Comparison of Three Physical—Cognitive Training Programs in Healthy Older Adults: A Study Protocol for a Monocentric Randomized Trial

Abstract

(1) Combining aerobic, coordination and cognitive training allows for more improved physical and cognitive performance than when performed separately. A Nordic walking (NW) and two cognitive-motor circuit training programs (CT-c and CT-fit) are compared. CT-c and CT-fit stimulate cognition differently: CT-c, is through conventional complex coordination training performed in single and dual-task conditions; CT-fit, incorporates it into complex goal-directed actions, implemented by fitness gaming technology (2) The aim is to determine whether CT-fit brings additional benefits to cognition compared to more traditional training. (3) Forty-five healthy independent living community dwellers participants (65–80 years) will be included after a general medical examination. The main exclusion criteria are signs of cognitive impairments (Mini–Mental State Examination < 26/30) and physical impairments. Pre and post-tests will be performed to assess: cognitive functions (Montreal Cognitive Assessment; Trail Making Test; Stroop task, working memory test, Rey Complex Figure copy task, Oral Trail Making Test, and dual-task); motor fitness (Bipedal and unipedal balance test, gait assessments, Time Up and Go, chair sit and reach test and four-square stepping test); and physical fitness (10 m incremental shuttle walking test, maximal handgrip force, Timed-Stands test). (4) Incorporating cognitive demands into complex, goal-directed actions using fitness gaming technology should be the best solution to optimize training benefits.

A Review of Combined Training Studies in Older Adults According to a New Categorization of Conventional Interventions

“…On the other hand, the available data did not support the hypothesis that MDT resulted in superior cognitive benefits, as compared to separated cognitive training (Rahe et al, 2015a,b;Kalbe et al, 2018). These results were rather unexpected since MDT was hypothesized to be an effective training intervention that capitalizes on the combination of the effects of physical, motor, and cognitive exercises (Voelcker-Rehage et al, 2010Pesce, 2012;Temprado et al, 2019;Temprado, 2021;Torre et al, 2021). The weakness of the effects of MDT training on brain and cognition could reflect the too low intensity of physical exercises and/or the low complexity of motor and cognitive exercises.…”

“…Once again, further works are needed to address this issue, in particular, to test the potential superiority of MDT over the other training interventions. The hypothesis that MDT should be the most effective training intervention remains, however, to be confirmed thanks to conceptuallygrounded training protocols (e.g., Torre et al, 2021).…”

“…According to the well-demonstrated effects of separated training, it can be speculated that combining cognitive, motor, and/or physical exercises should be more effective than training interventions carried out in isolation to improve brain and cognition in older adults (Stojan and Voelcker-Rehage, 2019;Pesce and Voelcker-Rehage, 2020;Temprado et al, 2020;Torre et al, 2021). The question remains, however, of how separated training must be combined in the literature to design effective intervention programs.…”

“…Within each different type of combined training intervention, two sub-categories were also distinguished, depending on whether cognitive and physical/motor exercises were delivered either sequentially or simultaneously (Tait et al, 2017). Moreover, within the simultaneous association, we distinguished those that associated an additional cognitive task (so-called "Thinking while Moving, " or to dual-task situations) and those where cognitive processes were embedded into complex motor tasks ("Moving while Thinking") (for a similar distinction, see Herold et al, 2018;Torre et al, 2021) (Figure 2).…”

“…An important question was whether specific moderators to combined training could be identified. Herold et al, 2018;Torre et al, 2021).…”