Objective: Physical and cognitive impairments are common with aging and often coexist. Changes in the level of physical and mental activity are prognostic for adverse health events and falls. Dual-task (DT) training programs that can improve mobility and cognition simultaneously can bring significant improvements in rehabilitation. The objective of this mixed methods exploratory RCT was to provide evidence for the feasibility and therapeutic value of a novel game-assisted DT exercise program in older adults.Methods: Twenty-two community dwelling participants, between the ages of 70–85 were randomized to either dual-task treadmill walking (DT-TR) or dual-task recumbent bicycle (DT-RC). Both groups viewed a standard LED computer monitor and performed a range of cognitive game tasks while walking or cycling; made possible with the use of a “hands-free”, miniature, inertial-based computer mouse. Participants performed their respective 1-h DT exercise program twice a week, for 12 weeks at a community fitness centre. Semi-structured interviews and qualitative analysis was conducted to evaluate the participant’s experiences with the exercise program. Quantitative analysis included measures of standing balance, gait function (spatiotemporal gait variable), visuomotor and executive cognitive function, tested under single and DT walking conditions.Results: Compliance was 100% for all 22 participants. Four themes captured the range of participant’s experiences and opinions: 1) reasons for participation, 2) difficulties with using the technologies, 3) engagement with the computer games, and 4) positive effects of the program. Both groups showed significant improvements in standing balance performance, visuomotor and visuospatial executive function. However, significant improvement in dual task gait function was observed only in the DT-TR group. Medium to large effect sizes were observed for most balance, spatiotemporal gait variables, and cognitive performance measure.Conclusion: With only minor difficulties with the technology being reported, the findings demonstrate feasible trial procedures and acceptable DT oriented training with a high compliance rate and positive outcomes. These findings support further research and development, and will direct the next phase of a full-scale RCT.
Introduction Mobility limitations and cognitive impairments which are common with ageing, cause a reduction in the levels of physical and mental activity and are prognostic of future adverse health events, including falls. Consequently, multi-task training paradigms that simultaneously address both mobility and cognition benefit healthy ageing and are important to consider in rehabilitation. In this regard, the application of computer technology provides a number of promising approaches, in particular, virtual reality and therapeutic gaming. These approaches have the potential to improve clinical outcomes by making therapy more motivating, more ecological, and effective, blending of balance, mobility, gaze and cognitive exercises/tasks. Using a computer-based platform, one can also objectively quantify duration and intensity of both exercise and cognitive activity. Performance can also be quantified, trend analysis can be conducted and dose-response relationships established. The aim of this critical review is to discuss the technology-assisted and motivational programme approach to prevent
Background: Mobility limitations and cognitive impairments which are common with ageing often coexist, causing a reduction in the levels of physical and mental activity and are prognostic of future adverse health events and falls. Consequently, multi-task training paradigms that simultaneously address both mobility and cognition benefit healthy ageing are important to consider in rehabilitation as well as primary prevention. Objectives: An exploratory RCT is being conducted to: a) describe the feasibility and acceptability of the study design and process, procedures, resources and management in two game-based dual-task training programs delivered in the community; b) to explore the lived experiences of the study participants who completed their respective exercise programs. A secondary objective is to obtain preliminary data on the therapeutic effectiveness of the two dual-task training programs. Methods: Thirty healthy older community dwelling participants aged 70-85 with previous history of falls will be recruited and randomized to either dualtask treadmill walking (experimental group) or dual-task recumbent bicycle (control group). Data analysis: The qualitative data will be analyzed by two investigators using a content analysis approach. For the quantitative data, outcome measures will be collected pre and post intervention and included measures to assess core balance, spatial-temporal gait variables, visual tracking and cognitive function, as well as, balance and gait analysis under dual-task conditions. Discussion:
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