- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT05854316
Protocols and Guidelines for the Use of Digital Twins in Frail Older People (Proto-Aging)
The Proto-Aging study aims to define experimental protocols and guidelines to enable the development of musculoskeletal models (digital twins) of elderly people, with the ultimate goal to comprehensively characterize frail elders from a biomechanical standpoint.
It is typical for the elderly to present with weakness, slowed movements and reduced levels of physical activity, all of which may be related to the loss of muscle force (dynapenia). Unfortunately, to date, the primary cause for dynapenia is difficult to identify. Digital twins may help to this end, but their development remains critical as it requires a specialized skillset and experimental data for model personalisation.
In this study, where the investigators will recruit a small group of frail elders and a cohort of healthy young individuals, all participants will undergo the following examinations: (i) gait assessment, (ii) maximal voluntary isometric contraction (MVIC) test, (iii) superimposed neuromuscular electrical stimulation, and (iv) full lower limb magnetic resonance imaging. Surface electromyography data will further be collected while the subjects perform both the gait assessment and the MVIC test. Last, clinical questionnaires will be administered, and the subjects will be asked to perform additional clinical measures (i.e., hand-grip test, bioelectrical impedance analysis).
At the end of the study, a reduced version of the experimental protocol will be developed, with the intent to provide clinicians with a protocol that can be deployed in clinical settings, accounting for the observed reliability and repeatability of each measure, the required level of expertise, and the associated costs and time expenditure.
Study Overview
Status
Conditions
Intervention / Treatment
Study Type
Enrollment (Actual)
Phase
- Not Applicable
Contacts and Locations
Study Contact
- Name: Marco Viceconti, Professor
- Phone Number: 578 +39 051.63.66
- Email: marco.viceconti@ior.it
Study Contact Backup
- Name: Maria Grazia Benedetti, Professor
- Phone Number: 236 +39 051.63.66
- Email: mariagrazia.benedetti@ior.it
Study Locations
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-
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Bologna, Italy, 40136
- IRCCS Istituto Ortopedico Rizzoli
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Participation Criteria
Eligibility Criteria
Ages Eligible for Study
- Adult
- Older Adult
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- Age: 65-80 years
- Body Mass Index between 18.5 and 30 kg/m2
- Frailty syndrome diagnosed according to Fried's criteria (i.e., at least three of the following items: unintended loss of weight, weakness, self-reported exhaustion, slow walking speed, low level of physical activity)
Exclusion Criteria:
- Any musculoskeletal, neurological, rheumatic or tumoral diseases
- Dementia
- Diabetes
- Inguinal or abdominal hernia
- Severe Hypertension (Level 3)
- Severe Cardio-pulmonary insufficiency
- Diagnosis of Osteonecrosis in the lower limb joints
- Pathologies or physical conditions incompatible with the use of magnetic resonance imaging and electrostimulation (i.e., active and passive implanted biomedical devices, epilepsy, severe venous insufficiency in the lower limbs)
- Previous interventions or traumas to the joints of the lower limb
NOTE: A group of healthy volunteers, who meet the following criteria, will be enrolled in the study:
Inclusion Criteria:
- Age: 20-40 years;
- Body Mass Index: 15-30 kg/m²;
- Physical activity level (Saltin-Grimby): 2-4
- No previous or known musculoskeletal, neurological, rheumatic or tumoral diseases
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Diagnostic
- Allocation: N/A
- Interventional Model: Single Group Assignment
- Masking: None (Open Label)
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Experimental: Frail elders
Frail elders; Age: 65-80 years; Body Mass Index: 18.5-30 kg/m²; Frailty diagnosed according to Fried's criteria (i.e., at least three of the following items: unintended loss of weight, weakness, self-reported exhaustion, slow walking speed, low level of physical activity).
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Magnetic resonance images, electromyography and dynamometry data will be used, together with data from the gait assessment and clinical questionnaires/measures, to characterize the biomechanics of the participants, and to develop and inform personalised musculoskeletal models
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What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Muscle volume
Time Frame: at baseline (Day 0)
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Full lower limb MRI data will be acquired with subjects in supine position.
Individual muscle volumes (in cm3) will be segmented using commercial software and stored in anonymized form.
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at baseline (Day 0)
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MVIC Torque
Time Frame: at baseline (Day 0)
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Dynamometry data will be acquired while participants perform a MVIC leg extension test.
The maximum torque values (Nm) measured over three repetitions will be recorded.
These correspond to the values observed in correspondence of the plateaux of force, developed over a sustained contraction
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at baseline (Day 0)
|
Muscle Inhibition level
Time Frame: at baseline (Day 0)
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The difference between the maximal force exerted during the MVIC test (voluntary contraction) and that achieved when the muscles are electrically stimulated (involuntary contraction) will be computed
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at baseline (Day 0)
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Body kinematics
Time Frame: at baseline (Day 0)
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A standard gait assessment will be performed where motion capture data will be collected.
Joint angles will be extracted to identify abnormal gait patterns.
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at baseline (Day 0)
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Co-contraction index (CCI)
Time Frame: at baseline (Day 0)
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Experimental EMG data will be recorded from the major lower limb muscles involved in the knee extension, while participants perform a maximal voluntary isometric contraction on a dynamometer (i.e., MVIC test to quantify muscle strength).
The co-contraction index, defined as the relative activation of agonist and antagonist muscles (for this task: quadriceps and hamstrings) in the act of kicking (MVIC test).
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at baseline (Day 0)
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Collaborators and Investigators
Sponsor
Investigators
- Principal Investigator: Maria Grazia Benedetti, Professor, IRCCS Istituto Ortopedico Rizzoli
Study record dates
Study Major Dates
Study Start (Actual)
Primary Completion (Actual)
Study Completion (Actual)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Actual)
Study Record Updates
Last Update Posted (Actual)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Keywords
Other Study ID Numbers
- Proto-Aging
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
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