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Cognitive Training and Dual-task Ability

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VA Office of Research and Development

Status

Completed

Conditions

Gait Disorder

Treatments

Behavioral: Cognitive training (general cognition)
Behavioral: Standard balance rehabilitation
Behavioral: Balance rehabilitation + dual-tasking
Behavioral: Cognitive training (speed of processing)

Study type

Interventional

Funder types

Other U.S. Federal agency

Identifiers

NCT01895608
E7614-P

Details and patient eligibility

About

The first goal of this study is to examine the extent to which the inclusion of dual-task practice to standard balance rehabilitation results in greater benefits to dual-task ability. The second goal of this study is to examine the extent to which the addition of cognitive training following balance rehabilitation results in greater benefits to dual-task ability.

Full description

Historically, degradation of balance control in older adults has been attributed to impairments of the motor and/or sensory systems. As a result, therapy has focused on motor and sensory impairments. However, evidence suggests that an impaired ability to allocate attentional resources to balance during dual-task situations is a powerful predictor of falls. Despite this fact, few studies have examined whether interventions can improve older adults' dual-task ability. The goal of this study is to develop effective interventions to improve ability to allocate attention to balance and gait under dual-task conditions.

Older adults (n = 44) who have been referred to physical therapy (PT) for gait or balance impairments who have dual-task impairment will be randomized to receive either standard balance rehabilitation or balance rehabilitation with dual-task practice. Following PT, subjects will receive cognitive training (CT), either speed of processing or generalized cognitive training. Primary outcomes are ability to walk while performing four different cognitive tasks of varying difficulty. Assessment will occur at baseline, post-PT, post-CT.

Enrollment

34 patients

Sex

All

Ages

60 to 89 years old

Volunteers

Accepts Healthy Volunteers

Inclusion criteria

  • Inclusion criteria include:
  • > 60 years of age
  • documented balance or mobility problems
  • dual-task impairment (timed up and go with subtraction task > 15 s)

Exclusion criteria

  • Exclusion criteria include:
  • cognitive impairment (> 2 errors on Short Portable Mental Status Questionnaire41)
  • progressive medical issues that would impact mobility (e.g., Parkinson's disease).

Trial design

Primary purpose

Treatment

Allocation

Randomized

Interventional model

Parallel Assignment

Masking

Double Blind

34 participants in 4 patient groups

Balance rehabilitation + dual-tasking
Experimental group
Description:
Balance rehabilitation will involve a structured framework of balance activities that require increasing levels of complexity and multimodal stimuli and response demands with the addition of cognitive tasks, (e.g., counting backwards or reciting lists) to be added when the participant can safely perform the primary balance or gait task.
Treatment:
Behavioral: Balance rehabilitation + dual-tasking
Standard balance rehabilitation
Active Comparator group
Description:
Standard balance rehabilitation will involve a structured framework of balance activities that require increasing levels of complexity and multimodal stimuli and response demands.
Treatment:
Behavioral: Standard balance rehabilitation
Cognitive training (speed of processing)
Experimental group
Description:
Speed of processing cognitive training involves systematically increasing the complexity of visual tasks. Task demands are increased by reducing stimulus duration, adding visual or auditory distractors, increasing number of concurrent tasks or increasing the visual field.
Treatment:
Behavioral: Cognitive training (speed of processing)
Cognitive training (general cognition)
Active Comparator group
Description:
General cognitive training involves systematic training of 14 key cognitive abilities, including visual scanning, response time, eye-hand coordination, spatial perception, and working memory. Initial starting point is determined by the software using baseline evaluation.
Treatment:
Behavioral: Cognitive training (general cognition)

Trial contacts and locations

2

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Data sourced from clinicaltrials.gov

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