Table 2 The duality training program
Intensity | |||
|---|---|---|---|
6 weeks | 2x/week | 40 min | Therapy session with physiotherapist |
2x/week | 30 min | Therapy session without physiotherapist | |
Integrated training group | Consecutive training group | ||
- Gait training while doing cognitive exercises | - Cognitive training while sitting | ||
- Functional training of dual tasks in ADL | - Gait training without extra cognitive load | ||
- Consecutive functional training avoiding dual tasks | |||
Contents of components in both training arms | |||
Exercises | Progression | ||
Gait training | Depending on clinical need walking while: | Increase speed | |
Focussing on big steps | Increase amplitude | ||
Focussing on heel strike | Increase or decrease frequency | ||
Focussing on arm swing | Introduce speed variations | ||
Focussing on upright posture | |||
Walking while raising knees | Decrease exercise execution time | ||
Tandem gait | Increase coordination demands | ||
Turning | Increase environmental demands: surfaces, narrow spaces, doorways, outdoors | ||
Transitions: sit-to-stand, start-stop | |||
Stepping in multi-directions | |||
Cognitive training | Verbal fluency tasks | ||
e.g. Name cities and countries starting with A,B,C | More difficult categories | ||
Discrimination and decision making tasks | |||
e.g. Say yes when you hear “strawberry” but say nothing when you hear another sort of fruit | Decrease response time, responding to two or three different words | ||
Working memory tasks | |||
e.g. Digit span backwards, Word memory task | Increase the length of series, related vs. unrelated words | ||
Mental tracking tasks | |||
e.g. Count how many times you hear the word “cat” in this story about cats. | Count two or three words in a story | ||
Counting: summing and subtracting | Increase the complexity of the counting task | ||
Reaction time tasks | |||
e.g. React as fast as you can on a certain word or sound | Decrease time between two reactions, react to two or three words or sounds | ||
Cognitive exercise is delivered by the therapist using a laptop. | |||
During self-administered practice, cognitive exercise is played via an MP3 player | |||
Functional training | Integrated training group | ||
Walking while having a conversation | |||
Describing route while walking | |||
Taking wallet, handkerchief, … out pocket while walking | |||
Closing buttons and zipper while walking | |||
Carrying tray, cup, plate | |||
Carrying groceries | |||
Moving kitchenware from sink to cupboard | |||
Integrated AND consecutive training group | |||
Laying the table | |||
Picking object from the ground | |||
Maneuvering in bathroom | |||
Getting mail out the mailbox | |||
Self-reported functional difficulties | |||