A Transfer Training Program to Reduce Falls in Cognitively Impaired Older Adults with Higher Level Gait Disorders: A Pilot Study

The 3 week intervention is a transfer training program using combined Errorless Learning (EL) and Spaced Retrieval (SR) techniques to improve safety in transfers. It starts with more intensive therapy in week 1 (5 sessions, 30 minutes each session) and gradually decreases the intensity in week 2 (2 sessions, 30 minutes each session) and week 3 (1 session, 30 minutes each session). The sessions are one on one sessions run by either an occupational therapist or a physiotherapist, either on the ward or at the participant's home. The therapist demonstrates the transferring task in 3 steps: initiate walking after standing up from a chair, walk around an object at 3 metre distance, approach the chair and plan sitting. The instruction "take big steady steps" is emphasised at each step by the therapist. Following the demonstration, participants are provided with verbal cues/instructions prior to each step when performing the task to prevent errors (small, shuffly gait) from happening and the time intervals between each transfer practice gradually increase. The adherence of intervention will be monitored on the ward and at home by therapist's visits during the intervention period. Follow-up phone calls (every fortnight) will be carried out during the 3 month follow up period to check on any falls that do occur by participant using a Falls Calendar.