The Effect Of Balance Training With Dual Task On Cognitive Status And Functionality In Elderly

Study Overview
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Brief Summary
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Aging is a dynamic process that affects motor and cognitive functions. Activities of daily living and functionality, including dual task performance, are also negatively affected by these functions. The purpose of this study is to determine of balance training with dual task on cognitive function and functionality.

Detailed Description
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While physiological changes occur at the level of cells, tissues and systems with aging, these changes are reflected in motor and cognitive functions. The decrease in motor functions can be cause as balance and fall problems, which are the most serious and frequently encountered problems among the elderly. Especially the fall is one of the main reasons causing the elderly to be hospitalized in the hospital and nursing home. Balance system is one of the most affected by aging process. The balance is maintained by receiving input from several systems, for this reason it is the system that is easily and primarily affected by changes in any of these inputs. Balance disorders have been shown to be risk factor for falling in elderly. Studies have shown that balance training has been observed to improve postural control, so it is especially recommended for to reduce risk and rate of falls in the elderly. While general cognitive capacity decreases with aging, information processing, use and recall performance is lower than younger. Therefore, elderly have difficulty in tasks that require the use of more than one information at same time. In daily life, a motor function is often accompanied by another task. Dual task performance is a secondary motor or cognitive task that must be implemented during a main task. Therefore, ın order for the exercises to be functional, it is not enough to be focused only on motor skills, besides adding a motor or cognitive dual task is more effective than exercise alone. The changes in neuromusculoskeletal and movement-related functions during the aging process causes a decrease in functional ability. Most daily activities require the management of motor-cognitive tasks while simultaneously processing external information. The ability to perform in daily life activities decline in elderly. Investigators hypothesized that balance exercises with dual task would show greater significant improvements functionality and cognitive improvements than the balance exercises only.

Official Title
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The Effect Of Balance Training With Dual Task On Cognitive Status And Functionality In Elderly

Conditions
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Balance, Cognitive Functions, Dual Task, Functionality, Geriatrics

Intervention / Treatment
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* Other: Dual task exercises


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Being between the ages of 65-85 Being able to communicate Able to walk without mobility aids Be volunteer for intervention Exclusion Criteria: Cognitive impairment (<17 point on the Minimal Mental State Examination ) In physiotherapy treatment that trains balance Balance impairment (< 20 point on the berg balance test) having an orthopedic problem that may affect balance performance

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: Other
Allocation: Randomized
Intervention Model: Parallel Assignment
Interventional Model Description: randomized controlled
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Active Comparator: balance exercise group<br>The balance program was performed on soft and hard surface. Firstly the participants started the exercises on hard ground while standing. Postural balance program consisted of static and dynamic functional balance exercises (hıp flexion, hıp abduciton, semitandem stance, one leg stance, toe tips lifting). Afterwards exercises were performed on soft surface. Three sets of eight to ten repetitions of each exercise in a slow, controlled manner were performed. This section was completed 30 minitues. | Other: Dual task exercises<br>* Dual tasks, often also referred to as secondary tasks, present an objective-direct measurement in which two tasks are to be performed simultaneously to observe performance drops in either task.<br>* Other names: balance exercise group;|
| Experimental: Dual task exercises<br>Dual task exercises are in two forms as motor dual task and cognitive dual task. In this study we used cognitive secondary task exercises. In addition to the exercises applied by the balance exercise group, a cognitive task was added. Participants in this group tried to count 4, 5 and 7 back from 100 while practicing balance exercises. The balance program was performed on soft and hard surface. Firstly the participants started the exercises on hard ground while standing. Postural balance program consisted of static and dynamic functional balance exercises (hıp flexion, hıp abduciton, semitandem stance, one leg stance, toe tips lifting). Afterwards exercises were performed on soft surface. Three sets of eight to ten repetitions of each exercise in a slow, controlled manner were performed. This section was completed 30 minitues. | Other: Dual task exercises<br>* Dual tasks, often also referred to as secondary tasks, present an objective-direct measurement in which two tasks are to be performed simultaneously to observe performance drops in either task.<br>* Other names: balance exercise group;|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| The Mini-Mental Status Examination (MMSE) | Cognitive Functioning Test | 7 minutes | 
| The Functional Independence Measure (FIM) | Functionality Test | 10 minutes | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| The Berg Balance Scale (BBS) | Balance Test | 5 minutes | 
| The Timed Up and Go test (TUG) | Physical function test | 3 minutes | 
| Timed sit to stand test (TSST) | Physical function test | 2 minutes | 
| Ten meters walk test (TMTWT) | Physical function test | 3 minutes | 
| Tinetti Performance Oriented Mobility Assessment(POMA) | task-oriented test that measures an older adult's gait and balance abilities. | 15 minutes | 
| The Montreal Cognitive Assessment (MoCA) | Cognitive Function Assesment | 10 minutes |