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The study compares the impact of physical-cognitive exercises using Blazepod device versus conventional balance training on multiple outcomes in older adults aged 70 and above. Participants receive an 8-week intervention, three sessions per week for both groups. Outcome measures include balance assessments, fear of falling scales, activity of daily living performance, sleep quality questionnaires, reaction time tests, and cognitive assessments. The study aims to determine whether physical-cognitive training provides additional benefits compared to conventional balance exercises.
Worldwide and in Turkey, increasing life expectancy and the growth of the elderly population are associated with rising care, health, and social needs among older adults. Aging induces physiological changes that lead to declines in both physical and cognitive capacities. Recently, non-pharmacological interventions have gained importance over pharmacological treatments to improve function and avoid polypharmacy. Strength, aerobic, and balance exercises have been shown to induce structural and functional brain adaptations, increase BDNF secretion, and positively influence both physical and cognitive domains.
Systematic reviews suggest that combining cognitive training with physical exercises produces greater cognitive benefits than physical exercises alone. Conventional balance training programs for healthy older adults are widely reported in the literature, often including static and dynamic exercises performed with eyes open or closed. These exercises improve balance, reduce falls, and enhance quality of life.
However, traditional balance exercises may have limitations due to the absence of visual stimuli or reduced environmental challenges, which can limit their transfer to real-life daily activities. Recently, combined physical-cognitive training programs have gained attention.
The Blazepod system, controlled via a smartphone application, provides visual stimuli through LED lights to train reaction time and skill acquisition, while engaging both physical and cognitive processes simultaneously. Unlike conventional programs, Blazepod allows unpredictable sequences of stimuli, requiring participants to respond in real time, thus activating both physical and cognitive skills.
The aim of this study is to investigate the effects of simultaneous physical-cognitive training using Blazepod and conventional balance exercises on cognitive function, balance, daily activity performance, fall risk, and sleep quality in older adults.
This study will include two groups of participants aged 70 years and older with a Mini-Mental State Examination (MMSE) score of 24 or higher who are able to walk independently. Each group will include 17 participants, for a total of 34 participants. Both groups will participate in an 8-week intervention, three sessions per week.
In the physical-cognitive exercise group, each session will begin with a warm-up period including strengthening and mobilization exercises, followed by a Blazepod-based exercise program designed to simultaneously train balance and cognitive skills. Each session will conclude with a cool-down program including stretching and breathing exercises.
In the balance exercise group, sessions will follow the same structure: after warm-up exercises, participants will perform conventional balance exercises, followed by the same cool-down program as the physical-cognitive group.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Physical-Cognitive Training Group | Experimental | Blazepod-based physical-cognitive training (8 weeks, 3 sessions/week) |
|
| Conventional Balance Training Group | Active Comparator | Conventional balance training (8 weeks, 3 sessions/week) |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Physical-Cognitive Training | Other | Participants will receive an 8-week physical-cognitive training program using the Blazepod device, consisting of exercises targeting both balance and cognitive skills. Sessions will be conducted three times per week, each lasting one hour. |
| Measure | Description | Time Frame |
|---|---|---|
| Standartized Mini Mental Test | It is a test used to assess cognitive impairment and changes, scored out of 30 points, with scores below 24 indicating potential dementia. | From enrollment to the end of treatment at 8 weeks |
| Montreal Cognitive Assessment | A brief cognitive screening tool evaluating memory, attention, language, visuospatial skills, and executive function. Scores below 26 suggest possible cognitive impairment. | From enrollment to the end of treatment at 8 weeks |
| Fullerton Advanced Balance Scale | A clinical balance assessment consisting of 10 tasks that test static and dynamic balance, anticipatory postural adjustments, and sensory integration. Total score is changed 0-40 and higher scores indicated better balance. | From enrollment to the end of treatment at 8 weeks |
| Functional Reach Test | Assesses the maximal distance a person can reach forward beyond arm's length while maintaining a fixed base of support. Measures dynamic balance and risk of falling. | From enrollment to the end of treatment at 8 weeks |
| Timed Up and Go Test | Measures the time taken to stand up from a chair, walk 3 meters, turn around, walk back, and sit down. Evaluates mobility, balance and fall risk. | From enrollment to the end of treatment at 8 weeks |
| Modified Falls Efficacy Scale | Assesses fear of falling and confidence in performing daily activities. A self-reported questionnaire measuring perceived confidence in avoiding falls during various daily activities. |
| Measure | Description | Time Frame |
|---|---|---|
| Katz Index of Independence in Activities of Daily Living | Evaluates independence in six daily activities: bathing, dressing, toileting, transferring, continence, and feeding. Higher scores indicate greater independence. | From enrollment to the end of treatment at 8 weeks |
| Lawton Instrumental Activities of Daily Living Scale |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Gözde Baş Başer | Contact | +905385460124 | gozde.bas@std.medipol.edu.tr |
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Istanbul Medipol University | Recruiting | Istanbul | Beykoz | 34810 | Turkey (Türkiye) |
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| Conventional Balance Training | Other | Participants will receive an 8-week conventional balance training program. Sessions will be conducted three times per week, each lasting one hour. |
|
| From enrollment to the end of treatment at 8 weeks |
| Deary-Liewald Reaction Time Task | Evaluates simple and choice reaction time. A computerized test measuring the speed of cognitive-motor responses to visual stimuli. | From enrollment to the end of treatment at 8 weeks |
Assesses more complex daily living skills. Measures ability to perform tasks such as using the telephone, shopping, preparing meals, housekeeping, laundry, transportation, medication management, and handling finances. Higher scores indicate greater functional ability, and score is between 0-17. |
| From enrollment to the end of treatment at 8 weeks |
| Pittsburgh Sleep Quality Index | Assess sleep quality and disturbances. A self-reported questionnaire evaluating sleep quality over the past month, including components such as sleep duration, latency, efficiency, disturbances, and daytime dysfunction. Scores range from 0 to 21, with higher scores indicating poorer sleep quality. | From enrollment to the end of treatment at 8 weeks |