Balance Training Platform for Balance Disorder
(BATP Trial)
Recruiting in Palo Alto (17 mi)
Age: 18+
Sex: Any
Travel: May Be Covered
Time Reimbursement: Varies
Trial Phase: Academic
Recruiting
Sponsor: VA Office of Research and Development
Disqualifiers: Stroke, Neurological disease, Dementia, others
No Placebo Group
Trial Summary
What is the purpose of this trial?This is a proposal to develop a Balanced Reach Training Protocol (BRTP) to evaluate and train dynamic standing balance. The BRTP is based upon the Balanced Reach Test (BRT) that the investigators previously developed and validated. In the BRT subjects stand and point to a target disk moving unpredictably across a large projection screen in front of them without stepping. Body movements undertaken to track the disk are integral to many daily activities and represent an important class of "expected" balance disturbances that can precipitate falls. The BRTP employs engineering and psychophysical methods, and exploits advances in real time computing in a novel and innovative way to more effectively evaluate and train balance function. The BRTP presents a challenging reaching/tracking task that subjects perform at their limit of balance. The BRTP is an objective, quantitative test that can evaluate balance function without floor or ceiling effects, and train balance across the spectrum of aging, disease, and injury.
Will I have to stop taking my current medications?
The trial information does not specify whether you need to stop taking your current medications. However, if you have poorly controlled hypertension or diabetes, you may not be eligible to participate.
What data supports the effectiveness of the treatment Balanced Reach Assessment and Training Protocol for balance disorders?
Research shows that balance training, like the Balanced Reach Assessment and Training Protocol, can improve balance and mobility in older adults and stroke patients. Studies on similar balance training systems have demonstrated their ability to enhance balance confidence and functional reach, which are important for reducing fall risk.
12345How is the Balanced Reach Assessment and Training Protocol (BRTP) treatment different from other balance disorder treatments?
The Balanced Reach Assessment and Training Protocol (BRTP) is unique because it uses a platform like the Nintendo Wii Balance Board to provide real-time visual feedback for balance training, making it a safe, adaptable, and low-cost option for older adults at high risk of falling.
12678Eligibility Criteria
This trial is for adults who have balance disorders or have had a stroke. Participants must be able to reach without help and see well at close distances. Younger adults (18-40) should be healthy with no falls in the past year, while older adults (60+) should be able to stand up and walk unaided but may have motor deficits from a stroke.Inclusion Criteria
Adequate language and neurocognitive function to give adequate informed consent & to participate in testing and training
I am either between 18-40 years old and healthy or I am 60 years or older.
I am between 18 and 40 years old and have not fallen in the past year.
+5 more
Exclusion Criteria
Clinical history of any health condition that the study team deems would preclude safe completion of the BATP
I am 60 or older with a MOCA score below 23 and have more than a 9th grade education.
Poorly controlled hypertension (>190/105) on at least two separate occasions
+9 more
Trial Timeline
Screening
Participants are screened for eligibility to participate in the trial
2-4 weeks
Assessment
Development and evaluation of the Balance Assessment and Training Platform (BATP) based on the Balanced Reach Test (BRT). Subjects undergo balance assessment using the BATP Assessment Module.
1 week
2 visits (in-person)
Training
Participants undergo three one-hour training sessions over one week using the BATP Training Module to evaluate motor learning effects.
1 week
3 visits (in-person)
Follow-up
Participants are monitored for changes in balance capability and fear of falling using clinical measures.
1 week
1 visit (in-person)
Participant Groups
The study is testing a new Balance Reach Training Protocol (BRTP), which challenges participants to track a moving target on screen without stepping. It's designed to assess and improve balance by mimicking everyday situations that could cause falls.
1Treatment groups
Experimental Treatment
Group I: STRExperimental Treatment1 Intervention
Older people who have suffered a stroke
Find a Clinic Near You
Research Locations NearbySelect from list below to view details:
Baltimore VA Medical Center VA Maryland Health Care System, Baltimore, MDBaltimore, MD
Loading ...
Who Is Running the Clinical Trial?
VA Office of Research and DevelopmentLead Sponsor
References
Balance Assessment in Subacute Stroke Patients Using the Balance Control Trainer (BalPro). [2020]To demonstrate the efficacy of the balance control trainer (BCT), developed for training patients with balance problems, as a balance assessment tool in subacute stroke patients.
The effect of balance confidence and context on functional reach ability in healthy older adults. [2011]To assess functional reach (FR) ability in 4 contexts in older adults (≥ 60 years) with high balance confidence (HBC) and low balance confidence (LBC).
Functional reach: a new clinical measure of balance. [2022]A new clinically accessible measure of balance, functional reach (FR), is the difference between arm's length and maximal forward reach, using a fixed base of support. The purposes of this study were to (a) establish FR as a measure of the margin of stability versus the laboratory measure, center of pressure excursion (COPE); (b) test reliability and precision, and (c) determine factors that influence FR, including age and anthropometrics. We evaluated FR in 128 volunteers (age 21-87 years). FR was determined with a precise electronic device and a simple clinical apparatus (yardstick). FR correlates with COPE (Pearson r = .71) and is precise (coefficient of variation = 2.5%) and stable (intraclass correlation coefficient across days = .81). Age and height influence FR. FR is portable, inexpensive, reliable, precise, and a reasonable clinical approximator of the margin of stability. FR may be useful for detecting balance impairment, change in balance performance over time, and in the design of modified environments for impaired older persons.
Whole-body reaching as a measure of dynamic balance in patients with stroke. [2022]To investigate whether whole-body reaching (WBR) could be a task with adequate and gradable dynamic balance challenges for stroke patients.
Training on Biodex balance system improves balance and mobility in the elderly. [2019]To determine the effects of balance training with visual feedback using static and dynamic Biodex balance system for fall risk and mobility..
Reliability and validity of measures obtained from stroke patients using the Balance Master. [2022]To determine the test-retest reliability and validity of data obtained using the Balance Master (BM), a computerized balance assessment and training tool.
Assessing and training standing balance in older adults: a novel approach using the 'Nintendo Wii' Balance Board. [2022]Older adults, deemed to be at a high risk of falling, are often unable to participate in dynamic exercises due to physical constraints and/or a fear of falling. Using the Nintendo 'Wii Balance Board' (WBB) (Nintendo, Kyoto, Japan), we have developed an interface that allows a user to accurately calculate a participant's centre of pressure (COP) and incorporate it into a virtual environment to create bespoke diagnostic or training programmes that exploit real-time visual feedback of current COP position. This platform allows researchers to design, control and validate tasks that both train and test balance function. This technology provides a safe, adaptable and low-cost balance training/testing solution for older adults, particularly those at high-risk of falling.
Validity and reliability of balance assessment software using the Nintendo Wii balance board: usability and validation. [2022]A balance test provides important information such as the standard to judge an individual's functional recovery or make the prediction of falls. The development of a tool for a balance test that is inexpensive and widely available is needed, especially in clinical settings. The Wii Balance Board (WBB) is designed to test balance, but there is little software used in balance tests, and there are few studies on reliability and validity. Thus, we developed a balance assessment software using the Nintendo Wii Balance Board, investigated its reliability and validity, and compared it with a laboratory-grade force platform.