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Effect of Single-task, Dual-task and Analogy Training During Gait Rehabilitation

23. marts 2020 opdateret af: Dr. Thomson Wai-Lung Wong, The University of Hong Kong

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

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.

Studieoversigt

Undersøgelsestype

Interventionel

Tilmelding (Forventet)

105

Fase

  • Ikke anvendelig

Kontakter og lokationer

Dette afsnit indeholder kontaktoplysninger for dem, der udfører undersøgelsen, og oplysninger om, hvor denne undersøgelse udføres.

Studiesteder

      • Hong Kong, Hong Kong
        • Rekruttering
        • The HKJC Building for Interdisciplinary Research
        • Kontakt:
          • Thomson Wong

Deltagelseskriterier

Forskere leder efter personer, der passer til en bestemt beskrivelse, kaldet berettigelseskriterier. Nogle eksempler på disse kriterier er en persons generelle helbredstilstand eller tidligere behandlinger.

Berettigelseskriterier

Aldre berettiget til at studere

65 år og ældre (Ældre voksen)

Tager imod sunde frivillige

Ingen

Køn, der er berettiget til at studere

Alle

Beskrivelse

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.

Studieplan

Dette afsnit indeholder detaljer om studieplanen, herunder hvordan undersøgelsen er designet, og hvad undersøgelsen måler.

Hvordan er undersøgelsen tilrettelagt?

Design detaljer

  • Primært formål: Forebyggelse
  • Tildeling: Randomiseret
  • Interventionel model: Parallel tildeling
  • Maskning: Ingen (Åben etiket)

Våben og indgreb

Deltagergruppe / Arm
Intervention / Behandling
Eksperimentel: Single-task Training Group
Single-task walking group
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 Single-task Training instructions (20 minutes) and cool down (5 minutes).
Eksperimentel: Dual-task Training Group
Dual-task walking group
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 Dual-task Training instructions (20 minutes) and cool down (5 minutes).
Eksperimentel: Analogy Training Group
Analogy walking group
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 Analogy Training instructions (20 minutes) and cool down (5 minutes).

Hvad måler undersøgelsen?

Primære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Baseline propensity for conscious motor processing
Tidsramme: Before the start of training
The Chinese version Movement Specific Reinvestment Scale (MSRS-C) (Masters et al., 2005; Wong et al., 2015a; Wong et al., 2015b). The MSRS-C includes two sub-scales: Conscious motor processing and Movement self-consciousness. The scores for both sub-scales ranges from 5-30. A higher score indicate a higher propensity for conscious motor processing.
Before the start of training
Change from baseline propensity for conscious motor processing upon completion of training
Tidsramme: Upon completion of 12 Training Sessions (4 weeks of training)
The Chinese version Movement Specific Reinvestment Scale (MSRS-C) (Masters et al., 2005; Wong et al., 2015a; Wong et al., 2015b). The MSRS-C includes two sub-scales: Conscious motor processing and Movement self-consciousness. The scores for both sub-scales ranges from 5-30. A higher score indicate a higher propensity for conscious motor processing.
Upon completion of 12 Training Sessions (4 weeks of training)
Change from baseline propensity for conscious motor processing at 6 months after the completion of training
Tidsramme: 6 months after the completion of Training
The Chinese version Movement Specific Reinvestment Scale (MSRS-C) (Masters et al., 2005; Wong et al., 2015a; Wong et al., 2015b). The MSRS-C includes two sub-scales: Conscious motor processing and Movement self-consciousness. The scores for both sub-scales ranges from 5-30. A higher score indicate a higher propensity for conscious motor processing.
6 months after the completion of Training

Sekundære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Baseline single-task walking ability
Tidsramme: Before the start of training
10 meters comfortable and fast walking speed (Bohannon, 1997)
Before the start of training
Change from baseline single-task walking ability upon completion of training
Tidsramme: Upon completion of 12 Training Sessions (4 weeks of training)
10 meters comfortable and fast walking speed (Bohannon, 1997)
Upon completion of 12 Training Sessions (4 weeks of training)
Change from baseline single-task walking ability at 6 months after the completion of training
Tidsramme: 6 months after the completion of Training
10 meters comfortable and fast walking speed (Bohannon, 1997)
6 months after the completion of Training
Baseline dual-task walking ability
Tidsramme: Before the start of training
10 meters comfortable and fast walking speed with concurrent verbal or visual-spatial dual-tasks of auditory stroop task (Siu, Catena, Chou, van Donkelaar, & Woollacott, 2008) or clock test (Plummer-D'Amato, Altmann, Saracino, Fox, Behrman, & Marsiske, 2008)
Before the start of training
Change from baseline dual-task walking ability upon completion of training
Tidsramme: Upon completion of 12 Training Sessions (4 weeks of training)
10 meters comfortable and fast walking speed with concurrent verbal or visual-spatial dual-tasks of auditory stroop task (Siu, Catena, Chou, van Donkelaar, & Woollacott, 2008) or clock test (Plummer-D'Amato, Altmann, Saracino, Fox, Behrman, & Marsiske, 2008)
Upon completion of 12 Training Sessions (4 weeks of training)
Change from baseline dual-task walking ability at 6 months after the completion of training
Tidsramme: 6 months after the completion of Training
10 meters comfortable and fast walking speed with concurrent verbal or visual-spatial dual-tasks of auditory stroop task (Siu, Catena, Chou, van Donkelaar, & Woollacott, 2008) or clock test (Plummer-D'Amato, Altmann, Saracino, Fox, Behrman, & Marsiske, 2008)
6 months after the completion of Training
Baseline Tinetti Balance Assessment Tool score
Tidsramme: Before the start of training
Tinetti Balance Assessment Tool (Tinetti, 1986).
Before the start of training
Change from baseline Tinetti Balance Assessment Tool score upon completion of training
Tidsramme: Upon completion of 12 Training Sessions (4 weeks of training)
Tinetti Balance Assessment Tool (Tinetti, 1986)
Upon completion of 12 Training Sessions (4 weeks of training)
Change from baseline Tinetti Balance Assessment Tool score at 6 months after the completion of training
Tidsramme: 6 months after the completion of Training
Tinetti Balance Assessment Tool (Tinetti, 1986)
6 months after the completion of Training
Baseline Timed 'Up & Go' Tests time
Tidsramme: Before the start of training
Timed 'Up & Go' Tests (TU&G(Podsiadlo & Richardson, 1991)
Before the start of training
Change from baseline Timed 'Up & Go' Tests time upon completion of training
Tidsramme: Upon completion of 12 Training Sessions (4 weeks of training)
Timed 'Up & Go' Tests (TU&G(Podsiadlo & Richardson, 1991)
Upon completion of 12 Training Sessions (4 weeks of training)
Change from baseline Timed 'Up & Go' Tests time at 6 months after the completion of training
Tidsramme: 6 months after the completion of Training
Timed 'Up & Go' Tests (TU&G(Podsiadlo & Richardson, 1991)
6 months after the completion of Training
Baseline Berg Balance Scale score
Tidsramme: Before the start of training
Berg Balance Scale (BBS) (Berg, Wood Dauphinee, Williams & Gayton, 1989)
Before the start of training
Change from baseline Berg Balance Scale score upon completion of training
Tidsramme: Upon completion of 12 Training Sessions (4 weeks of training)
Berg Balance Scale (BBS) (Berg, Wood Dauphinee, Williams & Gayton, 1989)
Upon completion of 12 Training Sessions (4 weeks of training)
Change from baseline Berg Balance Scale score at 6 months after the completion of training
Tidsramme: 6 months after the completion of Training
Berg Balance Scale (BBS) (Berg, Wood Dauphinee, Williams & Gayton, 1989)
6 months after the completion of Training
Cognitive function
Tidsramme: Before the start of training
The Chinese version Mini-Mental State Examination (MMSE-C) (Folstein et al., 1975; Chiu et al., 1994). A mark of 24 or above out of 30 is required to meet the inclusion criteria.
Before the start of training
Baseline fear of falling
Tidsramme: Before the start of training
Fall Efficacy Scale (FES-13) (Tinetti, Richman, & Powell L, 1990; Tinetti, Leon, Doucette & Parker, 1994; Hellström & Lindmark, 1999). The FES-13 score ranges from 16-64. A higher score indicates greater fear of falling.
Before the start of training
Change from baseline fear of falling upon completion of training
Tidsramme: Upon completion of 12 Training Sessions (4 weeks of training)
Fall Efficacy Scale (FES-13) (Tinetti, Richman, & Powell L, 1990; Tinetti, Leon, Doucette & Parker, 1994; Hellström & Lindmark, 1999). The FES-13 score ranges from 16-64. A higher score indicates greater fear of falling.
Upon completion of 12 Training Sessions (4 weeks of training)
Change from baseline fear of falling at 6 months after the completion of training
Tidsramme: 6 months after the completion of Training
Fall Efficacy Scale (FES-13) (Tinetti, Richman, & Powell L, 1990; Tinetti, Leon, Doucette & Parker, 1994; Hellström & Lindmark, 1999). The FES-13 score ranges from 16-64. A higher score indicates greater fear of falling.
6 months after the completion of Training
Number of falls between T1 and T2 (post training to 6 months after completion of training)
Tidsramme: 6 months after the completion of Training
Record of the the 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.
6 months after the completion of Training

Samarbejdspartnere og efterforskere

Det er her, du vil finde personer og organisationer, der er involveret i denne undersøgelse.

Efterforskere

  • Ledende efterforsker: Thomson Wai Lung WONG, The University of Hong Kong

Datoer for undersøgelser

Disse datoer sporer fremskridtene for indsendelser af undersøgelsesrekord og resumeresultater til ClinicalTrials.gov. Studieregistreringer og rapporterede resultater gennemgås af National Library of Medicine (NLM) for at sikre, at de opfylder specifikke kvalitetskontrolstandarder, før de offentliggøres på den offentlige hjemmeside.

Studer store datoer

Studiestart (Faktiske)

1. oktober 2018

Primær færdiggørelse (Forventet)

31. august 2021

Studieafslutning (Forventet)

31. august 2021

Datoer for studieregistrering

Først indsendt

10. januar 2019

Først indsendt, der opfyldte QC-kriterier

18. januar 2019

Først opslået (Faktiske)

22. januar 2019

Opdateringer af undersøgelsesjournaler

Sidste opdatering sendt (Faktiske)

25. marts 2020

Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier

23. marts 2020

Sidst verificeret

1. marts 2020

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