Graded Motor Imagery and Fall Risk in Older Adults (GMI)

Graded Motor Imagery and Fall Risk in Older Adults: An Exploratory Study

To determine if there is any carry over effect of sensation training for the feet, officially called Graded Motor Imagery (GMI), will impact balance and fall risk factors in older individuals. This will be looked at to see if there is a difference in balance and sensation before and right after the training.

Study Overview

• Status: Completed
• Conditions: Balance; Fall Risk
• Intervention / Treatment: Procedure: Graded Motor Imagery

Detailed Description

In order to increase acuity of body maps, various tactile and movement-based strategies have been recommended and supported for research focusing on sensory discrimination. Current evidence, specific to painful conditions related to altered cortical mapping, have shown growing evidence in reducing pain and disability. In regards to it's ability to alter foot pain in older adults and decreasing fall risk, prior conference case study and case series presentations have suggested potential clinical benefit, but it has not been formally studied. The aim of this study is to determine if a sensory discrimination training for feet in older adults can alleviate pain, improve sensory discrimination, and also decrease fall risk. Specifically, does a 20 minute training session improve pain, balance (Brief-BEST test), and sensory discrimination in individuals over 65 years of age. Secondary analysis may exam characteristics that best identify those who benefit from this training.

• Study Type: Observational
• Enrollment (Actual): 42

Contacts and Locations

Study Locations

• United States
  • Iowa
    • Davenport, Iowa, United States, 52803
      • St. Ambrose University

Participation Criteria

Eligibility Criteria

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

• Sampling Method: Non-Probability Sample

Study Population

A convenience sample of older adults (65 and older) will be recruited for the study.

Description

Inclusion Criteria:

• Be able to read and understand English
• Be over the age of 65
• Be independent with ambulation (with or without an assistive device)
• Not have any skin condition or injury to the plantar or dorsal part of the foot
• Have the visual ability to view images on a tablet to partake in a test

Exclusion Criteria:

• No existing skin conditions on the bottom of the foot that would impair sensation
• No current injury to the plantar or dorsal side of the foot
• No prior surgery or major injury to the plantar or dorsal side of the foot
• Lacking sensation in the foot
• Unable to read and understand English
• Lacking ability to view images on a tablet to partake in a test
• Unable to ambulate (with or without an assistive device)

Study Plan

How is the study designed?

Number of groups / cohorts

1

Cohorts and Interventions

Group / Cohort	Intervention / Treatment
Experimental group; A convenience sample of older adults (65 and older).	Procedure: Graded Motor Imagery; GMI consisting of education, sensory integration of the foot using contact, flooring samples, immersion, and two point discrimination.; Other Names: GMI

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Lower extremity pain rating	Change (from before treatment to immediately after treatment) in pain for the lower extremity using the numeric pain rating scale (NPRS - 0 to 10 where 0 = no pain and 10 + maximum pain)	self-reported, change from before to immediately after treatment
Laterality Speed	Change (from before treatment to immediately after treatment) in speed of foot recognition using Recognize (TM) (speed in seconds to recognize each of 40 images as right or left foot)	tested for 60 seconds before and immediately after treatment
Laterality Accuracy	Change (from before treatment to immediately after treatment) in accuracy of foot recognition using Recognize (TM) (percent accurately correctly identified as right or left foot of those 40 images)	tested for 60 seconds before and immediately after treatment
Balance / fall risk	Change (from before treatment to immediately after treatment) in Brief-BESTest (6 task subsets to assess static and dynamic balance) (0 - 15 scale where 0 - lowest score / unstable and 15 = highest / no balance issues)	Assessed before and immediately after treatment
Nerve Sensitivity Dorsum of dominant hand	Change (from before treatment to immediately after treatment) in Pain Pressure Threshold (PPT) on dorsum of web space of dominant hand (in pounds)	Assessed before and immediately after treatment
Nerve Sensitivity Dorsum of Right Foot	Change (from before treatment to immediately after treatment) in Pain Pressure Threshold (PPT) on dorsum of right foot (in pounds)	Assessed before and immediately after treatment
Nerve Sensitivity Dorsum of Left Foot	Change (from before treatment to immediately after treatment) in Pain Pressure Threshold (PPT) on dorsum of left foot (in pounds)	Assessed before and immediately after treatment

Collaborators and Investigators

• Sponsor: St. Ambrose University
• Investigators: Principal Investigator: Kevin Farrell, PT, PhD, St. Ambrose University

Study record dates

Study Major Dates

• Study Start (Actual): August 17, 2022
• Primary Completion (Actual): August 18, 2022
• Study Completion (Actual): August 18, 2022

Study Registration Dates

• First Submitted: January 13, 2023
• First Submitted That Met QC Criteria: February 4, 2023
• First Posted (Actual): February 6, 2023

Study Record Updates

• Last Update Posted (Actual): May 10, 2023
• Last Update Submitted That Met QC Criteria: May 8, 2023
• Last Verified: May 1, 2023

More Information

Terms related to this study

• Keywords: Elderly; Balance; Graded Motor Imagery; Fall Risk
• Other Study ID Numbers: StAmbroseU GMI fall risk

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