TENS and Taping for Older People

Study Overview
=================
Brief Summary
-----------------
Aim: To examine the acute effects of transcutaneous electrical nerve stimulation (TENS) and Kinesio Taping (KT) on lower limb joint proprioception, static standing balance, limits of stability and functional balance performance in community-dwelling older adults. Design: A one-group experimental study with a repeated-measures design. Sample: 24+ community-dwelling older adults Interventions: TENS and KT, TENS and sham taping, KT and sham TENS, and sham TENS and sham taping (30 minutes each) Major outcomes: Outcomes will be evaluated during each of the intervention conditions. Lower limb joint active repositioning error will be evaluated using a joint position sense test; a force platform will be used to assess the single-leg standing body sway path length and velocity; a functional reach test will give a score that reflects the limits of stability of the participants; and the timed up-and-go test will be used to quantify functional balance performance of the participants. Anticipated results and significance: It is predicted that both TENS and KT, when applied together, may best improve lower limb joint proprioception and facilitate all balance performances among the community-dwelling older adults. These interventions could be applied in clinical settings to improve joint proprioception and postural control of the elderly people.

Official Title
-----------------
Acute Effects of Transcutaneous Electrical Nerve Stimulation and Kinesio Taping on Lower Limb Joint Proprioception, Static Standing Balance, Limits of Stability and Functional Balance Performance in Community-dwelling Older Adults

Conditions
-----------------
Postural, Defect

Intervention / Treatment
-----------------
* Behavioral: TENS and KT
* Behavioral: TENS and sham taping
* Behavioral: KT and sham TENS
* Behavioral: Sham TENS and sham taping


Participation Criteria
=================
Eligibility Criteria
-----------------
Inclusion criteria: Between 60 and 75 years old Able to ambulate independently and safely without using any walking aid Able to follow instructions Exclusion criteria: Known unstable medical condition (e.g., uncontrolled hypertension) Known sensorimotor or neurological disorders (e.g., stroke and epilepsy) Significant musculoskeletal disorder of the lower limbs (e.g., osteoarthritis of the knee) Cognitive disorder Presence of an implanted electrical device (e.g., cardiac pacemaker) Cancer A change in skin sensation Wound around the lower limb joints A recent injury that may affect test performance Allergy to adhesive tapes

Ages Eligible for Study
-----------------
Minimum Age: 60 Years
Maximum Age: 75 Years

Sexes Eligible for Study
-----------------
All

Accepts Healthy Volunteers
-----------------
Accepts Healthy Volunteers

Study Plan
=================
How is the study designed?
-----------------

Design Details

Primary Purpose: Treatment
Allocation: Non-Randomized
Intervention Model: Factorial Assignment
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: TENS and KT<br>TENS will be applied on the medial and lateral joint lines of the knee and ankle joints and the anterior and posterior joint lines of the hip joint of both legs. In addition, KT will be applied to major postural muscles including the bilateral gluteus medius, quadriceps, and gastrocnemius of the participants. | Behavioral: TENS and KT<br>* TENS will be delivered using three E704SD TIMER TENS devices (or similar) through pairs of electrodes placed on the medial and lateral joint lines of the knee and ankle joints and the anterior and posterior joint lines of the hip joint of both legs. In addition, KT (Kinesio Tex Gold) will be applied to major postural muscles including the bilateral gluteus medius (i.e., crosses hip joint), quadriceps (i.e., crosses the knee joint), and gastrocnemius (i.e., crosses ankle joint) of the participants.<br>|
| Sham Comparator: TENS and sham taping<br>TENS will be applied on the medial and lateral joint lines of the knee and ankle joints and the anterior and posterior joint lines of the hip joint of both legs. In addition, sham tapes will be applied to major postural muscles including the bilateral gluteus medius, quadriceps, and gastrocnemius of the participants. | Behavioral: TENS and sham taping<br>* TENS will be delivered using three E704SD TIMER TENS devices (or similar) through pairs of electrodes placed on the medial and lateral joint lines of the knee and ankle joints and the anterior and posterior joint lines of the hip joint of both legs. In addition, sham tapes will be applied to major postural muscles including the bilateral gluteus medius (i.e., crosses hip joint), quadriceps (i.e., crosses the knee joint), and gastrocnemius (i.e., crosses ankle joint) of the participants.<br>|
| Sham Comparator: KT and sham TENS<br>KT will be applied to major postural muscles including the bilateral gluteus medius, quadriceps, and gastrocnemius of the participants. In addition, sham TENS will be applied on the medial and lateral joint lines of the knee and ankle joints and the anterior and posterior joint lines of the hip joint of both legs. | Behavioral: KT and sham TENS<br>* KT (Kinesio Tex Gold) will be applied to major postural muscles including the bilateral gluteus medius (i.e., crosses hip joint), quadriceps (i.e., crosses the knee joint), and gastrocnemius (i.e., crosses ankle joint) of the participants. In addition, sham TENS will be applied on the medial and lateral joint lines of the knee and ankle joints and the anterior and posterior joint lines of the hip joint of both legs.<br>|
| Sham Comparator: Sham TENS and sham taping<br>Sham TENS will be applied on the medial and lateral joint lines of the knee and ankle joints and the anterior and posterior joint lines of the hip joint of both legs. In addition, sham tapes will be applied to major postural muscles including the bilateral gluteus medius, quadriceps, and gastrocnemius of the participants. | Behavioral: Sham TENS and sham taping<br>* Sham TENS will be applied on the medial and lateral joint lines of the knee and ankle joints and the anterior and posterior joint lines of the hip joint of both legs. In addition, sham tapes will be applied to major postural muscles including the bilateral gluteus medius (i.e., crosses hip joint), quadriceps (i.e., crosses the knee joint), and gastrocnemius (i.e., crosses ankle joint) of the participants.<br>|

What is the study measuring?
-----------------
Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Joint active repositioning test error (using goniometry, in degree) | Lower limb joint proprioception test - Joint active repositioning error of the hip, knee and ankle joints of both lower limbs | Day 1 to Day 4 | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Center of pressure (COP) sway path length in static single-leg standing (using a force platform, in cm) | Static single-leg standing balance performance - COP sway path length in static single-leg standing | Day 1 to Day 4 | 
| Center of pressure (COP) sway velocity in static single-leg standing (using a force platform, in m/s) | Static single-leg standing balance performance - COP sway velocity in static single-leg standing | Day 1 to Day 4 | 
| Functional Reach Test score (using a cloth measuring tape, in cm) | Limits of stability balance performance - Functional Reach Test score | Day 1 to Day 4 | 
| Timed Up-and-Go Test completion time (using a stop watch, in s) | Functional balance performance - Timed Up-and-Go Test completion time | Day 1 to Day 4 |