Cognitive motor interference for preventing falls in older adults: a systematic review and meta-analysis of randomised controlled trials

Wang, Xueqiang; Pi, Yanling; Chen, Peijie; Liu, Yu; Wang, Ru; Chan, Che Hin Chetwyn

doi:10.1093/ageing/afu175

Cited by 41 publications

(52 citation statements)

References 26 publications

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“…How to combine or integrate motor and cognitive demands in physical training represents a recently growing line of research across the lifespan in exercise science [33]. In aging research, specific forms of DT training with cognitive-motor interference and multitask balance training have been developed and demonstrated to benefit both gait and cognitive performance [13, 15, 34]. In the present study, physical training was rendered cognitively challenging by integrating executive function demands in DT fashion and its effects were compared to those of mainly physical training in ST fashion.…”

Section: Discussionmentioning

confidence: 99%

Effects of Physical-Cognitive Dual Task Training on Executive Function and Gait Performance in Older Adults: A Randomized Controlled Trial

Falbo

Condello

Capranica

et al. 2016

BioMed Research International

107

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Physical and cognitive training seem to counteract age-related decline in physical and mental function. Recently, the possibility of integrating cognitive demands into physical training has attracted attention. The purpose of this study was to evaluate the effects of twelve weeks of designed physical-cognitive training on executive cognitive function and gait performance in older adults. Thirty-six healthy, active individuals aged 72.30 ± 5.84 years were assigned to two types of physical training with major focus on physical single task (ST) training (n = 16) and physical-cognitive dual task (DT) training (n = 20), respectively. They were tested before and after the intervention for executive function (inhibition, working memory) through Random Number Generation and for gait (walking with/without negotiating hurdles) under both single and dual task (ST, DT) conditions. Gait performance improved in both groups, while inhibitory performance decreased after exercise training with ST focus but tended to increase after training with physical-cognitive DT focus. Changes in inhibition performance were correlated with changes in DT walking performance with group differences as a function of motor task complexity (with/without hurdling). The study supports the effectiveness of group exercise classes for older individuals to improve gait performance, with physical-cognitive DT training selectively counteracting the age-related decline in a core executive function essential for daily living.

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Section: Discussionmentioning

confidence: 99%

Effects of Physical-Cognitive Dual Task Training on Executive Function and Gait Performance in Older Adults: A Randomized Controlled Trial

Falbo

Condello

Capranica

et al. 2016

BioMed Research International

107

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“…Compared to the most recent systematic review and meta-analysis [13] , which pooled only 8 RCTs to examine treatment effects on dual-task gait speed, the current review included 21 comparisons from 14 RCTs. Due to the number of included trials, we were also able to conduct subgroup analyses based on the type of dual-task assessment and the type of control group.…”

Section: Summary Of Evidencementioning

confidence: 99%

“…One reason for this difference may be the larger number of studies included in our review. Additionally, most of the studies in the analysis of Wang et al [13] included active control groups that performed similar gait and balance exercises as the experimental group, which may have diminished the mean between-group difference. However, our subgroup analyses indicated no significant difference in the benefit of physical exercise intervention when compared to active or inactive control groups.…”

Section: Summary Of Evidencementioning

confidence: 99%

“…Our statistical analysis focused exclusively on gait speed, and we included only studies that measured unobstructed dual-task walking in order to maximize homogeneity for comparison. It is possible that the interventions in the included (and some excluded) studies may have demonstrated significant effects on gait in other everyday mobility tasks (e.g., transfers or negotiating obstacles), but these have been considered in other reviews [6,13,14] . There remains a limited number of well-conducted trials examining treatment-related effects of other gait parameters during dual-task walking.…”

Section: Limitationsmentioning

confidence: 99%

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Effects of Physical Exercise Interventions on Gait-Related Dual-Task Interference in Older Adults: A Systematic Review and Meta-Analysis

Plummer¹,

Zukowski²,

Giuliani³

et al. 2015

Gerontology

117

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Dual-task interference during walking can substantially limit mobility and increase the risk of falls among community-dwelling older adults. Previous systematic reviews examining intervention effects on dual-task gait and mobility have not assessed relative dual-task costs (DTC) or investigated whether there are differences in treatment-related changes based on the type of dual task or the type of control group. The purpose of this systematic review was to examine the effects of physical exercise interventions on dual-task performance during walking in older adults. A meta-analysis of randomized controlled trials (RCTs) compared treatment effects between physical exercise intervention and control groups on single- and dual-task gait speed and relative DTC on gait speed. A systematic search of the literature was conducted using the electronic databases PubMed, CINAHL, EMBASE, Web of Science, and PsycINFO searched up to September 19, 2014. Randomized, nonrandomized, and uncontrolled studies published in English and involving older adults were selected. Studies had to include a physical exercise intervention protocol and measure gait parameters during continuous, unobstructed walking in single- and dual-task conditions before and after the intervention. Of 614 abstracts, 21 studies met the inclusion criteria and were included in the systematic review. Fourteen RCTs were included in the meta-analysis. The mean difference between the intervention and control groups significantly favored the intervention for single-task gait speed (mean difference: 0.06 m/s, 95% CI: 0.03, 0.10, p < 0.001), dual-task gait speed (mean difference: 0.11 m/s, 95% CI 0.07, 0.15, p < 0.001), and DTC on gait speed (mean difference: 5.23%, 95% CI 1.40, 9.05, p = 0.007). Evidence from subgroup comparisons showed no difference in treatment-related changes between cognitive-motor and motor-motor dual tasks, or when interventions were compared to active or inactive controls. In summary, physical exercise interventions can improve dual-task walking in older adults primarily by increasing the speed at which individuals walk in dual-task conditions. Currently, evidence concerning whether physical exercise interventions reduce DTC or alter the self-selected dual-task strategy during unobstructed walking is greatly lacking, mainly due to the failure of studies to measure and report reciprocal dual-task effects on the non-gait task.

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“…Metaanalýzy, systematické přehledy a reviews zveřejněné v uplynulých dvou letech (2015-2016) [3][4][5][6][7][8][9][10][11][12][13][14][15] se zabývají výzkumy publikovanými v rozmezí let 1999-2015. Většina z uvedených přehledů zahrnuje studie, které se věnují efektivitě preventivních protipádových opatření v souvislosti s vybranými faktory (u osob se srdečním selháváním [7], u psychiatricky nemocných [6], u osob s ko-gnitivní poruchou [5,8] a další) nebo zohledňující demografické charakteristiky respondentů (starší 60 let [3,14] či 65 let [10]).…”

Section: úVodunclassified

The effectiveness of intervention programs for preventing patients from falls

Horová¹,

Brabcová²,

Krocová³

2017

Kontakt

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a Jihočeská univerzita v Českých Budějovicích, Zdravotně sociální fakulta, Ústav ošetřovatelství, porodní asistence a neodkladné péče, České Budějovice, Česká republika b Západočeská univerzita v Plzni, Fakulta zdravotnických studií, katedra ošetřovatelství a porodní asistence, Plzeň, Česká republikaThe goal was to write a review article which would summarize the conclusions of empirical studies on the effectiveness of preventive programs established in hospitals over the last 5 years. Incorporated research studies were found by using seven electronic databases on nursing and related health professional research (full text databases: Cinahl, Ebsco, Nursing Ovid, ProQuest STM+ Hospital Collection -Medline, Science Direct and citation databases PubMed and Scopus) entering keywords: accidental falls, effectiveness, fall prevention programs, institution. Other search criteria were: full text, reviewed publications, English language, human subject (human) and research results published within the last 5 years (namely 2011-2016).Twelve research studies meeting the required criteria were incorporated in the final review. The most often mentioned intervention strategy was the education of patients and staff. Whether the programs, which were focused on educational influence, are effective depends on areas involving the so called "soft-factors", i.e. compliance, leadership, and proper team training, along with information technology support, both with staff and -in certain fields -patients.Curriculums of the currently preferred multifaceted intervention program involve education. The focus and course of the education process should correspond with the information from the field of fall prevention, gained by evidence-based nursing, and respect the individual assessment of each patient, as is stated by most authors of related research studies. S O U H R N Cílem přehledové studie bylo shrnout závěry empirických výzkumů o efektivitě zavedených preventivních programů v oblasti pádů pacientů či klientů nemocničních zařízení s poskytovanou ošetřovatelskou péčí za uplynulých 5 let. * Korespondenční autor: PhDr. Jana Horová, Západočeská univerzita v Plzni, Fakulta zdravotnických studií, katedra ošetřovatelství a porodní asistence, Náměstí Odboje 18, 301 00 Plzeň, Česká republika, (Print) • ISSN 1804-7122 (Online) o š e t ř o v a t e l s t v í Článek citujte takto: Horová J, Brabcová I, Krocová J. The effectiveness of intervention programs for preventing patients from falls. Kontakt 2017; 19(2): e105-e115; http://dx.

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Cognitive motor interference for preventing falls in older adults: a systematic review and meta-analysis of randomised controlled trials

Cited by 41 publications

References 26 publications

Effects of Physical-Cognitive Dual Task Training on Executive Function and Gait Performance in Older Adults: A Randomized Controlled Trial

Effects of Physical-Cognitive Dual Task Training on Executive Function and Gait Performance in Older Adults: A Randomized Controlled Trial

Effects of Physical Exercise Interventions on Gait-Related Dual-Task Interference in Older Adults: A Systematic Review and Meta-Analysis

The effectiveness of intervention programs for preventing patients from falls

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