To assess properties of neuromuscular reflex performance, viz. reflexive impedance, reflex gain, reflex time delay and reflex gain modulation in patients over 65 with a positive history of falling, compared to an age and sex matched control group
ID
Source
Brief title
Condition
- Movement disorders (incl parkinsonism)
Synonym
Research involving
Sponsors and support
Intervention
Outcome measures
Primary outcome
reflex gain and reflex time delay; reflex modulation from relationship between
damping conditions and reflex gain.
Secondary outcome
body length, length of lower arm and leg, Range of Motion of ankle and wrist,
body weight and maximal voluntary contraction around wrist and ankle, outcome
of falling questionaire, sensibility hand and foot, Tinettiscore (balance and
walking section)
Background summary
Falling in the elderly is of major socio-economical importance due to the
occurrence of hip- and wrist fractures. As reported in literature, one out of
three people over the age of 65, falls at least once a year. We hypothesize
that falling is related to altered reflex chain properties including actuator
(muscle) dynamics and/or impaired adaptation of reflex properties to
environmental conditions.
Study objective
To assess properties of neuromuscular reflex performance, viz. reflexive
impedance, reflex gain, reflex time delay and reflex gain modulation in
patients over 65 with a positive history of falling, compared to an age and sex
matched control group
Study design
Cross- sectional, pilot experiment; assessment of joint impedance of wrist- and
ankle during a maximal posture task by using haptic robots. Application of
linear system identification techniques to separate intrinsic from reflex
impedance using applied force perturbations, resulting joint angle deviations,
torque exertion by the subject and EMG activity of agonist and antagonist
muscles as input signals. Assessment of reflex adaptation by measuring during
increasing environmental viscosity, imposed upon the subject by adjusting
manipulator mechanical behavior.
Study burden and risks
Measurements require concentrated task performance for half- an- hour per joint
(wrist- and ankle) during which perturbations around a neutral joint position
are to be counteracted. During the experiment, the subjects are seated. No
adverse reactions are to be expected. The risks are considered to be minimal.
Postbus 9600
2300 RC Leiden
Nederland
Postbus 9600
2300 RC Leiden
Nederland
Listed location countries
Age
Inclusion criteria
Patients:
Symptomatic fallers (>65) who seek professional assistance for this problem at the outpatient clinic for falling issues of the Geriatric Department of the LUMC. The falling should be judged to be mostly of loco motor origin, not resulting from e.g. cardiovascular diseases, problems in the field of E, N & T, impaired cognition or neurological disorders of central origin;Tinetti score equal or below 10 on the balance section;Controls:
Age- (within one year deviation per patient), sex- and arm dominance- matched; ;Active, high performers, taking part in sports activities, e.g. cycling, swimming, tennis, walking (at least * hour/ week).;Predominantly healthy
Exclusion criteria
Patients:
History of previous or current neurological disorders of central origin, e.g. Parkinson, Multiple Sclerosis or Stroke.;Restricted movement of wrist and/or ankle preventing patient from delivering the required task performance, e.g. recent fractures of wrist and/or ankle.;Restricted vision (< 0.5);Loss of sensibility of hand and/or the foot preventing the patient from delivering the required task performance.;Cognitive impairments (MMSE < 23), preventing the patient from understanding the instructions required for the task that has to be performed.;Other severe co- morbidity preventing patients from delivering the required task performance.;Controls:
Tinetti score below maximal score.;History of previous or current neurological disorders of central origin, e.g. Parkinson, Multiple Sclerosis or Stroke.;Restricted movement of wrist and/or ankle preventing patient from delivering the required task performance, e.g. recent fractures of wrist and/or ankle.;Restricted vision preventing patient from delivering the required task performance.;Loss of sensibility of the foot preventing from delivering the required task performance.;Cognitive impairments (MMSE < 23), preventing the patient from understanding the instructions required for the task that has to be performed.
Design
Recruitment
metc-ldd@lumc.nl
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In other registers
| Register | ID |
|---|---|
| CCMO | NL12319.058.06 |