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

Research Article

Eva van het Reve¹  Eling D de Bruin² 

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

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

DOI  :  10.1186/1471-2318-14-134

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

来源: Springer

【 摘 要 】

BackgroundExercise 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.MethodsA 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.ResultsThe 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).ConclusionsCombining 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 registrationThis trial has been registered under ISRCTN75134517

【 授权许可】

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