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Age is one of the primary risk factors for falls, with risk increasing as people get older. Research on fall risk and prevention has identified hundreds of contributing factors, showing that falls have complex and multifactorial causes. Risk factors can be categorized as environmental, extrinsic, or intrinsic. Intrinsic factors include physiological aspects-such as reduced lower-limb strength, impaired gait and balance, weaker grip strength, diminished sensory function, and poorer sensorimotor control-as well as psychological aspects, including fear of falling, depression, and cognitive decline. Strongly associated intrinsic risk factors include a history of falls, physical weakness, gait and balance disorders, certain medications, and dizziness. While fixed factors like age and fall history cannot be changed, identifying and targeting modifiable risk factors is crucial for prevention. Among these, gait and balance impairments are considered the most important modifiable intrinsic factors.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Neck Strengthening Only | Placebo Comparator | The control group will receive an intervention consisting of neck muscle strengthening only. |
|
| Neck Strengthening plus Oculomotor Training | Experimental | The experimental group will receive an intervention combining neck muscle strengthening with oculomotor saccade tasks. |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Combining neck muscle strengthening with oculomotor saccade tasks. | Behavioral | he exercise program begins at 30% of 1RM, progressing by first increasing repetitions (8-10 up to 8-12) and then intensity (+5% of 1RM). Training sessions include a 5-minute warm-up, 20 minutes of exercise, and a 5-minute cool-down, performed twice per week for 30 minutes per session. Neck strengthening is performed using the Iron Neck, which provides constant resistance. Exercises include maintaining a neutral neck position, protraction-retraction, left-right rotation, dynamic figure-8 movements, and synchronized 360° head-body rotations. Each exercise consists of two sets of 8-12 repetitions, with 30 seconds rest between repetitions and 1 minute between sets. After neck training, participants in the intervention group perform oculomotor saccade tasks while maintaining a neutral head position. Five visual targets appear randomly in front of the participant for 1 second each. The task lasts 40 seconds, followed by 1-2 minutes of rest, and is repeated three times. |
| Measure | Description | Time Frame |
|---|---|---|
| Neck range of motion | Assessments will be conducted at baseline, and at three, six, and twelve months post-intervention. | |
| Neck proprioception | Laser Joint Position Error Test | Assessments will be conducted at baseline, and at three, six, and twelve months post-intervention. |
| Neck position | Measurement Method: Craniovertebral Angle | Assessments will be conducted at baseline, and at three, six, and twelve months post-intervention. |
| Neck muscle | craniocervical flexion test, CCFT | Assessments will be conducted at baseline, and at three, six, and twelve months post-intervention. |
| Center of Pressure | force plate | Assessments will be conducted at baseline, and at three, six, and twelve months post-intervention. |
| Oculomotor | tobii eye tracker 5 :Latency and Accuracy | Assessments will be conducted at baseline, and at three, six, and twelve months post-intervention. |
| Dynamic balance | y-balance | Assessments will be conducted at baseline, and at three, six, and twelve months post-intervention. |
| L/E Muscle strength |
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Inclusion Criteria:
No major medical conditions that significantly affect functional capacity.
Exclusion Criteria:
Cognitive impairment. Current use of antidepressant medications.
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Oculomotor training device | Kaohsiung City | Sanmin District | 807 | Taiwan |
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| Neck Strengthening Only | Behavioral | he exercise program begins at 30% of 1RM, progressing by first increasing repetitions (8-10 up to 8-12) and then intensity (+5% of 1RM). Training sessions include a 5-minute warm-up, 20 minutes of exercise, and a 5-minute cool-down, performed twice per week for 30 minutes per session. Neck strengthening is performed using the Iron Neck, which provides constant resistance. Exercises include maintaining a neutral neck position, protraction-retraction, left-right rotation, dynamic figure-8 movements, and synchronized 360° head-body rotations. Each exercise consists of two sets of 8-12 repetitions, with 30 seconds rest between repetitions and 1 minute between sets. |
|
MicroFET2 MMT
| Assessments will be conducted at baseline, and at three, six, and twelve months post-intervention. |
| Ankle proprioception | Joint Position Reproduction Test Kinesthesia | Assessments will be conducted at baseline, and at three, six, and twelve months post-intervention. |
| The Falls Efficacy Scale International | The scale scores range from 16 to 64, with higher scores indicating greater severity | Assessments will be conducted at baseline, and at three, six, and twelve months post-intervention. |