The Feasibility of a Novel Dual-Task Exercise Program Which Integrates Balance, Gaze, Mobility and Cognition in Community Dwelling Older Adults: Protocol for a Randomized Clinical Pilot Trial

Abstract

Background: Mobility limitations and cognitive impairments which are common with ageing often coexist, causing a reduction in the levels of physical and mental activity and are prognostic of future adverse health events and falls. Consequently, multi-task training paradigms that simultaneously address both mobility and cognition benefit healthy ageing are important to consider in rehabilitation as well as primary prevention. Objectives: An exploratory RCT is being conducted to: a) describe the feasibility and acceptability of the study design and process, procedures, resources and management in two game-based dual-task training programs delivered in the community; b) to explore the lived experiences of the study participants who completed their respective exercise programs. A secondary objective is to obtain preliminary data on the therapeutic effectiveness of the two dual-task training programs. Methods: Thirty healthy older community dwelling participants aged 70 - 85 with previous history of falls will be recruited and randomized to either dual- task treadmill walking (experimental group) or dual-task recumbent bicycle (control group). Data analysis: The qualitative data will be analyzed by two investigators using a content analysis approach. For the quantitative data, outcome measures will be collected pre and post intervention and included measures to assess core balance, spatial-temporal gait variables, visual tracking and cognitive function, as well as, balance and gait analysis under dual-task conditions. Discussion: This research will demonstrate the feasibility of the dual-task training programs in the community, and demonstrate the system’s ability to improve targeted and integrated (dual-task) aspects of balance, mobility, gaze, and cognitive performance. A blended analysis of balance, mobility gaze and cognition will also contribute to a better understanding of the functional consequences of decline in physical and mental skills with age. Trial registration: This pilot clinical trial has been registered at ClinicalTrials.gov Protocol Registration System: NCT01940055.