Effects of Square-stepping Exercise on Frailty and Cognitive Function in Elderly With Frailty and MCI
Keywords
Abstract
Description
Background and purpose:
Frailty is a continuous decline of multiple physiological systems along with aging. Common characteristics of frailty are fatigue, weakness, weight loss, slowness, and low physical activity. Brain changes accompanying frailty may lead to cognitive decline. Moreover, evidence showed positive relations between frailty and cognitive decline. Frailty with cognitive decline increases the risk of various adverse outcomes, such as disability, hospitalization, incidence of dementia, loss of daily activity functioning, and poor quality of life. Physical exercise training is a common intervention for frail elderly; however, most studies applying physical exercise to frail elderly are for enhancing physical performance, few are for improving cognitive function. On the other hand, the square-stepping exercise has been proven to be beneficial to healthy older adults for both physical performance and cognitive function, but it's application for frail elderly is scarce. Therefore, the purpose of this study is to explore the effects of the square-stepping exercise on frailty and cognitive function in elderly with frailty and mild cognitive impairment (MCI).
Method:
This is a single-blinded, randomized controlled trail with pre- and post-measurements. The inclusion criteria are: (1) age between 65 to 90 years old, (2) the presence of at least one of the 5 physical characteristics defined by Fried, (3) with mini-mental state examination (MMSE) score≧24 and Montreal cognitive assessment (MoCA) score < 26, and (4) ability to walk independently for 1 min without assistive devices. The exclusion criteria are: unstable physical condition, any neurological, psychiatric disorder, or diagnosed with learning disability which may affect participation in this study. Twenty-eight elderly will be recruited, and randomly assigned to one of two groups: square-stepping exercise (SSE) group (n=14) or control group (n=14). The intervention for both group will be 50 minutes per session, 3 sessions per week for 8 weeks. The primary outcomes include frailty status indicated by Fried frailty criteria, and global cognitive function indicated by MoCA score. Secondary outcomes include frailty and MCI reverse rate, attention and memory, executive function, and physical performance.
SPSS 25.0 will be used for data analysis, with significant level set at 0.05. Repeated measures two-way analysis of variance (ANOVA) with Tukey's post-hoc analysis will be used to compare between time (pre-test, post-test) and between groups. Chi-square test (χ2 test) will be applied comparing data of frailty/ MCI reverse rate.
Dates
| Last Verified: | 06/30/2020 |
| First Submitted: | 07/05/2020 |
| Estimated Enrollment Submitted: | 07/05/2020 |
| First Posted: | 07/08/2020 |
| Last Update Submitted: | 07/05/2020 |
| Last Update Posted: | 07/08/2020 |
| Actual Study Start Date: | 07/06/2020 |
| Estimated Primary Completion Date: | 05/30/2021 |
| Estimated Study Completion Date: | 08/30/2021 |
Condition or disease
Intervention/treatment
Other: Square-stepping exercise group
Other: Control group
Phase
Arm Groups
| Arm | Intervention/treatment |
|---|---|
| Experimental: Square-stepping exercise group Square-stepping exercise | Other: Square-stepping exercise group The square-stepping exercise is a low-cost indoor program to improve lower extremities fitness and cognitive function. |
| Active Comparator: Control group Whole-body stretching and upper extremity strengthening | Other: Control group whole-body stretching and upper extremity strengthening |
Eligibility Criteria
| Ages Eligible for Study | 65 Years To 65 Years |
| Sexes Eligible for Study | All |
| Accepts Healthy Volunteers | Yes |
| Criteria | Inclusion Criteria: - (1) age between 65 to 90 years old, (2) the presence of at least one of the 5 physical characteristics defined by Fried, (3) with mini-mental state examination (MMSE) score ≧ 24 and Montreal cognitive assessment (MoCA) score < 26, (4) ability to walk independently for 1 min without assistive devices. Exclusion Criteria: - unstable physical condition, any neurological, psychiatric disorder, or diagnosed with learning disability which may affect participation in this study |
Outcome
Primary Outcome Measures
1. Fried frailty criteria [10 minutes]
2. The Montreal Cognitive Assessment [8 minutes]
Secondary Outcome Measures
1. Frailty reverse rate [2 minutes]
2. MCI reverse rate [2 minutes]
3. Digit Span Test [8 minutes]
4. Trail Making Test [8 minutes]
5. Timed Up and Go Test [5 minutes]
6. 6-minute walk test [10 minutes]
7. Lower extremity strength [5 minutes]
