Combined physical-cognitive training enhances postural performances during daily life tasks in older adults

Laatar, Rabeb; Kachouri, Hiba; Borji, Rihab; Rebai, Haithem; Sahli, Sonia

doi:10.1016/j.exger.2017.09.004

Cited by 24 publications

(24 citation statements)

References 37 publications

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“…Across 43 studies and 491 effect estimates, the overall effect of combined interventions on cognitive function was moderate and statistically significant, Hedges’ g = 0.34 (95% CI 0.14 to 0.55), with high heterogeneity (τ 2 = 0.29, I 2 = 82%). The funnel plot revealed two conspicuous outliers, both reporting implausibly large g values of 1.74 (Laatar et al, 2018) and 4.52-5.54 (Leon et al, 2015) under high risk of bias. The studies were therefore removed from all further analysis.…”

Section: Resultsmentioning

confidence: 98%

“…Examples of sequential training include separate sessions of aerobic and resistance training, and computerized cognitive training (see Table 1 for details). Thirteen studies used a simultaneous design (Boa Sorte Silva et al, 2018b; Combourieu Donnezan et al, 2018; Hiyamizu et al, 2012; Kitazawa et al, 2015; Laatar et al, 2018; Leon et al, 2015; Mrakic-Sposta et al, 2018; Nishiguchi et al, 2015; Norouzi et al, 2019; Park et al, 2019; Reigal and Mendo, 2014; Rezola-Pardo et al, 2019; Shimada et al, 2018), such as learning complex stepping patterns, solving cognitive tasks while simultaneously performing strength and balance exercises, or conducting computerized cognitive training during aerobic exercise on bikes. Seventeen studies included exergaming interventions (Adcock et al, 2020; Anderson-Hanley et al, 2018; Bacha et al, 2018; Barcelos et al, 2015; Delbroek et al, 2017; Eggenberger et al, 2016; Gschwind et al, 2015; Htut et al, 2018; Hughes et al, 2014; Karssemeijer et al, 2019; Maillot et al, 2012; Pompeu et al, 2012; Schattin et al, 2016; Schoene et al, 2013; Schoene et al, 2015; Song et al, 2018; Stanmore et al, 2019), examples include videogame dancing, cybercycling exergames, and commercial videogames with cognitively challenging components.…”

Section: Resultsmentioning

confidence: 99%

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Combined physical and cognitive training for older adults with and without cognitive impairment: A systematic review and network meta-analysis of randomized controlled trials

Gavelin

Dong

Minkov

et al. 2020

Preprint

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Background Large systematic reviews have pointed to the efficacy of cognitive training and physical exercise on cognitive performance in older adults, making them the most common interventions in multidomain dementia prevention trials. However, it remains unclear to which extent combinations of these interventions yield additive effects beyond their individual components and what combination strategies are most beneficial. Our aim therefore was to synthesize the evidence from randomized controlled trials of combined cognitive and physical training on cognitive, physical, psychosocial and functional outcomes in older adults with or without cognitive impairment, and to compare and rank the efficacy of the three main types of combined intervention delivery formats (simultaneous, sequential or exergaming) relative to either intervention alone or control conditions. Methods and Findings We systematically searched MEDLINE, Embase and PsycINFO from inception to 23 July 2019. Change from baseline to post-intervention were extracted for each outcome and results were analyzed using random-effects models. The overall efficacy of combined interventions was assessed using multivariate pairwise meta-analysis and the comparative efficacy across different intervention delivery formats and control conditions was investigated using network meta-analysis. A total of 47 trials encompassing 4052 participants were eligible, including cognitively healthy older adults (k=30), mild cognitive impairment (k=13), dementia (k=2) and Parkinson disease (k=2). Due to the small number of identified studies in dementia and Parkinson disease, these were excluded from the pooled analyses and instead summarized narratively. Relative to any control condition, combined interventions were associated with small and heterogeneous effects on overall cognitive (k=41, Hedges g = 0.22, 95% CI 0.14 to 0.30, prediction interval -0.34 to 0.78) and physical function (k=32, g = 0.25, 95% CI 0.13 to 0.37, prediction interval -0.46 to 0.96). Cognitive and physical effects were similar for cognitively healthy older adults and those with mild cognitive impairment. No robust evidence for benefit on psychosocial function (k=9) or functional abilities (k=2) was found. The efficacy of simultaneous and sequential training for cognition exceeded all control conditions apart from cognitive training alone, with small to moderate effect estimates and moderate certainty of the evidence. The efficacy of simultaneous and sequential training on physical outcomes was comparable but not significantly greater than physical exercise alone. Exergaming was ranked low for both outcomes and superior only to passive control. The certainty of the evidence was low for physical outcomes, and we were not able to compare interventions in Parkinson disease and dementia. Conclusion Combined cognitive and physical training, delivered either simultaneously or sequentially, is efficacious for cognitive and physical outcomes in cognitively healthy and mildly impaired older adults, but not superior to cognitive or physical exercise alone in each domain. There is little systematic evidence to support potential additive effects of combined interventions or the use of exergaming in older adults. Given simultaneous training is as efficacious but less burdensome than sequential design, the former may be better suited for practical implementation to promote cognitive alongside physical health in late life. More research is needed to establish the effects of combined interventions on everyday function and well-being.

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Section: Resultsmentioning

confidence: 98%

Section: Resultsmentioning

confidence: 99%

Combined physical and cognitive training for older adults with and without cognitive impairment: A systematic review and network meta-analysis of randomized controlled trials

Gavelin

Dong

Minkov

et al. 2020

Preprint

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show abstract

“…Based on our best knowledge, VWM-B is the only training program, which contains a mix of cognitive and balance-related performance simultaneously, which has been used in DD. Previous studies have also reported some positive effects for a combination of cognitive and physical training in other populations [82][83][84]. Regarding the sequential nature of the process in a dual-task condition, e.g., the VWM-B program, the nervous system first prioritizes a task and then assigns further cognitive/attentional resources for the prioritized task.…”

Section: Discussionmentioning

confidence: 99%

Evaluating a new verbal working memory-balance program: a double-blind, randomized controlled trial study on Iranian children with dyslexia

et al. 2021

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Background It is important to improve verbal Working Memory (WM) in reading disability, as it is a key factor in learning. There are commercial verbal WM training programs, which have some short-term effects only on the verbal WM capacity, not reading. However, because of some weaknesses in current verbal WM training programs, researchers suggested designing and developing newly structured programs that particularly target educational functions such as reading skills. In the current double-blind randomized clinical trial study, we designed a new Verbal Working Memory-Balance (VWM-B) program which was carried out using a portable robotic device. The short-term effects of the VWM-B program, on verbal WM capacity, reading skills, and postural control were investigated in Iranian children with developmental dyslexia. Results The effectiveness of the VWM-B program was compared with the VWM-program as a traditional verbal WM training. In comparison with VWM-program, the participants who received training by the VWM-B program showed superior performance on verbal WM capacity, reading skills, and postural control after a short-term intervention. Conclusions We proposed that the automatized postural control resulting from VWM-B training had a positive impact on improving verbal WM capacity and reading ability. Based on the critical role of the cerebellum in automatizing skills, our findings support the cerebellar deficit theory in dyslexia. Trial registration: This trial was (retrospectively) registered on 8 February 2018 with the Iranian Registry of Clinical Trials (IRCT20171219037953N1).

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“…The separation of the combined interventions is a possible cause of the negative result [34]. Meanwhile, simultaneous combined interventions have been demonstrated to induce beneficial effects on cognitive functions in older adults [24,35,36]. The possible reason for this discrepancy is that neural plasticity is influenced by time factors and will return to the baseline level at one hour after exercise.…”

Section: Introductionmentioning

confidence: 99%

Effect of Combined Physical and Cognitive Interventions on Executive Functions in Older Adults: A Meta-Analysis of Outcomes

Guo

Zang

Klich

et al. 2020

IJERPH

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Background: Both physical exercise and cognitive training can effectively improve executive functions in older adults. However, whether physical activity combined with cognitive training is more effective than a single intervention remains controversial. The aim of this study was to perform a meta-analysis to evaluate the effect of combined physical and cognitive interventions on executive functions in older adults aged 65–80 years old. Methods: Randomized controlled trials of combined physical and cognitive interventions on executive functions in older adults were searched using the Web of Science, Elsevier Science, PubMed, EBSCO, Springer-Link, and NATURE databases. Data extraction and quality evaluation were done by Comprehensive Meta-Analysis, V3. Results: A total of 21 studies were included. The results showed that the combined physical and cognitive interventions produced significantly larger gains in executive functions, compared to the control group (standardized mean difference (SMD) = 0.26, 95% confidence interval (CI) [0.14, 0.39], p < 0.01). Furthermore, the effects of the combined physical and cognitive interventions were moderated by the study quality, intervention length, and intervention frequency. No significant differences were found between the combined interventions and the physical intervention alone (SMD = 0.13, 95% CI [−0.07, 0.33], p > 0.05) or the cognitive intervention alone (SMD = 0.13, 95% CI [−0.05, 0.30], p > 0.05). Conclusions: The combined physical and cognitive interventions effectively delayed the decrease of executive functions in older adults and this effect was influenced by the length and frequency of the intervention as well as the research quality. However, the effect of the combined physical and cognitive interventions was not significantly better than that of each intervention alone.

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Combined physical-cognitive training enhances postural performances during daily life tasks in older adults

Cited by 24 publications

References 37 publications

Combined physical and cognitive training for older adults with and without cognitive impairment: A systematic review and network meta-analysis of randomized controlled trials

Combined physical and cognitive training for older adults with and without cognitive impairment: A systematic review and network meta-analysis of randomized controlled trials

Evaluating a new verbal working memory-balance program: a double-blind, randomized controlled trial study on Iranian children with dyslexia

Effect of Combined Physical and Cognitive Interventions on Executive Functions in Older Adults: A Meta-Analysis of Outcomes

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