Effect of Single-task, Dual-task and Analogy Training During Gait Rehabilitation

Not Applicable

• Conditions: Balance; Reinvestment Propensity; Fall; Gait Rehabilitation
• Interventions: Behavioral: Single-task Training; Behavioral: Dual-task Training; Behavioral: Analogy Training

• Registration Number: NCT03811782
• Lead Sponsor: The University of Hong Kong

Brief Summary

The study aims to examine the effect of single-task, dual-task and analogy training during gait rehabilitation on conscious motor processing propensity, balance, walking ability and fear of falling by older adults at risk of falling in Hong Kong. One-hundred and five healthy older adults will be recruited from elderly community centres in Hong Kong by convenience sampling. They will be randomly assigned into 3 groups (i.e., single-task walking group (active control group), dual-task walking group and analogy walking group). Participants in different groups will have training sessions (about 45 minutes each) three times per week for 4 weeks in a group of 5 participants. A total of 12 sessions will be completed by each participant. All training sessions will be conducted by experienced Hong Kong registered Physiotherapists. In each training session, all groups will have warm-up (5 minutes), balance training (5 minutes), body transport training (5 minutes), body transport with hand manipulation training (5 minutes), walking training with various difficulties in a 10 meters walkway with different instructions in different walking groups (20 minutes) and cool down (5 minutes). Participants in the different groups will receive different instructions during walking training. Well- developed single-task (explicit), dual-task and analogy instructions will be utilized in the single-task walking group, dual-task walking group and analogy walking group, respectively. Each participant will undergo assessment sessions (total 3 assessment sessions) before training at baseline (T0), just after completion of all training sessions (T1) and 6 months after completion of all training sessions (T2). In the baseline assessment, a structural questionnaire will be used to ask for demographics, detailed history of fall incident, detailed medical history, social history and social-economic status of the participants. A battery of assessments will be done to assess physical and cognitive abilities of the participants in all assessment sessions. Single-task walking ability, dual-task walking ability, functional gait and balance assessment, cognitive function, fearing of falling and propensity for conscious motor processing.

All participants will also be asked to record their number of falls prospectively at the time between T1 (completion of all training sessions) and T2 (6 months after completion of all training sessions) using a calendar. The number of falls within the 6-month follow- up period will then be collected.

Detailed Description

Not available

Study Timeline

• Study Start: 2018-10-01
• Study First Submitted: 2019-01-10
• Study First Submitted QC: 2019-01-18
• Study First Posted: 2019-01-22
• Status Verified: 2020-03
• Last Update Submitted: 2020-03-23
• Last Update Posted: 2020-03-25
• Primary Completion: 2021-08-31
• Study Completion: 2021-08-31

Recruitment & Eligibility

• Status: UNKNOWN
• Sex: All
• Target Recruitment: 105

Inclusion Criteria

• Age 65 or above;
• No history of cerebral vascular disease, Parkinson's disease or other neurological deficit;
• Chinese version of the Mini-Mental State Examination (MMSE-C) (Folstein, Folstein, & McHuge, 1975; Chiu, Lee, Chung, & Kwong, 1994) total score of equal or more than 24;
• Able to walk independently indoor for at least 10 meters;
• Older adults with moderate to high risk of falling, as indicated by the score of less than 24 out of 28 in the Tinetti Balance Assessment Tool (Tinetti, 1986).

Read More

Exclusion Criteria

• Any potential participant who cannot meet the inclusion criteria.

Read More

Study & Design

• Study Type: INTERVENTIONAL
• Study Design: PARALLEL

Arm && Interventions

Group	Intervention	Description
Single-task Training Group	Single-task Training	Single-task walking group
Dual-task Training Group	Dual-task Training	Dual-task walking group
Analogy Training Group	Analogy Training	Analogy walking group

Primary Outcome Measures

Name	Time	Method
Baseline propensity for conscious motor processing	Before the start of training	The Chinese version Movement Specific Reinvestment Scale (MSRS-C) (Masters et al., 2005; Wong et al., 2015a; Wong et al., 2015b). The MSRS-C includes two sub-scales: Conscious motor processing and Movement self-consciousness. The scores for both sub-scales ranges from 5-30. A higher score indicate a higher propensity for conscious motor processing.
Change from baseline propensity for conscious motor processing upon completion of training	Upon completion of 12 Training Sessions (4 weeks of training)	The Chinese version Movement Specific Reinvestment Scale (MSRS-C) (Masters et al., 2005; Wong et al., 2015a; Wong et al., 2015b). The MSRS-C includes two sub-scales: Conscious motor processing and Movement self-consciousness. The scores for both sub-scales ranges from 5-30. A higher score indicate a higher propensity for conscious motor processing.
Change from baseline propensity for conscious motor processing at 6 months after the completion of training	6 months after the completion of Training	The Chinese version Movement Specific Reinvestment Scale (MSRS-C) (Masters et al., 2005; Wong et al., 2015a; Wong et al., 2015b). The MSRS-C includes two sub-scales: Conscious motor processing and Movement self-consciousness. The scores for both sub-scales ranges from 5-30. A higher score indicate a higher propensity for conscious motor processing.

Secondary Outcome Measures

Name	Time	Method
Baseline fear of falling	Before the start of training	Fall Efficacy Scale (FES-13) (Tinetti, Richman, \& Powell L, 1990; Tinetti, Leon, Doucette \& Parker, 1994; Hellström \& Lindmark, 1999). The FES-13 score ranges from 16-64. A higher score indicates greater fear of falling.
Number of falls between T1 and T2 (post training to 6 months after completion of training)	6 months after the completion of Training	Record of the the number of falls prospectively at the time between T1 (completion of all training sessions) and T2 (6 months after completion of all training sessions) using a calendar.
Change from baseline dual-task walking ability upon completion of training	Upon completion of 12 Training Sessions (4 weeks of training)	10 meters comfortable and fast walking speed with concurrent verbal or visual-spatial dual-tasks of auditory stroop task (Siu, Catena, Chou, van Donkelaar, \& Woollacott, 2008) or clock test (Plummer-D'Amato, Altmann, Saracino, Fox, Behrman, \& Marsiske, 2008)
Change from baseline dual-task walking ability at 6 months after the completion of training	6 months after the completion of Training	10 meters comfortable and fast walking speed with concurrent verbal or visual-spatial dual-tasks of auditory stroop task (Siu, Catena, Chou, van Donkelaar, \& Woollacott, 2008) or clock test (Plummer-D'Amato, Altmann, Saracino, Fox, Behrman, \& Marsiske, 2008)
Change from baseline Berg Balance Scale score at 6 months after the completion of training	6 months after the completion of Training	Berg Balance Scale (BBS) (Berg, Wood Dauphinee, Williams \& Gayton, 1989)
Change from baseline Timed 'Up & Go' Tests time at 6 months after the completion of training	6 months after the completion of Training	Timed 'Up \& Go' Tests (TU\&G(Podsiadlo \& Richardson, 1991)
Baseline Berg Balance Scale score	Before the start of training	Berg Balance Scale (BBS) (Berg, Wood Dauphinee, Williams \& Gayton, 1989)
Baseline single-task walking ability	Before the start of training	10 meters comfortable and fast walking speed (Bohannon, 1997)
Change from baseline single-task walking ability at 6 months after the completion of training	6 months after the completion of Training	10 meters comfortable and fast walking speed (Bohannon, 1997)
Change from baseline single-task walking ability upon completion of training	Upon completion of 12 Training Sessions (4 weeks of training)	10 meters comfortable and fast walking speed (Bohannon, 1997)
Baseline dual-task walking ability	Before the start of training	10 meters comfortable and fast walking speed with concurrent verbal or visual-spatial dual-tasks of auditory stroop task (Siu, Catena, Chou, van Donkelaar, \& Woollacott, 2008) or clock test (Plummer-D'Amato, Altmann, Saracino, Fox, Behrman, \& Marsiske, 2008)
Change from baseline Tinetti Balance Assessment Tool score at 6 months after the completion of training	6 months after the completion of Training	Tinetti Balance Assessment Tool (Tinetti, 1986)
Baseline Tinetti Balance Assessment Tool score	Before the start of training	Tinetti Balance Assessment Tool (Tinetti, 1986).
Baseline Timed 'Up & Go' Tests time	Before the start of training	Timed 'Up \& Go' Tests (TU\&G(Podsiadlo \& Richardson, 1991)
Change from baseline Timed 'Up & Go' Tests time upon completion of training	Upon completion of 12 Training Sessions (4 weeks of training)	Timed 'Up \& Go' Tests (TU\&G(Podsiadlo \& Richardson, 1991)
Change from baseline Tinetti Balance Assessment Tool score upon completion of training	Upon completion of 12 Training Sessions (4 weeks of training)	Tinetti Balance Assessment Tool (Tinetti, 1986)
Change from baseline Berg Balance Scale score upon completion of training	Upon completion of 12 Training Sessions (4 weeks of training)	Berg Balance Scale (BBS) (Berg, Wood Dauphinee, Williams \& Gayton, 1989)
Cognitive function	Before the start of training	The Chinese version Mini-Mental State Examination (MMSE-C) (Folstein et al., 1975; Chiu et al., 1994). A mark of 24 or above out of 30 is required to meet the inclusion criteria.
Change from baseline fear of falling upon completion of training	Upon completion of 12 Training Sessions (4 weeks of training)	Fall Efficacy Scale (FES-13) (Tinetti, Richman, \& Powell L, 1990; Tinetti, Leon, Doucette \& Parker, 1994; Hellström \& Lindmark, 1999). The FES-13 score ranges from 16-64. A higher score indicates greater fear of falling.
Change from baseline fear of falling at 6 months after the completion of training	6 months after the completion of Training	Fall Efficacy Scale (FES-13) (Tinetti, Richman, \& Powell L, 1990; Tinetti, Leon, Doucette \& Parker, 1994; Hellström \& Lindmark, 1999). The FES-13 score ranges from 16-64. A higher score indicates greater fear of falling.

Trial Locations

Locations (1)

The HKJC Building for Interdisciplinary Research; 🇭🇰 Hong Kong, Hong Kong