Strength-balance supplemented with computerized cognitive training to improve dual task gait and divided attention in older adults: a multicenter randomized-controlled trial

BMC Geriatrics

Eling D de Bruin¹  Eva van het Reve² 

[1] Department of Epidemiology, Centre for Evidence Based Physiotherapy, PO Box 616, 6200, MD Maastricht, Netherlands;Department of Health Sciences and Technology, Institute of Human Movement Sciences and Sport, ETH Zürich, Wolfgang-Pauli-Str. 27, 8093 Zürich, Switzerland

关键词: Fall prevention;    Exercise;    Executive functions;    Cognitive functions;    Divided attention;    Dual task costs;    Cognitive-motor training;   

Others  :  1089801
DOI  :  10.1186/1471-2318-14-134

 received in 2014-08-19, accepted in 2014-12-09,  发布年份 2014

【 摘 要 】

Background

Exercise interventions often do not combine physical and cognitive training. However, this combination is assumed to be more beneficial in improving walking and cognitive functioning compared to isolated cognitive or physical training.

Methods

A multicenter parallel randomized controlled trial was conducted to compare a motor to a cognitive-motor exercise program. A total of 182 eligible residents of homes-for-the-aged (n = 159) or elderly living in the vicinity of the homes (n = 23) were randomly assigned to either strength-balance (SB) or strength-balance-cognitive (SBC) training. Both groups conducted similar strength-balance training during 12 weeks. SBC additionally absolved computerized cognitive training. Outcomes were dual task costs of walking, physical performance, simple reaction time, executive functions, divided attention, fear of falling and fall rate. Participants were analysed with an intention to treat approach.

Results

The 182 participants (mean age ± SD: 81.5 ± 7.3 years) were allocated to either SB (n = 98) or SBC (n = 84). The attrition rate was 14.3%. Interaction effects were observed for dual task costs of step length (preferred walking speed: F(1,174) = 4.94, p = 0.028, η2 = 0.027, fast walking speed: F(1,166) = 6.14, p = 0.009, η2 = 0.040) and dual task costs of the standard deviation of step length (F(1,166) = 6.14, p = 0.014, η2 = 0.036), in favor of SBC. Significant interactions in favor of SBC revealed for in gait initiation (F(1,166) = 9.16, p = 0.003, η2 = 0.052), ‘reaction time’ (F(1,180) = 5.243, p = 0.023, η² = 0.028) & ‘missed answers’ (F(1,180) = 11.839, p = 0.001, η² = 0.062) as part of the test for divided attention. Within-group comparison revealed significant improvements in dual task costs of walking (preferred speed; velocity (p = 0.002), step time (p = 0.018), step length (p = 0.028), fast speed; velocity (p < 0.001), step time (p = 0.035), step length (p = 0.001)), simple reaction time (p < 0.001), executive functioning (Trail making test B; p < 0.001), divided attention (p < 0.001), fear of falling (p < 0.001), and fall rate (p < 0.001).

Conclusions

Combining strength-balance training with specific cognitive training has a positive additional effect on dual task costs of walking, gait initiation, and divided attention. The findings further confirm previous research showing that strength-balance training improves executive functions and reduces falls.

Trial registration

This trial has been registered under ISRCTN75134517

【 授权许可】

   
2014 van het Reve and de Bruin; licensee BioMed Central Ltd.

【 图 表 】

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