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

23 mars 2020 uppdaterad av: 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.

Studieöversikt

Status

Okänd

Betingelser

Intervention / Behandling

Studietyp

Interventionell

Inskrivning (Förväntat)

105

Fas

  • Inte tillämpbar

Kontakter och platser

Det här avsnittet innehåller kontaktuppgifter för dem som genomför studien och information om var denna studie genomförs.

Studieorter

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

Deltagandekriterier

Forskare letar efter personer som passar en viss beskrivning, så kallade behörighetskriterier. Några exempel på dessa kriterier är en persons allmänna hälsotillstånd eller tidigare behandlingar.

Urvalskriterier

Åldrar som är berättigade till studier

65 år och äldre (Äldre vuxen)

Tar emot friska volontärer

Nej

Kön som är behöriga för studier

Allt

Beskrivning

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

Det här avsnittet ger detaljer om studieplanen, inklusive hur studien är utformad och vad studien mäter.

Hur är studien utformad?

Designdetaljer

  • Primärt syfte: Förebyggande
  • Tilldelning: Randomiserad
  • Interventionsmodell: Parallellt uppdrag
  • Maskning: Ingen (Open Label)

Vapen och interventioner

Deltagargrupp / Arm
Intervention / Behandling
Experimentell: Single-task Training Group
Single-task walking group
Beteende: Single-task Training
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).
Experimentell: Dual-task Training Group
Dual-task walking group
Beteende: Dual-task Training
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).
Experimentell: Analogy Training Group
Analogy walking group
Beteende: Analogy Training
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).

Vad mäter studien?

Primära resultatmått

Resultatmått
Åtgärdsbeskrivning
Tidsram
Baseline propensity for conscious motor processing
Tidsram: 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
Tidsram: 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
Tidsram: 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

Sekundära resultatmått

Resultatmått
Åtgärdsbeskrivning
Tidsram
Baseline single-task walking ability
Tidsram: 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
Tidsram: 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
Tidsram: 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
Tidsram: 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
Tidsram: 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
Tidsram: 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
Tidsram: 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
Tidsram: 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
Tidsram: 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
Tidsram: 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
Tidsram: 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
Tidsram: 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
Tidsram: 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
Tidsram: 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
Tidsram: 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
Tidsram: 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
Tidsram: 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
Tidsram: 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
Tidsram: 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)
Tidsram: 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

Samarbetspartners och utredare

Det är här du hittar personer och organisationer som är involverade i denna studie.

Sponsor

The University of Hong Kong

Utredare

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

Studieavstämningsdatum

Dessa datum spårar framstegen för inlämningar av studieposter och sammanfattande resultat till ClinicalTrials.gov. Studieposter och rapporterade resultat granskas av National Library of Medicine (NLM) för att säkerställa att de uppfyller specifika kvalitetskontrollstandarder innan de publiceras på den offentliga webbplatsen.

Studera stora datum

Studiestart (Faktisk)

1 oktober 2018

Primärt slutförande (Förväntat)

31 augusti 2021

Avslutad studie (Förväntat)

31 augusti 2021

Studieregistreringsdatum

Först inskickad

10 januari 2019

Först inskickad som uppfyllde QC-kriterierna

18 januari 2019

Första postat (Faktisk)

22 januari 2019

Uppdateringar av studier

Senaste uppdatering publicerad (Faktisk)

25 mars 2020

Senaste inskickade uppdateringen som uppfyllde QC-kriterierna

23 mars 2020

Senast verifierad

1 mars 2020

Mer information

Termer relaterade till denna studie

Nyckelord

Andra studie-ID-nummer

  • UW17-049

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