Effects of Dual Task Prioritization Training on Dual Task Walking in Older People

Study Overview
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Brief Summary
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The purpose of this single-blinded three-armed randomized controlled trial is to investigate the effect of different task prioritization during dual task training on dual task performance.

Detailed Description
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Introduction: Many activities of daily livings involve performing two tasks simultaneously, i.e. dual tasking. Performing dual task increases the demand on attentional resources, which may further decrease the dual task performance, especially in older adults. According to capacity sharing theory, the two tasks compete and influence with each other due to limited attention and information processing capacity. It has been noted that task prioritization during dual tasking may influence the dual task performance. Previous study indicated that supraposture-focus strategy resulted in better posture and task performance in older people. On the other hand, it is known that dual task training improved dual task performance. However, the effects of applying task prioritization during dual task training have not yet been investigated. Therefore, the purpose of this study is to investigate the effect of different task prioritization during dual task training on dual task performance. Methods: Participants will be randomized into three groups: posture-focus, supraposture-focus and control group. Participants will receive a total of 12 sessions of cognitive dual task training with different prioritization strategies, i.e. prioritization on posture, cognitive or neither task. Walking and task performance during dual task walking, executive function, and balance performance will be assessed before and after the interventions (pre- and post-test).

Official Title
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Effects of Dual Task Prioritization Training on Dual Task Walking in Older People: A Single-blinded Randomized Controlled Trial

Conditions
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Healthy, Older People

Intervention / Treatment
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* Other: Dual task training


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Age ≥ 65 years old MMSE scores > 24 Exclusion Criteria: Unstable health conditions Any neurological, psychological disease or diagnosis of learning disability which interferes the participation in this study

Ages Eligible for Study
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Minimum Age: 65 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Posture-focus group<br>Participants will be instructed to pay most attention to practice the posture task during training | Other: Dual task training<br>* All participants will receive cognitive dual task training for 30 min/session, 2-3 sessions/week for 4-6 weeks (a total of 12 sessions). The cognitive dual task training includes 15 min of cognitive task combining with standing task and 15 min of cognitive task combining with walking task. The differences among group are the instructions of task prioritization given by the therapist<br>|
| Experimental: Supraposture-focus group<br>Participants will be instructed to pay most attention to practice the cognitive task during training | Other: Dual task training<br>* All participants will receive cognitive dual task training for 30 min/session, 2-3 sessions/week for 4-6 weeks (a total of 12 sessions). The cognitive dual task training includes 15 min of cognitive task combining with standing task and 15 min of cognitive task combining with walking task. The differences among group are the instructions of task prioritization given by the therapist<br>|
| Active Comparator: Control group<br>Participants will not be receive any instruction to prioritize either task | Other: Dual task training<br>* All participants will receive cognitive dual task training for 30 min/session, 2-3 sessions/week for 4-6 weeks (a total of 12 sessions). The cognitive dual task training includes 15 min of cognitive task combining with standing task and 15 min of cognitive task combining with walking task. The differences among group are the instructions of task prioritization given by the therapist<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Dual task walking performance assessment- speed (m/s) | Using GaitUp system to evaluate gait speed during cognitive and motor dual task walking | Change from baseline dual task walking speed and up to 6 weeks (pre- and post-test) | 
| Dual task walking performance assessment- cadence (steps/min) | Using GaitUp system to evaluate cadence during cognitive and motor dual task walking | Change from baseline dual task walking cadence and up to 6 weeks (pre- and post-test) | 
| Dual task walking performance assessment- stride length variability (CV, %) | Using GaitUp system to evaluate stride length variability during cognitive and motor dual task walking | Change from baseline dual task walking stride length variability and up to 6 weeks (pre- and post-test) | 
| Dual task walking performance assessment- stride time variability (CV, %) | Using GaitUp system to evaluate stride time variability during cognitive and motor dual task walking | Change from baseline dual task walking stride time variability and up to 6 weeks (pre- and post-test) | 
| Rate of dual task cost- gait speed (%) | Using the dual and single task walking speed to calculate the dual task cost of gait speed | Change from baseline dual task cost and up to 6 weeks (pre- and post-test) | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Trail Making Test | Use Trail Making Test (TMT)-Chinese version to indicate executive function. The duration for completing the test will be measured, and the shorter duration means the better executive function. | Change from baseline Trail Making Test and up to 6 weeks (pre- and post-test) | 
| Berg Balance Scale | Use Berg Balance Scale (BBS) to assess balance performance. Berg balance scale scoring ranges from 0 to 56. The higher scores indicate better balance performance. | Change from baseline Berg Balance Scale and up to 6 weeks (pre- and post-test) | 
| Single task walking performance assessment- speed (m/s) | Using GaitUp system to evaluate gait speed during single walking | Change from baseline single task walking speed and up to 6 weeks (pre- and post-test) | 
| Single task walking performance assessment- cadence (steps/min) | Using GaitUp system to evaluate cadence during single walking | Change from baseline single task walking cadence and up to 6 weeks (pre- and post-test) | 
| Single task walking performance assessment- stride length variability (CV, %) | Using GaitUp system to evaluate stride length variability during single walking | Change from baseline single task walking stride length variability and up to 6 weeks (pre- and post-test) | 
| Single task walking performance assessment- stride time variability (CV, %) | Using GaitUp system to evaluate stride time variability during single walking | Change from baseline dual task walking stride time variability and up to 6 weeks (pre- and post-test) | 
| Cognitive dual task walking performance assessment- correct number (times) | The number of the correct answer for serially subtracting 7 from a predefined 3-digit number during cognitive dual task walking task will be recorded. | Change from baseline cognitive dual task walking performance and up to 6 weeks (pre- and post-test) | 
| Motor dual task walking performance assessment- number of go (pieces) | The number of successfully transferred go pieces from one side to another during motor dual task walking task will be recorded. | Change from baseline motor dual task walking performance and up to 6 weeks (pre- and post-test) | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Older people, Prioritization strategy, Dual task walking, Dual task walking performance