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Balance Board


 


Fear-of-falling is a significant issue with older adults, leading many older adults to restrict their activity, leading to a loss of quality of life and independent mobility. This is an extremely costly problem, as individuals that lose their independent mobility will need to seek assisted living, with a cost of nearly $250 billion projected for 2012. Currently, there are no targeted, evidence-based interventions to reducing fear-of-falling and onlymulti-faceted/multi-factorial approaches that “throw everything against the wall” have been shown to be efficacious. We are thus left with a costly intervention for a costly problem. The major weakness of the current interventions is that they do not target the mechanisms of decline with age.

In this project, we seek to create a novel approach that is based on neurobiology and specifically targets the mechanisms of declines that occur as a result of aging. The scientific literature consistently points to two key mechanisms of age-related declines in motor function: 1) increased neural noise; and 2) a loss of physiological complexity. Greater neural noise causes increased random activity in the nervous system, resulting in inconsistent movement patterns. A loss of complexity occurs when the motor system has a reduced ability to effect rapid corrections to movements, restricting the ability to correct movement errors. A technique that has been used to attenuate noise and increase complexity in both biological and engineered systems is stochastic resonance. Specific to human balance, stochastic resonance is achieved by adding a small amount of random interference into assistive devices such as shoe insoles, and has been shown to improve posture and balance with older adults. However, the positive effects disappear when the device is no longer worn.

We are developing an alternative game-based approach that uses random perturbations to the visual feedback of an individual’s postural sway as a form of stochastic resonance. By tapping the visual system, we expect that the use of a higher order sensory input will allow the participant to learn to overcome these random perturbations and retain the performance improvements. A unique benefit of our proposed approach over existing randomized controlled trials of exercise-based interventions is that we can now collect data during the intervention. Until now, there has been no measurement of performance during the exercise intervention sessions. These data will allow us to covary for performance during the intervention itself, providing an index of change on a longitudinal basis. Our study has the potential for a significant impact, creating a paradigm-shift in the delivery of physical rehabilitation interventions through games. There is the potential for new economic avenues for such games, while also aiding in bending the cost-curve downward for eldercare. Most importantly, future generations of seniors will only become more comfortable with computer games and game-based interventions.

Project Team: Kay Connelly, Richie Halzewood, Lee Hong, Lesa Huber

Funding: IU’s Clinical and Translational Sciences Institute