The Effects of Dual-Task Exercises Performed Through Telerehabilitation on Balance, Falls, Cognitive Function, and Sleep Quality in Geriatric Individuals: A Randomised Control Trial
试验速览
- 阶段
- 不适用
- 状态
- 招募中
- 发起方
- 入组人数
- 60
- 试验地点
- 1
- 主要终点
- Balance performance
研究概览
简要总结
The purpose of this study is to investigate the effects of dual-task exercises-which simultaneously target cognitive and motor functions-delivered via telerehabilitation on fall risk, balance, cognitive functions, and sleep quality in geriatric individuals.Aging is often associated with balance disorders, increased fall risk, cognitive decline, and impaired sleep quality, all of which significantly impact the quality of life in the elderly. Dual-task interventions require individuals to perform physical and cognitive tasks concurrently, aiming to improve sensorimotor control and enhance balance strategies under cognitive load.This study utilizes telerehabilitation as a cost-effective and sustainable solution to facilitate access to healthcare services, providing a remote alternative to face-to-face rehabilitation. The research aims to demonstrate that dual-task exercises performed through telerehabilitation can contribute to functional recovery, reduce the fear of falling, and increase the safe mobility capacity of geriatric individuals.
详细描述
Aging is associated with various physiological and functional changes that can negatively affect independence and quality of life in older adults. Among the most common problems observed in geriatric individuals are balance impairments, increased risk of falls, decline in cognitive functions, and deterioration in sleep quality. These conditions not only reduce functional independence but also increase morbidity and healthcare utilization in older populations. Therefore, effective and accessible rehabilitation strategies are needed to address these multidimensional problems.
In recent years, technological approaches have increasingly been integrated into rehabilitation programs. One of the most prominent approaches is telerehabilitation, which enables healthcare professionals to deliver rehabilitation interventions remotely using digital communication technologies. Telerehabilitation facilitates access to rehabilitation services for older individuals who may have limited mobility or difficulty accessing healthcare facilities. Previous studies have demonstrated that telerehabilitation can provide outcomes comparable to conventional face-to-face rehabilitation, particularly in terms of pain reduction, functional improvement, and quality of life enhancement in musculoskeletal conditions. These findings suggest that telerehabilitation may serve as a safe, effective, and sustainable rehabilitation model for older adults.
Dual-task training has emerged as an important intervention approach aimed at improving both cognitive and motor functions simultaneously. Dual-task exercises require individuals to perform a motor task while concurrently completing a cognitive task, thereby stimulating the interaction between motor and cognitive systems. This approach reflects real-life situations in which individuals frequently perform multiple tasks at the same time during daily activities. Research has shown that dual-task training can improve postural stability, enhance cognitive performance, and reduce fall risk in older adults by strengthening sensorimotor control and motor-cognitive integration.
Functional mobility and dynamic balance are important determinants of independence in older adults. The interaction between cognitive load and motor performance plays a critical role in maintaining postural control and preventing falls in this population. In addition, cognitive status in older individuals is frequently evaluated using standardized tools that assess attention, memory, executive functions, and orientation, as these cognitive processes are closely related to balance performance and functional mobility.
Sleep quality is another important factor affecting the health and functional capacity of older adults. Poor sleep quality has been associated with decreased cognitive performance, impaired balance, and increased risk of falls. Previous studies have reported that combined physical and cognitive training interventions, such as dual-task exercise programs, may improve not only physical performance but also cognitive functioning and sleep quality in older adults.
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Parallel
- 主要目的
- Treatment
- 盲法
- Single (Outcomes Assessor)
入排标准
- 年龄范围
- 65 Years 至 74 Years（Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Participants aged 65 to 74 years.
- •Berg Balance Scale (BBS) score between 41 and
- •Tinetti Performance Oriented Mobility Assessment (POMA) score between 19 and
- •Mini-Mental State Examination (MMSE) score between 18 and
- •Independent in activities of daily living.
- •Able to walk without assistive devices.
- •Capable of using video call applications for telerehabilitation sessions.
排除标准
- •Participants younger than 65 years.
- •Individuals with cardiovascular diseases.
- •Individuals with severe cognitive impairment.
- •Individuals with significant visual or hearing impairments.
- •Individuals without internet access.
- •Individuals unable to use video call applications for telerehabilitation sessions.
研究组 & 干预措施
Telerehabilitation Group
Participants will perform supervised telerehabilitation dual-task exercises at home for 4 weeks, 3 days per week, to improve balance, posture, cognitive function, and reduce fall risk. Each session includes warm-up, dual-task exercises (motor + cognitive), and cool-down.
干预措施: Telerehabilitation Based Dual-Task Exercises (Other)
Control Group
Participants will receive an educational brochure including guidance on posture, balance, safe activity, sleep, and the dual-task exercises provided to the intervention group. Participation will be monitored weekly by phone.
干预措施: Educational Brochure and Phone Follow-Up (Other)
结局指标
主要结局
Balance performance
时间窗: Baseline, 4 weeks, 1 month
Berg Balance Scale (BBS) will be used to assess static and dynamic balance in older adults. Participants perform 14 items evaluating daily functional movements, each scored 0-4 points, total score 0-56. Higher scores indicate better balance. Assessments will be conducted at baseline, after 4-week intervention, and at 1-month follow-up.
Fall risk and fear of falling
时间窗: Baseline, 4 weeks, 1 month
Falls Efficacy Scale - International (FES-I) will be used to evaluate participants' concern about falling during 16 daily activities. Each item is scored 1-4, with higher scores indicating greater fear of falling. Assessments will be conducted at baseline, after 4-week intervention, and at 1-month follow-up.
Sleep quality
时间窗: Baseline, 4 weeks, 1 month
Pittsburgh Sleep Quality Index (PSQI) will be used to evaluate sleep quality and disturbances over the past month. Total score ranges 0-21; higher scores indicate poorer sleep quality. Assessments will be performed at baseline, after 4-week intervention, and at 1-month follow-up.
Balance and gait performance
时间窗: Baseline, 4 weeks, 1 month
Tinetti Performance Oriented Mobility Assessment (POMA) will be used to assess both balance (9 items) and gait performance (7 items) in older adults. Each item is scored 0-2 (0 = unable, 1 = partial/unsafe, 2 = safe and correct), with a total score ranging from 0 to 28. Fall risk is classified as high (\<19), medium (19-23), or low (≥24). Assessments will be conducted at baseline, after the 4-week intervention, and at 1-month follow-up.
次要结局
- Functional mobility(Baseline, 4 weeks, 1 month)
- Mental state(Baseline, 4 weeks, 1 month)
- Cognitive function(Baseline, 4 weeks, 1 month)
研究者
Sanem ŞENER
Principal Investigator
Bulent Ecevit University