Motor-Cognitive Training Outperforms State-Funded Mobility Programs in Improving Dynamic Gait Stability in Older Adults.

Abstract

Background/objectives: Falls are a major cause of injury and mortality in older adults. Numerous programs have been implemented to improve mobility and reduce fall risk but these focus on strength, balance, and coordination, while cognitive abilities remain unconsidered. This study compares an official state-funded rehabilitation sport program with a novel motor-cognitive training.

Methods: Thirty-two participants (Mage: 71 years) were assigned either to the accredited rehabilitation sport or the motor-cognitive training. Following the official regulations, participants trained once a week for 45 min over 6 the course of weeks. Motor-cognitive training was performed using the SKILLCOURT technology where cognitive tasks were integrated into locomotor or stepping exercises. Before and after the training, gait stability using the Dynamic Gait Index and timed-up-and-go test was measured. Moreover, endurance capacity (6-min walking test), executive function, dual-task performance, and reactive agility were assessed on the SKILLCOURT. Training motivation and intention to continue with the training were surveyed after the 6-week training intervention.

Results: Results indicate stronger performance gains for the motor-cognitive training group in the Dynamic Gait Index (p = .020, ηp2=.198) and timed-up-and-go (p = .014, ηp2=.227). No differences were observed for the 6-min walking, dual task, and executive function tests (p ≥ .174). Participants in the motor-cognitive group were more motivated to come to the training (p = .002), and a higher proportion expressed their interest in training continuation (p < .001).

Conclusion: The results indicate that motor-cognitive training outperforms purely motor training programs in improving gait stability in older adults. Significance/Implications: Mobility training programs should be revised by integrating motor-cognitive components.