Perturbation Training for Alzheimer's Disease
(STAD Trial)
Recruiting in Palo Alto (17 mi)
Overseen byFeng Yang, PhD
Age: 65+
Sex: Any
Travel: May Be Covered
Time Reimbursement: Varies
Trial Phase: Academic
Recruiting
Sponsor: Georgia State University
Disqualifiers: Hypotension, Hypertension, Osteoporosis, others
No Placebo Group
Trial Summary
What is the purpose of this trial?
This study will examine the overall capacity of people with Alzheimer's disease learning fall-resistant skills from perturbation training.
Do I need to stop my current medications for the trial?
The trial information does not specify whether you need to stop taking your current medications.
What data supports the effectiveness of the treatment Perturbation Training for Alzheimer's Disease?
Research shows that perturbation-based balance training (PBT) can significantly reduce falls in older adults and people with conditions like Parkinson's disease and stroke. This suggests that PBT might help improve balance and reduce falls in Alzheimer's patients as well, although more specific studies are needed.12345
Is perturbation training safe for humans?
Perturbation training, which helps improve balance and prevent falls, has been studied in older adults and people with neurological conditions like Parkinson's disease and stroke. While it shows promise in reducing falls, more research is needed to fully understand its safety and effectiveness in different groups.35678
How is perturbation training different from other treatments for Alzheimer's disease?
Perturbation training is unique because it focuses on improving reactive balance control by repeatedly exposing participants to unexpected movements that challenge their balance, which is different from traditional exercise programs that may not specifically target fall prevention. This approach is emerging as a promising method to reduce falls, particularly in older adults and those with neurological conditions.13679
Eligibility Criteria
This trial is for English-speaking individuals aged 65 or older with probable Alzheimer's Disease who can walk and stand independently. They must have certain scores on cognitive tests indicating moderate impairment but cannot have had perturbation training before, osteoporosis, other major psychiatric or neurological conditions, injuries, or uncontrolled blood pressure issues.Inclusion Criteria
I can stand on my own for at least 30 seconds.
I can walk by myself for at least 25 feet.
Participants can read and understand English
Exclusion Criteria
I have a psychiatric or neurological condition.
I have very low or uncontrolled high blood pressure.
You have never received perturbation training.
Trial Timeline
Screening
Participants are screened for eligibility to participate in the trial
2-4 weeks
Training
Participants receive a single-session perturbation training treatment on a treadmill under the protection of a safety harness
1 session
1 visit (in-person)
Control
Control group undergoes harnessed walking on the treadmill without perturbation training
1 session
1 visit (in-person)
Follow-up
Participants are monitored for fall incidents and skill retention over six months
6 months
Periodic assessments (in-person)
Treatment Details
Interventions
- Perturbation training (Behavioral Intervention)
Trial OverviewThe study is testing the effectiveness of perturbation training in teaching people with Alzheimer's Disease how to resist falls better. Perturbation training involves controlled exposure to disturbances that challenge balance.
Participant Groups
2Treatment groups
Experimental Treatment
Placebo Group
Group I: Training groupExperimental Treatment1 Intervention
This arm will receive a single-session perturbation training treatment on a treadmill under the protection of a safety harness.
Group II: Control groupPlacebo Group1 Intervention
This arm will not receive perturbation training but will go through harnessed walking on the same treadmill for the same time as the other group.
Find a Clinic Near You
Research Locations NearbySelect from list below to view details:
ReminiscentValdosta, GA
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Who Is Running the Clinical Trial?
Georgia State UniversityLead Sponsor
National Institutes of Health (NIH)Collaborator
Alzheimer's AssociationCollaborator
References
Perturbation-based balance training for falls reduction among older adults: Current evidence and implications for clinical practice. [2023]Falls are a leading cause of injury, hospitalization and even death among older adults. Although various strength and balance exercise interventions have shown moderate reductions in falls incidence among healthy older adults, no significant falls incidence improvements have been consistently seen in frail older adults or in patient groups with an increased falls risk (e.g. people with Parkinson's disease and stroke). This might be due to a lack of task specificity of previous exercise interventions to the recovery actions required to prevent a fall. Perturbation-based balance training (PBT) is an emerging task-specific intervention that aims to improve reactive balance control after destabilizing perturbations in a safe and controlled environment. Although early studies were carried out predominantly in research laboratory settings, work in clinical settings with various patient groups has been proliferating. A systematic search of recent PBT studies showed a significant reduction of falls incidence among healthy older adults and certain patient groups (e.g. people with Parkinson's disease and stroke), with clinically relevant reductions in frail older adults. The most practical methods in clinical settings might be treadmill-based systems and therapist-applied perturbations, and PBT that incorporates multiple perturbation types and directions might be of most benefit. Although more controlled studies with long-term follow-up periods are required to better elucidate the effects of PBT on falls incidence, PBT appears to be a feasible and effective approach to falls reduction among older adults in clinical settings. Geriatr Gerontol Int 2017; 17: 2294-2303..
Effects of Perturbation-Based Balance Training in Subacute Persons With Stroke: A Randomized Controlled Trial. [2019]Reactive balance responses are critical for fall prevention. Perturbation-based balance training (PBBT) has shown a positive effect in reducing the risk of falls among older adults and persons with Parkinson's disease.
Perturbation-based balance training: Principles, mechanisms and implementation in clinical practice. [2023]Since the mid-2000s, perturbation-based balance training has been gaining interest as an efficient and effective way to prevent falls in older adults. It has been suggested that this task-specific training approach may present a paradigm shift in fall prevention. In this review, we discuss key concepts and common issues and questions regarding perturbation-based balance training. In doing so, we aim to provide a comprehensive synthesis of the current evidence on the mechanisms, feasibility and efficacy of perturbation-based balance training for researchers and practitioners. We address this in two sections: "Principles and Mechanisms" and "Implementation in Practice." In the first section, definitions, task-specificity, adaptation and retention mechanisms and the dose-response relationship are discussed. In the second section, issues related to safety, anxiety, evidence in clinical populations (e.g., Parkinson's disease, stroke), technology and training devices are discussed. Perturbation-based balance training is a promising approach to fall prevention. However, several fundamental and applied aspects of the approach need to be further investigated before it can be widely implemented in clinical practice.
Intensive Balance Training for Adults With Incomplete Spinal Cord Injuries: Protocol for an Assessor-Blinded Randomized Clinical Trial. [2023]Impaired reactive balance control can lead to increased falls in people with neurological impairments. Perturbation-based balance training (PBT), which involves repetitive exposure to destabilizing external perturbations, improves the ability to take reactive steps in older adults and individuals who have had a stroke.
Does Perturbation-Based Balance Training Improve Control of Reactive Stepping in Individuals with Chronic Stroke? [2019]Although perturbation-based balance training (PBT) may be effective in improving reactive balance control and/or reducing fall risk in individuals with stroke, the characteristics of reactive balance responses that improve following PBT have not yet been identified. This study aimed to determine if reactive stepping characteristics and timing in response to support-surface perturbations improved to a greater extent following PBT, compared to traditional balance training.
Perturbation training to promote safe independent mobility post-stroke: study protocol for a randomized controlled trial. [2019]Falls are one of the most common medical complications post-stroke. Physical exercise, particularly exercise that challenges balance, reduces the risk of falls among healthy and frail older adults. However, exercise has not proven effective for preventing falls post-stroke. Falls ultimately occur when an individual fails to recover from a loss of balance. Thus, training to specifically improve reactive balance control could prevent falls. Perturbation training aims to improve reactive balance control by repeatedly exposing participants to postural perturbations. There is emerging evidence that perturbation training reduces fall rates among individuals with neurological conditions, such as Parkinson disease. The primary aim of this work is to determine if perturbation-based balance training can reduce occurrence of falls in daily life among individuals with chronic stroke. Secondary objectives are to determine the effect of perturbation training on balance confidence and activity restriction, and functional balance and mobility.
Can higher training practice dosage with treadmill slip-perturbation necessarily reduce risk of falls following overground slip? [2021]Perturbation training is an emerging paradigm to reduce idiopathic falls (without clinical signs or symptoms) in older adults. While a higher threat dosage (intensity) in motor learning often directly relates to greater adaptation, retention, and generalization, little is known whether increasing the practice dosage (repetition) of slip-perturbation training would necessarily improve its outcomes.
A systematic review of perturbation-based balance training on reducing fall risk among individuals with stroke. [2023]Perturbation-based balance training has been proven effective to reduce falls in older adults. However, it remains inconclusive if this training paradigm reduces falls in the stroke population. This review sought to summarize the existing literature to assess the effects of perturbation-based balance training on falls and some common fall risk factors in people with stroke.
Interindividual Balance Adaptations in Response to Perturbation Treadmill Training in Persons With Parkinson Disease. [2020]Perturbation training is a promising approach to reduce fall incidence in persons with Parkinson disease (PwPD). This study aimed to evaluate interindividual differences in balance adaptations in response to perturbation treadmill training (PTT) and identify potential outcome predictors.