Here is the design of a clinical trial:

Official Title: Effects of Multimodal Training of Combined Cognitive and Physical and Cognitive or Physical Training Only on Cognition and Physical Fitness of Older Adults: A Cluster Randomized Controlled Trial

Included conditions:
- Cognitive Decline
- Cognitive Impairment, Mild

Study Armgroups:
- {'label': '1. Integrated format', 'type': 'ACTIVE_COMPARATOR', 'description': 'Integrated or Combination of ABC of A: cognitive training. B: physical training and C: Combined Cognitive and Physical Training (CCPT).', 'interventionNames': ['Behavioral: Cognitive training', 'Behavioral: physical training', 'Behavioral: Combination of cognitive and physical training (CCPT)-BIGMAP']}
- {'label': '2. Cognitive training + Physical Training (A+B)', 'type': 'ACTIVE_COMPARATOR', 'description': 'Intervention of A \\& B treatments.', 'interventionNames': ['Behavioral: Cognitive training', 'Behavioral: physical training']}
- {'label': '3. Physical training + CCPT (B+C)', 'type': 'ACTIVE_COMPARATOR', 'description': 'Intervention of B \\& C treatments.', 'interventionNames': ['Behavioral: physical training', 'Behavioral: Combination of cognitive and physical training (CCPT)-BIGMAP']}
- {'label': '4. CCPT + Cognitive training (C+A)', 'type': 'ACTIVE_COMPARATOR', 'description': 'Intervention of C \\& A treatments.', 'interventionNames': ['Behavioral: Cognitive training', 'Behavioral: Combination of cognitive and physical training (CCPT)-BIGMAP']}
- {'label': '5. Control group', 'type': 'NO_INTERVENTION', 'description': 'No intervention'}

Interventions:
- {'type': 'BEHAVIORAL', 'name': 'Cognitive training', 'description': 'Involves participants engaging in selected games which require thinking skills to be played in a group of 2-4 people.', 'armGroupLabels': ['1. Integrated format', '2. Cognitive training + Physical Training (A+B)', '4. CCPT + Cognitive training (C+A)']}
- {'type': 'BEHAVIORAL', 'name': 'physical training', 'description': 'Involves learning of preselected routines of "line dancing" taught by a line dance instructor.', 'armGroupLabels': ['1. Integrated format', '2. Cognitive training + Physical Training (A+B)', '3. Physical training + CCPT (B+C)']}
- {'type': 'BEHAVIORAL', 'name': 'Combination of cognitive and physical training (CCPT)-BIGMAP', 'description': 'BIGMAP is a program engaging participants in specially designed cognitive/memory games together with physical training (Fu \\& Chow, 2019).', 'armGroupLabels': ['1. Integrated format', '3. Physical training + CCPT (B+C)', '4. CCPT + Cognitive training (C+A)'], 'otherNames': ['"Brain Invigoration Gross Motor Activation Program" (BIGMAP)']}

Primary Outcomes:
- {'measure': 'Cognitive Tests: for executive function (pre-test)', 'description': 'Wisconsin Card Sorting Test (WCST) for the executive function will be conducted (20-30 min, unit on a scale) in four evaluation time frames, respectively. The evaluators at all sessions will be blind to the group membership of participants.', 'timeFrame': 'Pre-test (1st test): before intervention'}
- {'measure': 'Cognitive Tests: for executive function (2nd test)', 'description': 'Wisconsin Card Sorting Test (WCST) for the executive function will be conducted (20-30 min, unit on a scale) in four evaluation time frames, respectively. The evaluators at all sessions will be blind to the group membership of participants.', 'timeFrame': '2nd test: after 2-month intervention'}
- {'measure': 'Cognitive Tests: for executive function (3rd test)', 'description': 'Wisconsin Card Sorting Test (WCST) for the executive function will be conducted (20-30 min, unit on a scale) in four evaluation time frames, respectively. The evaluators at all sessions will be blind to the group membership of participants.', 'timeFrame': '3rd test: after 4-month intervention'}
- {'measure': 'Cognitive Tests: for executive function (4th test)', 'description': 'Wisconsin Card Sorting Test (WCST) for the executive function will be conducted (20-30 min, unit on a scale) in four evaluation time frames, respectively. The evaluators at all sessions will be blind to the group membership of participants.', 'timeFrame': '4th test: after 2-month follow up'}
- {'measure': 'Cognitive Tests: for attention (pre-test)', 'description': 'Color Trail Making test (CTMT) for attention will be conducted (5-8 min, unit on a scale) in four evaluation time frames, respectively. The evaluators at all sessions will be blind to the group membership of participants.', 'timeFrame': 'Pre-test (1st test): before intervention'}
- {'measure': 'Cognitive Tests: for attention (2nd test)', 'description': 'Color Trail Making test (CTMT) for attention will be conducted (5-8 min, unit on a scale) in four evaluation time frames, respectively. The evaluators at all sessions will be blind to the group membership of participants.', 'timeFrame': '2nd test: after 2-month intervention'}
- {'measure': 'Cognitive Tests: for attention (3rd test)', 'description': 'Color Trail Making test (CTMT) for attention will be conducted (5-8 min, unit on a scale) in four evaluation time frames, respectively. The evaluators at all sessions will be blind to the group membership of participants.', 'timeFrame': '3rd test: after 4-month intervention'}
- {'measure': 'Cognitive Tests: for attention (4th test)', 'description': 'Color Trail Making test (CTMT) for attention will be conducted (5-8 min, unit on a scale) in four evaluation time frames, respectively. The evaluators at all sessions will be blind to the group membership of participants.', 'timeFrame': '4th test: after 2-month follow up'}
- {'measure': 'Cognitive Tests: for everyday memory (pre-test)', 'description': 'Rivermead Behavioral Memory Test (RBMT) for everyday memory will be conducted (30 min, unit on a scale) in four evaluation time frames, respectively. The evaluators at all sessions will be blind to the group membership of participants.', 'timeFrame': 'Pre-test (1st test): before intervention'}
- {'measure': 'Cognitive Tests: for everyday memory (2nd test)', 'description': 'Rivermead Behavioral Memory Test (RBMT) for everyday memory will be conducted (30 min, unit on a scale) in four evaluation time frames, respectively. The evaluators at all sessions will be blind to the group membership of participants.', 'timeFrame': '2nd test: after 2-month intervention'}
- {'measure': 'Cognitive Tests: for everyday memory (3rd test)', 'description': 'Rivermead Behavioral Memory Test (RBMT) for everyday memory will be conducted (30 min, unit on a scale) in four evaluation time frames, respectively. The evaluators at all sessions will be blind to the group membership of participants.', 'timeFrame': '3rd test: after 4-month intervention'}
- {'measure': 'Cognitive Tests: for everyday memory (4th test)', 'description': 'Rivermead Behavioral Memory Test (RBMT) for everyday memory will be conducted (30 min, unit on a scale) in four evaluation time frames, respectively. The evaluators at all sessions will be blind to the group membership of participants.', 'timeFrame': '4th test: after 2-month follow up'}

Please estimate the sample size based on the assumption: 
Alpha level of 0.05, power of 0.90, rho of 0.5, ICC of 0.1, 20% attrition rate
Sample size
        As suggested by Brown et al. (2015) [20], the first step of CRCT sample size estimation is to determine one for a non-clustered design. Based on the repeated measures of ANOVA analyses of 4 trials by 5 groupings (4 IGsâ+â1 CG) with parameters set to an effect size of 0.175 (small to medium), an alpha level of 0.05, power of 0.90, rho of 0.5, the sample size (nn) estimated is 95 (calculated by G*Power software). Next, the second step is to determine the design effect (De) for clustering estimation. It is calculated with a group size of 15 and ICC of 0.1 (from previous a study titled BIGMAP, to be published) [15] and yields 2.4. The required sample size for a CRCT is 228 (i.e., nnÃDe). By considering a 20% of attrition rate of the participants, the total sample size (N) of this study is set at 285, composed of 20 groups/centres of 14â15 participants each.