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IS COMBINED TRAINING MORE EFFECTIVE THAN SINGLE-DOMAIN TRAINING: A RANDOMIZED CONTROLLED TRIAL WITH OLDER ADULTS

ABSTRACT: Abstract Previous research suggests that both cognitive training and physical exercise help to maintain brain health and cognitive functions that decline with age. The main objectives of this four-arms RCT are (1) to investigate the synergetic effects of a group-based multidomain training program that combines cognitive video-game training with physical exercise, in comparison to those produced by cognitive training combined with physical control activity, physical training combined with cognitive control activity, or a combination of both control activities; (2) to investigate in a memory-based task switching task whether event Related Potential (ERP) latencies of the P2 component are shorter, and N2 and P3b components are enhanced after training; and (3) to find out whether possible enhancements persist after a 3-month period without training. One hundred and twenty participants will be randomly assigned to one of the four combinations of cognitive training and physical exercise. The cognitive component will be either video-game training (cognitive intervention, CI) or video games not specifically designed to train cognition (cognitive control, CC). The physical exercise component will either emphasize endurance, strength, and music-movement coordination (exercise intervention, EI) or stretching, toning and relaxation (exercise control, EC). This RCT will investigate the short and long-term effects of combined multi-domain training compared to cognitive training and physical training alone, on executive control and memory functions of healthy older adults, in comparison with the performance of an active control group. This trial is an ongoing project started in 2018. Trial registration: Clinicaltrials.gov ID: NCT03823183; https://register.clinicaltrials.gov/

SUBMITTER: Ballesteros S

PROVIDER: S-EPMC6845876 | biostudies-literature | 2019 Nov

REPOSITORIES: biostudies-literature

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Project description:BACKGROUND:Previous research suggests that both cognitive training and physical exercise help to maintain brain health and cognitive functions that decline with age. Some studies indicate that combined interventions may produce larger effects than each intervention alone. The aim of this study is to investigate the effects of combined cognitive and physical training compared to cognitive training and physical training alone on executive control and memory functions in healthy older adults. OBJECTIVES:The main objectives of this four-arm randomized controlled trial (RCT) are: to investigate the synergetic effects of a simultaneous, group-based multidomain training program that combines cognitive video-game training with physical exercise, in comparison to those produced by cognitive training combined with physical control activity, physical training combined with cognitive control activity, or a combination of both control activities; to investigate whether event-related potential latencies of the P2 component are shorter and N2 and P3b components assessed in a memory-based task switching task are enhanced after training; and to find out whether possible enhancements persist after a 3-month period without training. METHODS:In this randomized, single-blind, controlled trial, 144 participants will be randomly assigned to one of the four combinations of cognitive training and physical exercise. The cognitive component will be either video-game training (cognitive intervention, CI) or video games not specifically designed to train cognition (cognitive control, CC). The physical exercise component will either emphasize endurance, strength, and music-movement coordination (exercise intervention, EI) or stretching, toning, and relaxation (exercise control, EC). DISCUSSION:This RCT will investigate the short and long-term effects of multidomain training, compared to cognitive training and physical training alone, on executive control and memory functions in healthy older adults, in comparison with the performance of an active control group. TRIAL REGISTRATION:ClinicalTrials.gov, NCT03823183. Registered on 21 January 2019.

Project description:BackgroundFalls are the leading cause of injuries among older adults, and trips and slips are major contributors to falls.ObjectiveThe authors sought to compare the effectiveness of adding a component of surface perturbation training to usual gait/balance training for reducing falls and fall-related injury in high-risk older adults referred to physical therapy.DesignThis was a multi-center, pragmatic, randomized, comparative effectiveness trial.SettingTreatment took place within 8 outpatient physical therapy clinics.PatientsThis study included 506 patients 65+ years of age at high fall risk referred for gait/balance training.InterventionThis trial evaluated surface perturbation treadmill training integrated into usual multimodal exercise-based balance training at the therapist's discretion versus usual multimodal exercise-based balance training alone.MeasurementsFalls and injurious falls were assessed with a prospective daily fall diary, which was reviewed via telephone interview every 3 months for 1 year.A total of 211/253 (83%) patients randomized to perturbation training and 210/253 (83%) randomized to usual treatment provided data at 3-month follow-up. At 3 months, the perturbation training group had a significantly reduced chance of fall-related injury (5.7% versus 13.3%; relative risk 0.43) but no significant reduction in the risk of any fall (28% versus 37%, relative risk 0.78) compared with usual treatment. Time to first injurious fall showed reduced hazard in the first 3 months but no significant reduction when viewed over the entire first year.LimitationsThe limitations of this trial included lack of blinding and variable application of interventions across patients based on pragmatic study design.ConclusionThe addition of some surface perturbation training to usual physical therapy significantly reduced injurious falls up to 3 months posttreatment. Further study is warranted to determine the optimal frequency, dose, progression, and duration of surface perturbation aimed at training postural responses for this population.

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IS COMBINED TRAINING MORE EFFECTIVE THAN SINGLE-DOMAIN TRAINING: A RANDOMIZED CONTROLLED TRIAL WITH OLDER ADULTS

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