BACKGROUND Functional independence and safe mobility, especially in older people, mostly rely on the ability to perform dual tasks, particularly during activities with variable- and fixed-priority attention. The aim of this study is to compare the dual-task training with progression from variable- to fixed-priority instructions versus dual-task training with variable-priority on gait speed in community-dwelling older adults. METHODS This is an assessor- and participant-blinded, two-arm, randomized controlled trial with 60 community-dwelling male and female older adults between the ages of 60 and 80 years old. Participants will be randomly allocated into either the intervention group or the control group using a computer-generated permuted block randomization schedule. The intervention group will undertake a progressive dual-task training in which the participants will be progressively submitted to dual-task walking and postural balance exercises with variable- to fixed-priority instructions. The control group will be submitted to dual-task training with variable-priority attention exercises. Both groups will receive 48 sessions lasting for 60 min each over 24 weeks. The primary outcome will be the gait speed under single- and dual-task conditions. Secondary outcomes will include spatiotemporal gait parameters, functional balance, executive function, falls, quality of life, and depression symptoms. All the analyses will be based on the intention-to-treat principle. DISCUSSION This is the first assessor- and participant-blinded, two-arm, randomized controlled trial with 6 months of intervention and an additional 6-month post-training follow up aiming to evaluate the effectiveness of training with progression from variable- to fixed-priority instructions on gait biomechanics, postural balance, falls episodes, executive functioning, and quality of life in community-dwelling older adults. If our hypotheses are confirmed, this training protocol can be implemented widely to improve gait speed and other functional activities and quality of life in community-dwelling older adults. This study protocol can be used to improve these functional aspects of community-dwelling older adults. This study may also contribute to future guidelines for the improvement of these clinical and biomechanical aspects in older people. TRIAL REGISTRATION ClinicalTrials.gov Identifier - NCT03886805, Registered 22 March 2019.

中文翻译：

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从可变优先级到固定优先级指令的双任务训练与在社区居住的老年人中步态速度可变优先级的双任务训练：一项随机对照试验的方案：可变优先级和固定优先级的双任务对于老年人。

背景技术功能独立性和安全机动性，特别是在老年人中，主要依赖于执行双重任务的能力，尤其是在具有可变和固定优先级注意的活动期间。这项研究的目的是比较在社区居住的老年人中，从可变优先级到固定优先级的指令进行的双任务训练与可变优先级的双任务训练在步态速度上的比较。方法这是一项评估者和参与者盲法的两臂随机对照试验，对象是60位年龄在60至80岁之间的社区居住的男性和女性老年人。使用计算机生成的置换区组随机对照表，将参与者随机分配到干预组或对照组中。干预小组将进行渐进式双任务训练，其中参与者将按照可变至固定优先级的指示逐步接受双任务步行和姿势平衡练习。对照组将接受双任务训练，并具有不同优先级的注意力练习。两组都将接受48个疗程，每个疗程持续60分钟，持续24周。主要结果将是单任务和双任务条件下的步态速度。次要结果将包括时空步态参数，功能平衡，执行功能，跌倒，生活质量和抑郁症状。所有分析将基于意向性治疗原则。讨论这是第一个对评估者和参与者不知情的两臂，随机对照试验，进行了6个月的干预，另外还有6个月的训练后随访，旨在评估从步态生物力学，姿势平衡，跌倒发作，执行功能和从步态可变到固定优先级的训练进展的训练效果社区老年人的生活质量。如果我们的假设得到证实，则可以广泛实施此培训协议，以提高居住在社区中的老年人的步态速度和其他功能活动以及生活质量。该研究方案可用于改善社区居住的老年人的这些功能方面。这项研究也可能为将来在老年人中改善这些临床和生物力学方面的指南做出贡献。试验注册ClinicalTrials.gov标识符-NCT03886805，