Effects of Telerehabilitation-Based Dual-Task Exercises on Balance, Fall Risk, Cognitive Function, and Sleep Quality in Geriatric Individuals

Aging is associated with various physiological and functional changes that can negatively affect independence and quality of life in older adults. Among the most common problems observed in geriatric individuals are balance impairments, increased risk of falls, decline in cognitive functions, and deterioration in sleep quality. These conditions not only reduce functional independence but also increase morbidity and healthcare utilization in older populations. Therefore, effective and accessible rehabilitation strategies are needed to address these multidimensional problems.

In recent years, technological approaches have increasingly been integrated into rehabilitation programs. One of the most prominent approaches is telerehabilitation, which enables healthcare professionals to deliver rehabilitation interventions remotely using digital communication technologies. Telerehabilitation facilitates access to rehabilitation services for older individuals who may have limited mobility or difficulty accessing healthcare facilities. Previous studies have demonstrated that telerehabilitation can provide outcomes comparable to conventional face-to-face rehabilitation, particularly in terms of pain reduction, functional improvement, and quality of life enhancement in musculoskeletal conditions. These findings suggest that telerehabilitation may serve as a safe, effective, and sustainable rehabilitation model for older adults.

Dual-task training has emerged as an important intervention approach aimed at improving both cognitive and motor functions simultaneously. Dual-task exercises require individuals to perform a motor task while concurrently completing a cognitive task, thereby stimulating the interaction between motor and cognitive systems. This approach reflects real-life situations in which individuals frequently perform multiple tasks at the same time during daily activities. Research has shown that dual-task training can improve postural stability, enhance cognitive performance, and reduce fall risk in older adults by strengthening sensorimotor control and motor-cognitive integration.

Functional mobility and dynamic balance are important determinants of independence in older adults. The interaction between cognitive load and motor performance plays a critical role in maintaining postural control and preventing falls in this population. In addition, cognitive status in older individuals is frequently evaluated using standardized tools that assess attention, memory, executive functions, and orientation, as these cognitive processes are closely related to balance performance and functional mobility.

Sleep quality is another important factor affecting the health and functional capacity of older adults. Poor sleep quality has been associated with decreased cognitive performance, impaired balance, and increased risk of falls. Previous studies have reported that combined physical and cognitive training interventions, such as dual-task exercise programs, may improve not only physical performance but also cognitive functioning and sleep quality in older adults.

Considering these findings, dual-task exercise programs delivered through telerehabilitation platforms may provide an effective and accessible intervention strategy for geriatric individuals. Such programs allow participants to perform exercises in their home environment under remote supervision, thereby improving accessibility and adherence while reducing barriers related to transportation and mobility.

The aim of this study is to investigate the effects of telerehabilitation-based dual-task exercises on balance, fall risk, cognitive functions, and sleep quality in geriatric individuals.

This experimental study is planned to be conducted with geriatric patients presenting to Zonguldak Atatürk State Hospital between February 2, 2026 and June 2, 2026. The findings of the study are expected to contribute to the growing body of evidence regarding the role of telerehabilitation and dual-task exercise approaches in improving functional and cognitive outcomes in older adults.

Inclusion criteria

Participants aged 65 to 74 years.

Berg Balance Scale (BBS) score between 41 and 56.

Tinetti Performance Oriented Mobility Assessment (POMA) score between 19 and 23.

Mini-Mental State Examination (MMSE) score between 18 and 30.

Independent in activities of daily living.

Able to walk without assistive devices.

Capable of using video call applications for telerehabilitation sessions.

Exclusion criteria

Participants younger than 65 years.

Individuals with cardiovascular diseases.

Amputees.

Individuals with severe cognitive impairment.

Individuals with significant visual or hearing impairments.

Individuals without internet access.

Individuals unable to use video call applications for telerehabilitation sessions.