Clinical Research Directory

Development of a Static Balance Assessment Tool for High-Functioning Older Adults (KSVGH25-CT3-09)

This single-center interventional study aims to develop and validate a static balance assessment tool tailored for high-functioning older adults. Participants aged 65 years or older, who achieve a perfect score on the Short Physical Performance Battery and can maintain an open-eyes single-leg stance for at least 10 seconds, will be recruited. The assessment includes body composition measurement, open-eyes/closed-eyes single-leg stance, and the Balance Error Scoring System under firm and foam surface conditions. Each participant will undergo two testing sessions, 5-7 days apart, with both on-site and video-based scoring to determine test-retest reliability. The expected outcome is the development of an accurate and highly applicable static balance measurement tool to support healthy aging and fall prevention in community and long-term care settings.

Effect of Physical-Cognitive Training in Older Adults

The study compares the impact of physical-cognitive exercises using Blazepod device versus conventional balance training on multiple outcomes in older adults aged 70 and above. Participants receive an 8-week intervention, three sessions per week for both groups. Outcome measures include balance assessments, fear of falling scales, activity of daily living performance, sleep quality questionnaires, reaction time tests, and cognitive assessments. The study aims to determine whether physical-cognitive training provides additional benefits compared to conventional balance exercises.

AquaReBal - Aquatic Reactive Balance Training for Older Adults

Falls are the second leading cause of accidental injury deaths worldwide, mostly in older adults. Injuries resulting from a fall are a leading cause of hospitalizations among older adults in Canada with a higher total injury cost than any other cause of injury. People must often perform rapid and complex movements to keep from falling. Reactive balance training (RBT) is a type of training that focuses on improving an individual's ability to perform those types of movements and respond to unexpected or sudden changes. RBT and aquatic therapy were identified as a research priority for fall prevention. There is evidence that RBT reduces the rate of falls by a half in daily life and improvements in reactive balance are maintained up to a year after the end of the program. When RBT is conducted on land, some adverse events such as fear of falling and joint pain may occur. The water environment could minimize the limitations and barriers associated with land-based RBT. To date, there are no studies showing the effects of water-based RBT on reactive balance control in older adults.The study aims to explore if water-based RBT is a practical intervention to reduce the number of falls in older adults. Older adults will be recruited from the Greater Toronto Area. They will receive training 2 times per week for 6 weeks. The main practical factors around the intervention, such as how participants adhere to the treatment and how they accept the intervention will be measured. It will be assessed how the water-based and land-based RBT affects falls, balance, mobility and quality of life. With this study, the aim is to inform the way for a larger study targeting falls - one of the biggest problems among older adults.

Effectiveness of Immersive Virtual Reality Combined With Occupational Therapy in Reducing Fall Risk and Frailty Among Older Adults

Population aging is a growing global phenomenon that poses significant challenges to healthcare systems, particularly in preventing falls and managing frailty among older adults. Falls remain a leading cause of morbidity and mortality in this population, affecting approximately one-third of individuals over 65 each year. At the same time, frailty syndrome (FS)-a clinical condition marked by progressive decline in physical and cognitive function-significantly increases the risk of falls, disability, and dependency. Pre-frailty, an intermediate and reversible stage, offers a key opportunity for preventive interventions. Scientific evidence supports the effectiveness of interdisciplinary approaches to address frailty and fall prevention. In this context, occupational therapy plays a central role by promoting functional autonomy through meaningful activities. However, traditional approaches may be limited in individuals with low motivation or mild cognitive impairment. Therefore, integrating innovative technologies such as immersive virtual reality (IVR) emerges as a promising therapeutic strategy. IVR enables users to interact with simulated three-dimensional environments, enhancing cognitive stimulation, motor training, and treatment adherence. Modern devices like the Meta Quest 3 headsets provide accessible, safe, and adaptable immersive experiences, with reported benefits in balance, gait, attention, and motivation. Nonetheless, no studies to date have specifically evaluated the effectiveness of this technology when combined with conventional occupational therapy to reduce fall risk and frailty in older adults. This project proposes a pilot randomized controlled trial (RCT), lasting 5 months, using a single-blind, parallel-group design. It will be conducted at the Bouco Madrid Ferraz Residential Center (Madrid, Spain), following CONSORT 2010 methodological guidelines. The primary aim is to assess the efficacy of a combined intervention using IVR through Meta Quest 3 headsets and occupational therapy, compared to conventional occupational therapy alone, in reducing fall risk, improving frailty status, enhancing quality of life, and increasing rehabilitation motivation in older adults. The sample will include 30 participants (15 per group), selected based on specific inclusion and exclusion criteria. Participants will be randomly assigned to a control group (CG), receiving standard occupational therapy, or to an experimental group (EG), receiving a combined intervention of occupational therapy and IVR using the Kinesix XR platform, which is designed to enhance balance. The intervention will last 8 weeks, with two one-hour sessions per week. The experimental group will receive 30 minutes of occupational therapy and 30 minutes of IVR per session. Assessments will be conducted at baseline, post-intervention, and at a 3-month follow-up using validated scales to measure fall risk, balance, frailty level, quality of life, and satisfaction. Data will be pseudonymized, statistically analyzed using SPSS, and managed in compliance with the European General Data Protection Regulation (EU 2016/679). The small sample size reflects the exploratory nature of the study, aimed at assessing feasibility, safety, and preliminary outcomes prior to conducting a larger-scale trial. Ultimately, this project aims to provide initial evidence on an innovative intervention for older adults by integrating digital tools with conventional therapeutic approaches. If proven effective, the VIRTO-FRAIL model could lay the groundwork for new strategies in geriatric rehabilitation and fall prevention.

Dance and Blood Flow Restriction as Balance Training for Older Women

Falls are one of the leading causes of hospitalization and mortality among older adults (aged 65+) in Canada. Falls result from postural instability following age-related declines in muscle strength which begin in the 5th decade of life. Older women have higher rates of injury from falls due to greater deterioration of bone mass density and lower levels of physical activity when compared to men. Participation in physical activity and exercise has been shown to slow these age-related declines in postural stability by improving muscle function as well as proprioceptive and sensory systems, however the majority of older women are inactive. Dance has been used to inspire physical activity uptake among older women, and is particularly good for balance due to its both sensory and motor aspects that focus on precise execution of movement. Dance interventions have been found to improve postural stability and balance confidence. Post-pandemic, online dance classes have provided greater accessibility to exercise interventions aimed at promoting balance. These help reach women facing transportation barriers, who have a fear of exercising with others, women with time-consuming caregiver roles at home etc. While beneficial, the intensity of online classes must be lower to ensure safety, thereby limiting physiological stimulus for adaptations. As typically higher intensity exercise is needed to promote muscle strength there may not be adequate stimulus for adaptations. Furthermore, there is little evidence of strength gains even from in-person dance classes. Blood flow restriction may offer an easy and cost-effective way to mimic higher intensity exercise and boost training benefits. Blood flow restriction has been found to boost strength during low-intensity resistance training, but there is little information on adaptations after balance training or potential transfer to reduce the risk of falls. This 12-week online exercise intervention investigates whether blood flow restriction during dance classes can augment strength, dynamic balance and postural stability of older women aged 65 years and above. Two groups of older women will participate in twice weekly 75 minute ballet and modern-dance classes over Zoom. One group will be randomized to wear 5 centimeter elasticised blood flow restriction bands on their proximal thighs during the classes. Bands will be tightened to a 7/10 of perceived tightness. Postural stability will be assessed using 9, 30-second trials of quiet standing on a force platform in conditions of eyes-open, eyes-closed and on a foam block - trials will be staggered to reduce fatigue effects. Trials will also be video recorded for kinematic analysis of shoulder and hip displacement using Kinovea. Dynamic balance will be assessed using the Star Excursion Balance Test. Participants will be asked to stand on one foot in the middle of the star and reach their other leg as far as they can above the line. The distance the participant reaches in each direction will be recorded and normalized by limb length. Strength will be assessed using the 30-second Sit-to-Stand test and Calf-Raise Senior test. Both tests involve participants doing the maximum number of repetitions possible within a 30-second time frame. Finally scales of fears of falling and overall perceptions of health will be collected. It is expected that this study will have great practical implications as the accessibility of this program can provide opportunities to older adults from various remote locations to increase their levels of physical activity in a safe manner. The affordability may also aid in adoption by community health and recreation centers as an easy-to-implement program that helps to reduce the risk of falls of older women, thereby promoting independence and quality of life.

Assessment of Postural Control and Balance in the Older Adult

A randomised clinical trial is proposed, using a probabilistic allocation design to ensure an equitable distribution of participants between the different intervention and control groups, minimising bias and increasing the internal validity of the results. The trial foresees the voluntary participation of a total of 60 subjects, selected on the basis of previously established criteria and meeting specific characteristics criteria previously established and who meet the specific characteristics required for the study. The distribution of the participants in the clinical trial will be structured into three groups with characteristics and specific objectives, among which the following groups are highlighted: * Group 1 (G1) or control: This group will be composed of 20 participants who will not receive any specific intervention related to gerontogymnastics or occupational therapy programmes designed from occupational therapy. * Group 2 (G2) or experimental with gerontogymnastics: this group will be made up of 20 participants who will receive exclusively an intervention based on gerontogymnastics. This programme will include a series of exercises adapted to the needs of the older adult population, with an emphasis on population, with emphasis on improving balance, muscle strength, flexibility and motor coordination. Group 3 (G3) or experimental: will be composed of 20 participants who will receive a combined intervention. This will consist of a gerontogymnastics programme, mentioned above, merged with a specific occupational therapy plan, in which exercises such as: * Unipodal stability * Gait re-education * Muscle strength * Stationary gait