scholarly journals Effectiveness of a community-based brain-computer interface cognitive group training in healthy community-dwelling older adults: A randomized controlled implementation study (Preprint)

2020 ◽  
Author(s):  
Pei Shi Yeo ◽  
Tu Ngoc Nguyen ◽  
Mary Pei Ern Ng ◽  
Robin Wai Munn Choo ◽  
Philip Lin Kiat Yap ◽  
...  
Keyword(s):  
Older Adults ◽  
Dual Task ◽  
Gait Speed ◽  
Intervention Group ◽  
Community Dwelling ◽  
Community Based ◽  
Healthy Older Adults ◽  
Randomized Controlled ◽  
Visuospatial Abilities ◽  
Healthy Community

BACKGROUND Cognitive training can improve cognition in healthy older adults OBJECTIVE The objectives are to evaluate the implementation of a community-based computerized cognitive training (CCT) and its effectiveness on cognition, gait, and balance in healthy older adults. METHODS A single-blind randomized controlled trial with baseline and follow-up assessments was conducted in two community centers (CCs) in Singapore. A total of 94 healthy community-dwelling adults aged 55 and above participated in a ten-week CCT program with two-hour instructor-led group classes conducted twice a week. Participants used a mobile application to play games targeting attention, memory, decision making, visuospatial abilities, and cognitive flexibility. Implementation was assessed at the participant-, provider-, and community-level (e.g., reach, implementation, and facilitators & barriers). Effectiveness measures were the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS), Color Trails Test Part 2 (CTT2), Berg Balance Scale, and GAITRite® walkway measures (single & dual task gait speed, dual task cost, and single & dual task gait variability index (GVI)). RESULTS The data was based on Intention-to-treat (ITT) and Per-protocol (PP) analysis. In the ITT group, single task GVI increased (b = 2.32, P = .02, 95% CI [0.30, 4.35]) and RBANS List Recognition subtest deteriorated (b = -0.57, P = .01, 95% CI [-1.00, -0.14]) in both groups. In the PP group, time taken to complete CCT2 (b = -13.5, P = .01, 95% CI [-23.95, -3.14]) was faster in the intervention group. Single task gait speed was also marginally significantly maintained in the intervention group (b = 5.38, P = .063, 95% CI [-0.30, 11.36]) but declined in the control group. For RBANS subtests, Picture Naming (b = 0.43, P = .04, 95% CI [0.01, 0.85]) improved significantly in both groups while List Recognition subtests (b = -0.54, P = .02, 95% CI [-1.00, -0.08]) performance deteriorated. CONCLUSIONS CCT can be successfully implemented in community settings to improve attention, executive function, and visuospatial abilities while maintaining gait speed amongst healthy older adults. Findings help to identify suitable healthy ageing programs that can be implemented on a larger scale within communities. CLINICALTRIAL ClinicalTrials.gov Identifier NCT04439591

scholarly journals Short-term balance training and acute effects on postural sway in balance-deficient older adults: a randomized controlled trial

2021 ◽  
Vol 13 (1) ◽  
Author(s):  
Niklas Sörlén ◽  
Andreas Hult ◽  
Peter Nordström ◽  
Anna Nordström ◽  
Jonas Johansson
Keyword(s):  
Older Adults ◽  
Postural Sway ◽  
Intervention Group ◽  
Community Dwelling ◽  
Control Group ◽  
Positive Effects ◽  
Randomized Controlled ◽  
Eyes Closed ◽  
Balance Exercise

Abstract Background We aimed to determine the effectiveness of 4 weeks of balance exercise compared with no intervention on objectively measured postural sway. Methods This was a single-center parallel randomized controlled, open label, trial. A six-sided dice was used for allocation at a 1:1-ratio between exercise and control. The trial was performed at a university hospital clinic in Sweden and recruited community-dwelling older adults with documented postural instability. The intervention consisted of progressively challenging balance exercise three times per week, during 4 weeks, with follow-up at week five. Main outcome measures were objective postural sway length during eyes open and eyes closed conditions. Results Sixty-five participants aged 70 years (balance exercise n = 32; no intervention n = 33) were randomized. 14 participants were excluded from analysis because of early dropout before follow-up at week five, leaving 51 (n = 22; n = 29) participants for analysis. No significant differences were detected between the groups in any of the postural sway outcomes. Within-group analyses showed significant improvements in hand grip strength for the intervention group, while Timed Up & Go improvements were comparable between groups but only statistically significant in the control group. Conclusions Performing balance exercise over a four-week intervention period did not acutely improve postural sway in balance-deficient older adults. The lower limit in duration and frequency to achieve positive effects remains unclear. Trial registration Clinical trials NCT03227666, July 24, 2017, retrospectively registered.

scholarly journals Relationship between Daily and In-laboratory Gait Speed among Healthy Community-dwelling Older Adults

2019 ◽  
Vol 9 (1) ◽  
Author(s):  
Naoto Takayanagi ◽  
Motoki Sudo ◽  
Yukari Yamashiro ◽  
Sangyoon Lee ◽  
Yoshiyuki Kobayashi ◽  
...  
Keyword(s):  
Older Adults ◽  
Gait Speed ◽  
Community Dwelling ◽  
Healthy Community ◽  
Community Dwelling Older Adults

scholarly journals Effectiveness of a Treadmill Training Programme in Improving the Postural Balance on Institutionalized Older Adults

2020 ◽  
Vol 2020 ◽  
pp. 1-7
Author(s):  
Natalia Moya Pereira ◽  
Marcel Jean Pierre Massè Araya ◽  
Marcos Eduardo Scheicher
Keyword(s):  
Older Adults ◽  
Gait Speed ◽  
Postural Balance ◽  
Intervention Group ◽  
Community Dwelling ◽  
Treadmill Walking ◽  
Control Group ◽  
Timed Up And Go ◽  
Positive Effects ◽  
Before And After

Background. Institutionalized older adults have increased gait and balance impairment compared with community-dwelling older adults. The use of the treadmill for the rehabilitation process has been studied in different groups, but not in the institutionalized elderly. Objectives. The objective of this study was to assess the effects of a treadmill walking workout program on the postural balance of institutionalized older adults. Methods. Postural balance was assessed by the Berg Balance Scale (BBS), Short Physical Performance Battery (SPPB), gait speed, and Timed Up and Go Test (TUG) on 37 institutionalized older adults (23 in the intervention group and 14 in the control group). Training consisted of a 20-minute treadmill walking workout carried out twice a week for 10 weeks. Measurements were obtained before and after 10 weeks and with 1 month of follow-up for the intervention group. For the control group, the data were obtained before and after the training period. Results. Significant improvement occurred in all motor function parameters (BBS: p<0.01; gait speed: p<0.001; SPPB: p<0.001; and TUG: p<0.001). Conclusions. The present results permit us to conclude that a treadmill walking program had positive effects on the postural balance of institutionalized older adults.

Evaluation of Implementation and Effectiveness of a Pilot Multi-Domain Program for Older Adults at Risk of Cognitive Impairment at Neighborhood Senior Centres – A Randomized Controlled Trial

2020 ◽  
Author(s):  
Pei Ern Mary Ng ◽  
Sean Olivia Nicholas ◽  
Shiou-Liang Wee ◽  
Teng Yan Yau ◽  
Alvin Chan ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Older Adults ◽  
At Risk ◽  
Cognitive Impairment ◽  
Intervention Group ◽  
Blood Lipid ◽  
Community Based ◽  
Randomized Controlled ◽  
Lipid Panel

Abstract Background The efficacy of multi-domain interventions for dementia prevention has been investigated in a few large randomized controlled trials (RCT). To link research to community action, we evaluated the implementation and effectiveness of a community-based multi-domain program for older adults at risk of cognitive impairment. Methods Three enterprises implemented a 24-week, bi-weekly, multi-domain program for older adults at risk of cognitive impairment through neighborhood senior centres (SCs). The program comprised a combination of dual-task group physical exercise, pen-and-paper cognitive games, computerised cognitive training, and mobile application-based personalized nutritional guidance. An effectiveness-implementation hybrid design using a RCT design and informed by the RE-AIM (Reach, Effectiveness, Adoption, Implementation, Maintenance) framework was adopted to evaluate the program. Cognition and quality of life were assessed using the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS), and EuroQol EQ-5D-5L (EQ-5D) respectively, at baseline and 24-weeks. Blood lipid panel and physical assessments were also conducted. Questionnaires on implementation outcomes were administered at the participants-, provider- and community-levels to participants, implementers, and SC managers. Program schedules and attendance were obtained from implementers and the research team conducted unannounced, random and non-intrusive observations of the program. Results The intervention program reached almost 50% of eligible participants, had an attrition rate of 22%, and was adopted by 8.7% of the SCs approached. The intervention was implemented as intended, except the nutritional component that was re-designed due to participants’ unfamiliarity with the application. There were no between-group differences in cognition, quality of life, and blood lipid panel, though there was a reduction in quality of life in the control group and improved physical function in the intervention group at 24-weeks. Intervention group participants reported improvement in their physical and cognitive functions. The program was well-received by participants and centre managers, who wanted the intervention to continue post-study. Conclusions A six-month multi-domain program for older adults at risk of cognitive impairment can be implemented through neighborhood SCs and elicit improvement in physical but not cognitive performance. Implementation evaluation highlight areas to improve on the uptake of such community-based interventions. Trial registration Trial registration: ClinicalTrials.gov NCT04440969. Registered 22 June 2020 - Retrospectively registered, https://clinicaltrials.gov/ct2/show/NCT04440969

scholarly journals Cognitive Load and Dual-Task Performance During Locomotion Poststroke: A Feasibility Study Using a Functional Virtual Environment

2010 ◽  
Vol 90 (2) ◽  
pp. 252-260 ◽  
Author(s):  
Rachel Kizony ◽  
Mindy F. Levin ◽  
Lucinda Hughey ◽  
Claire Perez ◽  
Joyce Fung
Keyword(s):  
Older Adults ◽  
Virtual Environment ◽  
Dual Task ◽  
Gait Speed ◽  
Stride Length ◽  
Community Dwelling ◽  
Control Group ◽  
Dual Task Condition ◽  
Dual Tasking ◽  
Stroke Group

Background Gait and cognitive functions can deteriorate during dual tasking, especially in people with neurological deficits. Most studies examining the simultaneous effects of dual tasking on motor and cognitive aspects were not performed in ecological environments. Using virtual reality technology, functional environments can be simulated to study dual tasking. Objectives The aims of this study were to test the feasibility of using a virtual functional environment for the examination of dual tasking and to determine the effects of dual tasking on gait parameters in people with stroke and age-matched controls who were healthy. Design This was a cross-sectional observational study. Methods Twelve community-dwelling older adults with stroke and 10 age-matched older adults who were healthy participated in the study. Participants walked on a self-paced treadmill while viewing a virtual grocery aisle projected onto a screen placed in front of them. They were asked to walk through the aisle (single task) or to walk and select (“shop for”) items according to instructions delivered before or during walking (dual tasking). Results Overall, the stroke group walked slower than the control group in both conditions, whereas both groups walked faster overground than on the treadmill. The stroke group also showed larger variability in gait speed and shorter stride length than the control group. There was a general tendency to increase gait speed and stride length during dual-task conditions; however, a significant effect of dual tasking was found only in one dual-task condition for gait speed and stride duration variability. All participants were able to complete the task with minimal mistakes. Limitations The small size and heterogeneity of the sample were limitations of the study. Conclusions It is feasible to use a functional virtual environment for investigation of dual tasking. Different gait strategies, including an increase or decrease in gait speed, can be used to cope with the increase in cognitive demands required for dual tasking.

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