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To determine if there is any carry over effect of sensation training for the feet, officially called Graded Motor Imagery (GMI), will impact balance and fall risk factors in older individuals. This will be looked at to see if there is a difference in balance and sensation before and right after the training.
In order to increase acuity of body maps, various tactile and movement-based strategies have been recommended and supported for research focusing on sensory discrimination. Current evidence, specific to painful conditions related to altered cortical mapping, have shown growing evidence in reducing pain and disability. In regards to it's ability to alter foot pain in older adults and decreasing fall risk, prior conference case study and case series presentations have suggested potential clinical benefit, but it has not been formally studied. The aim of this study is to determine if a sensory discrimination training for feet in older adults can alleviate pain, improve sensory discrimination, and also decrease fall risk. Specifically, does a 20 minute training session improve pain, balance (Brief-BEST test), and sensory discrimination in individuals over 65 years of age. Secondary analysis may exam characteristics that best identify those who benefit from this training.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Experimental group | A convenience sample of older adults (65 and older). |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Graded Motor Imagery | Procedure | GMI consisting of education, sensory integration of the foot using contact, flooring samples, immersion, and two point discrimination. |
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| Measure | Description | Time Frame |
|---|---|---|
| Lower extremity pain rating | Change (from before treatment to immediately after treatment) in pain for the lower extremity using the numeric pain rating scale (NPRS - 0 to 10 where 0 = no pain and 10 + maximum pain) | self-reported, change from before to immediately after treatment |
| Laterality Speed | Change (from before treatment to immediately after treatment) in speed of foot recognition using Recognize (TM) (speed in seconds to recognize each of 40 images as right or left foot) | tested for 60 seconds before and immediately after treatment |
| Laterality Accuracy | Change (from before treatment to immediately after treatment) in accuracy of foot recognition using Recognize (TM) (percent accurately correctly identified as right or left foot of those 40 images) | tested for 60 seconds before and immediately after treatment |
| Balance / fall risk | Change (from before treatment to immediately after treatment) in Brief-BESTest (6 task subsets to assess static and dynamic balance) (0 - 15 scale where 0 - lowest score / unstable and 15 = highest / no balance issues) | Assessed before and immediately after treatment |
| Nerve Sensitivity Dorsum of dominant hand | Change (from before treatment to immediately after treatment) in Pain Pressure Threshold (PPT) on dorsum of web space of dominant hand (in pounds) | Assessed before and immediately after treatment |
| Nerve Sensitivity Dorsum of Right Foot | Change (from before treatment to immediately after treatment) in Pain Pressure Threshold (PPT) on dorsum of right foot (in pounds) |
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Inclusion Criteria:
Exclusion Criteria:
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A convenience sample of older adults (65 and older) will be recruited for the study.
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| Name | Affiliation | Role |
|---|---|---|
| Kevin Farrell, PT, PhD | St. Ambrose University | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| St. Ambrose University | Davenport | Iowa | 52803 | United States |
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| Assessed before and immediately after treatment |
| Nerve Sensitivity Dorsum of Left Foot | Change (from before treatment to immediately after treatment) in Pain Pressure Threshold (PPT) on dorsum of left foot (in pounds) | Assessed before and immediately after treatment |