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Home-based physical exercice with additional cognitive training for improving mobility in older adults: a secondary
Emma Gabrielle Dupuy1,2, Caroll-Ann Blanchette3,4, Florent Besnier3
1Research center and Centre ÉPIC, Montreal Heart Institute, Montreal, Canada. emma.dupuy@u-bourgogne.fr.
Background:
Home-based physical exercise is an accessible strategy to help maintain physical functioning in adults over 50, but mobility gains may be limited without direct supervision. By improving cognitive processes involved in motor control, cognitive training may help enhance the effectiveness of home-based physical exercise in preventing age-related decline in mobility. This study compares the effects of a six-month home-based physical exercise, with or without cognitive training, on gait speed and balance.
Methods:
127 community-dwelling adults aged 50-87 years (mean 65.20 ± 7.93; 76% women) were randomly assigned to (1) home-based, remotely monitored physical exercise alone (n = 64; 72% women) or (2) combined with cognitive training (n = 63; 81% women) for six months. The primary outcome was the change from baseline in usual gait speed, measured by the 4-meter walking test. Secondary outcomes included fast gait speed, balance (one-leg stance test), and lower-limb strength (five-time sit-to-stand test), all of which were assessed via videoconference at 3 and 6 months. Changes in outcomes were analyzed using adjusted mixed linear models with intervention group, time (ΔT0-T3, ΔT0-T6), and their interaction as fixed effects.
Results:
Change in usual gait speed did not differ between groups. In contrast, the combined group showing greater improvements than the physical exercise alone group in fast gait speed (+ 0.07 m/s; F(1,199) = 6.24, p = 0.013, η2p ≃0.03) and one-leg balance test (+ 3.83 s; F(1,202) = 6.05, p = 0.015, η2p ≃0.03) in response to intervention. No significant group × time interaction was observed, indicating similar changes at 3 and 6 months.
Conclusion:
Adding cognitive training to home-based physical exercise may improve fast gait speed and balance in adults aged 50 and above. These findings support the interplay between sensorimotor and cognitive functions in older adults and suggest that combined physical and cognitive interventions could help prevent age-related mobility decline.
Clinical Trial Registration Id:
COVEPIC was retrospectively registered on November 19, 2020.
Clinical Trial Identifier:
NCT04635462. https://clinicaltrials.gov/ct2/show/record/NCT04635462?term=NCT04635462&draw=2&rank=1.
