• Francis Trombini-Souza, Marcelo de Maio Nascimento, Tarcísio Fulgêncio Alves da Silva, Rodrigo Cappato de Araújo, Mônica Rodrigues Perracini, and Sacco Isabel C N ICN Physical Therapy, Speech and Occupational Therapy Department, Universidade de Sao Paulo (USP), School of Medicine, São Paulo, SP, Brazil..
• Department of Physical Therapy, University of Pernambuco (UPE) Campus Petrolina, Petrolina, PE, Brazil. francis.trombini@upe.br.
• BMC Geriatr. 2020 Feb 22; 20 (1): 76.

BackgroundFunctional 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.MethodsThis 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.DiscussionThis 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 RegistrationClinicalTrials.gov Identifier - NCT03886805, Registered 22 March 2019.

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