Dysfunction of Coordination

Researchers are investigating the relationship between functional measures of balance and gait and objective kinetic and kinematic parameters in people with Multiple Sclerosis (MS). This cross-sectional observational study aims to understand how biomechanical gait and balance data collected through the Vicon motion analysis system relate to clinical assessments of balance, gait, and physical performance. The study seeks to identify which biomechanical factors are most closely linked to functional abilities and mobility challenges in MS. Participants will attend a single laboratory session where they will undergo biomechanical analysis of balance and gait using the Vicon motion capture system. They will also complete standardized functional tests including the Mini Balance Evaluation Systems Test, Functional Gait Assessment, Short Physical Performance Battery, and a 2-Minute Walk Test. Additionally, they will fill out questionnaires assessing fear of falling and fatigue and have their lower-limb spasticity evaluated with the modified Ashworth Scale. During the session, which takes about 40 minutes for the primary kinetic and kinematic analysis and additional time for functional assessments, researchers will collect detailed movement data alongside clinical measures. This data will be analyzed to explore correlations between biomechanical parameters and functional outcomes. The study includes assessments of postural control, gait performance, physical endurance, fatigue, and spasticity. The findings aim to improve understanding of movement impairments in MS and support better clinical assessments and rehabilitation approaches.

Researchers are evaluating a low-cost augmented reality platform for balance training in patients with balance disorders caused by degenerative injuries or cerebrovascular diseases. The study aims to determine if the system is usable, acceptable, safe, and if it improves balance. The trial is a usability study conducted by the Hospital Universitari Vall d'Hebron Research Institute. The intervention has two phases: the first phase lasts four weeks with supervised balance training sessions at the hospital, conducted for 60 minutes, three times a week. If patients meet inclusion criteria, the intervention continues for two additional weeks at home with a family member trained to assist as a training partner. The platform uses different exercise protocols accessed through RGSweb, including balance and sit-to-stand exercises with visual targets and movement tracking. Participants undergo three assessments: before treatment (Day 0), after the hospital phase (Week 4), and after the home phase (Week 6). Evaluations include usability scales, adherence measures, balance tests like the Berg Balance Scale, postural sway, sit-to-stand tests, balance confidence, and quality of life questionnaires. Safety is monitored throughout, and adherence is tracked during both hospital and home interventions.

Researchers are evaluating a 12-week home-based mobile health (mHealth) intervention called the Shining Star study, aimed at improving adherence to the 24-Hour Movement Guidelines among preschool-aged children (3-4 years old) who currently meet zero or one of the guidelines for physical activity, screen time, and sleep. The trial seeks to determine if the intervention increases the number of children meeting all three guidelines and if the program is feasible for parents to implement. This randomized controlled trial compares an intervention group using the app to a waitlist control group. Participants in the intervention group will use the Shining Star mobile app, which delivers weekly lessons and behavior-related goals through concise messages, gamification features, behavior trackers, and a parent forum. The control group will receive no intervention during the initial 12 weeks but will complete the same assessments as the intervention group. After 12 weeks, control group participants will gain access to the app and resources. Physical activity and sleep will be tracked with accelerometers, and parents will complete questionnaires. Children's physical activity, sedentary behavior, and sleep patterns will be assessed at baseline, 6 weeks, and 12 weeks using accelerometers. Parents will provide feedback on their child's movement behaviors, development, and app usability through questionnaires and weekly surveys. Additional measures include motor skills tests, cognition assessments, behavioral problems, executive function, and BMI. Data will be securely stored and analyzed to evaluate the intervention's impact and app feasibility over the 12-week period.

Researchers are developing a multicenter registry to collect and share data on pediatric patients who have undergone deep brain stimulation (DBS) for movement disorders such as dystonia, epilepsy, Tourette syndrome, and mood disorders. The study aims to improve understanding of DBS safety and effectiveness in children, as current data are limited and individual centers often have too few cases for strong research. This registry will support large-scale analyses and help refine DBS as a treatment option for hyperkinetic movement disorders in the pediatric population. The study involves gathering both retrospective and prospective clinical data from multiple pediatric centers. The registry will collect information on surgical techniques, patient outcomes, implant sites, and long-term effects of DBS. This collaborative data-sharing approach enables comprehensive evaluation of which patients benefit most from DBS and how it impacts their quality of life over time. Participants include children aged 0 to 18 years who have already received or are scheduled to receive DBS for neurological movement disorders. Data will be collected over five years to monitor safety, efficacy, and quality of life outcomes. The study does not involve treatment administration but focuses on gathering and analyzing clinical information. Parental or legal guardian consent is required for prospective participation.

Cerebellar ataxia is a condition that affects coordination, balance, walking, limb movements, and eye movements due to problems in the cerebellum. This study aims to understand the clinical and genetic features of cerebellar ataxia by creating a registered group of Chinese patients with this condition to follow over time. This observational study does not involve any treatment or intervention. It includes patients diagnosed with cerebellar ataxia by two neurologists, their relatives, and unrelated healthy individuals to serve as controls. Participants or their legal guardians must be willing and able to give informed consent. Participants will be followed up for up to 20 years to observe the occurrence of hereditary cerebellar ataxia. Researchers will collect clinical and genetic information during the study period. The study also tracks participant adherence and compliance with scheduled visits, with attention to those able to complete trial procedures and visit schedules.

Researchers are investigating epilepsy-dyskinesia syndromes, which are rare genetic diseases causing both movement disorders and epilepsy in children. This multinational retrospective survey, supported by the International Parkinson and Movement Disorder Society, aims to collect detailed clinical and molecular data to better understand these conditions. The study focuses on identifying patterns in disease features, progression, and genetic links to improve knowledge and support precision medicine. The study collects previously recorded data from multiple countries, harmonizing information on clinical features, disease progression, age of onset, genetic variants, and coexisting neurological conditions. By standardizing this data, the survey addresses challenges in rare disease research like small, dispersed patient groups and inconsistent protocols. The goal is to build a shared clinical database and analyze how movement and seizure disorders relate at both clinical and molecular levels. Participants are children aged 0 to 18 years with diagnosed movement disorders linked to specific genetic variants. The study reviews existing medical records and genetic information without new treatments or interventions. Researchers will assess the disease spectrum, how movement disorders affect quality of life, and the effectiveness of symptomatic treatments over one year. The study encourages international collaboration to advance understanding and improve care for these rare conditions.

Researchers are evaluating whether an experimental vestibular implant system can improve balance in adults with bilateral vestibulopathy who have normal to severe hearing loss. The implant system includes a vestibular implant surgically placed behind the ear in the mastoid bone, combined with a cochlear implant sound processor and programming software, designed to preserve hearing in the implanted ear. The study aims to assess safety and performance in restoring balance in this population. Participants will receive the vestibular implant device, which stimulates the vestibular nerve via an electrode. The sound processor worn behind the ear powers the implant. The study includes a baseline pre-surgery phase and a six-month post-implantation follow-up period to evaluate changes in balance and hearing function. The intervention is implanted surgically and assessed over time. During the study, participants will undergo various tests to evaluate balance and hearing, including the Dynamic Gait Index, Functional Gait Assessment, posturography sensory tests, and questionnaires on dizziness, fall risk, and quality of life. Hearing thresholds will also be monitored. Assessments occur from baseline up to six months after activation of the implant. Safety and device-related adverse events will be closely monitored throughout the study.

Researchers are studying how electrical stimulation combined with walking practice impacts the connections between the brain and muscles in able-bodied adults. The goal is to develop new personalized rehabilitation methods based on understanding how brain and spinal circuits respond to these stimulations to improve walking performance. This preliminary study focuses on healthy individuals to explore changes in brain circuits and gait performance induced by electrical stimulation and stepping practice. Participants will take part in 1 to 5 sessions over 2 to 8 weeks. Sessions include treadmill or overground walking practice with or without functional electrical stimulation (FES) applied to leg muscles. FES is delivered during specific phases of walking using a specialized device to stimulate ankle muscles. Some participants will also undergo paired associative stimulation combining peripheral electrical stimulation and cortical magnetic pulses. Walking bouts range from 30 seconds to 6 minutes with rest breaks. During visits lasting up to 5 hours each, researchers will measure brain and spinal cord circuit excitability noninvasively before, during, and after walking or stimulation sessions. Assessments include gait performance and neurophysiology tests lasting up to 36 minutes. The study tracks changes in how brain and spinal circuits control muscles and walking ability. Participants’ safety, ability to follow commands, and informed consent are ensured throughout the study, which continues until December 2026.

Diabetic Peripheral Neuropathy (DPN) is a common problem in people with type 2 diabetes, causing symptoms like pain, numbness, and balance difficulties. These issues can lead to falls, foot ulcers, and lower quality of life. Current treatments mainly focus on symptom management, so this study aims to evaluate if adding Neural Mobilization (NM) to balance training can further improve pain, balance, and quality of life in people with DPN. The trial is a randomized controlled study involving 32 patients aged 50 to 75 years. Participants will be randomly assigned to one of two groups for six weeks: one group will receive Neural Mobilization combined with balance training plus standard care, while the other group will receive balance training alone along with standard care. Each group will have two 30-minute sessions per week. The NM protocol includes hot packs, TENS, nerve sliding and tensioning techniques, and various balance exercises that increase in difficulty over time. The balance training group receives similar physical therapy without the neural mobilization techniques. Throughout the study, participants will undergo assessments at the beginning and end of the six-week treatment period. Researchers will measure pain levels using the Numeric Pain Rating Scale, balance using the Berg Balance Scale, and quality of life with the Norfolk Quality of Life-Diabetic Neuropathy questionnaire. Data will be analyzed to determine if adding Neural Mobilization offers additional benefits. Ethical approval has been obtained, and participants will provide informed consent before joining.

Diabetes Mellitus, especially type 2, is a widespread condition often leading to Diabetic Peripheral Neuropathy (DPN), which affects sensation and muscle control in the feet, legs, hands, and arms. This condition can cause symptoms like pain, numbness, and balance problems, increasing the risk of falls. This research aims to assess whether adding Proprioceptive Neuromuscular Facilitation (PNF) exercises to the Otago Exercise Program can improve balance, reduce fear of falling, and enhance sensory function in people with DPN. The study compares two groups: one follows the Otago Exercise Program alone, which includes 14 strengthening and balance exercises targeting leg muscles and walking skills; the other group combines Otago exercises with PNF, a method involving diagonal and spiral movement patterns designed to improve neuromuscular control through progressive resistance. Both interventions are delivered in sessions lasting 40 to 50 minutes, three times a week, over six weeks. Participants will be evaluated using measures such as the Berg Balance Scale, Fall Efficacy Scale, Functional Reach Test, and Semmes Weinstein Monofilament Test at the start and end of the six-week program. Screening includes the Michigan Neuropathy Screening Instrument and Berg Balance Scale to confirm eligibility. The study will document changes in balance, fear of falling, and sensory function to understand the effects of the exercise protocols on fall risk in this population.