Dual-Task Training Exercise to Reduce Falls in Older Adults with Mild Cognitive Impairment

双任务训练可减少患有轻度认知障碍的老年人跌倒的情况

基本信息

批准号：
10578178
负责人：
FUZHONG LI
金额：
$ 79.28万
依托单位：
OREGON RESEARCH INSTITUTE
依托单位国家：
美国
项目类别：
财政年份：
2023
资助国家：
美国
起止时间：
2023-02-01 至 2028-01-31
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/10578178
关键词：
Activities of Daily Living Address Age-associated memory impairment Alzheimer&apos s Disease Alzheimer&apos s disease related dementia American Attention Balance training Clinical Clinical Practice Guideline Clinical Trials Cognitive Communities Country Coupled Data Educational Intervention Elderly Equilibrium Exercise Exercise Therapy Exhibits Fall prevention Gait Goals Health Healthcare Impaired cognition Impairment Incidence Intervention Knowledge Mediating Methodology Modeling Motor Movement Musculoskeletal Equilibrium Outcome Participant Performance Persons Physical Exercise Physical Performance Population Populations at Risk Prevention Guidelines Public Health Randomized, Controlled Trials Recommendation Research Risk Risk Factors Single-Blind Study Stretching Tai Ji Testing Therapeutic Therapeutic Intervention Time Training Treatment Efficacy United States Walking Work aging population arm care burden clinical practice cognitive ability cognitive enhancement cognitive function cognitive performance cognitive task community setting comparative efficacy design eHealth efficacy evaluation equilibration disorder evidence based guidelines executive function exercise intervention experience fall injury fall risk falls follow-up improved innovation insight instructor intervention delivery mild cognitive impairment mind/body multitask novel patient engagement post intervention preventive intervention primary outcome programs response secondary outcome targeted treatment virtual

项目摘要

PROJECT SUMMARY/ABSTRACT Non-pharmacological interventions, such as physical exercise or movement therapies, to prevent falls in older adults with mild cognitive impairment (MCI) have not been effective. Our long-term goal is to establish a safe and efficacious mind-body exercise intervention that can be made widely available in community settings and for clinical practice to prevent falls in a rapidly growing, at-risk population of community-dwelling older adults with MCI. The objective of this proposal is to evaluate a novel intervention—dual-task Tai Ji Quan: Moving for Better Balance (Dual-TJQMBB)—that is specifically tailored for older adults with MCI to prevent falls. The rationale underlying this proposal is that by integrating cognitive exercises with physical (tai ji quan) movements we address the impaired balance and concomitant attention (dual-tasking) deficits associated with the increased risk of falling in this population. The central hypothesis is that our therapeutically tailored and dual-task augmented tai ji quan training approach will be more efficacious than traditional tai ji quan training in preventing falls. The central hypothesis, with its premise established from our prior work and promising pilot data, will be tested by pursuing our Primary Aim in which we will determine the efficacy of a 6-month Dual- TJQMBB intervention in reducing the incidence of falls among older adults with MCI. We will address our Primary Aim using an innovative e-health (online) intervention delivery approach with a 3-arm, single-blind, randomized controlled trial involving a test of the comparative efficacy of the two tai ji quan fall prevention interventions (Dual-TJQMBB, standard TJQMBB) relative to a stretching control. We hypothesize that, by month 6, participants assigned to the Dual-TJQMBB intervention will show a significant reduction in the incidence of falls (primary outcome) and improvement in dual-task walking and physical and cognitive performances (secondary outcomes) compared to those assigned to the stretching control. The project has two secondary aims: (1) to determine how well the benefits of our Dual-TJQMBB intervention persist over a 6- month post-intervention follow-up, and (2) to examine whether the impact of Dual-TJQMBB training on reducing the incidence of falls is mediated by change in dual-task walking performance. Our proposed research is significant because it will fill a vital gap in clinical practice by providing efficacy evidence about a tailored fall prevention intervention that combines tai ji quan with cognitive task training, for the first time, for older adults with MCI who are at risk of falling and continuing cognitive decline. If the evidence supports the Dual-TJQMBB hypothesis, the proposed study can (a) make a rapid impact on clinical practice guidelines in the field of fall prevention and (b) have a widespread positive impact very quickly because it can be coupled with the standard TJQMBB program, which has been broadly disseminated across the country.

项目概要/摘要非药物干预措施，例如体育锻炼或运动疗法，以预防老年人跌倒患有轻度认知障碍（MCI）的成年人尚未有效。我们的长期目标是建立一个安全的方法。有效的身心锻炼干预措施可以在社区环境中广泛使用，用于临床实践，以预防快速增长的社区老年人高危人群中的跌倒该提案的目的是评估一种新颖的干预措施——双任务太极拳：移动 Better Balance (Dual-TJQMBB)——专为患有 MCI 的老年人量身定制，以防止跌倒。该提议的基本原理是通过将认知练习与身体（太极拳）相结合我们解决与相关的平衡受损和伴随的注意力（双重任务）缺陷的运动该人群跌倒的风险增加，核心假设是我们的治疗方案是量身定制的。双任务强化太极拳训练方法将比传统太极拳训练更有效预防跌倒的中心假设，其前提是根据我们之前的工作和有前途的试点建立的。数据，将通过追求我们的主要目标进行测试，其中我们将确定 6 个月双- TJQMBB 干预降低 MCI 老年人跌倒发生率我们将解决我们的问题。主要目标采用创新的电子医疗（在线）干预提供方法，采用三臂、单盲、随机对照试验，测试两种太极拳预防跌倒的效果比较相对于拉伸控制的干预措施（双 TJQMBB、标准 TJQMBB）我们为此苦苦挣扎。第 6 个月，分配到双 TJQMBB 干预的参与者将表现出显着降低跌倒发生率（主要结果）以及双任务行走以及身体和认知方面的改善与分配给拉伸控制的性能（次要结果）相比，该项目有两个。次要目标：(1) 确定我们的 Dual-TJQMBB 干预措施的益处在 6- 干预后一个月的随访，以及（2）检查双 TJQMBB 训练是否对我们提出的减少跌倒发生率是通过改变双任务步行表现来调节的。研究意义重大，因为它将通过提供有关以下药物的功效证据来填补临床实践中的重要空白：首次将太极拳与认知任务训练相结合的定制跌倒预防干预措施如果证据支持以下观点，则患有 MCI 的老年人有跌倒和持续认知能力下降的风险。双 TJQMBB 假设，拟议的研究可以 (a) 对临床实践指南产生快速影响跌倒预防领域和 (b) 很快就会产生广泛的积极影响，因为它可以结合起来标准TJQMBB计划已在全国广泛推广。