Task Training In Older Adults With Age-Related Hearing Loss

Study Overview
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Brief Summary
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This study aimed to examine the effects of single and dual-task training on physical function, cognitive function, quality of life, balance, concerns about falling, and activities of daily living in the elderly with age-related hearing loss. The elderly who were diagnosed with age-related hearing loss in Pamukkale University Health, Practice and Research Center, Department of Otorhinolaryngology participated in the study. The elderly were allocated a single-task training group, dual-task training group, and control group. Thirteen patients in the single-task training group, 15 patients in the dual-task training group, 14 patients in the control group completed the study. Degrees of hearing loss were determined by pure tone audiometry. Evaluations, Senior Fitness Test, Montreal Cognitive Assessment, World Health Organization- Quality of Life- Old Module, Berg Balance Scale, Falls Efficacy Scale International, Functional Independence Measure, Dual Task Questionnaire, Dual Task Effect, were performed initially, after the interventions and at the 6th month. The interventions were carried out two days a week and 40 minutes, for five weeks.

Detailed Description
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Outcome Measures Physical function, cognitive function, auditory function, quality of life, balance, concerns about falling, independence in activities of daily living, and dual-task performance were evaluated. Older adults were evaluated initially, after the dual-task and single-task training, and at 6th month for long-term control. All evaluations and interventions were carried out in an isolated and quiet environment in the examination room of the Department of Otorhinolaryngology. Interventions A special program including motor and cognitive tasks was prepared. Both lower and upper extremity motor tasks and verbal, arithmetic, auditory, and visual cognitive tasks were planned based on evidence. Tasks were completed at the same time in the dual-task training group, were completed separately in the single-task training group. No intervention was performed in the control group. The dual-task and single-task training were held 2 days a week, 40 minutes, for a total of 10 sessions for 5 weeks. A patient-appropriate task was selected for each cognitive task each week. It has been tried to prevent the learning effect by providing individual and weekly progress according to the patients' performance in the tasks in the motor and cognitive parts. Variable priority instructions were used in the dual-task training group, and fixed priority instructions were used in the single-task training group. At the beginning and end of the intervention programs, 7 types of warm-up and cool-down exercises involving large muscle groups were performed for 10-minutes. Each task in the intervention programs was performed for 60 seconds and/or 10 repetitions.

Official Title
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Investigation Of the Effects Of Dual-Task And Single-Task Training In Older Adults With Age-Related Hearing Loss

Conditions
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Hearing Loss, Age Related Hearing Loss, Physical Disability, Vestibular Disease

Intervention / Treatment
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* Other: TASK TRAINING


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Being >65 years old Montreal Cognitive Assessment Scale score > 21 Diagnosed with Age-Related Hearing Loss Having bilateral symmetrical hearing loss (average ±10dB difference) Having normal visual functions Ability to ambulate independently (may use a self-help device) Exclusion Criteria: Using a hearing aid Receiving a physical therapy intervention for Age-Related Hearing Loss Having an orthopedic or neurological condition that may affect cognition or postural control Using medication that may affect cognition or postural control Having vertigo or being hospitalized in the emergency room due to vertigo attacks Missing or refusing the follow-up

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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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Health Services Research
Allocation: Randomized
Intervention Model: Parallel Assignment
Interventional Model Description: Intervention groups were formed as single-task training, dual-task training, and control group. Distribution was made into groups using a simple randomized number selection technique.
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: single-task training group<br>Tasks were completed separately in the single-task training group | Other: TASK TRAINING<br>* A special program including motor and cognitive tasks was prepared. Both lower and upper extremity motor tasks and verbal, arithmetic, auditory, and visual cognitive tasks were planned based on evidence. The dual-task and single-task training were held 2 days a week, 40 minutes, for a total of 10 sessions for 5 weeks. A patient-appropriate task was selected for each cognitive task each week.<br>|
| Experimental: dual-task training group<br>Tasks were completed at the same time in the dual-task training group | Other: TASK TRAINING<br>* A special program including motor and cognitive tasks was prepared. Both lower and upper extremity motor tasks and verbal, arithmetic, auditory, and visual cognitive tasks were planned based on evidence. The dual-task and single-task training were held 2 days a week, 40 minutes, for a total of 10 sessions for 5 weeks. A patient-appropriate task was selected for each cognitive task each week.<br>|
| No Intervention: control group<br>No intervention was performed in the control group | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Senior Fitness Test | This test is valid in the elderly population and provides comprehensive, continuous measurement, consisting of 6 sub-heading, including chair stand, arm curl, 2-minute step, chair sit-and-reach, back scratch, and 8-foot-up-and-go tests | Initially, 1st week | 
| Senior Fitness Test | This test is valid in the elderly population and provides comprehensive, continuous measurement, consisting of 6 sub-heading, including chair stand, arm curl, 2-minute step, chair sit-and-reach, back scratch, and 8-foot-up-and-go tests | At 5th week | 
| Senior Fitness Test | This test is valid in the elderly population and provides comprehensive, continuous measurement, consisting of 6 sub-heading, including chair stand, arm curl, 2-minute step, chair sit-and-reach, back scratch, and 8-foot-up-and-go tests | Through study completion at 6th month | 
| Montreal Cognitive Assessment | It evaluates 8 different cognitive functions: visuospatial/executive functions, naming, attention, concentration and calculation, language, abstraction, delayed recall, and orientation. The highest score is 30 in total. A score of 21 and above is considered normal | Initially, 1st week | 
| Montreal Cognitive Assessment | It evaluates 8 different cognitive functions: visuospatial/executive functions, naming, attention, concentration and calculation, language, abstraction, delayed recall, and orientation. The highest score is 30 in total. A score of 21 and above is considered normal | At 5th week | 
| Montreal Cognitive Assessment | It evaluates 8 different cognitive functions: visuospatial/executive functions, naming, attention, concentration and calculation, language, abstraction, delayed recall, and orientation. The highest score is 30 in total. A score of 21 and above is considered normal | Through study completion at 6th month | 
| Pure tone audiometry | Pure tone audiometry at 6 different frequencies (0.5, 1, 2, 4, 6, 8 kHz) frequently mentioned in the literature was performed by an audiologist with a clinical audiometer | Initially, 1st week | 
| World Health Organization Quality of Life - Old Module | It consists of 24 items in six facets. The facets of this module are sensory abilities, autonomy, past, present and future activities, social participation, death and death, intimacy. A high score indicates a high quality of life. | Initially, 1st week | 
| World Health Organization Quality of Life - Old Module | It consists of 24 items in six facets. The facets of this module are sensory abilities, autonomy, past, present and future activities, social participation, death and death, intimacy. A high score indicates a high quality of life. | At 5th week | 
| World Health Organization Quality of Life - Old Module | It consists of 24 items in six facets. The facets of this module are sensory abilities, autonomy, past, present and future activities, social participation, death and death, intimacy. A high score indicates a high quality of life. | Through study completion at 6th month | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Berg Balance Scale | It was designed to assess balance and determine fall risk in older adults (Berg et al, 1989). It is a scale that includes 14 instructions and is scored between 0 and 4 by observing the performance of the person for each instruction. The highest score is 56, 0-20 points indicate balance disorder, 21-40 points indicate that balance is maintained with assistance, and 41-56 points indicate the existence of a good balance | Initially, 1st week | 
| Berg Balance Scale | It was designed to assess balance and determine fall risk in older adults (Berg et al, 1989). It is a scale that includes 14 instructions and is scored between 0 and 4 by observing the performance of the person for each instruction. The highest score is 56, 0-20 points indicate balance disorder, 21-40 points indicate that balance is maintained with assistance, and 41-56 points indicate the existence of a good balance | At 5th week | 
| Berg Balance Scale | It was designed to assess balance and determine fall risk in older adults (Berg et al, 1989). It is a scale that includes 14 instructions and is scored between 0 and 4 by observing the performance of the person for each instruction. The highest score is 56, 0-20 points indicate balance disorder, 21-40 points indicate that balance is maintained with assistance, and 41-56 points indicate the existence of a good balance | Through study completion at 6th month | 
| International Fall Efficiency Scale | : It is a patient-rated scale that determines the level of concerns about falling in activities. of daily living and the confidence to perform activities without fear of falling. It was developed by Tinetti et al. in 1990. The 16 questions in the scale were scored between 1-4. Validity and reliability studies have been established | Initially, 1st week | 
| International Fall Efficiency Scale | : It is a patient-rated scale that determines the level of concerns about falling in activities. of daily living and the confidence to perform activities without fear of falling. It was developed by Tinetti et al. in 1990. The 16 questions in the scale were scored between 1-4. Validity and reliability studies have been established | At 5th week | 
| International Fall Efficiency Scale | : It is a patient-rated scale that determines the level of concerns about falling in activities. of daily living and the confidence to perform activities without fear of falling. It was developed by Tinetti et al. in 1990. The 16 questions in the scale were scored between 1-4. Validity and reliability studies have been established | Through study completion at 6th month | 
| Functional Independence Measurement | FIM was developed in 1987 and it indicates the degree of independence of a person in activities of daily living. The instrument includes 18 items under 6 subheadings: self-care, sphincter control, transfers, locomotion, communication, and social cognition. Each item is scored at 7 levels, with 'level 1' representing full assistance and 'level 7' representing complete independence. The total score is between 18-126. | Initially, 1st week | 
| Functional Independence Measurement | FIM was developed in 1987 and it indicates the degree of independence of a person in activities of daily living. The instrument includes 18 items under 6 subheadings: self-care, sphincter control, transfers, locomotion, communication, and social cognition. Each item is scored at 7 levels, with 'level 1' representing full assistance and 'level 7' representing complete independence. The total score is between 18-126. | At 5th week | 
| Functional Independence Measurement | FIM was developed in 1987 and it indicates the degree of independence of a person in activities of daily living. The instrument includes 18 items under 6 subheadings: self-care, sphincter control, transfers, locomotion, communication, and social cognition. Each item is scored at 7 levels, with 'level 1' representing full assistance and 'level 7' representing complete independence. The total score is between 18-126. | Through study completion at 6th month | 
| Dual Task Questionnaire | : DTQ is used to provide information about the difficulties experienced in dual tasks related to daily living activities. It is a short test consisting of 10 questions. It has been used in patients with stroke and traumatic brain injury. It consists of 5 answers and is scored between 0-4. A score of 4 indicates that difficulties are experienced very often, and 0 indicates that there is no difficulty. | Initially, 1st week | 
| Dual Task Questionnaire | : DTQ is used to provide information about the difficulties experienced in dual tasks related to daily living activities. It is a short test consisting of 10 questions. It has been used in patients with stroke and traumatic brain injury. It consists of 5 answers and is scored between 0-4. A score of 4 indicates that difficulties are experienced very often, and 0 indicates that there is no difficulty. | At 5th week | 
| Dual Task Questionnaire | : DTQ is used to provide information about the difficulties experienced in dual tasks related to daily living activities. It is a short test consisting of 10 questions. It has been used in patients with stroke and traumatic brain injury. It consists of 5 answers and is scored between 0-4. A score of 4 indicates that difficulties are experienced very often, and 0 indicates that there is no difficulty. | Through study completion at 6th month | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Age Related Hearing Loss, Dual Task, Cognitive Function, Physical Function