Aging HandsNCT07011160
Neural Substrates Underlying Adaptations in Manual Dexterity of Older Adults
A study testing Transcutaneous electrical nerve stimulation (TENS) and Familiarization in people with Aging Hands, run by University of Colorado, Boulder at 1 site in United States.
Trial summary
Age-related declines in motor function can compromise independence and quality of life. This project examines how practice and somatosensory stimulation reshape the neural control of hand muscles in older adults, leveraging neuroplasticity to enhance dexterity. Read more about this study
- Who is it for?
- Ages 54 to 89 yearsHealthy volunteers can take part
- Conditions the study is for
- Aging Hands
- What is being tested?
- Transcutaneous electrical nerve stimulation (TENS) and Familiarization
- Type of treatment
- Lifestyle or therapy programme
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 72 participants
- Where
- 1 siteUnited States
- Study dates
- 1 Apr 2026to 30 Mar 2030
- 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 54 to 89 years
- All sexes
- Healthy volunteers accepted
- Adult, Older adult
Who may be able to join
- Community-dwelling men and women who are 54-89 years of age and able to give fully informed consent; able to read, write, and speak English to ensure safe participation in the project; and able to arrange own transportation to Boulder campus.
Who cannot join
- Cognitive impairment, major psychiatric condition, or unstable depressive disorder that would influence the ability to understand the study and cooperate fully in the proposed protocols; any progressive neurological, muscular, cardiovascular, or skeletal disorder that limits participation, such as (but not limited to) (1) amyotrophic lateral sclerosis, multiple sclerosis, multiple system atrophy, muscular dystrophy, myasthenia gravis, Parkinson's disease, spinal muscular atrophy, spinocerebellar ataxia, or spasticity; (2) congenital, mitochondrial, or thyrotoxic myopathies, fibromyalgia, or myositis; (3) peripheral neuropathy, diabetes, or hypertension; or (4) cancer, gout, osteoarthritis with severe pain, or rheumatoid arthritis; chronic pain condition that would impair the ability to participate in the study; currently taking prescribed medication known to influence neuromuscular function, such as carisoprodol, cyclobenzaprine, metaxalone, and methocarbamol; function-limiting injury to the hands, arms, shoulders, neck, or legs; recent hospitalization (within the last 3 months) or enforced bedrest/sedentary state; inability to attend the evaluation and practice sessions in 2 weeks.
Trial locations and contacts
1 site in 1 country. Contact the study team or a site near you to ask about taking part.
Mélanie Henry, PhD contact
United States1 site
University of Colorado Boulder
Boulder, Colorado, 80309
Roger Enoka, 3039219325, enoka@colorado.edu
Mélanie Henry, PhD, melanie.henry@colorado.edu
About this study
Age-related declines in motor function can compromise independence and quality of life. This project examines how practice and somatosensory stimulation reshape the neural control of hand muscles in older adults, leveraging neuroplasticity to enhance dexterity. By identifying modifiable neural mechanisms that underlie improved motor performance, this research lays the groundwork for targeted, non-invasive interventions that can be translated into clinical and community settings to support healthy aging and functional independence.
Read the detailed description
Managing fine motor function is essential for independence and quality of life in older adults. However, the neural mechanisms underlying age-related declines in manual dexterity remain poorly understood. Traditional models of motor control suggest that the nervous system coordinates movement through shared motor commands across muscles-so-called "motor modules" or "muscle synergies". Yet, emerging evidence reveals that synaptic inputs to motor neurons can vary even within a single muscle, challenging this muscle-level concept and prompting a shift toward more a granular, motor-unit level framework. These "motor unit modes" offer a more accurate representation of the neural architecture of motor control.
This project will be the first to investigate whether improvements in manual dexterity-a core marker of neurological health in aging-are associated with neuroplastic changes in the strength of functionally relevant motor unit modes. Older adults (54-89 yrs) will practice a test of manual dexterity (Grooved Pegboard) with or without performance-enhancing transcutaneous electrical nerve stimulation (TENS). Outcomes will include force steadiness and motor unit activity derived from high-density electromyography during low-intensity contractions.
Our central hypothesis is that improvements in manual dexterity will be mediated by neuroplastic strengthening of functionally relevant motor unit modes. The project has three specific aims:
- Characterize short-term neuroplastic adaptations following task familiarization.
- Determine the effects of steady-contraction training on neuromuscular control.
- Evaluate the added benefit of somatosensory augmentation with TENS.
Innovation. This study introduces two key innovations: (1) It quantifies, for the first time, the extent to which improvements in a dynamic behavior are mediated by changes in shared synaptic inputs across motor units during low-intensity contractions; (2) it evaluates the capacity of TENS-induced somatosensory feedback to boost neuroplasticity in the aging motor system.
Expected Outcomes. We expect that gains in force steadiness and pegboard performance will strongly correlate with increased strength and consistency of motor unit modes. These findings will clarify the neural mechanisms underlying motor adaptation in older adults and define new markers for assessing motor function.
Impact. Aligned with the goals of PA-25-303 and the missions of NINDS and NIA, this research will generate foundational knowledge of spinal motor control and establish motor unit modes as a new biomarker for evaluating motor function and therapeutic efficacy. This work has the potential to inform targeted interventions aimed at preserving dexterity and independence in older individuals and those with neurological dysfunction.
- Conditions
- Aging Hands
- Being tested
- Transcutaneous electrical nerve stimulation (TENS), Familiarization
- Keywords
- manual dexterity, force steadiness, motor units, neuroplasticity
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Transcutaneous electrical nerve stimulation (TENS)Behavioural
Force-steadiness training will be performance either without (sham) or paired with TENS.
FamiliarizationBehavioural
Participants will perform 25 trials of the Grooved Pegboard Test
| Study group | Role | What they receive |
|---|---|---|
| Pegboard time | Experimental | Participants will be assigned to a group of slow or fast improvers based on the decrease in pegboard time after an initial familiarization session. Receives: Behavioral: Familiarization |
| Force-steadiness practice | Experimental | Participants will complete three training sessions in which they perform force-steadiness tasks either alone (sham) or paired with transcutaneous electrical nerve stimulation (TENS). One-half of the participants in each improver group will be to each of these practice groups. Receives: Behavioral: Transcutaneous electrical nerve stimulation (TENS) |
What is being measured
The primary outcome is the main question the study is designed to answer.
Grooved Pegboard Test
Time taken to insert 25 keyhole-shaped pegs into matching holes on the pegboard.
Measured: From enrollment until the end of the study at 2 weeks.
Force steadiness
Coefficient of variation for force during low-intensity isometric contractions.
Measured: From enrollment until the end of the study at 2 weeks.
Motor unit modes
The subsets of motor units in hand-forearm muscles that exhibit correlated modulation of discharge rate during low-intensity isometric contractions. The motor unit activity will be identified from high-density surface electromyography with grid electrodes.
Measured: From enrollment until study completion at 2 weeks.
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted8 Jun 2025
- Study start1 Apr 2026 (estimated)
- Primary completion30 Mar 2030 (estimated)
- Study completion30 Mar 2030 (estimated)
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Publications (3)Papers the sponsor has linked to this study.
- Other trials for Aging HandsStudies 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
- Basic science
- Allocation
- Randomised
- Intervention model
- Sequential
- Masking
- Double blind
- Who is masked
- Participant, Outcomes assessor
- Enrolment
- 72 participants (estimated)
Sponsor and investigators
- Lead sponsor
- University of Colorado, Boulder
- Sponsor type
- University, hospital or other
- Responsible party
- Principal investigator, Roger Enoka, University of Colorado, Boulder
- Investigators
- Roger M Enoka, PhD, Principal investigator, University of Colorado, Boulder
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT07011160
- Sponsor's protocol ID
- 1R01NS141829-01A1
- Status last verified
- May 2025
- First submitted
- 30 May 2025
- Last updated
- 8 Jun 2025
- Results posted
- No
- Data monitoring committee
- No
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- No: In this proposed project, the cleaned, item-level spreadsheet data for all variables will be shared openly, along with example quantifications and transformations from initial raw data. Final files used to generate specific analyses to answer the Specific Aims and related results will also be shared. The rationale for sharing only cleaned data is to foster ease of data reuse.
Publications
Tvrdy T, Henry M, Enoka RM. Influence of the variability in motor unit discharge times and neural drive on force steadiness during submaximal contractions with a hand muscle. J Neurophysiol. 2025 Feb 1;133(2):697-708. doi: 10.1152/jn.00333.2024. Epub 2025 Jan 17.
PubMed 39823197Daneshgar S, Tvrdy T, Enoka RM. Explaining the influence of practice on the grooved pegboard times of older adults: role of force steadiness. Exp Brain Res. 2024 Aug;242(8):1971-1982. doi: 10.1007/s00221-024-06878-9. Epub 2024 Jun 25.
PubMed 38916760Daneshgar S, Tvrdy T, Enoka RM. Practice-Induced Changes in Manual Dexterity of Older Adults Depend on Initial Pegboard Time. Med Sci Sports Exerc. 2023 Nov 1;55(11):2045-2052. doi: 10.1249/MSS.0000000000003245. Epub 2023 Jun 27.
PubMed 37379250
Study at a glance
From the registry record, last updated by the sponsor on 8 Jun 2025. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Neural Substrates Underlying Adaptations in Manual Dexterity of Older Adults
- ClinicalTrials.gov ID
- NCT07011160
- Acronym / sponsor ID
- 1R01NS141829-01A1
- Conditions
- Aging Hands
- Keywords
- manual dexterity, force steadiness, motor units, neuroplasticity
- Study type
- Interventional
- Recruitment status
- Not yet recruiting
- Enrolment
- 72 participants (estimated)
- Lead sponsor
- University of Colorado, BoulderUniversity, hospital or other
- Study start
- 1 Apr 2026 (estimated)
- Primary completion
- 30 Mar 2030 (estimated)
- Study completion
- 30 Mar 2030 (estimated)
- First posted
- 8 Jun 2025 (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.
Age-related declines in motor function can compromise independence and quality of life. This project examines how practice and somatosensory stimulation reshape the neural control of hand muscles in older adults, leveraging neuroplasticity to enhance dexterity. By identifying modifiable neural mechanisms that underlie improved motor performance, this research lays the groundwork for targeted, non-invasive interventions that can be translated into clinical and community settings to support healthy aging and functional independence.
Detailed description
Managing fine motor function is essential for independence and quality of life in older adults. However, the neural mechanisms underlying age-related declines in manual dexterity remain poorly understood. Traditional models of motor control suggest that the nervous system coordinates movement through shared motor commands across muscles-so-called "motor modules" or "muscle synergies". Yet, emerging evidence reveals that synaptic inputs to motor neurons can vary even within a single muscle, challenging this muscle-level concept and prompting a shift toward more a granular, motor-unit level framework. These "motor unit modes" offer a more accurate representation of the neural architecture of motor control.
This project will be the first to investigate whether improvements in manual dexterity-a core marker of neurological health in aging-are associated with neuroplastic changes in the strength of functionally relevant motor unit modes. Older adults (54-89 yrs) will practice a test of manual dexterity (Grooved Pegboard) with or without performance-enhancing transcutaneous electrical nerve stimulation (TENS). Outcomes will include force steadiness and motor unit activity derived from high-density electromyography during low-intensity contractions.
Our central hypothesis is that improvements in manual dexterity will be mediated by neuroplastic strengthening of functionally relevant motor unit modes. The project has three specific aims:
- Characterize short-term neuroplastic adaptations following task familiarization.
- Determine the effects of steady-contraction training on neuromuscular control.
- Evaluate the added benefit of somatosensory augmentation with TENS.
Innovation. This study introduces two key innovations: (1) It quantifies, for the first time, the extent to which improvements in a dynamic behavior are mediated by changes in shared synaptic inputs across motor units during low-intensity contractions; (2) it evaluates the capacity of TENS-induced somatosensory feedback to boost neuroplasticity in the aging motor system.
Expected Outcomes. We expect that gains in force steadiness and pegboard performance will strongly correlate with increased strength and consistency of motor unit modes. These findings will clarify the neural mechanisms underlying motor adaptation in older adults and define new markers for assessing motor function.
Impact. Aligned with the goals of PA-25-303 and the missions of NINDS and NIA, this research will generate foundational knowledge of spinal motor control and establish motor unit modes as a new biomarker for evaluating motor function and therapeutic efficacy. This work has the potential to inform targeted interventions aimed at preserving dexterity and independence in older individuals and those with neurological dysfunction.
Study design
- Primary purpose
- Basic science
- Allocation
- Randomised
- Intervention model
- Sequential
- Masking
- Double blind (participant, outcomes assessor)
- Number of arms
- 2
| Arm | Type | Receives |
|---|---|---|
| Pegboard time | Experimental | Behavioral: FamiliarizationParticipants will be assigned to a group of slow or fast improvers based on the decrease in pegboard time after an initial familiarization session. |
| Force-steadiness practice | Experimental | Behavioral: Transcutaneous electrical nerve stimulation (TENS)Participants will complete three training sessions in which they perform force-steadiness tasks either alone (sham) or paired with transcutaneous electrical nerve stimulation (TENS). One-half of the participants in each improver group will be to each of these practice groups. |
Who may qualify
- Ages
- 54 to 89 years
- Sex
- All
- Healthy volunteers
- Accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (1 listed)
- Community-dwelling men and women who are 54-89 years of age and able to give fully informed consent; able to read, write, and speak English to ensure safe participation in the project; and able to arrange own transportation to Boulder campus.
Key exclusion criteria (1 listed)
- Cognitive impairment, major psychiatric condition, or unstable depressive disorder that would influence the ability to understand the study and cooperate fully in the proposed protocols; any progressive neurological, muscular, cardiovascular, or skeletal disorder that limits participation, such as (but not limited to) (1) amyotrophic lateral sclerosis, multiple sclerosis, multiple system atrophy, muscular dystrophy, myasthenia gravis, Parkinson's disease, spinal muscular atrophy, spinocerebellar ataxia, or spasticity; (2) congenital, mitochondrial, or thyrotoxic myopathies, fibromyalgia, or myositis; (3) peripheral neuropathy, diabetes, or hypertension; or (4) cancer, gout, osteoarthritis with severe pain, or rheumatoid arthritis; chronic pain condition that would impair the ability to participate in the study; currently taking prescribed medication known to influence neuromuscular function, such as carisoprodol, cyclobenzaprine, metaxalone, and methocarbamol; function-limiting injury to the hands, arms, shoulders, neck, or legs; recent hospitalization (within the last 3 months) or enforced bedrest/sedentary state; inability to attend the evaluation and practice sessions in 2 weeks.
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 |
|---|---|---|
| Transcutaneous electrical nerve stimulation (TENS)Force-steadiness training will be performance either without (sham) or paired with TENS. | Behavioural | Force-steadiness practice |
| FamiliarizationParticipants will perform 25 trials of the Grooved Pegboard Test | Behavioural | Pegboard time |
Primary outcome
Grooved Pegboard Test
Time frame: From enrollment until the end of the study at 2 weeks.
Time taken to insert 25 keyhole-shaped pegs into matching holes on the pegboard.
Force steadiness
Time frame: From enrollment until the end of the study at 2 weeks.
Coefficient of variation for force during low-intensity isometric contractions.
Motor unit modes
Time frame: From enrollment until study completion at 2 weeks.
The subsets of motor units in hand-forearm muscles that exhibit correlated modulation of discharge rate during low-intensity isometric contractions. The motor unit activity will be identified from high-density surface electromyography with grid electrodes.
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 Jun 2025.
- Background: PubMed 39823197Tvrdy T, Henry M, Enoka RM. Influence of the variability in motor unit discharge times and neural drive on force steadiness during submaximal contractions with a hand muscle. J Neurophysiol. 2025 Feb 1;133(2):697-708. doi: 10.1152/jn.00333.2024. Epub 2025 Jan 17.
- Background: PubMed 38916760Daneshgar S, Tvrdy T, Enoka RM. Explaining the influence of practice on the grooved pegboard times of older adults: role of force steadiness. Exp Brain Res. 2024 Aug;242(8):1971-1982. doi: 10.1007/s00221-024-06878-9. Epub 2024 Jun 25.
- Background: PubMed 37379250Daneshgar S, Tvrdy T, Enoka RM. Practice-Induced Changes in Manual Dexterity of Older Adults Depend on Initial Pegboard Time. Med Sci Sports Exerc. 2023 Nov 1;55(11):2045-2052. doi: 10.1249/MSS.0000000000003245. Epub 2023 Jun 27.
- Individual participant dataSharing planned: No. In this proposed project, the cleaned, item-level spreadsheet data for all variables will be shared openly, along with example quantifications and transformations from initial raw data. Final files used to generate specific analyses to answer the Specific Aims and related results will also be shared. The rationale for sharing only cleaned data is to foster ease of data reuse.
Related trials for Aging Hands
Active, not recruiting
The Effects of PeptiStrong and Whey on Muscle Function In Older Adults
Healthy Ageing, Protein Supplementation
Recruiting
The Efficacy of a Technology-Assisted Block Training Program on Cognitive Function, Hand Dexterity, and Grip Strength in Community-Dwelling Older Adults: A Mixed-Methods Research
Community-Dwelling Older Adults, Aging
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.
Mélanie Henry, PhD contact
Roger M Enoka, PhD principal investigator
University of Colorado, Boulder
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A study testing Transcutaneous electrical nerve stimulation (TENS) and Familiarization in people with Aging Hands, run by University of Colorado, Boulder at 1 site in United States.
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 1 inclusion and 1 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: opening soon, as of the sponsor's last update on 8 Jun 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 United States. 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 Roger Enoka, PhD (13039219325, enoka@colorado.edu), or a site near the patient. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Grooved Pegboard Test (time frame: From enrollment until the end of the study at 2 weeks.). The study lists 3 primary outcomes in all. It is what the study was designed to measure, not a finding.
Where can I read the original study information?
On the ClinicalTrials.gov record for NCT07011160, which also lists 3 linked publications.
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 Jun 2025.