Dataset Information

Effects of two different dual-task training protocols on gait, balance, and cognitive function in community-dwelling older adults: a 24-week randomized controlled trial.

ABSTRACT:

Background

Although alternating dual-task (ADT) training is functionally easier for older adults, a large part of the motor and cognitive tasks is simultaneously performed, especially during activities of daily living that require maintaining body balance.

Objective

To evaluate the effects of mixed dual-task training on mobility, cognitive function, and balance in community-dwelling older adults.

Methods

Sixty participants were randomly allocated at a 1:1 ratio into the experimental group-single motor task (SMT) and simultaneous dual task (SDT) interchangeably in stage 1 (for 12 weeks) and after strictly with SDT in stage 2 (the last 12 weeks)-or into the control group-only SMT and SDT interchangeably in stages 1 and 2. Gait parameters were acquired by two inertial sensors. Physical and cognitive performance were acquired by specific questionnaires. Generalized linear mixed models were used for analyzing interaction and main effects.

Results

No between-group difference was observed for gait performance. Both protocols improved mobility (mean change ((MC) = 0.74)), dual-task effect (MC = -13.50), lower limb function (MC = 4.44), static (MC = -0.61), and dynamic balance (MC = -0.23), body sway (MC = 4.80), and cognitive function (MC = 41.69).

Conclusion

Both dual-task training protocols improved these outcomes.

SUBMITTER: Trombini-Souza F

PROVIDER: S-EPMC10124542 | biostudies-literature | 2023

REPOSITORIES: biostudies-literature

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Publications

Effects of two different dual-task training protocols on gait, balance, and cognitive function in community-dwelling older adults: a 24-week randomized controlled trial.

Trombini-Souza Francis F de Moura Vitória Thaysa Gomes VTG da Silva Lucas Willian Nunes LWN Leal Iara Dos Santos IDS Nascimento Cleber Anderson CA Silva Paloma Sthefane Teles PST Perracini Monica Rodrigues MR Sacco Isabel Cn IC de Araújo Rodrigo Cappato RC Nascimento Marcelo de Maio MM

PeerJ 20230421

<h4>Background</h4>Although alternating dual-task (ADT) training is functionally easier for older adults, a large part of the motor and cognitive tasks is simultaneously performed, especially during activities of daily living that require maintaining body balance.<h4>Objective</h4>To evaluate the effects of mixed dual-task training on mobility, cognitive function, and balance in community-dwelling older adults.<h4>Methods</h4>Sixty participants were randomly allocated at a 1:1 ratio into the exp ...[more]

PMID: 37101796

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Project description:Objective: Physical and cognitive impairments are common with aging and often coexist. Changes in the level of physical and mental activity are prognostic for adverse health events and falls. Dual-task (DT) training programs that can improve mobility and cognition simultaneously can bring significant improvements in rehabilitation. The objective of this mixed methods exploratory RCT was to provide evidence for the feasibility and therapeutic value of a novel game-assisted DT exercise program in older adults. Methods: Twenty-two community dwelling participants, between the ages of 70-85 were randomized to either dual-task treadmill walking (DT-TR) or dual-task recumbent bicycle (DT-RC). Both groups viewed a standard LED computer monitor and performed a range of cognitive game tasks while walking or cycling; made possible with the use of a "hands-free", miniature, inertial-based computer mouse. Participants performed their respective 1-h DT exercise program twice a week, for 12 weeks at a community fitness centre. Semi-structured interviews and qualitative analysis was conducted to evaluate the participant's experiences with the exercise program. Quantitative analysis included measures of standing balance, gait function (spatiotemporal gait variable), visuomotor and executive cognitive function, tested under single and DT walking conditions. Results: Compliance was 100% for all 22 participants. Four themes captured the range of participant's experiences and opinions: 1) reasons for participation, 2) difficulties with using the technologies, 3) engagement with the computer games, and 4) positive effects of the program. Both groups showed significant improvements in standing balance performance, visuomotor and visuospatial executive function. However, significant improvement in dual task gait function was observed only in the DT-TR group. Medium to large effect sizes were observed for most balance, spatiotemporal gait variables, and cognitive performance measure. Conclusion: With only minor difficulties with the technology being reported, the findings demonstrate feasible trial procedures and acceptable DT oriented training with a high compliance rate and positive outcomes. These findings support further research and development, and will direct the next phase of a full-scale RCT.

Project description:BackgroundFunctional independence and safe mobility, especially in older people, mostly rely on the ability to perform dual tasks, particularly during activities with variable- and fixed-priority attention. The aim of this study is to compare the dual-task training with progression from variable- to fixed-priority instructions versus dual-task training with variable-priority on gait speed in community-dwelling older adults.MethodsThis is an assessor- and participant-blinded, two-arm, randomized controlled trial with 60 community-dwelling male and female older adults between the ages of 60 and 80 years old. Participants will be randomly allocated into either the intervention group or the control group using a computer-generated permuted block randomization schedule. The intervention group will undertake a progressive dual-task training in which the participants will be progressively submitted to dual-task walking and postural balance exercises with variable- to fixed-priority instructions. The control group will be submitted to dual-task training with variable-priority attention exercises. Both groups will receive 48 sessions lasting for 60 min each over 24 weeks. The primary outcome will be the gait speed under single- and dual-task conditions. Secondary outcomes will include spatiotemporal gait parameters, functional balance, executive function, falls, quality of life, and depression symptoms. All the analyses will be based on the intention-to-treat principle.DiscussionThis is the first assessor- and participant-blinded, two-arm, randomized controlled trial with 6 months of intervention and an additional 6-month post-training follow up aiming to evaluate the effectiveness of training with progression from variable- to fixed-priority instructions on gait biomechanics, postural balance, falls episodes, executive functioning, and quality of life in community-dwelling older adults. If our hypotheses are confirmed, this training protocol can be implemented widely to improve gait speed and other functional activities and quality of life in community-dwelling older adults. This study protocol can be used to improve these functional aspects of community-dwelling older adults. This study may also contribute to future guidelines for the improvement of these clinical and biomechanical aspects in older people.Trial registrationClinicalTrials.gov Identifier - NCT03886805, Registered 22 March 2019.

Project description: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.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.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, ?2?=?0.027, fast walking speed: F(1,166)?=?6.14, p?=?0.009, ?2?=?0.040) and dual task costs of the standard deviation of step length (F(1,166)?=?6.14, p?=?0.014, ?2?=?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, ?2?=?0.052), 'reaction time' (F(1,180)?=?5.243, p?=?0.023, ?²?=?0.028) & 'missed answers' (F(1,180)?=?11.839, p?=?0.001, ?²?=?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).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.This trial has been registered under ISRCTN75134517.

Project description:BackgroundFalls in older adults are considered a major public health problem. Declines in cognitive and physical functions, as measured by parameters including reaction time, mobility, and dual-task performance, have been reported to be important risk factors for falls. The aim of this study was to investigate the effects of two multimodal programs on reaction time, mobility, and dual-task performance in community-dwelling older adults at risk of falling.MethodsIn this randomized controlled trial, fifty-one participants (75.4 ± 5.6 years) were allocated into two experimental groups (EGs) (with sessions 3 times per week for 24 weeks), and a control group: EG1 was enrolled in a psychomotor intervention program, EG2 was enrolled in a combined exercise program (psychomotor intervention program + whole-body vibration program), and the control group maintained their usual daily activities. The participants were assessed at baseline, after the intervention, and after a 12-week no-intervention follow-up period.ResultsThe comparisons revealed significant improvements in mobility and dual-task performance after the intervention in EG1, while there were improvements in reaction time, mobility, and dual-task performance in EG2 (p ≤ 0.05). The size of the interventions' clinical effect was medium in EG1 and ranged from medium to large in EG2. The comparisons also showed a reduction in the fall rate in both EGs (EG1: -44.2%; EG2: - 63.0%, p ≤ 0.05) from baseline to post-intervention. The interventions' effects on reaction time, mobility, and dual-task performance were no longer evident after the 12-week no-intervention follow-up period.ConclusionsThe results suggest that multimodal psychomotor programs were well tolerated by community-dwelling older adults and were effective for fall prevention, as well as for the prevention of cognitive and physical functional decline, particularly if the programs are combined with whole-body vibration exercise. The discontinuation of these programs could lead to the fast reversal of the positive outcomes achieved.Trial registrationClinicalTrials.gov Identifier: NCT03446352. Date of registration: February 07, 2018.

Project description:ObjectiveCognitive-motor dual-tasking training (CMDT) might improve limb function and motor performance in stroke patients. However, is there enough evidence to prove that it is more effective compared with conventional physical single-task training? This meta-analysis and Trial Sequential Analysis of randomized clinical trials (RCTs) aimed to evaluate the effectiveness of CMDT on balance and gait for treating hemiplegic stroke patients.MethodsThe databases were searched in PubMed, Web of Science, Ovid Database and The Cochrane Library, SinoMed database, Chinese National Knowledge Infrastructure (CNKI), Wan Fang database, and VIP database up to December 8, 2023. The Cochrane-recommended risk of bias (RoB) 2.0 tool was employed to assess risk of bias in trials. The statistical analysis was employed using R version 4.3.2. In addition, subgroup analyses and meta-regression were performed to explore the possible sources of heterogeneity. The evidence for each outcome was evaluated according to the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) Working Group criteria. The Copenhagen Trial Unit's Trial Sequential Analysis (version 0.9.5.10 Beta) was used for sequential analysis.ResultsSeventeen randomized clinical trials (RCTs) (n = 751 patients) were included. The results demonstrated that cognitive-motor dual-task training (CMDT) might be beneficial on stroke patients on Berg Balance Scale (BBS) (MD = 4.26, 95% CI 1.82, 6.69, p < 0.0001) (low-quality evidence). However, CMDT might not affect Time Up and Go test (TUG) (MD = -1.28, 95% CI -3.63, 1.06, p = 0.284); and single-task walking speed (MD = 1.35, 95% CI -1.56, 4.27, p = 0.413) in stroke patients (low-quality evidence). The Grading of Recommendations Assessment, Development, and Evaluation (GRADE) results indicated that all findings were very low to low certainty. Trial Sequential Analyses demonstrated larger sample sizes are required for confirming our findings.ConclusionCognitive-motor dual-task training (CMDT) compared with conventional physical single-task training might be an effective intervention for improving static balance function in stroke patients (low-quality evidence), which should be interpreted cautiously due to heterogeneity and potential biases. Nevertheless, further research is required to support the abovementioned findings. Trial Registration This protocol was registered in PROSPERO (CRD42023490530).

Dataset Information

Effects of two different dual-task training protocols on gait, balance, and cognitive function in community-dwelling older adults: a 24-week randomized controlled trial.

Background

Objective

Methods

Results

Conclusion

Publications

Effects of two different dual-task training protocols on gait, balance, and cognitive function in community-dwelling older adults: a 24-week randomized controlled trial.

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