Real-life Dual-Task Training
NCT Number: NCT06479694
Acronym: Real-DTT
Status: RECRUITING
Study Type: INTERVENTIONAL
Phases: NA
Conditions: Fall
Interventions: BEHAVIORAL: Real-life Dual-Task Training
Sponsor: Colorado State University
Sex: ALL
Age: OLDER_ADULT
Enrollment: 36
Study Design: Allocation: NA|Intervention Model: SINGLE_GROUP|Masking: NONE|Primary Purpose: TREATMENT
Start Date: 2024-07-03
Completion Date: 2026-07-01
Locations: Colorado State University, Fort Collins, Colorado, 80524, United States

Summary:
Older adults have difficulty optimizing two tasks at once and typically experience greater interference than younger adults when dual-tasking, meaningful that there is greater decline in performance of at least one task when comparing single and dual-tasking. Difficulty dual-tasking may actually predict falls in community-dwelling older adults. Dual-task training has been shown to improve cognitive outcomes (attention, memory), motor outcomes (balance, gait), and dual-task performance in older adults; however, most dual-task training involves simulated tasks that do not reflect functional dual tasks in the real world. Greater dual-task improvements could be seen when training functionally specific tasks. One way to increase task specificity is to offer real-life, contextually-relevant, dual-task training embedded in instrumental activities of daily living (IADLs). Limited evidence exists for dual-task training interventions for older adults with T2DM; however there is early evidence of improvements in cognitive and motor effects with simulated dual-task training, which could translate to improved dual-task performance, reduced impact on everyday life, and reduced fall risk. Therefore, the purpose of this study is to assess feasibility, acceptability, and preliminary efficacy of a real-life dual-task training program for older adults at risk to fall.

Primary Outcome Measures: Dual-Task Impact on Daily-living Activities Questionnaire, The Dual-Task Impact on Daily-living Activities Questionnaire is a 19 question self-report assessment with scoring from 0-76. Higher scores indicate greater dual-task inference during daily activities., baseline, pre-intervention and immediately after the intervention
Secondary Outcome Measures: Acceptability, Appropriateness, Feasibility, The Acceptability of Intervention Measure, Intervention Appropriateness Measure, Feasibility of Intervention Measure will be used to assess feasibility and acceptability. The assessments are 12 questions in total scored 12-60 with greater scores indicating greater acceptability, appropriateness, or feasibility., immediately after intervention|Dual-Task Performance, Dual-task performance will be classified into one of 4 categories (gait priority trade off, cognitive priority trade off, mutual interference, or mutual facilitation) based on performance in 3 different 2-minute conditions (gait single task, cognitive single task, dual-task). The gait task will be overground walking on a 12 meter obstacle-free course with a 1 meter turning area. Gait speed (m/s) will be calculated using the total distance covered over the 2 minutes. The cognitive task will be serial subtractions of seven, starting between 590-599. A corrected response rate will be calculated as: responses per second\*percent of correct responses. Dual-task performance will represent a participant's performance on improvement or decline on both gait and cognitive performance comparing single and dual-tasking. For example, mutual interference would be a decline in both gait (slower speed), and cognitive (lower corrected response ratio) from single to dual-tasking., baseline, pre-intervention and immediately after the intervention|Frenchay Activities Index, The Frenchay Activities Index is pragmatic for community-dwelling adults to self-rate participation in three domains: domestic chores, leisure/work, and outdoor activities. Frenchay Activity Index scores range from 0-45, with higher scores indicating greater participation in instrumental ADLs., baseline, pre-intervention and immediately after the intervention|Self-reported Falls, Participants will be asked: "Have you fallen in the last three months?" If yes, participants will be asked how many falls occurred in the last three months. Falls are defined as: "a unintended loss of balance with a result of coming to rest on the ground, floor, or lower level., baseline, pre-intervention and immediately after the intervention