Effects of Adapted Argentine Tango Training Frequency on Dual-Task Walking

Dance combines aerobic activity, dynamic balance, rhythmic movement, motor‐sequencelearning, spatial orientation, and cognitive‐motor coordination. Adapted Argentine tangomay be particularly suitable for improving motor‐cognitive function because it requiresmultidirectional stepping, weight shifting, movement initiation and cessation, directionchanges, rhythmic synchronization, and continuous planning of subsequent movements.Previous dance intervention studies have varied substantially in dance style, trainingfrequency, session duration, exercise intensity, and total training volume. Consequently,it remains unclear whether the distribution of training sessions across the weekindependently influences motor‐cognitive outcomes. This study will compare two adaptedArgentine tango schedules while maintaining the same total weekly intervention time.This will be a single‐center, three‐arm, parallel randomized controlled trial involving270 adults aged 55 to 60 years. After eligibility screening, written informed consent,and baseline assessment, participants will be randomly allocated in a 1:1:1 ratio to adistributed tango group, a concentrated tango group, or an active control group.Randomization will be stratified by sex and implemented using variable block sizes.Outcome assessors and statistical analysts will be blinded to group allocation wheneverfeasible.Participants in the distributed tango group will complete five 36‐minute sessions perweek, providing a total weekly intervention time of 180 minutes. Each session willconsist of approximately 6 minutes of warm‐up, 24 minutes of adapted tango, and 6 minutesof cool‐down. Participants in the concentrated tango group will complete two 90‐minutesessions per week, also providing 180 minutes per week. Each session will consist ofapproximately 15 minutes of warm‐up, 60 minutes of adapted tango, and 15 minutes ofcool‐down, with appropriate rest and water breaks. Participants in the active controlgroup will complete two 90‐minute sessions per week consisting of general healtheducation, low‐intensity joint mobility exercises, stretching, and relaxation activities.The control program will not include systematic tango steps, progressivemovement‐sequence learning, or cognitively demanding direction‐switching tasks.The adapted Argentine tango intervention will be progressively delivered over 8 weeks.Early sessions will emphasize postural control, weight shifting, forward stepping, andlateral stepping. Subsequent sessions will introduce backward stepping, movementinitiation and stopping, rhythm changes, small crossover steps, and controlled 90‐degreeturns. Later sessions will incorporate alternating leader‐follower roles, music‐ anddirection‐based cues, progressively longer movement sequences, and low‐difficultydual‐task activities. High‐risk movements, including jumping, rapid continuous spinning,deep lunges, large kicks, boleos, ganchos, and eyes‐closed movement, will be excluded.Tango exercise intensity will be targeted at approximately 50% to 65% of heart ratereserve, with a rating of perceived exertion of 11 to 13. Attendance, actual exerciseduration, average and peak heart rate, session rating of perceived exertion,interruptions, discomfort, falls, and other adverse events will be recorded throughoutthe intervention.Study assessments will be conducted at baseline, week 4, week 8, and 2 weeks aftercompletion of the intervention. Week 8 will be the primary endpoint. No study‐providedtraining will be delivered during the 2‐week follow‐up period. Physical activity andparticipation in other exercise programs during follow‐up will be documented.The primary outcome will be the between‐group difference in the change from baseline toweek 8 in dual‐task walking cost. Dual‐task walking cost will be calculated from walkingspeed under single‐task and dual‐task conditions. Secondary assessments will evaluatedynamic balance, complex mobility, walking performance, executive function, generalcognitive function, lower‐limb functional performance, walking endurance, interventionadherence, exercise intensity, falls, withdrawals, and adverse events.The primary analysis will follow the intention‐to‐treat principle. Longitudinal outcomeswill be analyzed using mixed‐effects models including group, time, and group‐by‐timeinteraction effects. Effect estimates will be reported with 95% confidence intervals.Appropriate adjustment for multiple comparisons and sensitivity analyses for missing datawill be conducted according to a prespecified statistical analysis plan.