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| Name | Class |
|---|---|
| European Union | OTHER |
| Castilla-La Mancha Health Service | OTHER |
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The aging process involves physiological changes in organs and tissues that can evolve towards fragility and increased risk of falls. Falls, which can be one of the adverse results of frailty in older people, are the second leading cause of death worldwide. When an elderly person falls, it entails not only hospitalization, immobilization, and the consequent deterioration, but also usually causes fear of falling again, which can also lead to the onset of disability. The inherent aging process can be linked to the deterioration of postural control and balance, posing serious health problems. In falls in the elderly, both sensorimotor and cognitive functions are affected, the functioning of which is degraded to a greater extent by anxiety and stress. Nowadays, more extensive, and more precise research is needed in the study of the interactions between cognition, stress, and postural control in the context of postural instability and falls in older adults.
The purpose of the DEPIE Project is to detect whether neuromuscular changes that occur when exposed to stressful situations can affect the postural and motor control of the elderly.
To this end, all participants will undergo the same intervention. Firstly, they will all take a baseline cognitive and physical assessment. Afterwards, they will take the experimental session, which will consist of a baseline test and an experimental test. During the baseline test, participants will visualize International Affective Picture System (IAPS) images of low arousal and during the experimental test of high arousal. Finally, physical assessment tests will be repeated.
Young and older adults will be tested. Additionally, sub-analyses will be conducted within the elderly group differentiating the degree of cognitive impairment and functional dependence.
The primary outcome measures will be surface electromyography, pressures on the floor, activity on manipulation, and balance.
The secondary outcome measures will be heart rate variability, respiratory rate and the visual analogue scale on unease after visualisation of the images.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Experimental | Experimental | All participants will perform a baseline and an experimental test. There will be a group of young people and a group of older people, but all participants will perform the same intervention |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Stress | Other | All participants will perform a baseline test in which they will first be asked to visualize low-arousal IAPS images for three minutes while seated in a chair, and then get up, walk to a table with two bottles, transfer liquid from one bottle to the other, return to the starting chair and sit down again. Subsequently, they will perform an experimental test, where they will repeat the same movements as in the baseline test after visualizing high-arousal IAPS images for three minutes. In addition, IAPS images will continue to be projected in the background while participants perform the described motor tasks. |
| Measure | Description | Time Frame |
|---|---|---|
| Pressures on the floor | They will be measured by a sensorised blanket that will give information on weight distribution and movement behaviour | It will be assessed while performing the movements of getting up from the chair, walking, manipulating the bottles, returning to the chair and sitting down, both during the baseline test and during the experimental test |
| Triaxial accelerometry: acceleration and deceleration in object handling | The maximum acceleration value during the handling activity of two bottles shall be measured with sensors installed on the bottles. | It will be assessed while performing the bottle manipulation movement (during which liquid has to be transferred from one bottle to another), both during the baseline test and during the experimental test |
| RMS value of the EMG signal | The root mean square (RMS) value of the EMG signal reflects the level of muscle activation during activity. | It will be assessed while performing the movements of getting up from the chair, walking, manipulating the bottles, returning to the chair and sitting down, both during the baseline test and during the experimental test |
| EMG: Synchronisation of activation between muscle groups | It will assess in milliseconds the ability of the muscles to work in a synchronised manner. | It will be assessed while performing the movements of getting up from the chair, walking, manipulating the bottles, returning to the chair and sitting down, both during the baseline test and during the experimental test |
| EMG: Activation ratio between upper and lower body muscles | RMS ratio between different muscles | It will be assessed while performing the movements of getting up from the chair, walking, manipulating the bottles, returning to the chair and sitting down, both during the baseline test and during the experimental test |
| Measure | Description | Time Frame |
|---|---|---|
| Heart Rate Variability | It will be explored for measures of autonomic nervous system activation | It will be assessed during the visualization of IAPS images both during the baseline test and during the experimental test |
| Respiratory Rate |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Susana N Núñez, PhD. Associate Professor | Contact | 0034918852524 | susana.nunez@uah.es |
| Name | Affiliation | Role |
|---|---|---|
| Susana N Núñez, PhD. Associate Professor | University of Alcalá | Principal Investigator |
| Bernardo A Alarcos, PhD. Full Professor | University of Alcalá | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| University of Alcalá | Recruiting | Alcalá de Henares | Spain |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 41592138 | Derived | Membership of GITES; Alarcos B, Diaz-Pulido B, Fernandez O, Fernandez-Guinea S, Garcia Herraiz A, Lendinez-Chica MDM, Martinez Muela J, Nunez-Nagy S, Perez-Martin Y, Rodriguez-Costa I, Rubio Gonzalez GM, Trapero-Asenjo S, Velasco JR. Detection of balance in the elderly under the influence of stress (DEPIE): A cross-sectional study protocol. PLoS One. 2026 Jan 27;21(1):e0341744. doi: 10.1371/journal.pone.0341744. eCollection 2026. |
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Although all participants will perform the same intervention, they will not know which intervention the other participants are performing. In addition, the entire experimental session (both baseline and experimental test) is computerized, so the researcher in charge of the experiment will only ensure that all systems are working properly. On the other hand, the outcome evaluator will analyze the baseline and experimental moments without knowing whether the data belong to one or the other moment.
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| EMG: Median Frequency (MDF) | In the frequency domain, this median frequency of the EMG signal will be calculated. | It will be assessed while performing the movements of getting up from the chair, walking, manipulating the bottles, returning to the chair and sitting down, both during the baseline test and during the experimental test |
| Balance | It will be assessed by Timed Up and Go Test (TUG) and Functional Reach Test (FRT) | Before the baseline test and after the experimental test |
It will be explored for measures of autonomic nervous system activation
| It will be assessed during the visualization of IAPS images both during the baseline test and during the experimental test |
| Analog Visual Scale | It will assess the feeling of unease after performing the baseline test and the experimental test respectively. The scale consists of a line from 0 (= totally relaxed) to 10 (=the most uneasy or restless feeling you have ever felt), which participants have to mark according to their feelings at that moment. Higher scores will correspond to a greater sense of unease. | Immediately after the baseline test and the experimental test respectively |