Gait Training in Dementia

A pilot study will be conducted involving 24 older adults with moderate dementia recruited from Hospital Canselor Tuanku Muhriz (HCTM), Universiti Kebangsaan Malaysia. Participants will be approached face-to-face at the Occupational Therapy Unit of HCTM. The Rehabilitation on Gait in Dementia (ReGait-DEM) Training Program will be implemented monitoring by certified physiotherapist and occupational therapist. This structured 12-week intervention is designed to improve gait, balance, and cognitive function among older adults with moderate dementia. The program integrates motor and cognitive components through progressive dual-task and multitasking exercises targeting executive function and attentional processes (Keeffe et al., 2020). Upon confirmation of eligibility, caregivers will receive a one-to-one briefing, including a one-hour demonstration of the program within one week prior to commencement. The intervention consists of 3 level home-based rehabilitation sessions delivered twice weekly (total of 24 session in 12-week intervention). The duration and progression of the intervention may be adjusted according to the clinical needs of each participant. Participants will be provided with a training manual and a session Daily Training Log to support adherence. Monthly follow-up sessions will be conducted either face-to-face at the hospital or through home visits to review progress, address challenges, and modify the program as needed. The training protocol includes stretching, dual-task activities, gait and balance exercises and cognitive tasks, with an intended duration of at least 30 minutes per session at mild-to-moderate intensity. Outcome assessments will be conducted at baseline (0 exercise session), Week 6 (after 12 sessions of exercise), and Week 12 (after 24 sessions of exercise). The ReGait-DEM Training Program will be administered as a caregiver-assisted home-based rehabilitation program. Caregivers will be trained by a certified physiotherapist and occupational therapist prior to the intervention and will guide the participants during each session at home using the provided training manual and Daily Training Log. The exercises will include progressive motor-cognitive and dual-task activities such as walking while counting, walking while repeating words, taking and placing a cup while turning, identifying colours while stepping, simple balance activities, gait practice, stretching, and functional movement tasks. These exercises will be performed according to the participant’s ability and progressed across three levels throughout the 12-week intervention.