The Dual-task Training Under Different Priority Instructions on Gait Speed in Community-dwelling Older Adults

Not Applicable

Completed

• Conditions: Gait; Postural Balance

• Registration Number: NCT03886805
• Lead Sponsor: University of Pernambuco

Brief Summary

This study analyzed the effect of different modalities of dual-task training in the improvement of gait biomechanics, postural balance, falls episodes, executive functioning, and quality of life in community-dwelling older adults. Half of the participants have undertaken a dual-task protocol training with progression from variable-priority to fixed-priority instructions, while the other half have undertaken a dual-task protocol training under variable-priority instructions.

Detailed Description

Although dual-task training for improving postural balance is an emerging interest area, the effects of dual tasks and dual-task training on static and dynamic postural stability remain unclear. Even though variable (alternating) instructional priority dual-task training has been shown higher effect than fixed (concurrent) priority dual-task training approach to improving the balance impairments, we must consider in everyday pragmatic situations, motor, and cognitive tasks are often demanded simultaneously and this requires an individual's attention toward an external source of attention while performing a primary task. Then, our rationale for this study is older adults who underwent a training protocol composed of a dual task with variable and fixed instructional priority will achieve better improvements regarding the studied variables in comparison to the group who will be submitted a protocol composed only by dual-task with variable priority training. Therefore, this protocol for a six-month, double-blind, randomized controlled trial with six-month follow-up post-training analyzed whether examine whether a dual-task protocol training with progression from variable priority to fixed priority instructions is effective in improvement of gait biomechanics, postural balance, falls episodes, executive functioning and quality of life in community-dwelling older adults.

Study Timeline

• Study First Submitted: 2019-03-12
• Study First Submitted QC: 2019-03-20
• Study First Posted: 2019-03-22
• Study Start: 2019-04-30
• Primary Completion: 2020-03-05
• Study Completion: 2020-03-05
• Status Verified: 2021-07
• Last Update Submitted: 2021-07-14
• Last Update Posted: 2021-07-21

Recruitment & Eligibility

• Status: COMPLETED
• Sex: All
• Target Recruitment: 60

Inclusion Criteria

Not provided

Exclusion Criteria

Not provided

Study & Design

• Study Type: INTERVENTIONAL
• Study Design: PARALLEL

Primary Outcome Measures

Name	Time	Method
Gait spatiotemporal variables	Post-intervention at week 24	These variables will be acquired by a couple of inertial sensors attached on participant's feet during walking on a 30-meter flat and level corridor under a single-task (only gait), dual-task under variable- (gait alternating with a cognitive task) and fixed-priority (gait and cognitive task performing simultaneously).

Secondary Outcome Measures

Name	Time	Method
Tri-axial acceleration, angular velocity, and displacement of the body center of mass during performing the Anterior Functional Reach test.	Post-intervention at week 24	These biomechanical variable acquired during performing the Anterior Functional Reach test will be assessed by an inertial sensor fixed on the participant's waist.
Tri-axial acceleration, angular velocity, and displacement of the body center of mass during performing the Sitting-rising test from the floor.	Post-intervention at week 24	These biomechanical variable acquired during performing the Sitting-rising test from the floor will be assessed by an inertial sensor fixed on the participant's waist.
Tri-axial acceleration, angular velocity and displacement of the body center of mass during gait under dual-task with fixed-priority instruction	Post-intervention at week 24	These biomechanical variable acquired during gait under dual-task with fixed-priority instruction will be assessed by an inertial sensor fixed on the participant's waist.
Tri-axial acceleration, angular velocity, and displacement of the body center of mass during performing the Stroop test in quasi-static standing posture	Post-intervention at week 24	These biomechanical variable acquired during performing the Stroop test in quasi-static standing posture will be assessed by an inertial sensor fixed on the participant's waist.
Tri-axial acceleration, angular velocity and displacement of the body center of mass during performing the Clinical Test of Sensory Interaction and Balance (CTSIB).	Post-intervention at week 24	These biomechanical variable acquired during performing the Clinical Test of Sensory Interaction and Balance (CTSIB) will be assessed by an inertial sensor fixed on the participant's waist.
Timed Up and Go conventional (TUG conventional)	Post-intervention at week 24	Test of basic mobility skills analyzed during rising from a chair, walking, turning the obstacle, and sitting again on the chair.
Tri-axial acceleration, angular velocity, and displacement of the body center of mass during manual timed up and go test.	Post-intervention at week 24	These biomechanical variable acquired during manual timed up and go test will be assessed by an inertial sensor fixed on the participant's waist.
Tri-axial acceleration, angular velocity, and displacement of the body center of mass during cognitive timed up and go test.	Post-intervention at week 24	These biomechanical variable acquired during cognitive timed up and go test will be assessed by an inertial sensor fixed on the participant's waist.
Timed Up and Go manual (TUG manual)	Post-intervention at week 24	Test of basic mobility skills analyzed during rising from a chair, walking, turning the obstacle, and sitting again on the chair, while the participant carries a dish with a cup on it.
Clinical Test of Sensory Interaction and Balance (CTSIB)	Post-intervention at week 24	This test will be used to assess the sensory integration on postural balance during standing on a stable and unstable surface with eyes open and closed.
Stroop test in a quasi-static standing posture	Post-intervention at week 24	This test will be used to measure a participant's selective attention capacity and skills, as well as his/her processing speed ability in quasi-static standing posture.
Five Times Sit-to-Stand test from a chair	Post-intervention at week 24	The functional performance of the lower limbs taken to lifting and sitting on a chair for five times. The time will be measured by a stopwatch
Short form of the Geriatric Depression Scale (GDS-15)	Post-intervention at week 24	This 15-item instrument will be used to evaluate the suggestive depression symptoms in the participants. Its items require a yes/no response. Answers indicating depression are in bold and italicized; score one point for each one selected. Each answer "yes" marked with X in questions 3, 4, 6, 8, 9, 10, 12, 14 and 15 or answer "no" noted in questions 1, 5, 7, 11 and 13, computes 1 point. A score of 0 to 5 is normal. A score greater than 5 indicates depression
Tri-axial acceleration, angular velocity, and displacement of the body center of mass during gait under single task	Post-intervention at week 24	These biomechanical variable acquired during gait under single task will be assessed by an inertial sensor fixed on the participant's waist.
Tri-axial acceleration, angular velocity and displacement of the body center of mass during gait under dual-task with variable-priority instruction	Post-intervention at week 24	These biomechanical variable acquired during gait under dual-task with variable-priority instruction will be assessed by an inertial sensor fixed on the participant's waist.
Tri-axial acceleration, angular velocity and displacement of the body center of mass during conventional timed up and go test.	Post-intervention at week 24	These biomechanical variable acquired during conventional timed up and go test will be assessed by an inertial sensor fixed on the participant's waist.
Tri-axial acceleration, angular velocity, and displacement of the body center of mass during performing the Five Times Sit-to-stand test from a chair.	Post-intervention at week 24	These biomechanical variable acquired during performing the Five Times Sit-to-stand test from a chair will be assessed by an inertial sensor fixed on the participant's waist.
Postural Balance Test (PBT)	Post-intervention at week 24	The Postural Balance Test evaluate the static and dynamic balance, in order to verify the typology of motor regulation, i.e. the exteroceptive or visual (six items) and interoceptive or vestibular (eight items), besides the general - proprioceptive information - of the movements.
Timed Up and Go cognitive (TUG cognitive)	Post-intervention at week 24	Test the basic mobility skills analyzed during raising from a chair, walking, bypassing the obstacle, and sitting back in the chair while the participant performs a concurrent cognitive task (solving mathematical subtraction operations).
Trail making test (TMT)	Post-intervention at week 24	Trail making test will be used to assess the participants executive abilities, which requires a variety of mental abilities including letter and number recognition mental flexibility, visual scanning, and motor function of upper limbs
Falls Efficacy Scale-International (FES-I)	Post-intervention at week 24	The 16-item Falls Efficacy Scale-International will be used to measure the participant's fear of falling (the concerns about falling). The sum of all 16 items is considered to compute a total score. The higher the total score achieved by the participant, the higher the concerns about falling.
Stroop test in sit posture	Post-intervention at week 12	This test will be used to measure a participant's selective attention capacity and skills, as well as his/her processing speed ability in sit posture
Sitting-and-rising test from the floor	Post-intervention at week 24	Sitting-and-rising test from the floor will be used to quantify how many supports (hands and/or knees or, still, hands on the knees or legs) the individual uses to sit and lift from the floor.
Anterior functional reach test	Post-intervention at week 24	Anterior functional reach test will be used to determine how far the participants are able to move forward within their stability limit. It is widely used to identify the risk of falling in older adults
Activities-specific Balance Confidence (ABC Scale)	Post-intervention at week 24	The 16-item Activities-specific Balance Confidence Scale will be used to measure the level of balance confidence of the individual during the accomplishment in performing daily activities. The higher the total score achieved by the participant, the higher the level of balance confidence and functioning in daily activities
Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36)	Post-intervention at week 24	Medical Outcomes Study 36-Item Short-Form Health Survey will be used to evaluate the quality of life of the participants. The SF-36 consists of eight scaled scores, which are the weighted sums of the questions in their section. Each scale is directly transformed into a 0-100 scale on the assumption that each question carries equal weight. The lower the score the more disability. The higher the score the less disability i.e., a score of zero is equivalent to maximum disability and a score of 100 is equivalent to no disability
The falls events	Post-intervention at week 24	Fall events will be evaluated through a falls diary, delivered monthly by each participant. The participants should note in this diary the day and the fall causes and circumstances.

Trial Locations

Locations (1)

Francis Trombini de Souza; 🇧🇷 Petrolina, Pernambucano, Brazil