Gait Training in Dementia

INTERVENTION: 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 ses CONDITION: Moderate Dementia; ; Moderate Dementia Neurological ‐ Dementias Physical Medicine / Rehabilitation ‐ Occupational therapy Physical Medicine / Rehabilitation ‐ Physiotherapy PRIMARY OUTCOME: Gait Parameters such as Stride Length, Stride Velocity, Cadence, Gait Cycle, Double support time, Stance phase time, Swing phase time, Duration of Turning, Turning step no. and Turning Peak Velocity. This gait parameters will be assessed as a composite outcomes. [Ambulatory Posture and Movement Monitoring (APDM) Mobility Lab system 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; primary timepoint)] SECONDARY OUTCOME: Functional independence[Barthel Inde XOutcome assessments will be conducted at baseline (0 exercise session), Week 6 (after 12 sessions of exercise), and Week 12 (after 24 sessions of exercise)] Neuropsychiatric symptoms [The Neuropsychiatric Inventory Questionnaire (NPIQ) 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)] Quality of Life [Quality of Life in Alzheimer’s Disease (QoL‐AD) 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)] INCLUSION CRITERIA: Each Program will be composed of one Caregiver and one participant with moderate dementia. The participant moderate dementia must: ‐ Older adults aged greater than or equal to 60 years ‐ Moderate Dementia (Clinical Dementia Rating (CDR) Scale: 2, Montreal Cognitive Assessment (MoCA): 10‐17) ‐ Participants must be ambulatory, either independently without assistive devices or with the use of walking aids (e.g., cane or walker), and capable of following simple one‐ to two‐step commands ‐ Medically stable; with no acute illness that limits mobility. ‐ Have a primary caregiver willing and able to participate in training sessions. ‐ Low to moderate risk of fall person (Able to sustain more than 10 second in Single‐Leg Stance Test) ‐ No significant eyes problem ‐ Provide informed consent The Caregiver in this program must: 1)Live with the participant with dementia and/or providing some portion of their daily care includ