Aquatic Exercise and Reactive Balance

Study Overview
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Brief Summary
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The present clinical trial aims to identify if skills acquired during aquatic exercise are more effectively transferred to a reactive balance task than land exercise. This study is designed as a double-blinded, randomized controlled clinical trial. Forty-four older adults aged 60 years or above who meet the eligibility criteria will be recruited and randomized into an aquatic exercise group or land exercise group. Each group will participate in the same balance training exercise during a single session that includes a ball throwing and catching task. A modified lean-and-release test will be implemented on land immediately before, after, and one week after the training session. The outcomes will include reaction time, rapid response accuracy, and mini-BESTest scores obtained from stepping and grasping reactions.

Detailed Description
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During the modified lean-and-release test, there are two possible settings: 1) the leg block is placed in front of both legs, and a safety handle is uncovered; or 2) the leg block is removed, and the safety handle is covered. The leg block and handle cover will be controlled via computer-triggered, servo motors. The testing session will be comprised of three blocks: 1) REACH (grasping a safety handle using their right hand while maintaining both feet fixed), 2) STEP (stepping forward using any leg), and 3) RANDOM (random variations of STEP and REACH).

Official Title
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Catching and Throwing Exercises to Improve Reactive Balance: A Randomized Controlled Trial Protocol for the Comparison of Aquatic and Dry-land Training Environments

Conditions
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Aging, Aged, Accidental Falls, Postural Balance, Exercise, Exercise Therapy

Intervention / Treatment
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* Other: Exercise intervention


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Ability to stand using a double-leg stance for one minute of time Ability to walk independently Normal or corrected to normal vision Normal or corrected to normal hearing based on a qualitative assessment Exclusion Criteria: Any neurological or musculoskeletal disorders that may inhibit the participation in the training and testing protocols A concussion within the past one year before the participation Any cognitive deficiencies (e.g., memory, concentration, or attention disorder) One or more 'yes' answered on the Physical Activity Readiness Questionnaire (PAR-Q) Fear of water

Ages Eligible for Study
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Minimum Age: 65 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Prevention
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Double


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Aquatic Exercise group<br>Participants will engage in a single session of training consisting of 120 repetitions of a ball throwing and catching task in water. | Other: Exercise intervention<br>* A ball catching and throwing exercise.<br>|
| Active Comparator: Land Exercise group<br>Participants will engage in a single session of training consisting of 120 repetitions of a ball throwing and catching task on dry land. | Other: Exercise intervention<br>* A ball catching and throwing exercise.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Reaction time measures (REACH) | Hand contact time during REACH following the cable release will be calculated. | Immediately before the intervention. Duration of each assessment will be 15 minutes. | 
| Reaction time measures (STEP1) | Foot-off time during STEP following the cable release will be calculated. | Immediately before the intervention. Duration of each assessment will be 15 minutes. | 
| Reaction time measures (STEP2) | Foot contact time during STEP following the cable release will be calculated. | Immediately before the intervention. Duration of each assessment will be 15 minutes. | 
| Rapid response accuracy | For the RANDOM block, response accuracy, defined as the percentage of accurate responses, will be calculated. To represent a composite measure of accuracy and speed of response, rapid response accuracy will be calculated using the ratio of response accuracy to the reaction time (%/ms). Foot-off and hand contact data will be used for the calculation. | Immediately before the intervention. Duration of each assessment will be 15 minutes. | 
| Mini-Balance Evaluation Systems Test | During the REACH, STEP, and RANDOM blocks, the quality of the compensatory reactions will be scored using the Reactive Postural Control section of the Mini-Balance Evaluation Systems Test. The scores will be ranged from 0 (worst) to 2 (best). | Immediately before the intervention. Duration of each assessment will be 15 minutes. | 
| Reaction time measures (REACH) | Hand contact time during REACH following the cable release will be calculated. | Immediately after the intervention. Duration of each assessment will be 15 minutes. | 
| Reaction time measures (STEP1) | Foot-off time during STEP following the cable release will be calculated. | Immediately after the intervention. Duration of each assessment will be 15 minutes. | 
| Reaction time measures (STEP2) | Foot contact time during STEP following the cable release will be calculated. | Immediately after the intervention. Duration of each assessment will be 15 minutes. | 
| Rapid response accuracy | For the RANDOM block, response accuracy, defined as the percentage of accurate responses, will be calculated. To represent a composite measure of accuracy and speed of response, rapid response accuracy will be calculated using the ratio of response accuracy to the reaction time (%/ms). Foot-off and hand contact data will be used for the calculation. | Immediately after the intervention. Duration of each assessment will be 15 minutes. | 
| Mini-Balance Evaluation Systems Test | During the REACH, STEP, and RANDOM blocks, the quality of the compensatory reactions will be scored using the Reactive Postural Control section of the Mini-Balance Evaluation Systems Test. The scores will be ranged from 0 (worst) to 2 (best). | Immediately after the intervention. Duration of each assessment will be 15 minutes. | 
| Reaction time measures (REACH) | Hand contact time during REACH following the cable release will be calculated. | One week after the intervention. Duration of each assessment will be 15 minutes. | 
| Reaction time measures (STEP1) | Foot-off time during STEP following the cable release will be calculated. | One week after the intervention. Duration of each assessment will be 15 minutes. | 
| Reaction time measures (STEP2) | Foot contact time during STEP following the cable release will be calculated. | One week after the intervention. Duration of each assessment will be 15 minutes. | 
| Rapid response accuracy | For the RANDOM block, response accuracy, defined as the percentage of accurate responses, will be calculated. To represent a composite measure of accuracy and speed of response, rapid response accuracy will be calculated using the ratio of response accuracy to the reaction time (%/ms). Foot-off and hand contact data will be used for the calculation. | One week after the intervention. Duration of each assessment will be 15 minutes. | 
| Mini-Balance Evaluation Systems Test | During the REACH, STEP, and RANDOM blocks, the quality of the compensatory reactions will be scored using the Reactive Postural Control section of the Mini-Balance Evaluation Systems Test. The scores will be ranged from 0 (worst) to 2 (best). | One week after the intervention. Duration of each assessment will be 15 minutes. | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Reactive balance, Aquatic exercise, Aquatic therapy, Fall prevention