Dr Daina Sturnieks

Treating dizziness in older people

Despite effective treatments being available, up to 40% of older people with reported dizziness remain undiagnosed and untreated. A multidisciplinary assessment battery, with new validated assessments of vestibular impairments is required for diagnosing and treating older people with dizziness. This project conducted a randomised-control trial of a multifaceted dizziness intervention based on a multidisciplinary assessment, and developed a multiple profile assessment of dizziness for use in Specialist Clinics.

SafeTrip – step training to reduce falls in older adults

The SafeTrip study will to investigate how older adults learn protective stepping skills to avoid falls when encountering obstacles, trips and slips. With NeuRA’s cutting-edge motion capture system and other wearable devices, the SafeTrip team will be able to observe and analyse movement and muscle activity during reactive or proactive step training.

The SafeTrip team are looking for older volunteers aged 65 years and over who:

• Have not been advised by a medical practitioner not to exercise
• Have no existing conditions that may prevent them from exercising (e.g. severe pain, heel ulcers, exercise intolerance)
• Have no neurological conditions (e.g. Parkinson’s Disease, Multiple Sclerosis, Dementia, etc.)
• Have no history of lower limb, pelvis or vertebral fracture(s) or lower limb joint replacement(s) in the past 6 months.
• Are able to walk 500m comfortably without mobility aids or rest
• Living independently in the Sydney metropolitan community
• Are not currently participating in any other falls prevention research studies

Eligible volunteers will be invited to NeuRA for some baseline assessments before being randomly allocated to either the intervention or control group. Only the intervention group will undertake 3 weekly reactive balance training sessions followed by 3-monthly retraining sessions, while the control group assume their usual activity. All participants will receive a fall prevention information booklet and will be invited back to NeuRA for a 12-month re-assessment.

For more information or to get involved, please contact the SafeTrip team on 02 9399 1067 or safetrip-study@neura.edu.au. HC190952

Mechanistic studies investigating the role of visuo-spatial working memory in balance and gait contr

There is emerging evidence that visuo-spatial processing is involved in balance control during gait. Importantly, visuo-spatial processing may be key for fall avoidance as it enables one to precisely remember the position and physical characteristics of upcoming hazards; an essential skill for the safe navigation of everyday environments. Yet, investigations of visuospatial processing use for obstacle avoidance have been restricted to animal studies and young adults. No studies have been undertaken in older people or people with Parkinson’s Disease for whom visuo-spatial processing deficits are evident and associated with impaired postural control.

This series of studies will investigate visuo-spatial processing required for obstacle avoidance and navigation in older people, older people at high risk of falls and people with Parkinson’s Disease. We will use motion capture to investigate behavioural outcomes and a freely-worn brain imaging device, functional near-infrared spectroscopy to study cortical activation in regions of interest. We will conduct two experiments one involving an obstacle crossing task and another, a stepping task.

We hypothesize that older age, Parkinson’s Disease and increasing task complexity will result in increased risk of tripping and impaired visuo-motor performance, in the obstacle crossing task and in the stepping task, respectively.

This research will greatly improve our understanding of central mechanisms for fall risk and build on our recent behavioural work in this area.

Implementation of a novel exergaming system for improving balance and mobility in aged care rehabili

We propose to install the smartstep system in rehabilitation units as an enjoyable, efficient and effective method of training balance, stepping and executive functions for people attending rehabilitation. The smartstep system includes modified versions of popular videogames, to maximise adherence and target specific balance and executive functions, played using an interactive stepping mat. This work aims to implement and evaluate the use of the smartstep system in aged care rehabilitation using a randomised controlled trial, comparing changes in patient balance and mobility performance between intervention and control groups. System user satisfaction will also be evaluated from the perspective of intervention group patients and therapists. In this randomised controlled trial with usual care control, groups will be compared on validated balance and mobility performance measures.

Training to prevent falls in older people

To date, no studies have examined the potential for cognitive or cognitive-motor training to prevent falls in older people, despite good evidence of fall-related cognitive and physical improvements following both intervention types. Building on our initial work, we have developed and validated a home-based computerised training intervention that can be delivered identically, either while seated (cognitive) or while standing and undertaking balance exercises (cognitive+motor). Our project will also uncover cognitive-motor interactions and their neural pathways related to falls, via state-of-the-art imaging techniques that measure brain structure and functional changes. This intervention addresses both physical and cognitive fall risk factors. It holds promise for a cost-effective fall prevention strategy with multiple health benefits for older people.

Interactive step training to reduce falls in people with MS

More than 50% of people with multiple sclerosis will fall over a 3 month period. A clinical trial is being conducted in 500 people with multiple sclerosis who have difficulties with mobility and balance. We hope results of this study will provide solid scientific evidence to include in fall management programs for people with this condition.

SAFE-PD (Stepping to avoid falls events in people with Parkinson’s disease)

A randomised controlled trial to reduce the risk of falling in people with Parkinson’s disease.

View the clinical trial page for more information and to express interest in volunteering for the study.