Neurophysiological Changes After Perturbation-based Training in Older Adults

Short-term Neurophysiological Changes After a Perturbation-based Training in Community-dwelling Older Adults: A Pilot Study

This is an assessor-blinded neurophysiological study. Participants will be randomly assigned to a perturbation-based training (PBT) or a walking (control) group. Changes in postural stability and neurophysiology in the brain following PBT compared to walking exercise without perturbation will be investigated.

A total of 88 participants will be randomly assigned to two groups receiving perturbation-based training (PBT) or walking exercise without perturbation (control). Written informed consent will be obtained from participants prior to the baseline assessment. The study will be reported and conducted in line with the CONSORT statement. Participants will be recruited via convenience sampling in the local community. Both groups will receive two sessions of treadmill walking at their comfortable speed. Perturbations will be induced during treadmill walking only for the PBT group. As informed from previous literature, two sessions of PBT could have improved postural stability for up to 1.5 years. Between-group differences in behavioural and MRI findings will be examined before and after training to identify training-induced changes in postural stability, brain structures, and functional connectivities. Retention of the changes in the postural stability will be assessed four months after the training period. Incidents of falls will be followed up for 12 months after training.

Inclusion Criteria:

• Aged ≥ 60 years old
• Community-dwelling
• Right-handed
• Able to communicate effectively in Cantonese or Mandarin
• Able to walk independently on level ground for ≥ 30 minutes
• Abbreviated Mental Test (Hong Kong version) score ≥ 6

Exclusion Criteria:

• Metal implants (e.g. pacemaker, artificial cochlea)
• Uncorrected vision or hearing impairment
• Osteoporosis
• Hip or knee replacement within the last year
• Musculoskeletal, cardiovascular, mental, or neurological disorders (such as Parkinson's disease) which can affect MRI examination, balance control, or exercise participation.