The present study aims to assess sensory weights and reweighting in healthy elderly and elderly with polyneuropathy, visual impairments or balance disorders compared to young healthy adults.
ID
Source
Brief title
Condition
- Hearing disorders
- Muscle disorders
- Movement disorders (incl parkinsonism)
Synonym
Research involving
Sponsors and support
Intervention
Outcome measures
Primary outcome
The primary study parameters are the sensory weights of the proprioceptive
information. The change of the sensory weights over the conditions with
increasing perturbation amplitude of the proprioceptive information is a
measure of sensory reweighting. The sensory reweighting can be represented by
the slope of the relation proprioceptive weight and perturbation amplitude
increase. Both, the proprioceptive reweighting of the left and right leg are
calculated.
Secondary outcome
The outcomes of the tests performed in the diagnostic street of the Bronovo
geriatrics Treatment Advice Center are secondary outcome measures of the
present study:
* Length, arm span, waist size, hip size and stand width
* Muscle mass by Bio Impedance Analysis (BIA)
* Hand grip strength by a hand held dynamometer
* Isometric quadriceps strength
* Visus, propriocepsis and vestibular function
* Short Physical Performance Battery
* Balance tests with closed eyes
* Time up and go with and without a cognitive tasks
* Walking speed during 10 meter walking test with and without cognitive task
* Blood pressure after 5 minutes rest in supine position and after 1 minute and
3 minutes during stance
* Cardiac output measured using a finometer
Background summary
The main cause of mobility disorders in elderly are balance deficits. In
balance several systems are involved, like muscles, proprioception, vision and
the vestibular organ and the sensory integration and processing. Balance
deficits are caused by dysfunction of one or more of these systems. The
information of the sensory systems is combined according to the sensory
reweighting hypothesis. When one of the systems is malfunctioning or disturbed,
the information of this system is considered less reliable and relatively
ignored compared to information from the other systems contributing to balance
control. To identify the function of each system, system identification
techniques are used. The sensory weights of the sensory systems can be
estimated. By perturbing a sensory system with increasing amplitudes, the
information from that particular system becomes less reliable and sensory
weighting is tuned down (reweighting). Changes in sensory function due to aging
could result in a change in sensory weights and reweighting between healthy
young adults and older adults and older adults without balance disorders.
Study objective
The present study aims to assess sensory weights and reweighting in healthy
elderly and elderly with polyneuropathy, visual impairments or balance
disorders compared to young healthy adults.
Study design
This study has a cross-sectional design. A bilateral ankle perturbator (BAP)
will be implemented as much as possible in the regular clinical care in the
Bronovo geriatrics Treatment Advice Center, The Hague. Besides the standard
tests for diagnosis of mobility disorders, tests with the BAP will be performed
after initial screening of the in- and exclusion criteria and obtaining
informed consent.
Study burden and risks
During the experiments with the BAP the patient has to perform an active task.
To avoid fatigue the patient can rest during the experiments.
The risk of the measurements is minimally. No invasive procedures are included.
Safety is performed by software and hardware of the device. The patient wears a
safety harness during the measurement to avoid falling.
Postbus 9600
2300 RC Leiden
NL
Postbus 9600
2300 RC Leiden
NL
Listed location countries
Age
Inclusion criteria
- aged between 20 and 30 years.
- aged 75 years or older, free living, ADL independent.
- aged 75 years or older with a known polyneuropathy diagnosed in the past five years.
- aged 75 years or older with a known visual impairment due to cataract
- aged 75 years or older and not possible to stand 10 seconds in semi-tandem stance
Exclusion criteria
- Patients unable to give a personal consent;
- Walking distance 250m or less;
- MMSE 23 or lower;
- GDS 5 or higher;
- Institutionalized;
- Comorbidity: neurological disorders (stroke, M. Parkinson, dementia, muscle disease), metabolic diseases (diabetes mellitus), arthritis: rheumatoid arthritis, severe (pain and functional limitation) osteoarthritis (hip and knee), cancer: diagnosis and treatment of cancer within the last year, polymyalgia rheumatic, heart failure (NYHA 3-4), COPD (Gold 3-4), chronic pain syndrome (fibromyalgia, complex regional pain syndrome etc);
- Medication: immunosuppressive drugs (e.g. prednisone, methotrexat, biologicals (TNF-alpha antagonists etc)), insulin
- Hip or knee replacement;
- Amputation;
- Immobilization for 1 week or longer during the last 3 months;
- Severe visual (visus < 0.6) and/or hearing impairment.
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 | NL37674.058.11 |