Feasibility and Effectiveness of a Home-based Motor-cognitive Training Program in Older Adults

NCT ID: NCT05751551

Last Updated: 2024-02-15

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

144 participants

Study Classification

INTERVENTIONAL

Study Start Date

2023-02-22

Study Completion Date

2024-02-09

Brief Summary

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The goal of this clinical study is to test feasibility and effectiveness of a personalized, home-based motor-cognitive training program in community-dwelling older adults with prescription for rehabilitation.

Participants will conduct a motor-cognitive intervention program which is based on exergames (=interactive video games controlled by body movements), added to usual care for 2 weeks in rehabilitation centers (face-to-face supervision) and for 10 weeks at home (remotely supervised).

Researchers will compare an intervention group and a control group to compare possible effects of the home-based study intervention to the effect of usual care alone on cognition, physical functions, and balance confidence.

Detailed Description

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Age-related declines in physical and cognitive functioning and the associated adverse outcomes such as restricted mobility, cognitive impairment, and falls ultimately result in a decrease of older adults' quality of life. In the light of the demographic change, these age-related declines gain special importance. Attempting to counteract these declines, previous studies have revealed that simultaneous motor and cognitive training may be equally or even more effective than separate training. In fact, simultaneous motor-cognitive training has shown to improve various physical, cognitive, and psychological functions in older adults - for instance balance, gait, executive control, processing speed, exercise enjoyment, depressive symptoms, and quality of life. However, most training programs are provided face-to-face, and accessibility is a major concern for older adults, especially in the post-pandemic era. Besides, due to the demographic change there is an increased need for long-term care/treatment challenging the health care system (in terms of finance, time, and personnel). Home-based rehabilitation programs offer a cost-effective solution to these problems.

However, previous research either investigated home-based training approaches based on separate motor-cognitive training, or, in case of simultaneous motor-cognitive training approaches, these have been tested in rather specific older populations (e.g., stroke survivors, Parkinson patients, older adults with cognitive impairment) or in healthy older adults. Yet, simultaneous motor-cognitive training in the home setting should be feasible and effective in a broader population of older adults especially in those without long-term access to traditional rehabilitation interventions accompanying them to full recovery. For this reason, this study aims to test the feasibility of a personalized, simultaneous motor-cognitive home-based training approach based on exergames for geriatric patients and to evaluate its effectiveness compared to usual care alone on physical and cognitive functions as well as on fall-related self-efficacy.

Potential participants will be screened and if eligible, asked if they are interested in partaking. All eligible and interested possible participants will be orally informed about the study and receive a written study information explaining the aim of the study, procedures, risks, and benefits of participation, as well as their rights and duties in case of participation. All participants will sign a written consent form, before any study-specific actions are performed.

The study will start with a baseline assessment. Then, participants will be randomized to either the intervention or the control group applying permuted block randomization. Subsequently, participants of the intervention group will perform 6 supervised, personalized motor-cognitive training sessions in a rehabilitation centre (ideally within 2 weeks) for about 20-30 minutes per session (familiarization period). Afterwards, participants of the intervention group will continue the training independently at home for 10 weeks, 3 times/week for about 20-30 minutes with the investigators supervising them via phone calls and regular personal visits. Physical and cognitive tests will be the basis for individual training plans which will further on be regularly adapted based on progression rules. All motor-cognitive training sessions in both intervention phases will be additional to usual care. The control group receives no additional training besides usual care. Participants of all groups will conduct 3 measurement sessions: (1) T1 (baseline assessments), (2) T2 (pre-intervention, after familiarization period, before starting the home-based training), (3) T3 (post-intervention assessment).

Conditions

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Aged Independent Living

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

This study will be conducted as an international, pragmatic pilot randomized controlled trial with two treatment arms, an intervention group (IG) and a control group (CG). It comprises a two-week intervention period in a rehabilitation clinic (for familiarization purpose) followed by a 10-week training period at home. It involves three trial partners: ETH Zürich, Don Carlo Gnocchi Foundation (Fondazione Don Carlo Gnocchi (FDG), Milan, Italy), and Materia Agecare ((MAT), Nicosia, Cyprus). The study conduction will take place at all three trial sites.
Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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Intervention group

The intervention group will conduct a motor-cognitive training program added to usual care. The intervention starts with a familiarization period in rehabilitation centers (face-to-face supervision) for 2 weeks before participants of the intervention group continue it at home (under remote supervision) for 10 weeks with 3 training sessions per week for about 20-30 minutes.

Besides, participants of the intervention group will participate in 3 assessment sessions: (1) T1 (baseline assessments), (2) T2 (pre-intervention, after familiarization period, before starting the home-based training), (3) T3 (post-intervention assessment).

Group Type EXPERIMENTAL

Personalized, home-based motor-cognitive training

Intervention Type OTHER

The simultaneous motor-cognitive training in this study will be conducted in form of exergames (interactive video games) using Senso hardware (DIV-SENSO-H, Dividat GmbH, Schindellegi, Switzerland) - a stepping platform with 5 pressure sensitive plates which is connected to a screen. For the home-based training, a more mobile version of the Dividat Senso will be used: a foldable pressure-sensitive mat. In both devices, stimuli of exergames appear on the screen and the participants have to react by stepping in one of 4 directions (front, back, left, right).

The motor-cognitive training approach allows targeting different cognitive functions such as attention, executive functions, memory, and visuo-spatial functions as well as balance, and strength.

FITT-VP principles will serve as a guideline but based on the functional status of each participant (physical and cognitive), the training sessions will be personalized in terms of training content, intensity and duration.

Control group

The control group will continue with their usual care. Apart from that, they will only attend 3 assessment sessions: (1) T1 (baseline assessments), (2) T2 (pre-intervention, after familiarization period, before starting the home-based training), (3) T3 (post-intervention assessment).

Group Type NO_INTERVENTION

No interventions assigned to this group

Interventions

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Personalized, home-based motor-cognitive training

The simultaneous motor-cognitive training in this study will be conducted in form of exergames (interactive video games) using Senso hardware (DIV-SENSO-H, Dividat GmbH, Schindellegi, Switzerland) - a stepping platform with 5 pressure sensitive plates which is connected to a screen. For the home-based training, a more mobile version of the Dividat Senso will be used: a foldable pressure-sensitive mat. In both devices, stimuli of exergames appear on the screen and the participants have to react by stepping in one of 4 directions (front, back, left, right).

The motor-cognitive training approach allows targeting different cognitive functions such as attention, executive functions, memory, and visuo-spatial functions as well as balance, and strength.

FITT-VP principles will serve as a guideline but based on the functional status of each participant (physical and cognitive), the training sessions will be personalized in terms of training content, intensity and duration.

Intervention Type OTHER

Eligibility Criteria

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Inclusion Criteria

* Patient with prescription for rehabilitation (as in- or outpatient)
* Mini-Mental State Examination (MMSE) score ≥ 24
* Physically able to independently stand for at least 2 minutes
* Able to give informed consent as documented by signature
* Access to the internet at home
* Availability of a TV or large screen at home

Exclusion Criteria

* Nursing home resident
* Mobility limitations or comorbidities impairing the ability to conduct a step-based motor-cognitive training
* Cognitive limitations or comorbidities impairing the ability to conduct a step-based motor-cognitive training
* Previous or current major psychiatric illness (e.g., schizophrenia, bipolar disorder, recur-rent major depression episodes)
* History of drug or alcohol abuse
* Terminal illness
* Severe sensory impairments
* Participation in another clinical trial/intervention study
* More than 2 weeks absence in the next 3-4 months
Minimum Eligible Age

60 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Swiss Federal Institute of Technology

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Julia Seinsche, M.Sc.

Role: PRINCIPAL_INVESTIGATOR

ETH Zürich

Locations

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ETH

Zurich, , Switzerland

Site Status

Countries

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Switzerland

References

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Reference Type DERIVED
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Other Identifiers

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BASEC-Nr. 2022-01746

Identifier Type: -

Identifier Source: org_study_id

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