Cortical Mechanisms and Modulation of Somatosensation in Older Adults With Foot Sole Somatosensory Impairments
Overview
- Phase
- Not Applicable
- Intervention
- transcranial direct current stimulation
- Conditions
- Somatosensory Function
- Sponsor
- Hebrew SeniorLife
- Enrollment
- 20
- Locations
- 1
- Primary Endpoint
- postural sway area when standing with eyes closed on the foam
- Status
- Recruiting
- Last Updated
- 10 days ago
Overview
Brief Summary
In older adults, diminished sensation of the legs and feet is highly prevalent and causes poor balance and reduced mobility. This type of sensation is not only dependent upon the receptors and nerves in the legs and feet, but also upon a complex central nervous system pathway that includes the cerebral cortex of the brain. This project will use a form of noninvasive brain stimulation called transcranial direct current stimulation (tDCS) to test whether increasing the excitability of the brain networks that process sensory feedback can augment foot sole sensation, balance, and mobility in older adults suffering from mild-to-moderate foot sole sensory impairments.
Investigators
Eligibility Criteria
Inclusion Criteria
- •Aged ≥65 years.
- •Self-reported feeling of unsteadiness or difficulty when standing and walking.
- •Mild-to-moderate foot-sole somatosensory impairment: the ability to perceive 75g monofilament but inability to perceive 10g monofilament.
Exclusion Criteria
- •self-reported inability to stand or walk continuously for one minute without personal assistance (canes or walkers allowed);
- •history or presence of foot ulceration, amputation, or deformities;
- •self-reported uncontrolled pain or pain that is associated with mobility disability;
- •uncontrolled diabetes mellitus;
- •hospitalization within the past three months due to acute illness, or as the result of a musculoskeletal injury significantly affecting balance;
- •persistent severe pain of lower extremity when standing or walking;
- •diagnosis of dementia, Parkinson's disease, or stroke that affects balance;
- •unstable medical condition;
- •legal blindness or deafness;
- •uncontrolled hypertension (i.e., systolic BP \>180, diastolic BP \>100 mm Hg, or prescription of ≥3 anti-hypertensive medications);
Arms & Interventions
tDCS group
Participants in this arm will receive the real tDCS intervention.
Intervention: transcranial direct current stimulation
sham group
Participants in this arm will receive the sham stimulation as control.
Intervention: active sham stimulation
Outcomes
Primary Outcomes
postural sway area when standing with eyes closed on the foam
Time Frame: Before and immediately after intervention
This metric assesses the degree to which the soft support and cut-off of the vision diminishes the control of standing posture.
Standing vibratory thresholds of each foot sole
Time Frame: Before and immediately after intervention
This metric assesses the degree to which the foot soles can sense the vibro-tactile stimuli when standing.
postural sway area when standing with eyes closed on the foam
Time Frame: Before and immediately after intervention
This metric assesses the degree to which the soft support and cut-off of the vision diminishes the control of standing posture.
Timed Up-and-Go (TUG) time
Time Frame: Before and immediately after intervention
This metric assesses mobility.
On-target Blood oxygen level dependent (BOLD) signal intensity in response to foot sole stimulation
Time Frame: Before and immediately after intervention
This metric assesses the degree to which brain cortical regions activated by the walking-related foot-sole stimulation.
Standing vibratory thresholds of each foot sole
Time Frame: Before and immediately after intervention
This metric assesses the degree to which the foot soles can sense the vibro-tactile stimuli when standing.
Secondary Outcomes
- Gait speed of 10m walking test(Before and immediately after intervention)
- Postural sway speed when standing with eyes closed on the foam(Before and immediately after intervention)