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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Medium difficulty fixed priority group | Experimental | Participants in this group underwent a medium-difficulty and fixed-priority cognitive-motor dual-task fall prevention intervention program |
|
| Medium difficulty variable priority group | Active Comparator | Participants in this group underwent a medium-difficulty and variable-priority cognitive-motor dual-task fall prevention intervention program |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Medium difficulty fixed priority group | Behavioral | During the intervention process, participants carried out cognitive and motor tasks simultaneously. They were told to divide attention equally between them and not prioritize one over the other. |
| Measure | Description | Time Frame |
|---|---|---|
| The changes of Time up and go test from baseline to the end of the intervention | From enrollment to the end of the intervention at 3 weeks |
| Measure | Description | Time Frame |
|---|---|---|
| The changes of the Berg Balance Scale (BBS) from baseline to the end of the intervention | The minimum and maximum values of the Berg Balance Scale are 0 and 56 points, respectively. The higher the score, the better the balance ability, and the lower the risk of falling. | From enrollment to the end of the intervention at 3 weeks |
| Measure | Description | Time Frame |
|---|---|---|
| The changes of the Falls Efficacy Scale-International (FES-I) from baseline to the end of the intervention | The minimum and maximum values of the Falls Efficacy Scale-International (FES-I) are 16 and 64 points, respectively. A higher score indicates a greater degree of an individual's concern about falling. | From enrollment to the end of the intervention at 3 weeks |
Inclusion Criteria:
Exclusion Criteria:
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A Sequential Multiple Assignment Randomized Trial (SMART) design was adopted in this study. The SMART intervention consisted of two stages. In the first stage, participants were randomly assigned to either the VP group (receiving variable-priority dual-task intervention) or the FP group (receiving fixed-priority dual-task intervention). Outcome data were collected and assessed immediately after the first-stage intervention, and participants were classified as responders or non-responders based on predefined tailoring variables. Responders in both the VP and FP groups continued with their original intervention protocol in the second stage, whereas non-responders were re-randomized in the second stage. The re-randomization was conducted within their original priority group by adjusting the difficulty level of the intervention, with non-responders being re-assigned to either a difficulty-increase or difficulty-decrease CMDT intervention group.
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Given the inherent nature of the intervention, blinding of participants and intervention providers was not feasible; only the outcome assessors were kept blinded to group assignment.
| Medium difficulty variable priority group | Behavioral | During the intervention process, participants performed medium-difficulty cognitive and motor tasks simultaneously. Participants alter focus between the motor task and the cognitive task every half of the intervention time. |
|
| The changes of the Mini-Mental State Examination (MMSE) from baseline to the end of the intervention |
The minimum and maximum values of the Mini-Mental State Examination (MMSE) are 0 and 30 points, respectively. The higher the score, the better the cognitive function. |
| From enrollment to the end of the intervention at 3 weeks |
| The changes of Trail making test from baseline to the end of the intervention | From enrollment to the end of the intervention at 3 weeks |
| The changes of gait from baseline to the end of the intervention | The gait of participants is measured using insole plantar pressure measurement systems to assess the step length, cadence, walking speed, and plantar pressure distribution. The results could determine whether gait abnormalities are present. | From enrollment to the end of the intervention at 3 weeks |
| The changes of 12-Item Health Survey from baseline to the end of the intervention | From enrollment to the end of the intervention at 3 weeks |
| The changes of the Geriatric Depression Scale (GDS) from baseline to the end of the intervention | The minimum and maximum scores of the Geriatric Depression Scale (GDS) are 0 and 30 points, respectively. A higher score indicates more severe depressive symptoms in individuals. | From enrollment to the end of the intervention at 3 weeks |