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Principal Investigator: Odessa Addison
Organization: BALTIMORE VA MEDICAL CENTER
Fiscal Year: 2024
Funding agency: Veterans Affairs
Falls are a leading cause of injurious death and non-fatal injuries in older adults. While fall prevention is a major
VA initiative, the current best fall preventions program only reduces falls by ~30% suggesting further research
and interventions are needed to reduce fall risk. Decreased lower extremity muscle mass and strength
contribute to balance and mobility limitations. Our recent studies show the hip abductors have a unique role in
balance and mobility function. Older adults with impaired hip abductor muscles demonstrate decreased hip
abductor strength, lower balance scores, and poor stepping mechanics when recovering from a balance
perturbation. Our preliminary results also show increased fatty infiltration of the hip abductor muscles may
contribute to poor muscle recruitment and make changing the hip abductor muscles with a traditional strength
intervention difficult. Neuromuscular electrical stimulation is one method to improve muscles in older adults,
though it is not traditionally used on the hip abductors.
Our preliminary results demonstrate that older adults who use neuromuscular electrical stimulation on their hip
abductors, in conjunction with a balance training intervention; demonstrate larger improvements in hip abductor
strength, balance, and mobility function. Our central hypothesis is that the addition of neuromuscular electrical
stimulation applied to the hip abductors during a balance intervention will result in: improved balance, larger
improvements in muscle and mobility function, and fewer falls than a balance intervention alone. In this
randomized control trial, we will determine the effects of a balance and strengthening program with and without
neuromuscular electrical stimulation on fall risk and mobility (aim 1), changes in hip abductor composition,
function, activation and gait variability (aim 2), and the retention of these changes at a six and twelve-month
follow up (aim 3). We anticipate that this patient-oriented translational research will provide the first evidence
from a large randomized control trial for the use of neuromuscular electrical stimulation applied to the primary hip
abductors as an efficacious adjunct to traditional rehabilitation programs to improve balance, mobility, and
muscle in older Veterans at risk for falls.
Terms: <Active Follow-up><Address><Adipose tissue><Age><Area><Balance training><CAT scan><CT X Ray><CT Xray><CT imaging><CT scan><Caring><Cessation of life><Clinical Treatment><Computed Tomography><Coxa><Data><Death><Education for Intervention><Educational Intervention><Electrodes><Equation><Equilibrium><Exercise><Exhibits><Fall prevention><Fascia Lata><Fascia lata structure><Fats><Fatty Tissue><Fatty acid glycerol esters><Future><Gait><Health><Hip><Hip region structure><Hospital Admission><Hospitalization><Impairment><Incidence><Infiltration><Injury><Instruction Intervention><Intervention><Intervention Strategies><Intramuscular><Isometric Exercise><Isometrics><Lower Extremity><Lower Limb><Mechanics><Medical Rehabilitation><Membrum inferius><Methods><Mission><Muscle><Muscle Atrophy><Muscle Cell Contraction><Muscle Contraction><Muscle Tissue><Muscle function><Muscle-Setting Exercise><Muscular Atrophy><Muscular Contraction><Physical Performance><Prevention program><Publishing><Randomized, Controlled Trials><Recommendation><Rehabilitation><Rehabilitation therapy><Research><Role><Static Exercise><Step Tests><Surface><Testing><Time><Tomodensitometry><Training><Training Intervention><Translational Research><Translational Science><Trauma><Veterans><Work><X-Ray CAT Scan><X-Ray Computed Tomography><X-Ray Computerized Tomography><Xray CAT scan><Xray Computed Tomography><Xray computerized tomography><active followup><adipose><ages><balance><balance function><catscan><computed axial tomography><computer tomography><computerized axial tomography><computerized tomography><cost><cost effective><electromyostimulation><exercise training><fall risk><falls><follow up><follow-up><followed up><followup><functional outcomes><improved><injuries><instructional intervention><intervention program><interventional strategy><mechanic><mechanical><multi-modality><multimodality><muscle breakdown><muscle bulk><muscle degradation><muscle deterioration><muscle form><muscle loss><muscle mass><muscle strength><muscle wasting><muscular><neuromuscular Electrical Stimulation><neuromuscular stimulation><non-contrast CT><noncontrast CT><noncontrast computed tomography><novel><older adult><older adulthood><patient centered><patient oriented><patient safety><performance tests><preventing falls><primary outcome><programs><randomized control trial><recruit><rehab therapy><rehabilitative><rehabilitative therapy><response><social role><tool><train balance><translation research><translational investigation><trial regimen><trial treatment><white adipose tissue><yellow adipose tissue>