Dual-Task Training for Falling

(Real-DTT Trial)

Overseen By Laura A Swink, PhD

Age: 65+

Sex: Any

Trial Phase: Academic

Sponsor: Colorado State University

Disqualifiers: Dementia, Not fluent in English

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Compensation: Varies

Number of Visits: Unknown

Duration: 10 sessions

36 Participants Needed

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial aims to determine if a special training program, Real-life Dual-Task Training, can assist older adults at risk of falling. The program uses real-life scenarios to enhance participants' ability to perform dual tasks, such as walking while talking. Participants will train with an occupational therapist, focusing on everyday tasks. This study suits individuals aged 65 or older who have discussed fall risks with their therapist and are receiving occupational therapy that includes daily living tasks. As an unphased trial, it offers participants the chance to contribute to valuable research that could improve daily living skills and reduce fall risks.

Do I have to stop taking my current medications for the trial?

The trial protocol does not specify whether you need to stop taking your current medications.

What prior data suggests that this dual-task training is safe for older adults?

Previous studies have shown that dual-task training is safe and effective for older adults. It can enhance attention, memory, balance, and walking. Research indicates that this training is usually well-tolerated, with no major reports of harmful effects. By focusing on real-life tasks, it integrates into daily activities and can safely help reduce falls. Overall, dual-task training appears to be a promising option for older adults seeking to improve their balance and mental skills. ^{1 2 3 4 5}

Why are researchers excited about this trial?

Researchers are excited about Real-life Dual-Task Training for falling because it takes a unique approach by combining motor and cognitive exercises tailored to everyday activities. Unlike traditional treatments that often focus solely on physical therapy, this method integrates cognitive challenges, which may help improve the ability to multitask in real-life situations. The training sessions are conducted with a licensed occupational therapist, providing personalized guidance and support, potentially leading to more effective outcomes for individuals at risk of falls.

What evidence suggests that real-life dual-task training is effective for reducing fall risk in older adults?

Research shows that dual-task training, which participants in this trial will receive, can help older adults enhance thinking skills, such as attention and memory, along with physical abilities like balance and walking speed. Studies have found that this training can reduce the risk of falls by strengthening these crucial areas. Specifically, practicing tasks that combine thinking and movement, similar to everyday activities, has shown promising results. Early evidence also suggests that this approach could improve performance in real-life situations, potentially leading to fewer falls and less impact on daily life for older adults. ^{1 2 6 7 8}

Are You a Good Fit for This Trial?

This trial is for older adults who have trouble doing two things at once, which can increase their risk of falling. It aims to help them improve their ability to perform daily tasks that require attention and balance.

Inclusion Criteria

I have been identified as having a risk of falling.

I can walk around my home, with or without help from a device.

I am scheduled for occupational therapy with Covell Care to improve my daily living skills.

Exclusion Criteria

I have been diagnosed with dementia.

I am not fluent in English.

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Treatment

Ten real-life dual-task training sessions focusing on motor and cognitive components of instrumental activities of daily living with a licensed occupational therapist

10 sessions

Follow-up

Participants are monitored for safety and effectiveness after treatment

4 weeks

What Are the Treatments Tested in This Trial?

Interventions

• Real-life Dual-Task Training

Trial Overview The study tests a 'Real-life Dual-Task Training' program designed to mimic everyday activities. The goal is to see if practicing these real-world dual-tasks can help reduce the likelihood of falls by improving cognitive and motor skills.

How Is the Trial Designed?

Group I: Real-life Dual-Task Training Experimental Treatment 1 Intervention

Ten real-life dual-task training sessions with explicit focus on motor and cognitive components of instrumental activities of daily living. Training occurs with a licensed occupational therapist.

Who Is Running the Clinical Trial?

Colorado State University

Lead Sponsor

Trials

138

Recruited

38,200+

Published Research Related to This Trial

A systematic review of 22 studies found that specific training interventions can effectively improve dual-task postural control in older adults, which is crucial for reducing fall risk.

The review highlighted that single-task training does not effectively transfer to dual-task performance, indicating the need for targeted dual-task training programs to enhance postural control.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

A systematic review of interventions conducted in clinical or community settings to improve dual-task postural control in older adults. Agmon, M., Belza, B., Nguyen, HQ., et al.[2021]

A study involving 60 community-dwelling older adults showed that both mixed dual-task training protocols improved mobility, cognitive function, and balance over 24 weeks, indicating their effectiveness in enhancing daily living skills.

No significant differences in gait performance were found between the training groups, suggesting that while dual-task training benefits overall function, it may not specifically enhance walking speed.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Effects of two different dual-task training protocols on gait, balance, and cognitive function in community-dwelling older adults: a 24-week randomized controlled trial. Trombini-Souza, F., de Moura, VTG., da Silva, LWN., et al.[2023]

Dual-task training (DTT) significantly improves gait parameters such as walking speed, stride length, and cadence, as well as balance and motor impairments in patients with Parkinson's disease, based on a meta-analysis of 17 randomized controlled trials involving 826 participants.

DTT is a safe intervention with no reported adverse effects, making it an effective therapy compared to single-task training and usual care for enhancing the quality of life in individuals with Parkinson's disease.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Efficacy of Dual-Task Training in Patients with Parkinson's Disease: A Systematic Review with Meta-Analysis. García-López, H., de Los Ángeles Castillo-Pintor, M., Castro-Sánchez, AM., et al.[2023]

Dual-task exercises (DT) have been shown to effectively improve balance and walking speed in older adults, which can help reduce the risk of falls.

The review identified that the effectiveness of dual-task training depends on specific characteristics, such as the type of cognitive-motor tasks used and the training modalities, with variable prioritization showing greater improvements.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Dual-task exercises in older adults: A structured review of current literature. Varela-Vásquez, LA., Minobes-Molina, E., Jerez-Roig, J.[2020]

A study involving 33 healthy older adults showed that cognitive-motor dual-task training improved cognitive accuracy during walking, especially for those with lower cognitive abilities, indicating enhanced cognitive efficiency regardless of the type of training (executive function, aerobic exercise, or gross motor abilities).

While dual-task gait speed showed only small improvements, the significant enhancement in cognitive accuracy suggests that various training methods can effectively strengthen cognitive performance in dual-task situations, which may help reduce the risk of cognitive impairment in older adults.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Multiple routes to help you roam: A comparison of training interventions to improve cognitive-motor dual-tasking in healthy older adults. Downey, R., Bherer, L., Pothier, K., et al.[2022]

In a study involving 30 older adults with balance impairments, both cognitive dual-task training and executive function training significantly improved gait parameters such as walking speed and stride length after 8 weeks of training.

The executive function training group showed greater improvements in limb symmetry and inter-coordination during walking compared to the cognitive dual-task training group, indicating it may be more effective for enhancing gait in older adults.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

The effect of dual task and executive training on pattern of gait in older adults with balance impairment: A Randomized controlled trial. Azadian, E., Torbati, HR., Kakhki, AR., et al.[2018]

Dual-task training (DTT) can improve both cognitive functions and physical performance, particularly in mobility and postural stability, based on a meta-synthesis of systematic reviews.

While the quality of evidence was mostly rated as low to moderate, the findings suggest that DTT may be beneficial for individuals with various clinical conditions, enhancing aspects like memory, gait, and balance.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

The effect of dual-task training on cognition of people with different clinical conditions: An overview of systematic reviews. Pereira Oliva, HN., Mansur Machado, FS., Rodrigues, VD., et al.[2022]

Training can significantly enhance dual-task performance in both older and younger adults, even when tasks require similar motor responses, suggesting that attentional control skills can be improved with practice.

The improvements in dual-task processing skills were not limited to the trained tasks, as participants also performed better with new task combinations, indicating a generalization of the training effects.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Training effects on dual-task performance: are there age-related differences in plasticity of attentional control? Bherer, L., Kramer, AF., Peterson, MS., et al.[2007]

A study involving 60 older adults (average age 74.4 years) found that 16 weeks of dual-task (DT) training significantly improved mobility, as measured by the Timed Up and Go (TUG) and Four Square Step Test (FSST), compared to control and single-task groups.

The DT training, which included additional motor tasks like carrying a glass of water or a ball, led to better performance in mobility tasks, indicating that incorporating everyday challenges into training can enhance functional abilities in older adults.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Dual-task training in older adults: The effect of additional motor tasks on mobility performance. Brustio, PR., Rabaglietti, E., Formica, S., et al.[2019]

An 8-week dual-task training program, involving either cognitive tasks (mCdtt) or motor tasks (mMdtt), improved balance in older adults, with no significant differences in outcomes between the two types of training.

Both training methods were effective in enhancing balance, fear of falling, walking functionality, and muscle strength, suggesting that either approach can be beneficial for older adults.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Do motor-cognitive and motor-motor dual task training effect differently balance performance in older adults? Akin, H., Senel, A., Taskiran, H., et al.[2022]

Citations

1. clinicaltrials.gov clinicaltrials.gov/ct2/show/NCT06479694?draw=2&rank=1

Study Details | NCT06479694 | Real-life Dual-Task Training Dual-task training has been shown to improve cognitive outcomes (attention, memory), motor outcomes (balance, gait), and dual-task performance in older adults; ...

2. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC4379606/

Effectiveness of dual-task functional power training for ... To our knowledge, this study will be the first to investigate whether dual-task functional power training can reduce the rate of falls and improve risk factors ...

3. sciencedirect.com sciencedirect.com/science/article/pii/S2274580724003510

Review The Effects of Dual-Task Training on Cognitive and ... This systematic review with meta-analysis summarizes the emerging evidence of dual-task training for enhancing cognitive and physical functions in older ...

4. withpower.com withpower.com/trial/phase-fall-6-2024-a6cda

Dual-Task Training for Falling (Real-DTT Trial) The available research shows that Dual-Task Training can improve balance and walking speed in older adults, which helps reduce the risk of falling.

5. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC8869774/

Effect of Dual-Task Motor-Cognitive Training in Preventing ... We found that our experimental motor-cognitive dual-task rehabilitation program could be an effective method to improve walking balance, gait, ...

6. sciencedirect.com sciencedirect.com/science/article/abs/pii/S016749432400044X

Review Effect of dual-task training on balance in older adults The findings of this review suggest that DTT may be an effective intervention to improve balance in healthy older adults.

7. journals.lww.com journals.lww.com/md-journal/fulltext/2025/03070/comparing_the_effectiveness_of_dual_task_and.35.aspx

Comparing the effectiveness of dual-task and single-task... This study aims to systematically compare the efficacy of dual-task with single-task training interventions on improving walking function among stroke ...

8. ahajournals.org ahajournals.org/doi/10.1161/JAHA.124.040663

Impact of Vestibular Rehabilitation and Dual‐Task Training ... The evidence supports that VRT, can probably improve balance, and DTT may improve gait outcomes among survivors of late subacute and chronic stroke.