Effect of Action Observation Training on Gait Variables and Global Cognitive Functions

Not Applicable

Completed

Conditions: Mild Cognitive Impairment

Registration Number: NCT03522389

Lead Sponsor: Mahidol University

Brief Summary: This study will investigate the effect of Action Observation Teaining (AOT) on gait variables and global cognitive functions in older adults with mild cognitive impairment (MCI).

The specific objectives are 1) to compare gait variables and global cognitive functions among the AOT with gait training, gait training, and control groups at before training, after training, and follow up and 2) to compare gait variables and global cognitive functions among before training, after training, and follow up in each of the groups.

Detailed Description: Participants in this study will be older adults recruiting from the Physical Therapy Center of Mahidol University, Siriraj hospital, and community at Phuttamonthon area (n = 39).

They will be diagnosed as a MCI, using core clinical criteria of the National Institute on Aging and the Alzheimer's Association by a physiotherapist. Prior to participate in the study, participants will be informed the details of the study and sign the informed consent. All participants will be recorded the demographic data and will be assessed visual acuity, hearing, sensation and muscle strength of lower extremity, balance, gait variables, and global cognitive function.

Participants who pass the criteria will be randomly assigned to either the AOT with gait training group (n = 13), the gait training group (n = 13), and the control group (n = 13) by stratified randomization.

Gait variables will be collected by the Force Distribution Measurement platform during walking at comfortable speed (single task) and during counting backwards from 100 by sevens (dual tasks). Global cognitive function will be assessed by the Montral Cognitve Assessment (MoCA).

All varaibles will be assessed 3 times which will be at before training, after 4-week of training, and 4-week follow-up.

Recruitment & Eligibility

Status: COMPLETED

Sex: All

Target Recruitment: 39

Inclusion Criteria

Aged 60-80 years old.
Having subjective evidence of cognitive decline from patients, or from closely informants, or from a clinicians.
Having objective evidence of cognitive decline, deﬁned by using a Montreal Cognitive Assessment (MoCA) 18-24 points.
Independent function in daily life
Independent walking without using gait aids.
Having fall risk, defined by the fall risk threshold (gait velocity < 1 m/s in walking while counting backwards from 100 by sevens).
Able to understand Thai language and follow study protocol.

Exclusion Criteria

Having history of stroke or heart attack or Parkinsonism symptoms.
The presence of major depression disorder deﬁned by a Patient Health Questionnaire-9 > 9 points.
Diagnosis as dementia by neurologists.
Any cardiac or respiratory disease that could cause gait limiting.
Musculoskeletal disorder that affected gait performance.
Balance disorder in assessment day, such as vertigo and dizziness.
Visual acuity with a glasses worse than 6/15 (metric system) in both their eyes.

Study & Design

Study Type: INTERVENTIONAL

Study Design: PARALLEL

Primary Outcome Measures

Name	Time	Method
Gait Speed During the Single Task	Baseline (T1), After 4 weeks of training (T2), and 1-month follow-up (T3)	Gait speed during the single-task condition was measured in meter per second while participants walked at a comfortable pace over a measurement platform without performing any secondary task. Higher gait speed values indicate better physical function and mobility, whereas lower values may reflect impaired motor performance or increased risk of functional decline. Unit of Measure: meters per second (m/s)
Gait Speed During the Dual Task	Baseline (T1), After 4 weeks of training (T2), and 1-month follow-up (T3)	Gait speed during the dual-task condition was measured in meters per second (m/s), while participants walked at a comfortable pace over a measurement platform while simultaneously counting a number backward by 7. Higher gait speed values indicate better cognitive-motor performance, while lower values suggest impaired dual-task ability and potential functional or cognitive decline. Unit of Measure: meters per second (m/s).

Secondary Outcome Measures

Name	Time	Method
Stride Time Variability During Single Task	Baseline (T1), After 4 weeks of training (T2), and 1-month follow-up (T3)	Stride time variability during single task was measured while participants walked at a comfortable pace over a measurement platform. Stride time refers to the duration between successive heel contacts of the same foot. The variability of stride time was quantified using the coefficient of variation (CV), calculated as: (standard deviation of stride time / mean stride time) × 100. Higher CV values indicate greater variability in stride timing, which reflects reduced gait stability or impaired coordination. Lower CV values are considered better outcomes, indicating more stable and consistent gait. Unit of Measure: percentage of coefficient of variation (% Cov).
Stride Time Variability During Dual Task	Baseline (T1), After 4 weeks of training (T2), and 1-month follow-up (T3)	Stride time variability during dual-task walking was measured while participants walked at a comfortable pace, together with counting a number backward by 7 over a measurement platform. Stride time refers to the duration between successive heel contacts of the same foot. The variability of stride time was quantified using the coefficient of variation (CV), calculated as: (standard deviation of stride time / mean stride time) × 100. Higher CV values indicate greater variability in stride timing, which reflects reduced gait stability or impaired motor-cognitive coordination. Lower CV values are considered better outcomes, indicating more stable and consistent gait. Unit of Measure: percentage of coefficient of variation (% Cov).
Montreal Cognitive Assessment (MoCA)	Baseline (T1), After 4 weeks of training (T2), and 1-month follow-up (T3)	The Montreal Cognitive Assessment (MoCA) is a global cognitive screening tool designed to assess multiple cognitive domains, including attention, memory, language, visuospatial skills, executive function, and orientation. The test consists of 30 points in total and ranges from 0 to 30, with higher scores indicating better cognitive function. Unit of Measure: scores.

Trial Locations

Locations (1): Faculty of Physical Therapy, Mahidol University
🇹🇭
Salaya, Nakhon Pathom, Thailand
Faculty of Physical Therapy, Mahidol University
🇹🇭Salaya, Nakhon Pathom, Thailand