Short-term Postural Training for Older Adults

Study Overview
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Brief Summary
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Generalization refers to skill transfer under various working spaces following motor practice. The extent of generalization effect links causal to in-depth recognition of error properties during motor practice. Idiom says imperfect practice makes perfect. It could be beneficial for the elderly to gain superior capacity of balance transfer skill under the short-term productive failure learning environments. In contrast to traditional visual feedback that uses error avoidance training to optimize target balance task, the present 3-year proposal is to propose three potential neuro-cognitive strategies to improve motor skill transfer following stabilometer training. The strategies are expected to enhance opportunities of error experience and motor exploration via modified visual feedback, underlying facilitations of attentional resource and error-related neural networks. In the first year, the neuro-cognitive strategy for balance practice is progressive augmentation of visual error size to improve balance skill transfer. In the second year, the neuro-cognitive strategy for balance practice is visual feedback with virtual uncertainness of motor goal. In the third year, the neuro-cognitive strategy for balance practice is stroboscopic vision. EEG and central of pressure will be processed with non-linear approaches. Graph theory will characterize EEG functional connectivity and brain network efficiency regarding to brain mechanisms for practice-related leaning transfer. Trajectories of central of pressure will be analyzed with stabilogram diffusion analysis to reveal behavior mechanisms for practice-related variations in feedback and feedforward process for error corrections.

Official Title
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The Use of Neuro-cognitive Strategies to Power Generalization Effect After Short-term Postural Training for Older Adults

Conditions
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Aging, Balance

Intervention / Treatment
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* Behavioral: size of error visual feedback


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Age above 60 years old healthy older adults without a history of falls. Able to understand and give informed consent. The Mini-Mental State Examination test score above 25-30. Lower limb muscle strength is evaluated as G grade The corrected visual acuity was within the normal range. Exclusion Criteria: Any known history of mental illness Any neuromuscular or degenerative neurological disease(ex:stroke、SCI、TBI...etc) Any known history of cerebral cerebellar disease or intracranial metal implants. Weak of hearing or wearing a hearing aid

Ages Eligible for Study
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Minimum Age: 60 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: Basic Science
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: deterministic visual error gain<br>Day1(Pretest): stabilometer stance, 3 times/1 min air pillow stance, 3 time/30 sec poture-supraposture dual task, 3 times/1 min Day2 to Day5: Exp.group:27 times of posture tracking with high visual error gain. Control group:27 times of posture training with normal visual error gain. Day6 (Posttest): stabilometer stance, 3 times/1 min air pillow stance, 3 time/30 sec poture-supraposture dual task, 3 times/1 min | Behavioral: size of error visual feedback<br>* The strategies are expected to enhance opportunities of error experience and motor exploration via modified visual feedback, underlying facilitations of attentional resource and error-related neural networks.<br>* Other names: stroboscopic vision;|
| Experimental: stochastic visual noise<br>Day1(Pretest): stabilometer stance, 3 times/1 min air pillow stance, 3 time/30 sec poture-supraposture dual task, 3 times/1 min Day2 to Day5: Exp.group A:27 times of posture training with posture tracking signal-to-noise ratio=2:1. Exp.group B:27 times of posture training with posture tracking signal-to-noise ratio=4:1. Control group:27 times of posture training with normal visual error gain. Day6(Posttest): stabilometer stance, 3 times/1 min air pillow stance, 3 time/30 sec poture-supraposture dual task, 3 times/1 min | Behavioral: size of error visual feedback<br>* The strategies are expected to enhance opportunities of error experience and motor exploration via modified visual feedback, underlying facilitations of attentional resource and error-related neural networks.<br>* Other names: stroboscopic vision;|
| Experimental: intermittent visual gain<br>Day1 (Pretest): stabilometer stance with wearing flash glasses (low frequency with opaque ratio 50%), 4 times/45 sec stabilometer stance with wearing flash glasses (high frequency with opaque ratio 50%), 4 times/45 sec. stabilometer stance with wearing flash glasses (clear), 4 times/45 sec air pillow stance, 8 times/1 min Day2 (training section): Exp. group:Posture tracking with wearing flash glasses (low frequency with opaque ratio 50%), 12 times/45 sec. Control group:Posture tracking with wearing flash glasses (clear), 12 times/45 sec. Day3 (Posttest): stabilometer stance with wearing flash glasses (low frequency with opaque ratio 50%), 4 times/45 sec stabilometer stance with wearing flash glasses (high frequency with opaque ratio 50%), 4 times/45 sec stabilometer stance with wearing flash glasses (clear), 4 times/45 sec air pillow stance, 8 times/1 min | Behavioral: size of error visual feedback<br>* The strategies are expected to enhance opportunities of error experience and motor exploration via modified visual feedback, underlying facilitations of attentional resource and error-related neural networks.<br>* Other names: stroboscopic vision;|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| EEG graph analysis | Graph theory will characterize EEG functional connectivity and brain network efficiency regarding to brain mechanisms for practice-related leaning transfer. | through study completion, an average of 1 year | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| stabilogram diffusion analysis of central of pressure | Trajectories of central of pressure will be analyzed with stabilogram diffusion analysis to reveal behavior mechanisms for practice-related variations in feedback and feedforward process for error corrections. | through study completion, an average of 1 year | 
| root mean sqaure error of stabilometer | The root-mean-square value of the tracking trajectory of stabilometer and the target signal. | through study completion, an average of 1 year | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Posture training, Motor generalization, Aging, Cognition, High-density electroencephalography