Training effects on motor–cognitive dual-task performance in older adults

Abstract

This systematic review investigated whether healthy older adults benefit from training interventions in motor-cognitive dual-task (DT) situations and which specific aspects of the intervention and/or task selection contribute to training benefits. Training effects were analysed with regard to the training programme (e.g., general ST or DT training) and task conditions (e.g., standing or walking, complexity of secondary cognitive task). Literature was searched via OVIDsp (Medline, EMBASE, PsycINFO). DT studies were included by the following criteria: (1) investigation of at least one motor task, (2) assessment of DT performance outcomes on standing or walking, (3) conduction of an intervention, and (4) investigation of older adults in an experimental-control group design or an old-young comparison. Thirteen studies met all inclusion criteria. Four types of interventions were identified: (1) general single-task (ST) motor training, (2) specific ST motor training, (3) general DT training, and (4) task-related (specific) DT training. For DT standing conditions only DT interventions improved motor performance, whereas DT walking also benefits by ST training. Most benefits on motor and cognitive performance seem to be reached by DT training interventions whereas a GST produced lowest effects. Thus, balance orientated motor and cognitive DT performance in healthy older adults can be improved by performance related exercises. Furthermore, to reach beneficial effects, it seems necessary that the training intervention includes a certain level of exercise load such as rising difficulties, appropriate intensity and duration, a certain level of task specificity, and variable task prioritization. The transfer of training effects into everyday situations needs to be further investigated.

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

“…Moreover, according to evidence that motor and cognitive benefits at old age may be obtained by means of DT training with a certain level of task specificity and rising difficulty [15], further DT experiences with such characteristics were embedded in the exercise training of the experimental group. Task specificity was ensured using functional mobility tasks common in everyday life, as walking on uneven or narrow surface, or carrying objects, walking while talking, or picking up objects off the floor.…”

“…There is consistent evidence that both physical and cognitive training have the potential to maintain cognitive efficiency in aging [11] and that combining them in successive or simultaneous way amplifies their efficacy [12, 13]. For this reason, physical-cognitive dual tasking is emerging as a novel modality for reaping largest cognitive health benefits [14, 15]. In their review, Wollesen and Voelcker-Rehage [15] highlighted the beneficial effects of locomotor-cognitive DT training for gait and posture performance and for processing speed and executive function.…”

“…For this reason, physical-cognitive dual tasking is emerging as a novel modality for reaping largest cognitive health benefits [14, 15]. In their review, Wollesen and Voelcker-Rehage [15] highlighted the beneficial effects of locomotor-cognitive DT training for gait and posture performance and for processing speed and executive function. Moreover, the authors indicated the need for an adequate level of task complexity for DT training to be effective and questioned to what extent the locomotor and/or cognitive DT demands contribute to its effectiveness.…”

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

“…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.…”

Effects of a Pilates exercise program on muscle strength, postural control and body composition: results from a pilot study in a group of post-menopausal women

“…Apparently, this performance is highly developable in subjects with different chronic conditions ) than healthy elderly ; nevertheless, it appears that only few studies investigated appropriate physical activity interventions to improve dual tasking. Besides, it has to be considered a non-secondary aspect; exercise interventions and testing procedures were extensively different between the few trials reported by the literature (Wollesen and Voelcker-Rehage 2013).…”