Requirements of health professionals and affected persons for an App based Dual Task training for hearing impaired older adults - a Delphi survey

Background: Age-related hearing impairments significantly impact social interactions and physical activities for older adults. Recent studies have highlighted potential benefits of cognitive-motor training but lack specificity regarding the unique needs of this population. This study aimed to determine the exercise preferences and specific needs of older adults with hearing impairments to develop tailored cognitive-motor training programs. Methods: A Delphi survey was conducted to gather expert opinions and user preferences to inform the development of an app. The survey engaged 220 health and exercise professionals and 30 older adults with hearing impairments across three rounds, using a combination of open and closed questions. Data collection lasted from December 2023 to July 2024 and resulted in 10 to 14 complete responses per group and round. Statistical analyses included frequency analysis, mean, standard deviation and one-way ANOVA to identify significant differences between expert and user responses. Results: The study gathered a lot of opinions and perspectives regarding the aspects of a training app. All 570 responses were clustered in 148 items and only 35 were removed due to low relevance. While revealing a high level of consensus, the data showed significant differences between the groups. For example, in the preference for training types, health professionals differed from hearing-impaired participants. While professionals emphasised the integration of sensory challenges and dual-task exercises, participants preferred less demanding physical activities and those incorporating music or ambient sounds. Strength exercises and prescribed frequent sessions were deemed less feasible, indicating a preference for more adaptable and enjoyable training regimes. Conclusions: Tailored cognitive-motor training programs that incorporate the individual preferences and sensory capabilities of hearing-impaired older adults promise high adherence and effectiveness. Frequent training sessions stimulate neuroplasticity, enhancing both cognitive and motor functions, which is crucial for older adults facing sensory deficits. The intensity of the exercises should match the individual's abilities, gradually increasing to ensure engagement without overwhelming participants. These programs should emphasise ease of use, flexibility and autonomy to enhance the enjoyment while sensory accommodation helps to enhance physical and cognitive functions, supporting greater independence and quality of life for this vulnerable population.