Effects of Physical and Cognitive Training on Gait Speed and Cognition in Older Adults : A Randomized Controlled Trial
Sipilä, S., Tirkkonen, A., Savikangas, T., Hänninen, T., Laukkanen, P., Alen, M., Fielding, R. A., Kivipelto, M., Kulmala, J., Rantanen, T., Sihvonen, S. E., Sillanpää, E., Stigsdotter Neely, A., & Törmäkangas, T. (2021). Effects of Physical and Cognitive Training on Gait Speed and Cognition in Older Adults : A Randomized Controlled Trial. Scandinavian Journal of Medicine and Science in Sports, 31(7), 1518-1533. https://doi.org/10.1111/sms.13960
© 2021 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
Gait speed is a measure of health and functioning. Physical and cognitive determinants of gait are amenable to interventions, but best practices remain unclear. We investigated the effects of a 12‐month physical and cognitive training (PTCT) on gait speed, dual‐task cost in gait speed, and executive functions (EFs) compared to physical training (PT) (ISRCTN52388040). Community‐dwelling older adults, who did not meet physical activity recommendations, were recruited (n=314). PT included supervised walking/balance (once weekly) and resistance/balance training (once weekly), home exercises (2‐3 times weekly) and moderate aerobic activity 150 minutes/week in bouts of >10 minutes. PTCT included the PT and computer training (CT) on EFs 15‐20 minutes, 3‐4 times weekly. The primary outcome was gait speed. Secondary outcomes were 6‐minute walking distance, dual‐task cost in gait speed, and EF (Stroop and Trail Making B‐A). The trial was completed by 93% of the participants (age 74.5 [SD3.8] years; 60% women). Mean adherence to supervised sessions was 59‐72% in PT and 62‐77% in PTCT. Home exercises and CT were performed on average 1.9 times/week. Weekly minutes spent in aerobic activities were 188 (median 169) in PT and 207 (median 180) in PTCT. No significant interactions were observed for gait speed (PTCT‐PT, 0.02; 95%CI ‐0.03, 0.08), walking distance (‐3.8; ‐16.9, 9.3) or dual‐task cost (‐0.22; ‐1.74, 1.30). Stroop improvement was greater after PTCT than PT (‐6.9; ‐13.0, ‐0.8). Complementing physical training with EFs training is not essential for promotion of gait speed. For EF’s, complementing physical training with targeted cognitive training provides additional benefit. ...
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Related funder(s)European Commission; Academy of Finland
Funding program(s)Postdoctoral Researcher, AoF; Academy Project, AoF
The content of the publication reflects only the author’s view. The funder is not responsible for any use that may be made of the information it contains.
Additional information about fundingThis work was supported by the Academy of Finland Grant no: 296843 covering the costs of data collection, management, analysis, and writing the reports. Sipilä was also supported by funding from the European Union’s Horizon 2020 research and innovation programme under Marie Sklodowska-Curie grant agreement (No 675003). Dr. Fielding’s contribution to this work was also supported by the Boston Claude D. Pepper Older Americans Independence Center (1P30AG031679) and by the U.S. Department of Agriculture, under agreement No. 58-1950-4-003. Any opinions, findings, conclusion, or recommendations expressed in this publication are those of the author(s) and do not necessarily reflect the view of the U.S. Department of Agriculture. Professor Kivipelto’s contribution to this work was also supported by the Stiftelse Stocholms Sjukhem; Knut and Alice Wallenberg Foundation, Sweden; Joint Program of Neurodegenerative Disorders–prevention (MIND-AD) grant; Center for Innovative Medicine (CIMED) at Karolinska Institutet, Sweden. Professor Rantanen’s contribution to this work was also supported by the European Research Council (grant agreement No 310526) and the Academy of Finland (Grant No 693045). The content of this publication does not reflect the official opinion of the European Union. Responsibility for the information and views expressed in the publication lies entirely with the authors. Dr. Törmäkangas’s contribution to this work was supported by an Academy of Finland Postdoctoral Researcher grant (Grant no: 286536). ...
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