Development and Evaluation of a Home-Based Dual-Task Training Program to Improve Balance Performance for Older Adults

Development and Evaluation of a Home-Based Dual-Task Training Program to Improve Balance Performance for Older Adults

The purpose of this study is to (1) develop and test the effectiveness of home-based interventions on dual-task performance in older adults; and (2) determine the generalizability of the four trainings (i.e. single-task motor training, single-task cognitive training, dual-task motor-cognitive training, and dual-task cognitive-cognitive trainings) to novel tasks.

Although, dual-task motor-cognitive training has proven to be more effective in improving dual-task balance performance than traditional single-task motor training, poor evidence of training-related transfer to a novel dual task has been shown. Additionally, another important impediment to the development of intervention to improve dual-task balance performance is that the previous studies have largely focused on training in a laboratory, or clinical setting, often with one-on-one supervision by a therapist or research assistant. Even though the home-based approach is more pragmatic, desirable, and encourages accessibility, no study has been done to examine the efficacy of home-based dual-task training.

Therefore, this study aims to address these gaps in the literature by conducting a home-based program designed to improve dual-task performance with a broader transfer-of-training effects in older adults. Participants will be randomly assigned to one of four groups (i.e. single-task motor training, single-task cognitive training, dual-task motor-cognitive training, and dual-task cognitive-cognitive trainings).

Inclusion Criteria:

• Able to walk at least 10 meters without any assistive device
• Having greater than 16/23 for illiterate persons, greater than 20/30 for primary education level persons, and greater than 23/30 for secondary education level persons on the Mini-Mental State Examination-Thai 2002 (MMSE-Thai2002)

Exclusion Criteria:

• Severe neurological problems that could account for possible imbalance such as cerebral vascular accident, Parkinson's disease, transient ischemic attacks, and neuropathy
• Severe musculoskeletal problems that could impact gait such as severe osteoarthritis and active inflammatory joint disease
• Severe cardiopulmonary problems such as asthma and chronic obstructive pulmonary disease
• Visual impairment that cannot be corrected by lenses
• Severe auditory impairment such as deafness
• Depression as scored ≥ 13 by Thai Geriatric Depression Scale (TGDS)