Neural, Cognitive, and Biomechanical Determinants of Falls in Older Adults

Summary

The goal of this clinical trial with an embedded observational phase is to evaluate whether a phenotype-guided, personalized rehabilitation program can improve fall risk and underlying neural control mechanisms in older adults aged ≥65 years, including both high and low fall-risk individuals.

The main questions it aims to answer are:

Do older adults at high fall risk exhibit altered neural, neurocognitive, and biomechanical profiles compared with low/no fall-risk individuals? Does personalized rehabilitation guided by neurophysiological and neurocognitive profiles result in greater reductions in fall risk and improvements in motor control compared with conventional rehabilitation?

Researchers will compare personalized phenotype-guided rehabilitation to conventional evidence-based fall-prevention exercise to determine whether targeted, mechanism-based intervention leads to superior clinical and mechanistic outcomes.

Participants will:

Undergo a comprehensive multimodal assessment including neurophysiological (EEG, EMG), neurocognitive (fNIRS, dual-task testing), and biomechanical (gait and balance) measures Be classified into fall-risk and neurophysiological control profiles based on assessment results (Phase 2 - high fall-risk participants only) be randomly assigned to either personalized rehabilitation or conventional rehabilitation Attend supervised exercise sessions 2-3 times per week for 8-12 weeks Complete gait, balance, and cognitive-motor assessments before and after the intervention Record falls prospectively using monthly fall diaries and follow-up monitoring over 3-6 months

Conditions

• Accidental Falls/Prevention & Control

Interventions

OTHER

Personalized Neurophysiological Rehabilitation

The intervention targets underlying neural control mechanisms and is adapted based on identified control strategies (e.g., cortical-dominant, reflex-dominant, or integrated control). Intervention components may include: Task-specific balance and gait training under variable sensory conditions Dual-task training to improve cognitive-motor integration External focus and rhythm-based training to enhance movement automaticity Reaction-based and perturbation training to improve adaptability Progressive modulation of task complexity based on participant response Program details: Duration: 8-12 weeks Frequency: 2-3 supervised sessions per week Session length: 45-60 minutes The intervention is dynamically progressed based on neurophysiological and functional responses.

OTHER

Conventional Fall-Prevention Exercise Program

The intervention focuses on general physical improvements rather than individualized neural mechanisms. Intervention components include: Balance training (static and dynamic postural control exercises) Lower-limb strengthening exercises (e.g., sit-to-stand, step-ups, resistance training) Gait and functional mobility training (walking, turning, obstacle negotiation) Flexibility and mobility exercises Education on fall prevention strategies Program details: Duration: 8-12 weeks Frequency: 2-3 supervised sessions per week Session length: 45-60 minutes Progression is based on

Sponsors & Collaborators

• University of Sharjah

  lead OTHER

Principal Investigators

• Ibrahim Moustafa Abuamer, professor · University of Sharjah

Study Design

Allocation

RANDOMIZED

Purpose

OTHER

Masking

SINGLE

Model

PARALLEL

Eligibility

Min Age

65 Years

Sex

ALL

Healthy Volunteers

Yes

Timeline & Regulatory

Start

2026-12-31

Primary Completion

2028-12-31

Completion

2028-12-31

Countries

• United Arab Emirates

Study Locations