Imagery (Psychotherapy)NCT06056180
The Effect of Motor Image Training on Balance Performance in Geriatric Individuals
A study testing Balance Training, Motor İmagery Training and Action Observation Training in people with Imagery (Psychotherapy) and Postural Control, run by Muğla Sıtkı Koçman University at 1 site in Turkey (Türkiye).
Trial summary
The goal of this study [type of study: clinical trial] is to was planned to investigate the effect of motor imagery training given to geriatric individuals with action observation on their balance performance and to compare these two methods. The main questions it aims to answer are: 1. Read more about this study
- Who is it for?
- Ages 60 to 80 years
- Conditions the study is for
- Imagery (Psychotherapy), Postural Control, Postural Balance
- What is being tested?
- Balance Training, Motor İmagery Training and Action Observation Training
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 46 participants
- Where
- 1 siteTurkey (Türkiye)
- Study dates
- 1 Nov 2023to Dec 2025
- Phase
- Interventional
- Are there results?
- Not yet: the study is under way
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 60 to 80 years
- All sexes
- No healthy volunteers
- Adult, Older adult
Who may be able to join
- To be between 60-80 years old
- Having the ability to speak, read, understand and write Turkish
- To have the cognitive skills to understand and apply the trainings to be applied in the study (with ≥ 24 points from the Mini Mental State Test)
- Being able to do activities of daily living independently
- Being able to walk independently (without using a walking aid and at least 10 meters)
- Having a body mass index of <35 kg/m2 (not being severely obese or morbidly obese)
Who cannot join
- Having visual, hearing and sensory impairment
- To have had a trauma, lesion or surgery that may affect balance and musculoskeletal system in the last 6 months
- Having a history of 2 ≥ falls in the last 6 months
- Having any chronic lower extremity pain
- Having an acute or chronic illness that may cause problems with balance and falling
- Being diagnosed with sensory, vestibular and cerebellar ataxia
Show all 9Show fewer
- Being on any medication that may cause problems with balance, focus, attention and falling.
- Exercising regularly, which may affect performance results
- To stop participating in the study for any reason
Trial locations and contacts
1 site in 1 country. Contact the study team or a site near you to ask about taking part.
Mehmet Gürhan Karakaya contact
Turkey (Türkiye)1 site, 1 recruiting
- Recruiting
Mugla Sitki Kocman University
Menteşe, Muğla, 48050
Şeyda Ercan Yüceer, +905070202276, seydaercan22@gmail.com
About this study
Official title: Investigation of the Effects of Motor Imagery Training Given With Action Observation on Balance Performance in Geriatric Individuals
The goal of this study [type of study: clinical trial] is to was planned to investigate the effect of motor imagery training given to geriatric individuals with action observation on their balance performance and to compare these two methods.
The main questions it aims to answer are:
Read more
- Is virtual reality-based balance training given together with action observation and motor imagery for six weeks in geriatric individuals more effective in improving static balance than virtual reality-based balance training given alone?
- Is virtual reality-based balance training given together with action observation and motor imagery for six weeks in geriatric individuals more effective in improving dynamic balance than virtual reality-based balance training given alone?
- Is virtual reality-based balance training given together with motor imagery for six weeks in geriatric individuals more effective in increasing balance confidence than virtual reality-based balance training given alone?
46 geriatric individuals will be randomized into 2 groups. Along with action observation, motor imagery training and virtual reality-based balance training will be given to the study group. On the other hand, only virtual reality-based balance training will be given to the control group. All assessments will be repeated before and after the trainings. The trainings will be applied 2 days a week for 6 weeks. Each training session; 25 minutes for the control group and 45 minutes for the study group.
Read the detailed description
Muscle strength, proprioception, joint mobility, vestibular losses and vision losses may occur with the aging process. These losses may lead to a decrease in the ability of geriatric individuals to adapt to environmental factors. This loss of harmony may cause balance disorders in individuals by affecting static and dynamic postural control performance. Looking at the literature, balance trainings, functional exercises, flexibility, muscle strength and endurance trainings, Tai Chi, Qigong-like yoga exercises, dance, walking programs, motor imagery training given with traditional methods or virtual reality systems for the purpose of improving balance and postural control. There are studies showing the effectiveness of many methods in geriatric individuals. However, no study has been found that examines and compares the effects of virtual reality-based balance training and motor imagery training combined with action observation in addition to virtual reality-based balance training in geriatric individuals. For this reason, this study was planned to investigate the effect of motor imagery training given to geriatric individuals with action observation on their balance performance and to compare these two methods.
The study, which was designed as a prospective, randomized controlled, cross-sectional, single-blind (evaluator), will include 46 geriatric individuals aged 60 and over. The study will be initiated with individuals who meet the inclusion/exclusion criteria of the study. 46 geriatric individuals will be randomized into 2 groups. The study group (23 cases) will be given motor imagery training and virtual reality-based balance training along with action observation. Only virtual reality-based balance training will be given to the control group (23 cases). First of all, age, gender, height, body weight, upper extremity dominant side, lower extremity dominant side, body mass index, smoking history, alcohol consumption, occupation, employment status, chronic diseases, regularly used drugs, history of falling and staggering, history and pedigree information, independence in daily living activities, ability to walk 10 meters without any walking aid will be recorded. In the first evaluation before the training, the measurement of the electrical potential changes known as muscle motor unit action potentials of the subjects during the postural swings will be evaluated with the electromyography biofeedback device. Static and dynamic balance assessments will be evaluated with computerized kinesthetic balance device, Berg Balance Scale and 10 Meter Walk Test. Three-axis (x, y and z) evaluation of body oscillations will be made with an android-based smartphone application. Motor imagery skills will be evaluated with the Movement Imagination Questionnaire-3 (HIA-3) and the mental stopwatch test. All assessments will be repeated before and after the training (6 weeks later) by a researcher blinded to the training. As a training protocol, individuals in both groups will be given static and dynamic balance training with a balance platform game console (20 minutes) containing interactive video games based virtual reality for a total of 6 weeks. Before the balance training, a 5-minute relaxation training will be given to both groups. In addition to the virtual reality-based balance and relaxation training, the study group will be given motor imagery training (10 min + 10 min) with action observation before the balance training. The trainings will be applied 2 days a week for 6 weeks. Each training session; 25 min for the control group. (Relaxation training (5 min) + virtual reality-based balance training (20 min), 45 min for the study group. (Relaxation training (5 min) + motor imagery training (20 min) + virtual reality-based balance training (20 min) with action observation. All questionnaires, scales, tests and devices used in the initial evaluations will be repeated for the individuals in both groups at the end of the 6-week training. The effectiveness of the trainings will be compared with appropriate statistical methods within and between groups and discussed in the light of the literature.
- Conditions
- Imagery (Psychotherapy), Postural Control, Postural Balance, Virtual Reality Therapy, Surface Electromyography, Geriatric Assessment
- Being tested
- Balance Training, Motor İmagery Training, Action Observation Training
- Keywords
- visual motor imagery, kinesthetic motor imagery, postural control, virtual reality therapy, interactive video games, balance platform with pressure sensor, surface electromyography, balance confidence, fall risk, mobility, cognitive processing speed, smartphone gyroscope sensor dataset, action observation
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Balance TrainingOther
Participants will be given static and dynamic balance training with a balance platform game console (20 minutes) containing interactive video games based virtual reality for a total of 6 weeks.
Motor İmagery TrainingOther
For motor imagery training, two visualization scenarios will be created: anterior and posterior motor imagery. One of the visualization scenarios appropriate to each individual's needs will be used. Participants will be asked to perform kinesthetic or visual motor imagery in accordance with the scenario they listened to (10 minutes).
Action Observation TrainingOther
Action observation training will be done using video modeling method. The video content will include Nintendo Wii games in which the games that the person will play in that session are played by someone else and successful scores are achieved (10 minutes).
| Study group | Role | What they receive |
|---|---|---|
| Balance Training+ Action Observation Training + Motor İmagery Training | Experimental | The study group (23 cases) will be given motor imagery training and virtual reality-based balance training along with action observation. Receives: Other: Balance Training; Other: Motor İmagery Training; Other: Action Observation Training |
| Balance Training | Active comparator | Only virtual reality-based balance training will be given to the control group (23 cases). Receives: Other: Balance Training |
What is being measured
The primary outcome is the main question the study is designed to answer.
Measurement of Muscle Activities During Postural Swings
EMG Biofeedback device will be used to evaluate the muscle activities in the lower leg anterior (m. tibialis anterior) and posterior group (m. gastrocnemius lateralis) muscles while performing postural swings.
Measured: 1 day before starting treatment and First day after 6 weeks of treatment (2 times in total)
Berg Balance Scale
In this scale, the individual tries to maintain her balance during 14 different activities in which the center of gravity varies and is suitable for daily life activities.The total score on the Berg Balance Scale was 56. Low scores from the scale indicate a high risk of falling.
Measured: 1 day before starting treatment-First day after 6 weeks of treatment (2 times in total)
Portable computerized kinesthetic balance device of participants' static and dynamic balance
Static and dynamic balance will be evaluated while participants stand on one or two legs on the device (eyes open/closed, in 9 different conditions). The Balance Index Score (DI) displayed on the screen as a result of the test will be recorded as the individual's balance score. The score range is 0-6000. 0 is the best score.
Measured: 1 day before starting treatment-First day after 6 weeks of treatment (2 times in total)
10 meter Walking Test
How long it takes individuals to walk a distance of 10 meters will be recorded in seconds.
Measured: 1 day before starting treatment-First day after 6 weeks of treatment (2 times in total)
Activity-Specific Balance Confidence Scale
The Activity-Specific Balanced Confidence Scale will be used to measure balance confidence. The total score ranges from 0 to 100, with higher scores indicating greater confidence.
Measured: 1 day before starting treatment and First day after 6 weeks of treatment (2 times in total)
Movement Imagination Questionnaire-3
In the questionnaire consisting of 12 items, kinesthetic, internal and external visual imagination abilities are evaluated separately.Higher scores on the survey indicate better mental imagery ability.
Measured: 1 day before starting treatment-First day after 6 weeks of treatment (2 times in total)
Mental Stopwatch Test
Time Up and Go Test (TUG) will be used to look at the temporal similarity between the durations of real and imagined movement in geriatric individuals. Both test results will be recorded in seconds. The temporal harmony between real and imagined movement will be calculated in delta time. Higher delta time indicates lower motor imagery ability.
Measured: 1 day before starting treatment-First day after 6 weeks of treatment (2 times in total)
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted28 Sep 2023
- Study start1 Nov 2023
- Primary completionMay 2025 (estimated)
- Study completionDec 2025 (estimated)
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Other trials for Imagery (Psychotherapy)Studies of the same condition, open and under way.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase N/A
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Double blind
- Who is masked
- Investigator, Outcomes assessor
- Enrolment
- 46 participants (estimated)
Sponsor and investigators
- Lead sponsor
- Muğla Sıtkı Koçman University
- Sponsor type
- University, hospital or other
- Responsible party
- Principal investigator, Şeyda Ercan Yüceer, Muğla Sıtkı Koçman University
- Investigators
- Şeyda Ercan Yüceer, Principal investigator, Mugla Sitki Kocman Univercity
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT06056180
- Sponsor's protocol ID
- MSKUSYuceer_001
- Status last verified
- May 2025
- First submitted
- 12 Jun 2023
- Last updated
- 8 May 2025
- Results posted
- No
- Data monitoring committee
- No
- FDA-regulated drug
- No
- FDA-regulated device
- No
Study at a glance
From the registry record, last updated by the sponsor on 8 May 2025. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Investigation of the Effects of Motor Imagery Training Given With Action Observation on Balance Performance in Geriatric Individuals
- ClinicalTrials.gov ID
- NCT06056180
- Acronym / sponsor ID
- MSKUSYuceer_001
- Conditions
- Imagery (Psychotherapy), Postural Control, Postural Balance, Virtual Reality Therapy, Surface Electromyography, Geriatric Assessment
- Keywords
- visual motor imagery, kinesthetic motor imagery, postural control, virtual reality therapy, interactive video games, balance platform with pressure sensor, surface electromyography, balance confidence
- Study type
- Interventional
- Recruitment status
- Recruiting
- Enrolment
- 46 participants (estimated)
- Lead sponsor
- Muğla Sıtkı Koçman UniversityUniversity, hospital or other
- Study start
- 1 Nov 2023 (actual)
- Primary completion
- May 2025 (estimated)
- Study completion
- Dec 2025 (estimated)
- First posted
- 28 Sep 2023 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
The goal of this study [type of study: clinical trial] is to was planned to investigate the effect of motor imagery training given to geriatric individuals with action observation on their balance performance and to compare these two methods.
The main questions it aims to answer are:
- Is virtual reality-based balance training given together with action observation and motor imagery for six weeks in geriatric individuals more effective in improving static balance than virtual reality-based balance training given alone?
- Is virtual reality-based balance training given together with action observation and motor imagery for six weeks in geriatric individuals more effective in improving dynamic balance than virtual reality-based balance training given alone?
- Is virtual reality-based balance training given together with motor imagery for six weeks in geriatric individuals more effective in increasing balance confidence than virtual reality-based balance training given alone?
46 geriatric individuals will be randomized into 2 groups. Along with action observation, motor imagery training and virtual reality-based balance training will be given to the study group. On the other hand, only virtual reality-based balance training will be given to the control group. All assessments will be repeated before and after the trainings. The trainings will be applied 2 days a week for 6 weeks. Each training session; 25 minutes for the control group and 45 minutes for the study group.
Detailed description
Muscle strength, proprioception, joint mobility, vestibular losses and vision losses may occur with the aging process. These losses may lead to a decrease in the ability of geriatric individuals to adapt to environmental factors. This loss of harmony may cause balance disorders in individuals by affecting static and dynamic postural control performance. Looking at the literature, balance trainings, functional exercises, flexibility, muscle strength and endurance trainings, Tai Chi, Qigong-like yoga exercises, dance, walking programs, motor imagery training given with traditional methods or virtual reality systems for the purpose of improving balance and postural control. There are studies showing the effectiveness of many methods in geriatric individuals. However, no study has been found that examines and compares the effects of virtual reality-based balance training and motor imagery training combined with action observation in addition to virtual reality-based balance training in geriatric individuals. For this reason, this study was planned to investigate the effect of motor imagery training given to geriatric individuals with action observation on their balance performance and to compare these two methods.
The study, which was designed as a prospective, randomized controlled, cross-sectional, single-blind (evaluator), will include 46 geriatric individuals aged 60 and over. The study will be initiated with individuals who meet the inclusion/exclusion criteria of the study. 46 geriatric individuals will be randomized into 2 groups. The study group (23 cases) will be given motor imagery training and virtual reality-based balance training along with action observation. Only virtual reality-based balance training will be given to the control group (23 cases). First of all, age, gender, height, body weight, upper extremity dominant side, lower extremity dominant side, body mass index, smoking history, alcohol consumption, occupation, employment status, chronic diseases, regularly used drugs, history of falling and staggering, history and pedigree information, independence in daily living activities, ability to walk 10 meters without any walking aid will be recorded. In the first evaluation before the training, the measurement of the electrical potential changes known as muscle motor unit action potentials of the subjects during the postural swings will be evaluated with the electromyography biofeedback device. Static and dynamic balance assessments will be evaluated with computerized kinesthetic balance device, Berg Balance Scale and 10 Meter Walk Test. Three-axis (x, y and z) evaluation of body oscillations will be made with an android-based smartphone application. Motor imagery skills will be evaluated with the Movement Imagination Questionnaire-3 (HIA-3) and the mental stopwatch test. All assessments will be repeated before and after the training (6 weeks later) by a researcher blinded to the training. As a training protocol, individuals in both groups will be given static and dynamic balance training with a balance platform game console (20 minutes) containing interactive video games based virtual reality for a total of 6 weeks. Before the balance training, a 5-minute relaxation training will be given to both groups. In addition to the virtual reality-based balance and relaxation training, the study group will be given motor imagery training (10 min + 10 min) with action observation before the balance training. The trainings will be applied 2 days a week for 6 weeks. Each training session; 25 min for the control group. (Relaxation training (5 min) + virtual reality-based balance training (20 min), 45 min for the study group. (Relaxation training (5 min) + motor imagery training (20 min) + virtual reality-based balance training (20 min) with action observation. All questionnaires, scales, tests and devices used in the initial evaluations will be repeated for the individuals in both groups at the end of the 6-week training. The effectiveness of the trainings will be compared with appropriate statistical methods within and between groups and discussed in the light of the literature.
Study design
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Double blind (investigator, outcomes assessor)
- Number of arms
- 2
| Arm | Type | Receives |
|---|---|---|
| Balance Training+ Action Observation Training + Motor İmagery Training | Experimental | Other: Balance Training, Other: Motor İmagery Training, Other: Action Observation TrainingThe study group (23 cases) will be given motor imagery training and virtual reality-based balance training along with action observation. |
| Balance Training | Active comparator | Other: Balance TrainingOnly virtual reality-based balance training will be given to the control group (23 cases). |
Who may qualify
- Ages
- 60 to 80 years
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (6 listed)
- To be between 60-80 years old
- Having the ability to speak, read, understand and write Turkish
- To have the cognitive skills to understand and apply the trainings to be applied in the study (with ≥ 24 points from the Mini Mental State Test)
- Being able to do activities of daily living independently
- Being able to walk independently (without using a walking aid and at least 10 meters)
Key exclusion criteria (9 listed)
- Having visual, hearing and sensory impairment
- To have had a trauma, lesion or surgery that may affect balance and musculoskeletal system in the last 6 months
- Having a history of 2 ≥ falls in the last 6 months
- Having any chronic lower extremity pain
- Having an acute or chronic illness that may cause problems with balance and falling
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| Balance TrainingParticipants will be given static and dynamic balance training with a balance platform game console (20 minutes) containing interactive video games based virtual reality for a total of 6 weeks. | Other | Balance Training, Balance Training+ Action Observation Training + Motor İmagery Training |
| Motor İmagery TrainingFor motor imagery training, two visualization scenarios will be created: anterior and posterior motor imagery. One of the visualization scenarios appropriate to each individual's needs will be used. Participants will be asked to perform kinesthetic or visual motor imagery in accordance with the scenario they listened to (10 minutes). | Other | Balance Training+ Action Observation Training + Motor İmagery Training |
| Action Observation TrainingAction observation training will be done using video modeling method. The video content will include Nintendo Wii games in which the games that the person will play in that session are played by someone else and successful scores are achieved (10 minutes). | Other | Balance Training+ Action Observation Training + Motor İmagery Training |
Primary outcome
Measurement of Muscle Activities During Postural Swings
Time frame: 1 day before starting treatment and First day after 6 weeks of treatment (2 times in total)
EMG Biofeedback device will be used to evaluate the muscle activities in the lower leg anterior (m. tibialis anterior) and posterior group (m. gastrocnemius lateralis) muscles while performing postural swings.
Berg Balance Scale
Time frame: 1 day before starting treatment-First day after 6 weeks of treatment (2 times in total)
In this scale, the individual tries to maintain her balance during 14 different activities in which the center of gravity varies and is suitable for daily life activities.The total score on the Berg Balance Scale was 56. Low scores from the scale indicate a high risk of falling.
Portable computerized kinesthetic balance device of participants' static and dynamic balance
Time frame: 1 day before starting treatment-First day after 6 weeks of treatment (2 times in total)
Static and dynamic balance will be evaluated while participants stand on one or two legs on the device (eyes open/closed, in 9 different conditions). The Balance Index Score (DI) displayed on the screen as a result of the test will be recorded as the individual's balance score. The score range is 0-6000. 0 is the best score.
10 meter Walking Test
Time frame: 1 day before starting treatment-First day after 6 weeks of treatment (2 times in total)
How long it takes individuals to walk a distance of 10 meters will be recorded in seconds.
Activity-Specific Balance Confidence Scale
Time frame: 1 day before starting treatment and First day after 6 weeks of treatment (2 times in total)
The Activity-Specific Balanced Confidence Scale will be used to measure balance confidence. The total score ranges from 0 to 100, with higher scores indicating greater confidence.
Movement Imagination Questionnaire-3
Time frame: 1 day before starting treatment-First day after 6 weeks of treatment (2 times in total)
In the questionnaire consisting of 12 items, kinesthetic, internal and external visual imagination abilities are evaluated separately.Higher scores on the survey indicate better mental imagery ability.
Mental Stopwatch Test
Time frame: 1 day before starting treatment-First day after 6 weeks of treatment (2 times in total)
Time Up and Go Test (TUG) will be used to look at the temporal similarity between the durations of real and imagined movement in geriatric individuals. Both test results will be recorded in seconds. The temporal harmony between real and imagined movement will be calculated in delta time. Higher delta time indicates lower motor imagery ability.
Results and safety
This study is still under way. Results are not available in the source record yet.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 8 May 2025.
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part.
Mehmet Gürhan Karakaya contact
Şeyda Ercan Yüceer principal investigator
Mugla Sitki Kocman Univercity
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A study testing Balance Training, Motor İmagery Training and Action Observation Training in people with Imagery (Psychotherapy) and Postural Control, run by Muğla Sıtkı Koçman University at 1 site in Turkey (Türkiye).
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 6 inclusion and 9 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: looking for participants now, as of the sponsor's last update on 8 May 2025. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 1 site in Turkey (Türkiye). Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
Are results available for this study?
This study is still under way. Results are not available in the source record yet.
How can a doctor refer a patient or contact the research team?
Contact Şeyda Ercan Yüceer (+905070202276, seydaercan22@gmail.com), or a site near the patient. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Measurement of Muscle Activities During Postural Swings (time frame: 1 day before starting treatment and First day after 6 weeks of treatment (2 times in total)). The study lists 7 primary outcomes in all. It is what the study was designed to measure, not a finding.
Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 8 May 2025.