Dual-task Training for Frail Older Adults With Chronic Musculoskeletal Pain (Pilot)

The Hong Kong Polytechnic University38 enrolled

Overview

The goal of this clinical trial is to investigate the feasibility and effect of a 10-week dual-task training program on frailty status in community-dwelling older adults with frailty and chronic musculoskeletal pain. Main question: Is a 10-week dual-task training program, that combines resistance and cognitive training, feasible and accepted by community-dwelling older adults who have frailty and chronic musculoskeletal pain, and what is the effect of a 10-week dual-task training program on the frailty status in community-dwelling older adults who have frailty and chronic musculoskeletal pain? Participants will attend supervised training sessions (either dual-task training \[Intervention group\] or resistance exercise \[Control group\]) for 10 weeks.

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

TREATMENT

Masking

SINGLE

Enrollment

Conditions

Chronic Musculoskeletal Pain Frailty

Interventions

Participants in the intervention group will engage in a dual-task training program, in which resistance training will be incorporated with cognitive tasks. \- Resistance training: Participants will be instructed to perform the following exercises with proper form: (1) squat to chair, (2) seated unilateral hip flexion, (3) seated unilateral knee extension, (4) standing unilateral knee flexion and (5) bilateral calf raise. The lower limb exercises will be followed by four upper limb exercises: (6) seated elbow flexion, (7) twisting a towel, (8) seated horizontal opening of arms and elbow, (9) seated diagonal opening of arm and elbow. \- Cognitive task: Subjects will be asked to perform a verbal fluency task or mental arithmetic tasks simultaneously with the resistance training exercises.

Eligibility

Sex: ALLMin age: 60 Years

Medical Language ↔ Plain English

Inclusion Criteria: * Adults, of either sex, aged 60 years or above, * living in Hong Kong, being able to read and communicate verbally, * screened frail using the Tilburg Frailty Indicator (TFI) (total score ≥5) with report of memory problems (question 9) (Gobbens et al., 2010), * experiencing any CMP with a pain level higher or equal to 4 in the numerical pain rating scale over a consecutive 3-month period. Exclusion Criteria: Any individuals with either of the following will be excluded: * absence of frailty, * surgical procedure in the lower limbs or the vertebral column; * wheelchair bound or inability to walk for five minutes; * severe balance impairment; * uncompensated cardiac or vascular condition; * acute inflammatory musculoskeletal conditions; * ongoing cancer; dementia; * neurological diseases such as stroke, Parkinson's disease, cerebellar disease, myelopathy, and peripheral neuropathy; * mental illnesses such as schizophrenia, bipolar, psychosis, borderline personality disorder; * illiteracy.

Outcomes

Primary Outcomes

Feasibility and acceptability

The primary outcomes will be feasibility and acceptability of the dual task training program. Feasibility will be evaluated through recruitment and compliance rates of the program. Recruitment rate will be defined as the total number of participants recruited out of the total number of participants screened. Treatment compliance will be defined as the proportion of scheduled sessions attended in each group. Acceptability will be assessed by a six-question post-program questionnaire based on the barriers to engaging in physical activity. Questions relating to perceived importance and satisfaction with the program, any discomfort felt during training, difficulty of the exercises, appropriateness of duration and usefulness on daily activity will be asked to rate from a 5-point Likert scale from 'Strongly disagree' to 'Strongly agree', and be collected at the end of the intervention.

Time frame: Post-treatment (Week 10)

Frailty status

Measured by the Tilburg frailty indicator (TFI). * There are 15 items in total, with a score of 0 or 1 on each item. The total score ranges from 0 to 15 points. A higher score mean a worse outcome (Higher frailty level). * A total score of \>/=5 has a validity of 0.86 to determine the frailty status of the community-dwelling older Chinese population (Dong et al., 2017).