Comparison between multicomponent and simultaneous dual-task exercise interventions in long-term nursing home residents: the Ageing-ONDUAL-TASK randomized controlled study

Abstract

Background the potential benefits of dual-task interventions on older adults living in long-term nursing homes (LTNHs) from a multidimensional perspective are unknown. We sought to determine whether the addition of simultaneous cognitive training to a multicomponent exercise program offers further benefits to dual-task, physical and cognitive performance, psycho-affective status, quality of life and frailty in LTNH residents. Design: a single-blind randomized controlled trial. Setting nine LTNHs in Gipuzkoa, Spain. Subjects 85 men and women (ACTRN12618000536268). Methods participants were randomly assigned to a multicomponent or dual-task training group. The multicomponent group performed two sessions per week of individualized and progressive strength and balance exercises for 3 months. The dual-task group performed simultaneous cognitive tasks to the same tasks as in the multicomponent group. Gait speed under single- and dual-task conditions, physical and cognitive performance, psycho-affective status, quality of life and frailty were measured at baseline and after 3 months of intervention. Results both groups showed clinically significant improvements on gait performance under single- and dual-task conditions and on the short physical performance battery (P < 0.05). Both interventions were effective in maintaining cognitive function (P > 0.05). Only the multicomponent group significantly improved quality of life, and reduced anxiety and Fried frailty score (P < 0.05). No group-by-time interactions were found except for the chair-stand test in favour of the multicomponent group (P < 0.05). Conclusions the addition of simultaneous cognitive training does not seem to offer significantly greater benefits to the evaluated multicomponent exercise program in older adults living in LTNHs.

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

“…No differences between the groups were found in working memory, executive function or episodic memory. Rezola-Pardo et al (2019) reported no additional benefits of simultaneous training compared to physical exercise alone on a range of cognitive, physical and psychosocial outcomes in people living in long-term nursing homes. In Parkinson’s disease, two studies reported no cognitive or physical benefits of exergaming compared to physical exercise (Pompeu et al, 2012) or passive control (Song et al, 2018).…”

“…A list of the excluded studies (with reasons) is provided in Appendix C. Two additional eligible studies were identified through manual search (Adcock et al, 2020; Rezola-Pardo et al, 2019). Thus, a total of 47 studies fulfilled inclusion criteria (Fig.…”

“…Two studies included participants with Parkinson’s disease without dementia (Pompeu et al, 2012; Song et al, 2018). One study included people with dementia (Karssemeijer et al, 2019) and one included long-term nursing home residents (Rezola-Pardo et al, 2019), which was classified as dementia and thus excluded from the pooled analyses. Intervention duration ranged from four to 40 weeks (median = 12 weeks).…”

“…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.…”

A three-armed cognitive-motor exercise intervention to increase spatial orientation and life-space mobility in nursing home residents: study protocol of a randomized controlled trial in the PROfit project

“…However, some studies show that dual-task training is not always more beneficial than e.g. multicomponent exercises to gain positive effects on cognitive-motor performance in older adults [ 43 – 45 ]. To become more effective in improving dual-task performance, intervention programs should include a combination of complex balance and coordination tasks [ 46 ].…”