Aquatic Exercise and Reactive Balance

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

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.

Study Overview

• Status: Not yet recruiting
• Conditions: Exercise; Aging; Aged; Accidental Falls; Postural Balance; Exercise Therapy
• Intervention / Treatment: Other: Exercise intervention

Detailed Description

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).

• Study Type: Interventional
• Enrollment (Estimated): 44
• Phase: Not Applicable

Contacts and Locations

• Study Contact: Name: Youngwook Kim; Phone Number: 4352945504; Email: youngwook.kim@usu.edu
• Study Contact Backup: Name: Eadric Bressel; Phone Number: 4357977216; Email: eadric.bressel@usu.edu

Participation Criteria

Eligibility Criteria

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

Description

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

Study Plan

How is the study designed?

Design Details

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

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Aquatic Exercise group; 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; A ball catching and throwing exercise.
Active Comparator: Land Exercise group; 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; A ball catching and throwing exercise.

What is the study measuring?

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.

Collaborators and Investigators

• Sponsor: Eadric Bressel
• Investigators: Principal Investigator: Eadric Bressel, Utah State University

Publications and helpful links

General Publications

• Bolton DAE, Mansour M. A Modified Lean and Release Technique to Emphasize Response Inhibition and Action Selection in Reactive Balance. J Vis Exp. 2020 Mar 19;(157):10.3791/60688. doi: 10.3791/60688.

Helpful Links

• Related Info

Study record dates

Study Major Dates

• Study Start (Estimated): January 1, 2025
• Primary Completion (Estimated): September 1, 2026
• Study Completion (Estimated): September 1, 2026

Study Registration Dates

• First Submitted: October 14, 2021
• First Submitted That Met QC Criteria: October 25, 2021
• First Posted (Actual): November 4, 2021

Study Record Updates

• Last Update Posted (Actual): April 22, 2024
• Last Update Submitted That Met QC Criteria: April 19, 2024
• Last Verified: April 1, 2024

More Information

Terms related to this study

• Keywords: Aquatic therapy; Fall prevention; Reactive balance; Aquatic exercise
• Other Study ID Numbers: 12227 (Company Internal)

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO
• IPD Plan Description: Any individual participant data collected in this study will not be shared with other researchers to follow the HIPAA Privacy Rule.

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No