Should Dual Task Training or Action Observation Therapy be Used in Geriatric Individuals?

Condition(s) studied

Investigational drug(s) / intervention(s)

Conventional exercises with dual task training (cognitive task): Individuals in this group will undergo exercise sessions under the supervision of a physiotherapist, with cognitive tasks added to conventional exercises, 3 days a week for a total of 8 weeks. EXERCISES 1. Sit-Reach in Bed (15 seconds each) 2. Hip Flexor Stretch Exercise (15 seconds each) 3. Cat-Camel Exercise 4. Bridge Exercise 5. Biceps Curl/Triceps Extension/Upper Limb Abduction While Sitting in a Chair 6. Sit-to-Stand in a Chair 7. One-Legged Stand 8. Mini Squat 9. Tandem Walk Cognitive Tasks to be Used in the Dual-Task Training Group Weeks 1 and 2 Simple single-digit addition Generate random numbers between 1 and 100 Count the days of the week Count the months of the year Repeat two spoken words Count from 0 to 100, incrementing by 10 Generate words starting with the specified letter Count from 1 to 100 The remaining cognitive task examples are in the study description. The exercises and cognitive tasks will be conducted sequentially and simultaneous

Conventional Exercise With Action Observation Therapy: Individuals in this group will watch exercises on a computer screen in three sessions (in bed, sitting, and standing), three days a week for a total of eight weeks. Each exercise in each session will be monitored for two minutes, and each session will be performed under the supervision of a physical therapist for one minute. A one-minute break will be provided between sessions. Each session will last approximately 40-50 minutes. EXERCISES 1. Sit-Reach in Bed (15 seconds each) 2. Hip Flexor Stretch Exercise (15 seconds each) 3. Cat-Camel Exercise 4. Bridge Exercise 5. Biceps Curl/Triceps Extension/Upper Limb Abduction While Sitting in a Chair 6. Sit-to-Stand in a Chair 7. One-Legged Stand 8. Mini Squat 9. Tandem Walk For Example: After watching the video of the exercise period in which you sit and stand on a chair on the computer, do the same exercise by imitating it. (1 set, 10 repetitions) Device: Handheld dynanometer, chair, stopwatch, computer

Conventional Exercise (Control Group): Individuals in this group will perform conventional exercise sessions under the supervision of a physical therapist three days a week for a total of eight weeks. Each session will last approximately 40-50 minutes. No cognitive tasks or action monitoring therapy will be used during the exercises. EXERCISES 1. Sit-Reach in Bed (15 seconds each) 2. Hip Flexor Stretch Exercise (15 seconds each) 3. Cat-Camel Exercise 4. Bridge Exercise 5. Biceps Curl/Triceps Extension/Upper Limb Abduction While Sitting in a Chair 6. Sit-to-Stand in a Chair 7. One-Legged Stand 8. Mini Squat 9. Tandem Walk. Device: Handheld dynanometer, chair, stopwatch

Study summary

Summary Aging leads to significant declines in both motor skills and cognitive functions. Declines in walking, balance, and general mobility are particularly evident, while declines in cognitive functions such as attention, memory, and decision-making are also observed. It is crucial to recommend therapeutic interventions that support healthy aging, aim to increase physical and cognitive function, and prevent physical limitations in individuals over 65. The aim of this study is to examine the effects of dual-task training and action observation therapy on parameters such as cognitive function, balance, gait, functional mobility, flexibility, strength, and quality of life in geriatric individuals. Sixty-six individuals over the age of 65 will be randomized into the Dual-Task Training (DTT) group (n=22), the Action Observation Therapy (EGT) group (n=22), and the Control Group (CG) (n=22), which will receive conventional exercise. The exercise program will be applied 3 days per week for 8 weeks in all three groups. To assess balance and walking, the "Tinetti Balance and Walk Test" will be used; to assess functional mobility, the "Timed Up and Go Test" will be used; to obtain information about muscle strength, the "Hand Dynanometer" and the "5-Time Chair Sit-to-Stand Test" will be used; the "Sit-and-Reach Flexibility Test" will be used; to assess quality of life, the "CASP-19 Quality of Life Scale for Elderly People - Turkey Version (CASP-13)" will be used; to assess cognitive functions, the "Mini Mental State Test" and the "Clock Drawing Test" will be used; and perceived fatigue levels after exercise will be assessed using the Modified Borg Scale. The analyses of the data taken into the study will be carried out using SPSS (Statistical Program in Social Sciences). The values of the data will be expressed as numbers, percentages, mean and standard deviation; the significance level (p) will be taken as 0.05 for comparison tests.

Eligibility

Primary outcome measure(s)

• Tinetti Balance and Walking Test Score — From enrollment to the end of treatment at 8 weeks
  Participants' balance and walking performance will be assessed using the Tinetti Balance and Walking Test. The sum of the balance and walking scores provides the total score. The total balance score is 16; a score below 11 indicates a risk of falling. The total walking score is 12; a score below 8 indicates a risk of falling. Measurements will be taken before and at the end of the 8th week of Action Observation Therapy (AOT), Dual Task Training (DTT), and Control Group interventions, and comparisons will be made between the groups.
• Timed Up and Go Test Score — From enrollment to the end of treatment at 8 weeks
  Functional mobility will be measured in seconds with the Timed Up and Go (TUG) test. The participant rises from a chair, walks 3 meters, turns, and sits back down. Elapsed time is measured in seconds. Measurements will be taken before and after the Action Observation Therapy (AOT), Dual Task Training (DTT) and Control Group interventions, and at the end of the 8th week, for comparison between groups.
• Mini Mental State Examination (MMSE) Test Scores — From enrollment to the end of treatment at 8 weeks
  Participants' general cognitive status will be evaluated with the Mini Mental State Examination (MMSE) Test. The highest possible total score on the mini mental test is 30, and scores below 24 indicate cognitive impairment. Measurements will be taken before and 8 weeks after the Action Observation Therapy (AOT), Dual Task Training (DTT), and Control Groups, and will be compared.
• Clock Drawing Test Score — From enrollment to the end of treatment at 8 weeks
  Participants' executive functions, visual-spatial skills and planning ability will be evaluated with the Clock Drawing Test. In the clock drawing test, a score below four is consistent with impaired cognitive function. Measurements will be taken before and 8 weeks after the Action Observation Therapy (AOT), Dual Task Training (DTT), and Control Groups, and will be compared.
• Hand dynamometer Score — From enrollment to the end of treatment at 8 weeks
  Grip strength will be measured with a hand dynamometer. Measurements will be taken before and after 8 weeks of action observation therapy (AOT), dual-task training (DDT), and the Control Group for comparison. The measurement will be taken three times, 10 seconds apart, and the average value will be used in the study. The measured force will be recorded in kg.
• 5-times chair sit-to-stand test score — From enrollment to the end of treatment at 8 weeks
  To measure lower extremity muscle strength, the participant will be asked to sit down and stand up from a chair five times in a row using a sit-to-stand test. The time will be recorded in seconds. Measurements will be taken before and after 8 weeks of action observation therapy (AOT), dual-task training (DDT), and the Control Group for comparison.
• Sit-Reach Test Score — From enrollment to the end of treatment at 8 weeks
  Flexibility will be assessed with the sit-and-reach test. The participant's forward reach while sitting will be measured in cm. Measurements will be taken before and after eight weeks of action observation therapy (AOT), dual-task training (DDT), and the control group, and for intergroup comparisons.
• CASP-19 Elderly Quality of Life Scale-Turkish Version (CASP-13) Score — From enrollment to the end of treatment at 8 weeks
  Participants' quality of life will be assessed using the CASP-19 Elderly Quality of Life Scale-Turkish Version (CASP-13). Scale scores range from 0 to 39. Higher total scores indicate improved quality of life. Measurements will be taken before and 8 weeks after interventions in the action observation therapy, dual-task training, and control groups. Measurement results will be compared across groups.
• Modified Borg Scale (MBS) Score — From enrollment to the end of treatment at 8 weeks
  Geriatric individuals' perceived fatigue levels after exercise will be assessed using the Modified Borg Scale (MBS). The MBS consists of 10 points indicating dyspnea severity. A score of 0 indicates no dyspnea or fatigue, while a score of 10 indicates the highest degree of dyspnea and fatigue. Measurements will be taken after the first session of week 1 and the last session of week 8 for geriatric individuals in the action observation therapy, dual-task training, and control groups.

Trial sites (1)

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