Training the brain with a robotic device for balance recovery in near frail older adults

DESCRIPTION provided by applicant The long term goal of this project is to reduce falls in older adults by improving their ability to recover equilibrium during a slip or trip The proposed strategy is to use AMES an FDA cleared non invasive intervention that has been shown to enhance motor performance in able bodied adults and to reduce sensorimotor impairment in both the upper and lower limbs of people with CNS injuries Based on results from previous studies we now hypothesize that the AMES intervention can reduce falls in near frail older adults ages years by increasing leg strength reducing reaction time and improving leg and axial motor coordination This project has the following specific aims to modify the hardware and software of the AMES device to deliver the testing and training proposed in this study and to test the proof of concept that hours of AMES training on each leg is sufficient to reduce falls in the study participants receiving AMES In the proposed proof of concept study an AMES device will be used to train both legs of near frail older residents in the Arkansas Veteransandapos Home of Fayetteville Test Group Another comparable group of participants will also be enrolled but will not receive AMES training Control Group At baseline all participants will be able to ambulate independently with or without assistive devices All participants will be evaluated for sensorimotor impairments i e ankle strength ankle range of motion and joint position control and ankle proprioception and motor function i e balance and gait at the beginning and end of a month period during which the Test Group will receive AMES training and the Control group will not During this month period and also in the months that follow i e for a total of months the incidence of falls in all participants will be tracked Participants in the Test Group are expected to experience an increase in leg strength a decrease in leg reaction time and an improvement in leg proprioception and in parallel a reduction in leg impairment and improvement in leg function Participants in the Test Group are also expected to experience fewer falls over the month tracking period compared to the number of falls in the Control Group over this same time period PUBLIC HEALTH RELEVANCE Our goal is to improve the ability of near frail older adults to recover equilibrium after losing balance by providing training with AMES a robotically delivered intervention with the expectation that this intervention will increase leg strength decrease reaction time to perturbations and improve the overall coordination of the lower body