The purpose of this study is to investigate the effects of dual-task exercises-which simultaneously target cognitive and motor functions-delivered via telerehabilitation on fall risk, balance, cognitive functions, and sleep quality in geriatric individuals.Aging is often associated with balance disorders, increased fall risk, cognitive decline, and impaired sleep quality, all of which significantly impact the quality of life in the elderly. Dual-task interventions require individuals to perform physical and cognitive tasks concurrently, aiming to improve sensorimotor control and enhance balance strategies under cognitive load.This study utilizes telerehabilitation as a cost-effective and sustainable solution to facilitate access to healthcare services, providing a remote alternative to face-to-face rehabilitation. The research aims to demonstrate that dual-task exercises performed through telerehabilitation can contribute to functional recovery, reduce the fear of falling, and increase the safe mobility capacity of geriatric individuals.
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Telerehabilitation Based Dual-Task Exercises
Other interventionParticipants perform 4-week home-based dual-task exercises 3 days/week via video call with a physiotherapist. Each session includes 5 minutes of warm-up, 50 minutes of combined motor and cognitive exercises, and 5 minutes of cool-down. Motor tasks focus on balance and posture (semi-tandem, tandem walking, single-leg stance, directional changes). Cognitive tasks are performed simultaneously, including counting, naming objects/colors/animals, simple arithmetic, memory, and sequencing tasks. Task difficulty is progressively increased weekly, and intensity is adjusted individually. The physiotherapist monitors exercise form and safety visually during each session.
Educational Brochure and Phone Follow-Up
Other interventionParticipants receive a brochure covering posture, balance, sleep hygiene, safe physical activity, and the dual-task exercises provided to the intervention group. Weekly phone calls are made to monitor adherence, encourage engagement, and answer questions. Participants perform exercises independently at home, following brochure instructions. No structured telerehabilitation sessions are provided.
Balance performance
Berg Balance Scale (BBS) will be used to assess static and dynamic balance in older adults. Participants perform 14 items evaluating daily functional movements, each scored 0-4 points, total score 0-56. Higher scores indicate better balance. Assessments will be conducted at baseline, after 4-week intervention, and at 1-month follow-up.
Fall risk and fear of falling
Falls Efficacy Scale - International (FES-I) will be used to evaluate participants' concern about falling during 16 daily activities. Each item is scored 1-4, with higher scores indicating greater fear of falling. Assessments will be conducted at baseline, after 4-week intervention, and at 1-month follow-up.
Sleep quality
Pittsburgh Sleep Quality Index (PSQI) will be used to evaluate sleep quality and disturbances over the past month. Total score ranges 0-21; higher scores indicate poorer sleep quality. Assessments will be performed at baseline, after 4-week intervention, and at 1-month follow-up.
Balance and gait performance
Tinetti Performance Oriented Mobility Assessment (POMA) will be used to assess both balance (9 items) and gait performance (7 items) in older adults. Each item is scored 0-2 (0 = unable, 1 = partial/unsafe, 2 = safe and correct), with a total score ranging from 0 to 28. Fall risk is classified as high (\<19), medium (19-23), or low (≥24). Assessments will be conducted at baseline, after the 4-week intervention, and at 1-month follow-up.
Functional mobility
Timed Up and Go (TUG) Test will be performed to evaluate mobility and fall risk. Participants rise from a chair, walk 3 meters, turn, return, and sit; time to complete is measured. Longer times indicate reduced mobility. Measurements will be performed at baseline, after 4-week intervention, and at 1-month follow-up.
Mental state
Mini-Mental State Examination (MMSE) will be used to evaluate orientation, attention, memory, language, and calculation skills. Total score ranges 0-30; lower scores indicate cognitive impairment. Assessments will be performed at baseline, after 4-week intervention, and at 1-month follow-up.
Cognitive function
Montreal Cognitive Assessment (MoCA) will be used to evaluate attention, executive functions, memory, language, visuospatial skills, abstraction, and orientation. Score ranges 0-30; higher scores indicate better cognitive performance. Assessments will be performed at baseline, after 4-week intervention, and at 1-month follow-up.
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