Effect of Exercise on Dual-task and Balance on Elderly in Multiple Disease Conditions

Abstract

Investigations on how exercise and physical activity affect dual-task (DT) performance in the elderly are growing rapidly due to the fact that DT activities are commonplace with activities of daily living. Preliminary evidence has shown the benefit in exercise on DT balance, though it is unclear to what extent the effect exercise has on DT performance in elderly subjects with disease conditions, including subjects with a high risk of falls. Hence, the objective of this study was to critically review the existing evidence of a potential relationship between exercise and improvement of static and dynamic balance during DT conditions as well as secondary outcomes in elderly subjects with different disease conditions. A systematic search using online databases was performed to source documents. Inclusion criteria sourced articles classified as randomized controlled trials (RCT), controlled trials (CT) and uncontrolled trials (UT). Moreover, the studies had to administrate an exercise or physical activity protocol in the intervention. Seventeen studies met the eligibility criteria and were comprised of 12 RCTs, 3 CTs, and 2 UTs. Overall, 13 studies supported exercise being effective to improve parameters of static and dynamic balance during single or DT conditions. Despite the heterogeneity of pathologic conditions, exercise showed similar benefits to improve function in two main areas: neurological conditions and frailty conditions. The lack of a common method to assess DT performance limited the ability to compare different interventions directly. Future research is warranted to study the optimal dose and exercise modalities to best reduce the risk of falls in the elderly with multiple disease conditions.

Nonpharmacological interventions to treat physical frailty and sarcopenia in older patients: a systematic overview – the SENATOR Project ONTOP Series

“…Overall, the 10 SRs22–31 yielded 140 primary studies, of which 732–38 satisfied the inclusion criteria, but three of these presented the results of the same study. An additional relevant study was included after manual search39 (Table 4).…”

“…Five out of 10 SRs27–31 included physically frail populations. From these SRs, 4 RCTs33–38 (described in 6 articles) were included; three articles33–35 described different aspects of the same study (the Frailty Intervention Trial – FIT), so that they are reported together here.…”

Effects of dual tasks and dual-task training on postural stability: a systematic review and meta-analysis

“…Furthermore, studies have extensively mentioned the beneficial effects of motor,32,33 dual-task training,34–36 for enhancing cognitive and motor performance even in fall-prone population groups. Another important determinant that is commonly utilized to enhance stability and cognitive performance is physical exercise 32,33,37.…”

“…Another important determinant that is commonly utilized to enhance stability and cognitive performance is physical exercise 32,33,37. The studies report these training maneuvers to be crucial for smoothening of various cognitive abilities and reducing cognitive–motor interference 38–40.…”

The effect of performing a dual-task on postural control and selective attention of older adults when stepping backward

“…It has been suggested that exercise training is beneficial for the static and dynamic balance of older adults with multiple disease conditions performing single and dual tasks29 ) . However, insufficient evidence has been found to verify these benefits in healthy older adults30 ) .…”