Effects of Water Inertia Load Training on Lower Limb Joint Moments, Gait, and Balance in Elderly Women

September 16, 2025 updated by: Hyun Ju Kim

Effects of Dynamic Stability Training Using Water Inertia Load on Lower Limb Joint Moments, Gait and Balance in Elderly Women

This study highlights that age-related neuromuscular changes negatively impact muscle strength, balance, joint mobility, and cardiovascular health, which in turn affect daily life activities and independence. In particular, aging leads to slower gait speeds and increased metabolic costs associated with shifting the body's center of mass, which are closely linked to functional decline in older adults. While previous studies have focused primarily on spatiotemporal variables like stride length and walking speed, there is a lack of research examining exercise interventions that analyze lower limb joint moments. This study aims to assess the effects of dynamic stability training using water inertia load on the distribution of lower limb joint moments, gait, and balance in older adults, ultimately providing valuable insights to support improvements in efficient gait function among the elderly.

Study Overview

Status

Completed

Conditions

Intervention / Treatment

Detailed Description

  1. Study Participants

    This study targets healthy women aged 65 and older who have not engaged in regular exercise in the past six months. Participants will be recruited through posted announcements at Mirine Center and Busan University of Foreign Studies in Busan. Individuals who express interest and sign the consent form after being informed of the study's purpose and eligibility criteria will be selected as participants.

    The appropriate sample size was determined using G*Power 3.1 software, with an effect size of 0.32, a power of 0.8, and a significance level of 0.05, resulting in an estimated sample size of 18 participants. However, to account for potential dropouts, the study will proceed with a total of 30 participants, divided into 15 in the experimental group and 15 in the control group. Participants will be randomly assigned to either the experimental or control group on the first day of exercise at a 1:1 ratio.

  2. Measurement

    1. Balance Measurement For this study, a ground reaction force plate (AMTI-OR6, Watertown, MA, USA) will be used to evaluate static balance. The device assesses the range, velocity, and Root Mean Square (RMS) of the center of pressure (COP) using pressure sensors.

      To prevent visual distractions during balance assessment, the surrounding environment will be blocked off with curtains. Both legs will be evaluated. For the single-leg standing test, participants will be instructed to stand barefoot, with arms crossed in front of their chest, supporting one leg while lifting the other leg with the knee bent at a 90-degree angle, maintaining the position for 40 seconds.

      This duration was set at 40 seconds to ensure sufficient time for data collection and to remove any errors at the beginning and end of the trial. To ensure accurate results, participants will be given sufficient rest between attempts, and the test will only be conducted once the participant feels fully prepared. Given that it may be challenging for elderly individuals to maintain this position for the full duration, if they cannot reach 40 seconds, the longest time achieved out of five attempts will be averaged for analysis.

    2. Gait Measurement

      In this study, gait spatial and temporal assessments will be conducted using a 6-meter walkway and six 3D infrared motion capture cameras (Vicon camera MX-T20, Oxford Metrics, Oxford, UK).

      The measured variables include cadence, step time, stride time, walking speed, step length, stride length, foot-off timing, single support time, and double support time. Gait measurements will be conducted in an environment free of external distractions.

      Participants will perform several practice walks at their preferred walking speed until they become accustomed to the evaluation. Once a normal walking speed is achieved, three trials will be recorded. Additionally, sufficient rest will be provided between each trial to ensure accurate data collection.

    3. kinetic Measurement

    To evaluate lower limb joint moments, this study will use a 6-meter walkway, six 3D infrared motion capture cameras (Vicon camera MX-T20, Oxford Metrics, Oxford, UK), and sixteen reflective markers (14mm). The reflective markers will be attached to the following anatomical landmarks: bilateral anterior superior iliac spines, posterior superior iliac spines, mid-thigh lateral sides, lateral femoral epicondyles, mid-shanks, lateral malleoli, second metatarsals, and heels. For analysis, participants' height, weight, leg length, and knee and ankle joint widths will be measured and input into the system.

    The analysis will track the movement of reflective markers to calculate hip and ankle joint moments and angular velocities using the Vicon Plug-in Gait system at a sampling rate of 100Hz. Hip and ankle joint moments will be analyzed for maximum moment, average values, and positive work during the terminal stance phase of the gait cycle. Each joint moment will be categorized into flexion and extension moments for analysis.

  3. Dynamic Stability Training

    The Dynamic Stability Training (DST) program is based on the Instability Neuromuscular Training program proposed by Kang (2024) and consists of exercises structured in progressive stages. The program spans 12 weeks, with two sessions per week, totaling 24 sessions. Each session lasts 50 minutes and includes a 10-minute warm-up, 30 minutes of DST exercises, and a 10-minute cool-down.

    From weeks 0 to 6, the DST program focuses on bilateral support and weight shifting. From weeks 7 to 12, the exercises progress to include single-leg support movements to enhance balance on one leg, while also increasing speed to adjust exercise intensity. The program incorporates movements involving a step box.

    Each exercise adheres to the ACSM exercise guidelines. During weeks 0 to 6, exercises are performed at low intensity (RPE 9-11) for 30 seconds of activity with 60 seconds of rest, totaling two sets using a weight of 3 kg. From weeks 7 to 12, exercises are conducted at moderate intensity (RPE 12-13) for 45 seconds of activity with 90 seconds of rest, totaling one set using a weight of 4 kg. Rest time between sets is 1 minute.

    The experimental group wears an aqua vest filled with water, while the control group wears a weight vest, performing the same exercises. The load of water and weights is determined based on the Rating of Perceived Exertion (RPE).

    The training sessions will be led by the researcher of this study, who has 13 years of experience. Additionally, two assistant instructors will be assigned to monitor participants throughout the sessions, as the participants are elderly individuals.

  4. Statistical Analysis

All data collected in this study will be analyzed using SPSS 28.0 to calculate means and standard deviations. The Shapiro-Wilks test will assess the normality of participants' general characteristics and variables. An independent t-test will verify group homogeneity. To compare intervention effects between groups and changes before, during, and after the intervention within groups, a two-way repeated measures ANOVA will be applied. All statistical significance levels will be set at 0.05.

Study Type

Interventional

Enrollment (Actual)

24

Phase

  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

  • South Korea
    • Geumjeong-gu
      • Busan, Geumjeong-gu, South Korea, 46234
        • University of Foreign Studies of Busan

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

  • Older Adult

Accepts Healthy Volunteers

Yes

Description

Inclusion Criteria:

  • Healthy women over the age of 65

Exclusion Criteria:

  • Musculoskeletal injury within the last 3 months Severe cardiopulmonary disease (heart failure, myocardial infarction) Use of anxiolytics, antidepressants, or sedatives Chronic lung disease Surgery within the last 6 months

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Treatment
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: None (Open Label)

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Experimental: Aqua vest group
Participants in this group will perform Dynamic Stability Training (DST) sessions twice a week for 12 weeks while wearing an aqua vest. Each session will focus on dynamic stability exercises aimed at improving balance, lower limb joint moment distribution, and gait. Each session will last for 50 minutes
Behavioral: Aqua vest group
Participants in this group will perform Dynamic Stability Training (DST) sessions twice a week for 12 weeks while wearing an aqua vest. Each session will focus on dynamic stability exercises aimed at improving balance, lower limb joint moment distribution, and gait. Each session will last for 50 minutes
Active Comparator: Weight vest group
Participants in this group will perform the same Dynamic Stability Training (DST) sessions twice a week for 12 weeks, but with a weight vest instead of an aqua vest. Each session will focus on balance, lower limb joint moment distribution, and gait, lasting for 50 minutes
Behavioral: Weight vest group
Participants in this group will perform the same Dynamic Stability Training (DST) sessions twice a week for 12 weeks, but with a weight vest instead of an aqua vest. Each session will focus on balance, lower limb joint moment distribution, and gait, lasting for 50 minutes

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Change in step
Time Frame: 6 weeks and 12 weeks after baseline
Step time is measured in seconds using a 3D motion capture system
6 weeks and 12 weeks after baseline
Change in stride time
Time Frame: 6 weeks and 12 weeks after baseline
Stride time is measured in seconds using a 3D motion capture system.
6 weeks and 12 weeks after baseline
Change in walking speed
Time Frame: 6 weeks and 12 weeks after baseline
Walking speed is measured in meters per second using a 3D motion capture system.
6 weeks and 12 weeks after baseline
Change in cadence
Time Frame: 6 weeks and 12 weeks after baseline
Cadence is measured in steps per minute using a 3D motion capture system
6 weeks and 12 weeks after baseline
Change in foot off
Time Frame: 6 weeks and 12 weeks after baseline
Foot off is measured as a percentage of the gate cycle using a 3D motion capture system.
6 weeks and 12 weeks after baseline
Change in step length
Time Frame: 6 weeks and 12 weeks after baseline
Step length is measured in meters per second (m/s) using a 3D motion capture system
6 weeks and 12 weeks after baseline
Change in stride length
Time Frame: 6 weeks and 12 weeks after baseline
Stride length is measured in meters per second (m/s) using a 3D motion capture system
6 weeks and 12 weeks after baseline
Change in single support phase
Time Frame: 6 weeks and 12 weeks after baseline
The single support phase of the gait cycle is measured as a percentage using a 3D motion capture system
6 weeks and 12 weeks after baseline
Change in dubble support phase
Time Frame: 6 weeks and 12 weeks after baseline
The double support phase of the gait cycle is measured as a percentage using a 3D motion capture system
6 weeks and 12 weeks after baseline
Change in balance stability
Time Frame: 6 weeks and 12 weeks after baseline
Balance was assessed using a single-leg stance test, measuring the center of pressure(COP) sway in both anterior posterior (AP) and medial-lateral (ML) directions.
6 weeks and 12 weeks after baseline
Change in Lower limb joint moments
Time Frame: 6 weeks and 12 weeks after baseline
The moments of the lower limb joints, specifically at the hip and ankle, are measured
6 weeks and 12 weeks after baseline

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Hyun Ju Kim

Investigators

  • Principal Investigator: Hyun Ju Kim, MSc, Department of Sports and Health Convergence

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

General Publications

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

December 1, 2024

Primary Completion (Actual)

February 15, 2025

Study Completion (Actual)

April 1, 2025

Study Registration Dates

First Submitted

November 23, 2024

First Submitted That Met QC Criteria

November 23, 2024

First Posted (Actual)

November 26, 2024

Study Record Updates

Last Update Posted (Estimated)

September 19, 2025

Last Update Submitted That Met QC Criteria

September 16, 2025

Last Verified

September 1, 2025

More Information

Terms related to this study

Keywords

Other Study ID Numbers

  • BUFS-DST-2024

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

YES

IPD Plan Description

De-identified individual participant data (IPD) will be shared via Figshare. The data will include demographic information, raw data from the assessments, and any other relevant data collected during the study.

IPD Sharing Time Frame

The data will be available immediately after the publication of the study results and will be accessible for at least 5 years

IPD Sharing Access Criteria

The data will be openly available via Figshare without the need for a data access request

IPD Sharing Supporting Information Type

  • SAP

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

Clinical Trials on Balance and Gait Impairment in Elderly Women

Clinical Trials on Aqua vest group

Search Similar Trials

Sponsors and Collaborators

Medical Conditions

Drug Interventions

CROs by country

CROs in Morocco

Conditions

Rare Diseases

Drug Interventions

Dietary Supplements

Sponsor/Collaborators

Locations

Subscribe