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Strength-balance supplemented with computerized cognitive training to improve dual task gait and divided attention in older adults: a multicenter randomized-controlled trial.
BMC Geriatr. 2014 Dec 15; 14:134.BG

Abstract

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.

Authors+Show Affiliations

Department of Health Sciences and Technology, Institute of Human Movement Sciences and Sport, ETH Zürich, Wolfgang-Pauli-Str, 27, 8093 Zürich, Switzerland. eva.vanhetreve@hest.ethz.ch.No affiliation info available

Pub Type(s)

Journal Article
Multicenter Study
Randomized Controlled Trial

Language

eng

PubMed ID

25511081

Citation

van het Reve, Eva, and Eling D. de Bruin. "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, vol. 14, 2014, p. 134.
van het Reve E, de Bruin ED. Strength-balance supplemented with computerized cognitive training to improve dual task gait and divided attention in older adults: a multicenter randomized-controlled trial. BMC Geriatr. 2014;14:134.
van het Reve, E., & de Bruin, E. D. (2014). 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, 14, 134. https://doi.org/10.1186/1471-2318-14-134
van het Reve E, de Bruin ED. Strength-balance Supplemented With Computerized Cognitive Training to Improve Dual Task Gait and Divided Attention in Older Adults: a Multicenter Randomized-controlled Trial. BMC Geriatr. 2014 Dec 15;14:134. PubMed PMID: 25511081.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Strength-balance supplemented with computerized cognitive training to improve dual task gait and divided attention in older adults: a multicenter randomized-controlled trial. AU - van het Reve,Eva, AU - de Bruin,Eling D, Y1 - 2014/12/15/ PY - 2014/08/19/received PY - 2014/12/09/accepted PY - 2014/12/17/entrez PY - 2014/12/17/pubmed PY - 2016/3/15/medline SP - 134 EP - 134 JF - BMC geriatrics JO - BMC Geriatr VL - 14 N2 - 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. SN - 1471-2318 UR - https://www.unboundmedicine.com/medline/citation/25511081/Strength_balance_supplemented_with_computerized_cognitive_training_to_improve_dual_task_gait_and_divided_attention_in_older_adults:_a_multicenter_randomized_controlled_trial_ L2 - https://bmcgeriatr.biomedcentral.com/articles/10.1186/1471-2318-14-134 DB - PRIME DP - Unbound Medicine ER -