Effects of Adapted Argentine Tango Training Frequency on Dual-Task Walking (AAT-FREQ)

Dance combines aerobic activity, dynamic balance, rhythmic movement, motor-sequence learning, spatial orientation, and cognitive-motor coordination. Adapted Argentine tango may be particularly suitable for improving motor-cognitive function because it requires multidirectional stepping, weight shifting, movement initiation and cessation, direction changes, rhythmic synchronization, and continuous planning of subsequent movements.

Previous dance intervention studies have varied substantially in dance style, training frequency, session duration, exercise intensity, and total training volume. Consequently, it remains unclear whether the distribution of training sessions across the week independently influences motor-cognitive outcomes. This study will compare two adapted Argentine tango schedules while maintaining the same total weekly intervention time.

This will be a single-center, three-arm, parallel randomized controlled trial involving 270 adults aged 55 to 60 years. After eligibility screening, written informed consent, and baseline assessment, participants will be randomly allocated in a 1:1:1 ratio to a distributed tango group, a concentrated tango group, or an active control group. Randomization will be stratified by sex and implemented using variable block sizes. Outcome assessors and statistical analysts will be blinded to group allocation whenever feasible.

Participants in the distributed tango group will complete five 36-minute sessions per week, providing a total weekly intervention time of 180 minutes. Each session will consist of approximately 6 minutes of warm-up, 24 minutes of adapted tango, and 6 minutes of cool-down. Participants in the concentrated tango group will complete two 90-minute sessions per week, also providing 180 minutes per week. Each session will consist of approximately 15 minutes of warm-up, 60 minutes of adapted tango, and 15 minutes of cool-down, with appropriate rest and water breaks. Participants in the active control group will complete two 90-minute sessions per week consisting of general health education, low-intensity joint mobility exercises, stretching, and relaxation activities. The control program will not include systematic tango steps, progressive movement-sequence learning, or cognitively demanding direction-switching tasks.

The adapted Argentine tango intervention will be progressively delivered over 8 weeks. Early sessions will emphasize postural control, weight shifting, forward stepping, and lateral stepping. Subsequent sessions will introduce backward stepping, movement initiation and stopping, rhythm changes, small crossover steps, and controlled 90-degree turns. Later sessions will incorporate alternating leader-follower roles, music- and direction-based cues, progressively longer movement sequences, and low-difficulty dual-task activities. High-risk movements, including jumping, rapid continuous spinning, deep lunges, large kicks, boleos, ganchos, and eyes-closed movement, will be excluded.

Tango exercise intensity will be targeted at approximately 50% to 65% of heart rate reserve, with a rating of perceived exertion of 11 to 13. Attendance, actual exercise duration, average and peak heart rate, session rating of perceived exertion, interruptions, discomfort, falls, and other adverse events will be recorded throughout the intervention.

Study assessments will be conducted at baseline, week 4, week 8, and 2 weeks after completion of the intervention. Week 8 will be the primary endpoint. No study-provided training will be delivered during the 2-week follow-up period. Physical activity and participation in other exercise programs during follow-up will be documented.

The primary outcome will be the between-group difference in the change from baseline to week 8 in dual-task walking cost. Dual-task walking cost will be calculated from walking speed under single-task and dual-task conditions. Secondary assessments will evaluate dynamic balance, complex mobility, walking performance, executive function, general cognitive function, lower-limb functional performance, walking endurance, intervention adherence, exercise intensity, falls, withdrawals, and adverse events.

The primary analysis will follow the intention-to-treat principle. Longitudinal outcomes will be analyzed using mixed-effects models including group, time, and group-by-time interaction effects. Effect estimates will be reported with 95% confidence intervals. Appropriate adjustment for multiple comparisons and sensitivity analyses for missing data will be conducted according to a prespecified statistical analysis plan.