balance and walking ability threaten independence. These declines are attributed to spinal network impairments and may be mitigated by targeted interventions aimed at addressing age-related spinal cord impairment to enhance functional outcomes. However, there is a lack of research into how the aging spinal cord affects balance/walking. In older adults, the spinal cord is less excitable, conducts signals more slowly, and is subject to neural noise. Intervening on age-related impairment of the spinal cord to improve balance/walking ability is a very promising but untapped area of research. A therapeutic approach that combines dynamic balance training with non-invasive electrical spinal stimulation may be effective in preserving functional abilities. This study tests whether electrical stimulation of the spinal lumbar regions is more beneficial than sham stimulation.
Eligibility
Inclusion Criteria6
- age range: 65 to 95 years
- no severe high blood pressure: Resting systolic < 180 mmHg and diastolic < 100 mmHg
- no severe vision impairment: Visual acuity ≥ 20/70 as determined by Snellen eye chart
- walking problem: Preferred walking speed slower than 1.0 m/s over 10 meters
- balance problem: Berg Balance Scale score < 45
- no cognitive impairment: Montreal Cognitive Assessment (MoCA) score ≥ 26 out of 30
Exclusion Criteria13
- diagnosed neurological disorder or injury of the central nervous system, or observation of symptoms consistent with such a condition (Alzheimer's, Parkinson's, stroke, etc.)
- severe arthritis, such as awaiting joint replacement
- current cardiovascular, lung or renal disease; untreated diabetes; terminal illness
- myocardial infarction or major heart surgery in the previous year
- cancer treatment in the past year, except for nonmelanoma skin cancers and cancers having an excellent prognosis (e.g., early stage breast or prostate cancer)
- current diagnosis of schizophrenia, other psychotic disorders, or bipolar disorder
- currently taking medications that affect the central nervous system, such as benzodiazepines, anti-cholinergic medication, and GABAergic medication, among others
- uncontrolled hypertension at rest (systolic > 180 mmHg and/or diastolic > 100 mmHg)
- bone fracture or joint replacement in the previous six months
- current enrollment in any other clinical trial
- planning to relocate out of the area during the study period
- non-English* speaking, due to the likelihood of difficulties following instructions and communicating remotely
- clinical judgment of the investigative team
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Interventions
Complex balance task involving static and dynamic weight shifting and coordinated stepping
Active tsDCS over lumbar regions
Sham tsDCS over lumbar regions
Locations(1)
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NCT06517043