Authors (including presenting author) :
Lee PLJ(1), Soong SWT(1), Lee CYR(2), Ng LYC(1), Yam YWA(1)
Affiliation :
(1)Occupational Therapy Department, MacLehose Medical Rehabilitation Centre, (2)Occupational Therapy Department, TWGHs Fung Yiu King Hospital
Introduction :
Activities of an individual’s daily living often involve simultaneous execution of cognitive and motor tasks, for example crossing the street and making a phone call while walking. The ability of performing dual tasks is positively associated with the risk of falls among individuals (Muir-Hunter & Wittwer, 2016). Frailty is a common geriatric condition characterized by the decline in physiological and mental reserves across multiorgan systems. Frail elderlies often experience difficulties in performing dual tasks, limiting their daily functioning and increasing fall risk (Piche et al., 2022). Currently in-patient and day-patient rehabilitation for patients with recent falls focuses on restoring self-care abilities through fall education and single component cognitive and motor training. The training effectiveness may not extend to complex daily functioning, activity participation and transfer skills in community integration, hence they might experience secondary fall.
Objectives :
A cognitive-motor dual task training program with twenty training sessions has been piloted in MMRC for frail elderlies with both cognitive and motor decline since August 2023. This pilot program is to examine the applicability and effectiveness of cognitive-motor dual task training as a fall prevention program for frail elderly people.
Methodology :
Patients discharged from FYKH and MMRC were screened in this pilot program. Subjects were patients (1) aged 65 or above living in the community; (2) with fall history in recent 6 months; (3) scored 4 or 5 in Clinical Frailty Scale (CFS); and (4) with no acute fracture or medical problems. Outcome measures were Hong Kong version of Montreal Cognitive Assessment (HK-MoCA), Stroop Color and Word Test (SCWT) and 9-axis inertial measurement unit (IMU)-based system Boo-Guu Aspire Fall Risk Management System.
Result & Outcome :
From August to December 2023, eight subjects aged between 75 and 90 were recruited for the training. The average score of CFS was 4.5 indicating very mild to mild frailty. The average score of HK-MoCA was 20 with patients ranging from mild to major cognitive impairment. The average score of SCWT was 25.7 seconds for dots, 34.1 seconds for words and 61.1 seconds for colour-words, indicating diminished selective attention capacity and processing speed. The average score of Boo-Guu was 3.625 indicating high fall risk. Individual and group training activities are provided in the program, including dual task balance and cognitive training, simulated task-based activities with virtual reality, brain health exercises, community fall scenarios discussion, etc. The training program is now in progress, evaluation will be performed after all training sessions have completed.
