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Geriatric IndividualsNCT06700928

Attentional Focus Training in Older Adults

A study testing External focus training, Internal focus training and No attentional focus training in people with Geriatric Individuals and Cognitive Function, run by Müşerref Ebru YALÇIN at 1 site in Turkey (Türkiye).

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

The ability to walk safely and efficiently is crucial for older adults to maintain their independence and minimize the risk of falls. In healthy geriatric individuals, walking typically occurs as an automatic process involving motor skills, meaning the movement is generally performed with minimal conscious thought. Read more about this study

Who is it for?
Ages 65 years and olderHealthy volunteers can take part
What is being tested?
External focus training, Internal focus training and No attentional focus training
Could I receive a placebo?
No, everyone receives an active treatment
How many people
50 participants
Where
1 siteTurkey (Türkiye)
Study dates
1 May 2025to 1 Nov 2025
Phase
Interventional
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 65 years and older
  • All sexes
  • Healthy volunteers accepted
  • Older adult

Who may be able to join

  • Aged 65 years or older
  • Willingness to participate in the study
  • Ability to read and write
  • Mini-Mental State Examination (MMSE) score > 24
  • Ability to independently perform the tests administered as part of the study
  • Ability to walk independently in the community (without a walking aid and able to walk at least 40 meters)

Who cannot join

  • Presence of orthopedic, neurological, vestibular, cognitive, or other medical conditions that may affect the applicability of the assessment methods or training interventions used in the study
  • History of myocardial infarction and/or coronary bypass surgery within the past year
  • Severe visual or auditory impairments causing communication difficulties
  • Polypharmacy (use of five or more medications per day)

Trial locations and contacts

1 site in 1 country.

Turkey (Türkiye)1 site
  • Retirement home

    Trabzon

Other trials in Turkey (Türkiye)

About this study

Official title: Effects of Different Attentional Focus Training Strategies on Physical Performance and Cognitive Function in Older Adults: a Randomized Controlled Trial

The ability to walk safely and efficiently is crucial for older adults to maintain their independence and minimize the risk of falls. In healthy geriatric individuals, walking typically occurs as an automatic process involving motor skills, meaning the movement is generally performed with minimal conscious thought. However, attention can influence motor performance; a lack of focus or distraction can lead to loss of balance and increase the risk of falling during walking. The effects of attention focus on geriatric individuals remain uncertain. Therefore, this study aims to investigate the effects of different attention-focused training on physical performance and cognitive function in geriatric individuals. In this randomized controlled trial, 60 participants will be randomly assigned to four groups: the internal focus exercise group (n = 15), the external focus exercise group (n = 15), the no attention focus group (n = 15), and the control group (n = 15). The control group will consist of participants from a different institution to prevent contamination. Participants in the non-control groups will attend training sessions twice a week (approximately 40 minutes each) for 12 weeks. The experimental groups will complete a total of 24 exercise sessions. All training sessions will be conducted by an experienced physiotherapist. Pre- and post-assessments will be conducted. The sociodemographic characteristics of all participants will be assessed using a descriptive form. Participants' physical performance will be evaluated using the Short Physical Performance Battery (SPPB), the Stair Climbing Test, the Timed Up and Go Test (TUG), a static balance test (single-leg stance test), and a dynamic balance test (Berg Balance Scale). Cognitive function will be assessed using the Central Nervous System Vital Signs (CNSVS) Cognitive Performance and Attention Tests. Additionally, participants' walking will be analyzed using Kinect V2 camera-based software. The data collected from the study will be analyzed using SPSS (Statistical Program for the Social Sciences). Descriptive statistics will include frequencies, percentages, means, and standard deviations. For comparisons, the significance level (p) will be set at 0.05.

Read the detailed description

Aging is an inevitable phase characterized by physiological and mental changes, including a decline in perception and awareness, as well as progressive deterioration of memory functions. According to the United Nations World Social Report (2023), the population aged 65 and older is expected to reach 1.6 billion by 2050.

With aging, motor performance, including balance, walking stability, postural stability, and movement speed, gradually declines. The literature indicates that one-third of individuals aged 65 and older experience a fall once or more per year, with the rate rising to 40% among those aged 85 and above. The risk of falling in older adults may be related to a decrease in the integration of physiological systems (cardiac, respiratory, and neuromuscular) that influence physical performance.

Physical performance is the objective measurement of an individual's ability to integrate various physiological systems (cardiac, respiratory, neuromuscular) to perform coordinated and effective movements. Due to its importance in evaluating mobility and overall physical well-being, it is considered a critical health indicator in older adults. The decline in physical performance can result from the complex interaction of physiological factors (e.g., declines in cardiovascular, musculoskeletal, and neuromuscular systems, leading to progressive loss of muscle mass and strength, reduced testosterone levels), clinical factors (e.g., depressive symptoms, multimorbidity, polypharmacy), lifestyle factors (e.g., physical activity levels), and sociodemographic factors (e.g., age, gender). This decline is evident not only in physical performance but also in cognitive function. With normal aging, the brain typically experiences shrinkage, a widely observed phenomenon, affecting both gray and white matter. This reduction in brain size is attributed to a decline in the development of dendrites, dendritic spines, axons, and synapses. As a result, cognitive abilities such as attention, memory, executive functions, language, and visuospatial skills decline with aging.

The decline in physical performance and cognitive function due to aging significantly impacts the ability to perform activities of daily living. The ability to walk safely and efficiently, which is essential for daily life, is necessary for older adults to maintain their independence and minimize the risk of falls. In healthy older adults, walking typically occurs with minimal conscious thought about the movement process. It is known that the focus of attention affects the performance of motor skills. The term "focus of attention" refers to the location of an individual's attention relative to the performance environment or task. This focus can be internal or external. An internal focus directs attention to the components of body movement during an action, whereas an external focus directs attention to the effect of the movement on the environment or the final goal. For example, during a ball throw, the individual may focus internally on the movement of the wrist, elbow, and shoulder, or externally on the ball and the target.

In recent years, various attention-focused approaches have been implemented to enhance functional and cognitive capacity in geriatric individualsProvidi. ng different attention-focus instructions to geriatric individuals has been shown to be an effective strategy for improving motor performance. A study examining the effects of internal focus, external focus, and no focus walking training during rehabilitation on conscious motor processing, balance, walking ability, and fear of falling in older adults at risk of falling found that focus reduced conscious motor processing while improving functional balance and walking (8). Furthermore, substantial evidence shows that using attention-focus methods results in improvements in physical performance. However, the effects of focus instructions on physical performance and cognitive function in geriatric individuals remain uncertain.

To address this gap in the literature, this study will investigate the effects of different attention-focus training on physical performance and cognitive function in geriatric individuals. We hypothesize that individuals who undergo attention-focused walking training during rehabilitation will demonstrate better physical performance and cognitive function compared to those who do not receive attention-focused walking training. Our study will provide data and contribute to filling this gap in the existing literature.

Being tested
External focus training, Internal focus training, No attentional focus training
Keywords
Geriatric individuals, Attention focus, Internal focus, External focus, Physical performance, Cognitive function

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • External focus trainingOther

    External focus training

  • Internal focus trainingOther

    internal focus training

  • No attentional focus trainingOther

    no attentional focus training

Study groups in NCT06700928
Study groupRoleWhat they receive
Internal focus groupExperimentalAfter obtaining informed consent to participate in the study, all participants, regardless of group, will undergo an assessment by an experienced physiotherapist prior to group allocation. They will participate in exercise sessions lasting approximately 40 minutes, twice a week for 12 weeks in the internal focus group. A total of 24 sessions will be completed by each participant. Exercise sessions will be carried out by an experienced physiotherapist. Each training session will consist of warm-up (5 minutes), balance, transfer and reaching activities (10 minutes), internal focused walking (20 minutes) and cool-down (5 minutes) exercises. The first assessment will be made before the sessions start and the final assessment will be made after the 12-week exercise program.
Receives: Other: Internal focus training
External focus groupExperimentalAfter obtaining informed consent to participate in the study, all participants, regardless of group, will undergo an assessment by an experienced physiotherapist prior to group allocation. They will participate in exercise sessions lasting approximately 40 minutes, twice a week for 12 weeks in the external focus group. A total of 24 sessions will be completed by each participant. Exercise sessions will be carried out by an experienced physiotherapist. Each training session will consist of warm-up (5 minutes), balance, transfer and reaching activities (10 minutes), external focused walking (20 minutes) and cool-down (5 minutes) exercises. The first assessment will be made before the sessions start and the final assessment will be made after the 12-week exercise program.
Receives: Other: External focus training
No attention focus groupExperimentalAfter obtaining informed consent to participate in the study, all participants, regardless of group, will undergo an assessment by an experienced physiotherapist prior to group allocation. They will participate in exercise sessions lasting approximately 40 minutes, twice a week for 12 weeks in the no attention focus group. A total of 24 sessions will be completed by each participant. Exercise sessions will be carried out by an experienced physiotherapist. Each training session will consist of warm-up (5 minutes), balance, transfer and reaching activities (10 minutes), no attentional focus walking (20 minutes) and cool-down (5 minutes) exercises. The first assessment will be made before the sessions start and the final assessment will be made after the 12-week exercise program.
Receives: Other: No attentional focus training
Control groupNo interventionno-intervention

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. The Short Physical Performance Battery (SPPB), stair climbing test, Timed Up and Go (TUG) test, Berg balance test, and single leg stance test

    The Short Physical Performance Battery (SPPB), stair climbing test, Timed Up and Go (TUG) test, Berg balance test, and single leg stance test will be used to assess physical performance.

    Measured: 12 weeks

  2. Central Nervous System Vital Signs (CNSVS)

    The "Central Nervous System Vital Signs (CNSVS) Cognitive Performance and Attention Tests" will be administered to assess cognitive functions. CNSVS is an evaluation tool designed to examine the neurocognitive status of individuals aged 7 to 90. It consists of several subtests, including the Verbal Memory Test, Visual Memory Test, Finger Tapping Test, Symbol-Digit Coding Test, Stroop Test, Continuous Performance Test, and Attention Switching Test. In our study, scores obtained from these subtests will be utilized. To determine the extent of neurocognitive impairment, classification is made based on standard score points. According to this classification: >110 indicates high capacity, 90-110 indicates normal capacity, 80-89 indicates mild cognitive impairment, 70-79 indicates moderate cognitive impairment, and <70 indicates severe cognitive impairment.

    Measured: 12 weeks

Secondary outcomes (1)
  1. Gait analysis using Kinect V2

    The gait analysis of participants will be conducted using Kinect V2 camera-based software. This software is developed in the MATLAB environment and processes depth images to identify joint positions. It determines the corresponding joint position for each pixel in the depth image and calculates the accuracy of this position. This enables the detection and accuracy assessment of joint positions. Parameters such as gait symmetry, step length, step width, cadence, and speed will be evaluated.

    Measured: 12 weeks

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted22 Nov 2024
  2. Study start1 May 2025
  3. Primary completion1 Nov 2025
  4. Study completion1 Nov 2025

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Masking
Single blind
Who is masked
Participant
Enrolment
50 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT06700928
Sponsor's protocol ID
2024/6463
Status last verified
Mar 2026
First submitted
14 Nov 2024
Last updated
7 Apr 2026
Results posted
No
Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No: I think the data should be kept confidential.

Questions about this trial

What is this clinical trial studying?

A study testing External focus training, Internal focus training and No attentional focus training in people with Geriatric Individuals and Cognitive Function, run by Müşerref Ebru YALÇIN at 1 site in Turkey (Türkiye).

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 6 inclusion and 4 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 7 Apr 2026. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in Turkey (Türkiye). Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

The Short Physical Performance Battery (SPPB), stair climbing test, Timed Up and Go (TUG) test, Berg balance test, and single leg stance test (time frame: 12 weeks). The study lists 2 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 7 Apr 2026; AzTrials last refreshed its copy on 2 Nov 2026.

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