Effectiveness of comprehensive cognitive and balance training strategies (CCBTS) on gait, balance, quality of life, and fall-related self-efficacy among institutionalized elderly in Udupi District: A mixed-method study protocol

Background: The geriatric population is at high risk for gait and balance-related issues as they grow older. The gait and balance-related issues then causes them to be more vulnerable to a fall. Following a fall, the psychological impact could result in fear of falling and decreased quality of life (QoL) in later life. This mixed-method study protocol was developed to evaluate the effectiveness of cognitive and balance training on gait, balance, fall-related self-efficacy, and QoL among institutionalized older adults. Methods: A sequential explanatory study has been designed with phase I as quantitative (QUAN) and phase II as qualitative (qual). A randomized controlled trial will be conducted to determine the effectiveness of combined cognitive and balance training among older adults. An in-depth interview will be conducted in phase II with thematic analysis to determine the phase II objectives. A nested sampling technique will be used, wherein the phase II participants will be selected from phase I. In phase I, the intervention arm will receive both cognitive and balance training whereas the control arm will receive only balance training. The phase II participants will be selected from the institutionalized older adults who show improved and not improved fall-related self-efficacy and QoL after comprehensive cognitive and balance training strategies (CCBTS) training. The outcome variables included in the phase I study are gait, balance, fall-related self-efficacy, and QoL. Conclusions: Cognitive training and balance training as a stand-alone intervention has proved their impact among older people. The gait and balance issue could impact from the consequences of both cognitive decline and physical decline; hence the proposed research would highlight the need for combined intervention to enhance overall well-being among the geriatric population. Registration: This study is registered with The Clinical Trials Registry - India (CTRI); CTRI reference ID: http://ctri.nic.in/Clinicaltrials/pdf_generate.php?trialid=15151&EncHid=&modid=&compid=%27,%2715151det%27 CTRI/2016/11/007449 ; registered on 08/11/2016.