Clinical trials

The overall objective for this clinical trial is to provide evidence for internal and external cueing for physical therapists and other rehabilitation clinicians to optimize resistance training within rehabilitation for older adults. The main questions it aims to answer are: * What is the impact of external focus (providing velocity of movement for each repetition) compared to internal focus (i.e., no cues, control group) on physical percent velocity loss and neuromuscular activation in older adults with sarcopenia? * Does internal and external focus influence motivation and perceptual workload following resistance training in older adults with sarcopenia? Researchers will compare external focus to internal focus to see if external focus impacts percent velocity loss, motivation, and perceived workload. Participants will: * Visit the lab once per week for 3 weeks * Perform exercise testing using a leg press * Answer questionnaires regarding perceived workload and motivation before and after exercise

The nervous system responds to changes in external or internal conditions by altering the behavior of neurons through multiple forms of neural plasticity. A specific form of plasticity, "homeostatic plasticity", stabilizes neural activity by driving the excitability of neurons toward a "set-point" level of activity. Over the last six years, new data have come to light showing that the vestibular system also possess a robust capacity to modulate sensitivity to self-motion cues in response to prolonged periods of motion. Collectively, these studies have demonstrated a capacity to use motion perturbations (i.e., low, or high levels of vestibular stimulation) to dynamically adjust the sensitivity of the vestibular system on both the single neuron and behavioral levels. The ability to use subthreshold motion stimuli to drive plasticity in the vestibular system motivates this study. The investigators aim to determine the impact of subthreshold motion on (a) balance performance and (b) balance training in individuals with peripheral vestibular hypofunction.

Alzheimer's disease and related dementias are a public health crisis impacting individuals across the world. In the United States, adults living in rural areas face an elevated risk for cognitive impairment mainly due to disparities in care, higher sedentary behavior, and reduced education. This project proposes to assess the impact of a remotely delivered exercise program (i.e., RemoteEx+) through a smartphone application. The app is programmed by our team and provides video demonstrations of exercises, workout regimes, motivational messaging, and weekly ADRD risk reduction education. The project aims to assess with a pre/post design the following aims: * Aim 1. Assess the RemoteEx+ intervention exercise adherence, efficacy, enjoyment, and quality of life. We hypothesize that rural adults will report high exercise adherence (80% of session adherence), efficacy (\>50% on Self Efficacy for Exercise), and enjoyment (\>5.0 on Intrinsic Motivation Inventory - Interest / Enjoyment Subscale) and that these variables will be positively correlated with quality of life scores (36-Item Short Form Health Survey \[SF-36\]) * Aim 2. Determine the impact of a technology-driven exercise program on blood pressure and functional mobility associated with dementia risk. We hypothesize that the exercise program will result in improvements in blood pressure and functional mobility (2-minute step test and 30-second chair rise test) and that participants with high exercise adherence will see the greatest improvements in biomarkers associated with reduced dementia risk. * Aim 3. Reduce health disparities among rural-dwelling Nebraska and Kansas residents. We hypothesize that RemoteEx+ will reduce barriers to exercise (Barriers to Being Active Quiz and improve knowledge surrounding dementia and modifiable risk factors (Dementia Knowledge Assessment Tool - Version 2 \[DKAT2\]) that will result in fewer lifestyle-related health disparities for the communities involved in this study. The results from this project will inform whether RemoteEx+ has an impact on the stated outcomes above for adults living in rural areas.

Patients with Type 1 Diabetes Mellitus (T1DM) have a higher risk of low-trauma (osteoporotic) fracture that is 7-12 times higher than non-diabetics. The bone density of people with Type 1 Diabetes is higher at the time of fracture than in non-diabetics. This suggests the presence of underlying bone tissue mechanical defects. The potential benefits to participants would be knowledge gained about their bone density and the results of laboratory tests. On a wider scale, there may be general benefits to society because the knowledge gained from this study may help better understand the effects of diabetes on bone health