Cognitive Training and Dual-task Ability
Condition: Gait Disorder
Study type: Interventional

Summary: 
      The first goal of this study is to examine the extent to which the inclusion of dual-task
      practice to standard balance rehabilitation results in greater benefits to dual-task ability.
      The second goal of this study is to examine the extent to which the addition of cognitive
      training following balance rehabilitation results in greater benefits to dual-task ability.
    

Detailed description: 
      Historically, degradation of balance control in older adults has been attributed to
      impairments of the motor and/or sensory systems. As a result, therapy has focused on motor
      and sensory impairments. However, evidence suggests that an impaired ability to allocate
      attentional resources to balance during dual-task situations is a powerful predictor of
      falls. Despite this fact, few studies have examined whether interventions can improve older
      adults' dual-task ability. The goal of this study is to develop effective interventions to
      improve ability to allocate attention to balance and gait under dual-task conditions.

      Older adults (n = 44) who have been referred to physical therapy (PT) for gait or balance
      impairments who have dual-task impairment will be randomized to receive either standard
      balance rehabilitation or balance rehabilitation with dual-task practice. Following PT,
      subjects will receive cognitive training (CT), either speed of processing or generalized
      cognitive training. Primary outcomes are ability to walk while performing four different
      cognitive tasks of varying difficulty. Assessment will occur at baseline, post-PT, post-CT.
    

Intervention name(s): Balance rehabilitation + dual-tasking; Standard balance rehabilitation; Cognitive training (speed of processing); Cognitive training (general cognition)
Intervention type(s): Behavioral; Behavioral; Behavioral; Behavioral
Intervention description(s): Balance rehabilitation will involve a structured framework of balance activities that require increasing levels of complexity and multimodal stimuli and response demands with the addition of cognitive tasks, (e.g., counting backwards or reciting lists) to be added when the participant; Standard balance rehabilitation will involve a structured framework of balance activities that require increasing levels of complexity and multimodal stimuli and response demands.; Speed of processing cognitive training involves systematically increasing the complexity of visual tasks. Task demands are increased by reducing stimulus duration, adding visual or auditory distractors, increasing number of concurrent tasks or increasing the visual field.; General cognitive training involves systematic training of 14 key cognitive abilities, including visual scanning, response time, eye-hand coordination, spatial perception, and working memory. Initial starting point is determined by the software using baseline evaluation.
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Double (Participant, Outcomes Assessor)
Primary purpose: Treatment
Keywords: aged or aged 80 and over; gait disorder; attention