Abstract
BackgroundFunctional independence and safe mobility, especially in older people, mostly rely on the ability to perform dual tasks, particularly during activities with variable- and fixed-priority attention. The aim of this study is to compare the dual-task training with progression from variable- to fixed-priority instructions versus dual-task training with variable-priority on gait speed in community-dwelling older adults.MethodsThis is an assessor- and participant-blinded, two-arm, randomized controlled trial with 60 community-dwelling male and female older adults between the ages of 60 and 80 years old. Participants will be randomly allocated into either the intervention group or the control group using a computer-generated permuted block randomization schedule. The intervention group will undertake a progressive dual-task training in which the participants will be progressively submitted to dual-task walking and postural balance exercises with variable- to fixed-priority instructions. The control group will be submitted to dual-task training with variable-priority attention exercises. Both groups will receive 48 sessions lasting for 60 min each over 24 weeks. The primary outcome will be the gait speed under single- and dual-task conditions. Secondary outcomes will include spatiotemporal gait parameters, functional balance, executive function, falls, quality of life, and depression symptoms. All the analyses will be based on the intention-to-treat principle.DiscussionThis is the first assessor- and participant-blinded, two-arm, randomized controlled trial with 6 months of intervention and an additional 6-month post-training follow up aiming to evaluate the effectiveness of training with progression from variable- to fixed-priority instructions on gait biomechanics, postural balance, falls episodes, executive functioning, and quality of life in community-dwelling older adults. If our hypotheses are confirmed, this training protocol can be implemented widely to improve gait speed and other functional activities and quality of life in community-dwelling older adults. This study protocol can be used to improve these functional aspects of community-dwelling older adults. This study may also contribute to future guidelines for the improvement of these clinical and biomechanical aspects in older people.Trial registrationClinicalTrials.gov Identifier - NCT03886805, Registered 22 March 2019.
Highlights
Functional independence and safe mobility, especially in older people, mostly rely on the ability to perform dual tasks, during activities with variable- and fixed-priority attention
This study protocol can be used to improve these functional aspects of community-dwelling older adults
This study may contribute to future guidelines for the improvement of these clinical and biomechanical aspects in older people
Summary
Functional independence and safe mobility, especially in older people, mostly rely on the ability to perform dual tasks, during activities with variable- and fixed-priority attention. We can assume that fixed-priority instructions could be adopted as a progression of the variable-priority method since the learning and retention of the simultaneous motor and cognitive tasks of the former method appear more complex than the latter. Based on this rationale, in the first 12 weeks of training, both groups will be trained with dual-task activities exclusively under variable-priority instructions so that they can better learn and retain the motor and cognitive gains provided by this type of dualtask training, as already shown in the literature [12]. No research to date has attempted to prove this rationale
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