Clinical trial NCT03811782: Effect of Single-task, Dual-task and Analogy Training During Gait Rehabilitation
Official title: Examining Conscious Motor Processing and the Effect of Single-task, Dual-task and Analogy Training on Walking During Rehabilitation by Older Adults at Risk of Falling in Hong Kong: A Randomized Controlled Trial
Study type: INTERVENTIONAL
Overall status: UNKNOWN
Phase: NA
Conditions: Fall
Balance
Reinvestment Propensity
Gait Rehabilitation
Keywords: conscious motor processing
single-task training
dual-task training
analogy training
gait rehabilitation
reinvestment propensity
balance
fear of falling
older adults
Hong Kong
Lead sponsor: The University of Hong Kong
Sponsor class: OTHER
First posted: 2019-01-22
Enrollment: 105
Sex: ALL
Minimum age (years): 65
Standard ages: OLDER_ADULT
Accepts healthy volunteers: yes
Allocation: RANDOMIZED
Intervention model: PARALLEL
Primary purpose: PREVENTION

Brief summary: The study aims to examine the effect of single-task, dual-task and analogy training during gait rehabilitation on conscious motor processing propensity, balance, walking ability and fear of falling by older adults at risk of falling in Hong Kong. One-hundred and five healthy older adults will be recruited from elderly community centres in Hong Kong by convenience sampling. They will be randomly assigned into 3 groups (i.e., single-task walking group (active control group), dual-task walking group and analogy walking group). Participants in different groups will have training sessions (about 45 minutes each) three times per week for 4 weeks in a group of 5 participants. A total of 12 sessions will be completed by each participant. All training sessions will be conducted by experienced Hong Kong registered Physiotherapists. In each training session, all groups will have warm-up (5 minutes), balance training (5 minutes), body transport training (5 minutes), body transport with hand manipulation training (5 minutes), walking training with various difficulties in a 10 meters walkway with different instructions in different walking groups (20 minutes) and cool down (5 minutes). Participants in the different groups will receive different instructions during walking training. Well- developed single-task (explicit), dual-task and analogy instructions will be utilized in the single-task walking group, dual-task walking group and analogy walking group, respectively. Each participant will undergo assessment sessions (total 3 assessment sessions) before training at baseline (T0), just after completion of all training sessions (T1) and 6 months after completion of all training sessions (T2). In the baseline assessment, a structural questionnaire will be used to ask for demographics, detailed history of fall incident, detailed medical history, social history and social-economic status of the participants. A battery of assessments will be done to assess physical and cognitive abilities of the participants in all assessment sessions. Single-task walking ability, dual-task walking ability, functional gait and balance assessment, cognitive function, fearing of falling and propensity for conscious motor processing.

All participants will also be asked to record their number of falls prospectively at the time between T1 (completion of all training sessions) and T2 (6 months after completion of all training sessions) using a calendar. The number of falls within the 6-month follow- up period will then be collected.


Eligibility criteria: Inclusion Criteria:

* Age 65 or above;
* No history of cerebral vascular disease, Parkinson's disease or other neurological deficit;
* Chinese version of the Mini-Mental State Examination (MMSE-C) (Folstein, Folstein, \& McHuge, 1975; Chiu, Lee, Chung, \& Kwong, 1994) total score of equal or more than 24;
* Able to walk independently indoor for at least 10 meters;
* Older adults with moderate to high risk of falling, as indicated by the score of less than 24 out of 28 in the Tinetti Balance Assessment Tool (Tinetti, 1986).

Exclusion Criteria:

* Any potential participant who cannot meet the inclusion criteria.

Primary outcomes:
measure: Baseline propensity for conscious motor processing
timeFrame: Before the start of training
measure: Change from baseline propensity for conscious motor processing upon completion of training
timeFrame: Upon completion of 12 Training Sessions (4 weeks of training)
measure: Change from baseline propensity for conscious motor processing at 6 months after the completion of training
timeFrame: 6 months after the completion of Training
Secondary outcomes:
measure: Baseline single-task walking ability
timeFrame: Before the start of training
measure: Change from baseline single-task walking ability upon completion of training
timeFrame: Upon completion of 12 Training Sessions (4 weeks of training)
measure: Change from baseline single-task walking ability at 6 months after the completion of training
timeFrame: 6 months after the completion of Training
measure: Baseline dual-task walking ability
timeFrame: Before the start of training
measure: Change from baseline dual-task walking ability upon completion of training
timeFrame: Upon completion of 12 Training Sessions (4 weeks of training)
measure: Change from baseline dual-task walking ability at 6 months after the completion of training
timeFrame: 6 months after the completion of Training
measure: Baseline Tinetti Balance Assessment Tool score
timeFrame: Before the start of training
measure: Change from baseline Tinetti Balance Assessment Tool score upon completion of training
timeFrame: Upon completion of 12 Training Sessions (4 weeks of training)
measure: Change from baseline Tinetti Balance Assessment Tool score at 6 months after the completion of training
timeFrame: 6 months after the completion of Training
measure: Baseline Timed 'Up & Go' Tests time
timeFrame: Before the start of training
measure: Change from baseline Timed 'Up & Go' Tests time upon completion of training
timeFrame: Upon completion of 12 Training Sessions (4 weeks of training)
measure: Change from baseline Timed 'Up & Go' Tests time at 6 months after the completion of training
timeFrame: 6 months after the completion of Training
measure: Baseline Berg Balance Scale score
timeFrame: Before the start of training
measure: Change from baseline Berg Balance Scale score upon completion of training
timeFrame: Upon completion of 12 Training Sessions (4 weeks of training)
measure: Change from baseline Berg Balance Scale score at 6 months after the completion of training
timeFrame: 6 months after the completion of Training
measure: Cognitive function
timeFrame: Before the start of training
measure: Baseline fear of falling
timeFrame: Before the start of training
measure: Change from baseline fear of falling upon completion of training
timeFrame: Upon completion of 12 Training Sessions (4 weeks of training)
measure: Change from baseline fear of falling at 6 months after the completion of training
timeFrame: 6 months after the completion of Training
measure: Number of falls between T1 and T2 (post training to 6 months after completion of training)
timeFrame: 6 months after the completion of Training
Other outcomes:
Locations:
city: Hong Kong
country: Hong Kong
facility: The HKJC Building for Interdisciplinary Research
Study officials:
affiliation: The University of Hong Kong
name: Thomson Wai Lung WONG
role: PRINCIPAL_INVESTIGATOR
References: