Effect of Nervous System Mobilization on Older Adults' Postural Control

Study Overview
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Brief Summary
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This study aims to compare the effectiveness of nervous system mobilization and exercise with exercise only on institutionalized older adults' postural control.

Detailed Description
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It is anticipated that 26 institutionalized older adults will be randomly allocated to receive either exercise and neural mobilization (n=13) or exercise only (n=13). Data on pain intensity (a vertical numeric rating scale) and location (body chart), depression (Geriatric Depression Scale), balance, hand grip strength, timed up and go and gait velocity will be collected at baseline, end of treatment and at 3 months follow up. Statistical analysis will be performed using a mixed-methods ANOVA.

Official Title
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Effect of Nervous System Mobilization on Older Adults' Postural Control

Conditions
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Older Adults

Intervention / Treatment
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* Other: Exercise
* Other: Neural mobilization


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: be 65 years of age or older; to have independent gait with or without technical aid; have indication of the institution's doctor for participation in the study Exclusion Criteria: inability to understand study aims.

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: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Double


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Exercise and nervous system mobilization<br>This group will receive neural mobilization and therapeutic exercise: two sessions of 60 minutes during 8 weeks. | Other: Exercise<br>* The exercise program will consist of: 1) warm up - consisting of stretches of large muscle groups of the upper limbs, lower limbs and trunk and by general mobility exercises; 2) strength training of moderate intensity; 3) balance training; 4) Cooling - will consist of performing overall stretching combined with deep breathing.<br>Other: Neural mobilization<br>* Neural gliding mobilization will target mainly the lower limb nerves and will be performed in series of 10 repetitions with 1 minute interval between series.<br>|
| Experimental: Exercise<br>This group will receive therapeutic exercise: two sessions of 60 minutes during 8 weeks. | Other: Exercise<br>* The exercise program will consist of: 1) warm up - consisting of stretches of large muscle groups of the upper limbs, lower limbs and trunk and by general mobility exercises; 2) strength training of moderate intensity; 3) balance training; 4) Cooling - will consist of performing overall stretching combined with deep breathing.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Gait velocity | Participants are asked to walk at normal gait velocity over 4 meters and gait velocity is calculated | Baseline | 
| Gait velocity | Participants are asked to walk at normal gait velocity over 4 meters and gait velocity is calculated | 9 weeks | 
| Gait velocity | Participants are asked to walk at normal gait velocity over 4 meters and gait velocity is calculated | 3 months | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Pain intensity | Pain intensity measured using a vertical numeric rating scale (Range: 0 to 10 and higher values are indicative of higher pain intensity) | Baseline | 
| Pain intensity | Pain intensity measured using a vertical numeric rating scale (Range: 0 to 10 and higher values are indicative of higher pain intensity) | 9 weeks | 
| Pain intensity | Pain intensity measured using a vertical numeric rating scale (Range: 0 to 10 and higher values are indicative of higher pain intensity) | 3 months | 
| Pain location | Measured using a body chart (a graphic representation of the body) where participants identify painful body sites | Baseline | 
| Pain location | Measured using a body chart (a graphic representation of the body) where participants identify painful body sites | 9 weeks | 
| Pain location | Measured using a body chart (a graphic representation of the body) where participants identify painful body sites | 3 months | 
| Depressive symptoms | Measured using the 15-itens Geriatric Depression Scale (range: 0-15; participants who score 5 or more have depression) | Baseline | 
| Depressive symptoms | Measured using the 15-itens Geriatric Depression Scale (range: 0-15; participants who score 5 or more have depression) | 9 weeks | 
| Depressive symptoms | Measured using the 15-itens Geriatric Depression Scale (range: 0-15; participants who score 5 or more have depression) | 3 months | 
| Balance | Participants are asked to maintain a tandem/semi-tandem position for up to 30 seconds. | Baseline | 
| Balance | Participants are asked to maintain a tandem/semi-tandem position for up to 30 seconds. | 9 weeks | 
| Balance | Participants are asked to maintain a tandem/semi-tandem position for up to 30 seconds. | 3 months | 
| Timed up and go test | Get up from a chair, walk 3 meters, go back to the chair and sit back. The amount of time that each participant takes to perform the task is taken. | Baseline | 
| Timed up and go test | Get up from a chair, walk 3 meters, go back to the chair and sit back.The amount of time that each participant takes to perform the task is taken. | 9 weeks | 
| Timed up and go test | Get up from a chair, walk 3 meters, go back to the chair and sit back. The amount of time that each participant takes to perform the task is taken. | 3 months |