Hip Muscle Power, Lateral Balance Function, and Falls in Aging (HIPS)

Falls and their consequences are among the major problems in the medical care of older individuals. The long-term goal of this research is to develop a mechanistically based therapeutic intervention to enhance muscle power, weight-shifting capability, and lateral balance function through protective stepping to prevent falls. When human balance is challenged, protective stepping is a vital strategy for preventing a fall during activities of daily life. Many older people at risk for falls have particular difficulties with successfully stepping sideways as a protective response to loss of balance in the lateral direction. Age-related declines in lateral balance function result from neuromuscular and biomechanical limitations in hip abductor-adductor muscle power generation. This study will test whether these impairments can be improved with high-velocity hip muscle resistance power training that will be more effective than conventional resistance strength training.

Study Overview

• Status: Completed
• Conditions: Accidental Falls
• Intervention / Treatment: Other: Power Training; Other: Strength Training

Detailed Description

Falls and their consequences are among the major problems in the medical care of older individuals. The long-term goal of this research is to develop a mechanistically based therapeutic intervention to enhance muscle power, weight-shifting capability, and lateral balance function through protective stepping to prevent falls. When human balance is challenged, protective stepping is a vital strategy for preventing a fall during activities of daily life. Many older people at risk for falls have particular difficulties with successfully stepping sideways as a protective response to loss of balance in the lateral direction. The investigators propose that age-related declines in lateral balance function through impaired weight transfer and protective stepping linked with falls, result from neuromuscular and biomechanical limitations in hip abductor-adductor (AB-AD) muscle power generation. Moreover, the investigators hypothesize that these balance and neuromotor impairments can be improved with high-velocity muscle resistance power training that will be more effective than conventional muscle resistance strength training. The specific aims are, Aim 1: To conduct a single blind, randomized, and controlled trial comparing the effects of 12 weeks of hip AB-AD muscle power training against strength training, and the rate of retention after 3 months of no training in community living older adults by determining a) the changes in neuromotor performance (kinetics, kinematics, muscle activation patterns) of pre-step weight transfer during waist-pull induced side stepping, and rapid voluntary reaction time (RT) sidestepping; and by b) the changes in isolated hip AB-AD muscle neuromotor performance. Weight shifting and stepping ability will be tested with different initial induced stepping limb load conditions, and by varying voluntary stepping limb selection certainty with simple and choice RT tasks; Aim 2: To compare the effectiveness of hip AB-AD muscle power and strength training in reducing the rate of prospective falls over a one-year monitoring period post-training. Secondary analyses will assess the number of in-task falls, and the effect of muscle power versus strength training on changes in functional balance and mobility. Overall, the studies are expected to establish support for the superiority of velocity dependent power training over strength training on enhancing muscle performance, protective balance control and functional mobility outcomes, and for the prevention of falls among older adults.

• Study Type: Interventional
• Enrollment (Actual): 97
• Phase: Not Applicable

Contacts and Locations

Study Locations

• United States
  • Maryland
    • Baltimore, Maryland, United States, 21201
      • VA Maryland Health Care System

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 65 years and older (Older Adult)
• Accepts Healthy Volunteers: Yes

Description

Inclusion Criteria:

1. 65 years of age or older
2. Functionally independent
3. Living in the community
4. Generally healthy

Exclusion Criteria:

1. Cognitive impairment (Mini Mental Score Exam less than 24)
2. Sedative use
3. Non-ambulatory
4. Any clinically significant musculoskeletal impairment
5. Any clinically significant neurological impairment
6. Any clinically significant cardiopulmonary impairment
7. Any clinically significant metabolic impairment
8. Any general medical problem that will interfere with testing or training
9. Diabetes, renal, or liver disease by identified by routine chemistry

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Prevention
• Allocation: Randomized
• Interventional Model: Factorial Assignment
• Masking: Double

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Power Training; Hip abductor-adductor resistance exercises at 75% maximum strength and maximum execution speed, 3, 1-hour training sessions per week for 12 weeks.	Other: Power Training; Hip abductor-adductor resistance exercises at maximum execution speed
Active Comparator: Strength Training; Hip muscle abductor-adductor resistance exercises at maximum strength at reduced execution speed (2s concentric/3s eccentric), 3, 1-hour training sessions per week for 12 weeks.	Other: Strength Training; Hip abductor-adductor resistance exercises at reduced execution speed

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Incidence of single lateral steps	Change in number of single steps between pre and post tests	At 3 months

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Hip muscle power	Change in maximum hip power between pre and post tests	At 3 months
Number of Falls	Total number of falls reported at 1 year follow up.	12 months

Collaborators and Investigators

• Sponsor: University of Maryland, Baltimore
• Collaborators: VA Maryland Health Care System
• Investigators: Principal Investigator: Vicki L Gray, PhD, University of Maryland, Baltimore

Study record dates

Study Major Dates

• Study Start (Actual): September 16, 2019
• Primary Completion (Actual): January 10, 2026
• Study Completion (Actual): January 10, 2026

Study Registration Dates

• First Submitted: October 1, 2018
• First Submitted That Met QC Criteria: November 2, 2018
• First Posted (Actual): November 6, 2018

Study Record Updates

• Last Update Posted (Actual): January 26, 2026
• Last Update Submitted That Met QC Criteria: January 22, 2026
• Last Verified: January 1, 2026

More Information

Terms related to this study

• Keywords: Elderly; Balance; Power training; Falls; Protective Stepping; Lateral Balance
• Additional Relevant MeSH Terms: Motor Activity; Movement; Musculoskeletal Physiological Phenomena; Musculoskeletal and Neural Physiological Phenomena; Therapeutics; Physical Therapy Modalities; Patient Care; Exercise Therapy; Rehabilitation; Aftercare; Continuity of Patient Care; Physical Conditioning, Human; Exercise; Resistance Training
• Other Study ID Numbers: HP-00082488

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No
• product manufactured in and exported from the U.S.: No