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The goal of this clinical trial is to determine the effect of a community-based rehabilitation intervention (Cognitive Groove, Brought to you by GERAS DANCE), compared to usual care, on clinical outcomes in community-dwelling older adults living with frailty. The main questions it aims to answer are:
Participants will participate in Cognitive Groove classes twice per week for 3 months or receive no intervention (usual care).
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Cognitive Groove (GERAS DANCE) | Experimental | Classes will occur twice per week for 3 months. Classes follow a consistent sequence of activities (orientation and socialization [10-mins]; warm-up [5-mins]; structured dance [30-mins]; cool-down [5-mins]; socialization and review of weekly hand-outs for balance exercises [10-mins]. The curriculum schedule includes five foundations and seven routines. Cognitive Groove (GERAS DANCE) foundations emphasize learning the ABCs of movement and increasing participants' confidence to move their bodies forward and backward and side-to-side with improved speed and rhythmicity. Cognitive Groove (GERAS DANCE) routines combine the foundational skills into full choreographed dances to music from the '50s and '60s (e.g., rock and roll, jazz, salsa, cha cha cha, rhythm soul, swing, disco, and Bollywood). Participants will receive an intervention-specific study manual that describes the homework exercises for each week. |
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| Usual Care | No Intervention | The control arm participants will continue with their usual care and normal activities. They will not receive any intervention during the study but will be given the opportunity to participate in Cognitive Groove (GERAS DANCE) programming after the study. |
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Dance Rehabilitation Intervention | Other | Cognitive Groove (GERAS DANCE) presents a novel approach to increasing or maintaining independence and quality of life by improving physical performance and mobility using reminiscent music and rhythmic movement in a fun, safe environment. Cognitive Groove was designed to meet the complex needs of older adults with frailty. Our pilot quasi-experimental studies have demonstrated Cognitive Groove results in clinically significant improvements in walking speed by 0.1 m/s with enhanced temporal-spatial walking parameters and improved lower extremity function, including balance and chair stands. |
| Measure | Description | Time Frame |
|---|---|---|
| Change in Physical Performance | Physical function will be assessed with the Short Performance Physical Battery [total score]. Higher scores indicate better physical performance [range 0-12]. | Baseline and 3-months |
| Measure | Description | Time Frame |
|---|---|---|
| Change in Walking Speed | Walking speed will be assessed with the 400-m Walk Test [walking speed, m/s]. Faster walking speeds indicate better performance. | Baseline and 3-months |
| Change in Walking Speed |
| Measure | Description | Time Frame |
|---|---|---|
| Individual-level Economic Evaluation | Individual-level economic evaluations will be assessed by changes in direct medical costs and effectiveness outcomes (e.g., quality-adjusted life years - QALYs), calculate and compare the incremental cost-effectiveness ratio (ICER) (e.g., $/ QALY gained, $/ a visit averted) against a willingness-to-pay threshold ($50,000/QALY) to show if this program represents good value for money. |
Inclusion Criteria:
Exclusion Criteria:
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Patricia Hewston, PhD | Contact | 905-521-2100 | 74161 | hewstonp@hhsc.ca |
| Name | Affiliation | Role |
|---|---|---|
| Alexandra Papaioannou, MD | McMaster University | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Geras Centre for Aging Research, St. Peter's Hospital, Hamilton Health Sciences | Recruiting | Hamilton | Ontario | L8M 1W9 | Canada |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 42163402 | Derived | Papaioannou A, Ioannidis G, Kennedy C, Hladysh G, Lee J, Adachi JD, Cowan D, Duarte D, Hategan A, Innes A, Keen S, Marr S, McArthur C, McKenna B, Tarride JE, Thabane L, Rabinovich A, Thrall S, Wang M, Azizudin AM, Choo WLO, Marr C, Perrotta A, Hewston P. Cognitive Groove community-based rehabilitation for older adults: study protocol for a multisite parallel randomized controlled trial. Trials. 2026 May 20. doi: 10.1186/s13063-026-09782-5. Online ahead of print. |
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| ID | Term |
|---|---|
| D000073496 | Frailty |
| ID | Term |
|---|---|
| D010335 | Pathologic Processes |
| D013568 | Pathological Conditions, Signs and Symptoms |
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Change in walking speed will be assessed by 8-ft walking speed [m/s]. Faster walking speeds indicate better performance.
| Baseline to 3-months |
| Change in Functional Mobility | Functional mobility will be assessed with the Timed Up and Go (TUG) Test [total time, s]. A higher score indicates a greater falls risk (greater or equal to 12 sec) and lower functional mobility. | Baseline and 3-months |
| Change in Dual Task Ability | Dual-task ability will be assessed by the TUG-Cognitive (Dual Task Ability) [total time, s]. Higher time indicates worse performance. | Baseline and 3-months |
| Change in Static Postural Control | Static postural control will be assessed by the Single Leg Stance Test [total time, s]. Higher scores indicate better postural control. | Baseline and 3-months |
| Change in Hand Grip Strength | Hand grip strength will be assessed with a handgrip dynamometer [kg]. Higher measures indicate higher grip strength. | Baseline and 3-months |
| Change in Cognition | Cognition will be assessed with the Montreal Cognitive Assessment [total score]. Higher scores indicate better cognition [range 0-30]. | Baseline and 3-months |
| Change in Cognition | Change in cognition will be assessed using the Trail Making Test (TMT) [total time, s]. Higher time indicates worse performance. | Baseline and 3-months |
| Change in Cognition | Cognition will be assessed using the Digit Symbol Substitution Test (DSST) [total score]. Higher scores indicate better cognition [range 0-100]. | Baseline and 3-months |
| Change in Frailty | Frailty will be assessed with the Fit-Frailty Index [total score]. Higher scores indicate greater frailty [range 0-1]. | Baseline and 3-months |
| Change in Fear of Falling | Fear of falling will be assessed by the Falls Efficacy Scale International (FES-I) [total score]. Higher scores indicate greater fear of falling [range 16-64]. | Baseline and 3-months |
| Change in Balance Confidence | Balance confidence will be assessed by the Activities-specific Balance Confidence (ABC) Scale [total score]. Higher scores indicate higher confidence [range 0-100]. | Baseline and 3-months |
| Change in Depression/Mood | Depression and mood will be assessed with the Patient Health Questionnaire-9 (PHQ-9) [total score]. Higher scores indicate more depressive symptoms [range 0-27]. | Baseline and 3-months |
| Change in Loneliness | Loneliness will be assessed by the University of California Los Angeles (UCLA) Loneliness Scale [total score]. Higher scores in indicate higher loneliness [range 20-80]. | Baseline and 3-months |
| Change in Basic Activities of Daily Living | Activities of daily living will be assessed with the Katz activities of daily living questionnaire [total score]. Lower scores indicate greater impairment [range 0-6]. | Baseline and 3-months |
| Change in Instrumental Activities of Daily Living | Activities of daily living will be assessed with Lawton instrumental activities of daily living questionnaire [total scores]. Lower scores indicate greater impairment [range 0-8]. | Baseline and 3-months |
| Change in Life Space Mobility | Life space mobility will be assessed with the Life Space Assessment [total score]. Higher scores indicate a larger life space [range 0-120]. | Baseline and 3-months |
| Change in Health-related Quality of Life | Health-related quality of life will be assessed using the Health Utilities Index (HUI). Higher scores indicate better health-related quality of life [range 0-1]. | Baseline, 3-months, and 12-months |
| Change in Healthcare Utilization | Number of emergency room visits and hospitalizations will be recorded. Higher number of visits indicates higher healthcare utilization. | Baseline, 3-months, and 12-months |
| Change in Healthcare Utilization | Healthcare services use will be recorded. Higher number of visits, medications, etc., indicates higher healthcare utilization. | Baseline, 3-months, and 12-months |
| Change in Falls | Number of falls will be assessed by self-report and electronic health record. | Baseline to 3-months |
| Change in Falls-Related Injuries | Number of falls-related injuries will be assessed by self-report and electronic health record. | Baseline to 3-months |
| Change in Mobility | Change in mobility will be assessed by the total number of steps taken daily (e.g., Actigraph accelerometer). Higher number of steps indicates greater mobility. | Baseline to 3-months |
| Adherence | Class attendance and homework completion will be recorded [total number completed]. Higher class attendance and homework completion indicates greater adherence. | Baseline to 3-months |
| Baseline, 3-months, and 12-months |