Influence of Square-stepping Exercise on Brain Activation, Cognitive Function and Physical Performance in Frail Elders With MCI

Study Overview
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Brief Summary
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This study is to elucidate the possible mechanisms of SSE by examining brain activation differences between SSE patterns and usual walking, as well as the relationship between brain activity and SSE performance, between cognitive function and SSE performance, and between physical performance and SSE performance in frail elders with MCI.

Detailed Description
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Background: Both frailty and MCI exert negative impact on motor and cognitive function, which increase the risks of fall and adverse health condition. SSE has been proved to be an effective intervention for motor and cognitive function in older adults. However, the underlying mechanisms of SSE still remain undetermined for its possible effects. This study aims to elucidate the possible mechanisms of SSE in frail elders with MCI. Methods: This is a cross-sectional study. The inclusion criteria are: (1) age between 65 and 90 years old, (2) the presence of at least 1 characteristic of the Fried frailty criteria, (3) with mini-mental state examination (MMSE) score≧24 and Montreal Cognitive Assessment (MoCA) score <26 (MCI criteria), and (4) ability to walk independently for 1 min without assistive devices. The exclusion criteria are: (1) central nervous system disorders (such as stroke, Parkinson's disease, spinal cord injury), and (2) any unstable physical condition, psychiatric disorder, and other neurological disorder or diagnosed with learning disability which may affect participating this study. Brain activity during SSE and usual walking, SSE performance, physical performance, and cognitive function are measured. The purpose of this study is to elucidate the possible mechanisms of SSE by examining brain activation differences between SSE patterns and usual walking, as well as the relationship between brain activity and SSE performance, between cognitive function and SSE performance, and between physical performance and SSE performance in frail elders with MCI.

Official Title
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Influence of Square-stepping Exercise on Brain Activation, Cognitive Function and Physical Performance in Frail Elders With MCI

Conditions
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Frailty, Mild Cognitive Impairment

Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Age between 65 and 90 years old Presence of at least 1 characteristic of the Fried frailty criteria Mini-mental state examination score equal to or more than 24 Montreal Cognitive Assessment score less than 26 Ability to walk independently for 1 min without assistive devices Exclusion Criteria: Central nervous system disorders (such as stroke, Parkinson's disease, spinal cord injury) Any unstable physical condition, psychiatric disorder, and other neurological disorder or diagnosed with learning disability which may affect participating this study

Ages Eligible for Study
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Minimum Age: 65 Years
Maximum Age: 90 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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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Older adults with frailty and mild cognitive impairment<br> | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Brain activity | The brain activity will be measured under 3 tasks: usual walking, SSE-pattern1 (SSE1), and SSE-pattern 2 (SSE2) | 20 minutes | 
| SSE performance | The number of the correct steps that participants complete in 1 min during SSEs will be recorded | 15 minutes | 
| Montreal Cognitive Assessment | Global cognitive function | 15 minutes | 
| Trail making test | Executive function | 5 minutes | 
| Stroop color and word test | Executive function | 5 minutes | 
| Digit span test | Executive function | 8 minutes | 
| Timed up and go test | Dynamic balance and functional mobility | 5 minutes | 
| Berg balance scale | Balance and fall risk | 15 minutes | 
| Five times sit to stand test | Lower extremity strength | 3 minutes | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Square-stepping exercise, Frailty, Mild Cognitive Impairment