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Many studies have indicated a weakening in several areas of cognitive functioning associated with the normal ageing process. One of the methods supporting cognitive functions in older adults is dual-task training which is based on performing cognitive and motor exercises at the same time. The study aimed at examining the characteristics of dual-task training compared to single-task training in participants over 65 years of age. Sixty-five subjects took part in the study. They were randomly assigned to three groups: dual-task cognitive-motor training (CM), single-task cognitive training (CT), and single-task motor training (MT). The training program in all groups encompassed 4 weeks and consisted of three, 30-min meetings a week. Specialized software was designed for the study. The main indicators, such as orientation and planning time and the number of errors, were monitored during the whole training in all groups. The obtained results have shown that the dual-task training was associated with a significantly greater number of movement errors, but not with a longer task planning time compared to the single-task condition training. There was a decrease in the time needed to plan a path in the mazes by subjects training in the CM, CT, and MT groups. The results indicate that after each type of training, the number of errors and the time needed to plan the path decrease, despite the increasing difficulty of the tasks. The length of planning time was strongly correlated with the number of errors made by individuals in the CM group (r = 0.74, p = 0.04), compared to the ST group-for which the said correlation was not significant (r = 0.7, p = 0.06). The dual-task cognitive-motor training is more cognitively demanding compared to the single-task cognitive and motor training. It manifests in a greater number of errors, but it does not extend the orientation and planning time.

Background: Randomized controlled trials (RCTs) provide the highest level of scientific evidence, but successful participant recruitment is critical to ensure the external and internal validity of results. This study describes the strategies associated with recruiting older adults at increased falls risk residing in retirement villages into an 18-month cluster RCT designed to evaluate the effects of a dual-task exercise program on falls and physical and cognitive function., Methods: Recruitment of adults aged ≥65 at increased falls risk residing within retirement villages (size 60-350 residents) was initially designed to occur over 12 months using two distinct cohorts (C). Recruitment occurred via a three-stage approach that included liaising with: 1) village operators, 2) independent village managers, and 3) residents. To recruit residents, a variety of different approaches were used, including distribution of information pack, on-site presentations, free muscle and functional testing, and posters displayed in common areas., Results: Due to challenges with recruitment, three cohorts were established between February 2014 and April 2015 (14 months). Sixty retirement villages were initially invited, of which 32 declined or did not respond, leaving 28 villages that expressed interest. A total of 3947 individual letters of invitation were subsequently distributed to residents of these villages, from which 517 (13.1%) expressions of interest (EOI) were received. Across three cohorts with different recruitment strategies adopted there were only modest differences in the number of EOI received (10.5 to 15.3%), which suggests that no particular recruitment approach was most effective. Following the initial screening of these residents, 398 (77.0%) participants were deemed eligible to participate, but a final sample of 300 (58.0% of the 517 EOI) consented and was randomized; 7.6% of the 3947 residents invited. Principal reasons for not participating, despite being eligible, were poor health, lack of time and no GP approval., Conclusion: This study highlights that there are significant challenges associated with recruiting sufficient numbers of older adults from independent living retirement villages into an exercise intervention designed to improve health and well-being., Trial Registration: Australian New Zealand Clinical Trials Registry: ACTRN12613001 161718 . Date registered 23rd October 2013.

Background: Dual-task training is an emerging field used for people with Parkinson disease (PD) to improve their physical and cognitive well-being, but the patients’ acceptability, safety, and adherence to such training in online settings are unknown. Objective: This study aims to evaluate the acceptability of a dual-task cognitive and motor online training program for people with PD as a group online community program. Methods: People with PD were invited to participate in an online program (PD3 Move) consisting of physical and vocal exercises in response to different cognitive challenges displayed as dynamic backgrounds on Zoom. The program ran twice per week for 16 weeks. Patient acceptability was assessed at 4 months by monitoring attendance rates and feedback from an exit questionnaire emailed to all participants assessing satisfaction, perceived benefit, safety, and willingness to continue and recommend to others. Results: The online program was delivered to 15 participants (n=9, 60%, females) with a diagnosis of PD, a mean age of 69.4 (SD 9.3) years, and Hoehn and Yahr (H&Y) stages I-IV. The attendance rate was high, with participants coming to more than 13 (81%) of the sessions. Participants were very satisfied (n=8, 53%) or satisfied (n=7, 47%) with the program. Participants reported that what they most liked were the new cognitive physical challenges. The 3 main facilitators to participating were perceiving the benefits, instructor’s flexibility and engagement, and the social interaction moments with others. The 3 main difficulties were dealing with motor fluctuations (n=3, 20%), difficulties in using technology (n=2, 13%), and difficulty hearing instructions due to hearing loss (n=2, 13%). Patients had favorable perceived benefits of the program, with 14 (93%) considering it very useful for the current management of health and 1 (7%) moderately useful. No adverse events were reported, and all participants said that they were willing to continue the program and recommend it to others. Conclusions: Our findings suggest that the online cognitive and motor program was well received, safe, and perceived to be of benefit to this group of medically stable people with PD in H&Y stages I-IV. Access to specialized care and enhancement of long-term adherence to regular exercise can be achieved with online community group programs. [ABSTRACT FROM AUTHOR]

• A simultaneous cognitive–physical dual-task training program based on familiar cultural backgrounds using fairy tales is beneficial for cognitive and physical functions in older adults with MCI. • Along with improvements in cognitive and physical function, the intervention has shown beneficial effects by increasing memory and physical self-efficacy. • Further studies examining beta band power in larger sample sizes using a randomized controlled design are required to determine the effects of the simultaneous dual-task intervention on neurophysiological function in older adults with MCI. In this study, we aimed to develop a simultaneous cognitive–physical dual-task training program based on familiar cultural backgrounds using fairy tales and to explore its feasibility and preliminary effects, including effects on neurophysiological, cognitive, and physical functions. A single-group pretest–posttest design (n = 9) was employed to evaluate the effects of the cognitive–physical intervention performed for 60–90 min once a week for 12 weeks. The findings showed that perceived memory and physical self-efficacy, muscle strength, and cognitive function were significantly increased after the intervention. Although the relative beta band power measured using electroencephalography showed a tendency to increase in eight brain domains after the 12-week intervention, the changes were not significant. Findings suggested that the intervention was feasible and provided beneficial effects on cognitive and physical functions in older adults with mild cognitive impairment. Future research on larger sample sizes using randomized controlled trials is needed to determine the effectiveness of such interventions on neurophysiological functions. [ABSTRACT FROM AUTHOR]

Objective: This systematic review aimed to examine the effects of dual-task balance and mobility training in people with stroke. Methods: An extensive electronic databases literature search was conducted using MEDLINE, PubMed, EBSCO, The Cochrane Library, Web of Science, SCOPUS, and Wiley Online Library. Randomized controlled studies that assessed the effects of dual-task training in stroke patients were included for the review (last search in December 2017). The methodological quality was evaluated using the Cochrane Collaboration recommendation, and level of evidence was determined according to the criteria described by the Oxford Center for Evidence-Based Medicine. Results: About 13 articles involving 457 participants were included in this systematic review. All had substantial risk of bias and thus provided level IIb evidence only. Dual-task mobility training was found to induce more improvement in single-task walking function (standardized effect size = 0.14–2.24), when compared with single-task mobility training. Its effect on dual-task walking function was not consistent. Cognitive-motor balance training was effective in improving single-task balance function (standardized effect size = 0.27–1.82), but its effect on dual-task balance ability was not studied. The beneficial effect of dual-task training on cognitive function was provided by one study only and thus inconclusive. Conclusion: There is some evidence that dual-task training can improve single-task walking and balance function in individuals with stroke. However, any firm recommendation cannot be made due to the weak methodology of the studies reviewed. [ABSTRACT FROM AUTHOR]

We aimed to examine the effect of 2-year cognitive–motor dual-task (DT) training on cognitive functions and motor ability of healthy elderly people without marked cognitive impairment. From the 25 participants of our 12-week DT trial conducted in 2014, we recruited 8 subjects who voluntarily participated in a new DT training program once a week for 2 years (exercise (EX) group). Their cognitive functions were evaluated by the Modified Mini-Mental State (3MS) examination and the Trail Making Test, and results were compared with those of the 11 subjects who discontinued the training and did not perform any types of exercise for 2 years (non-exercise (NO) group). Subjects in the NO group showed deterioration in the 3MS examination results, especially in the cognitive domain of attention. Meanwhile, participation in DT training maintained the scores in almost all domains of cognitive function, as well as the total 3MS scores. However, both groups had impaired quadriceps muscle strength and motor ability after the 2-year observation period. These results suggest that participating in exercise program comprising DT training for 2 years may be beneficial for maintaining the broad domains of cognitive function in healthy elderly people, although further verification is needed.

Summary: Osteoporosis is a serious disease characterized by muscle weakness in the lower extremities, shortened length of trunk, and increased dorsal kyphosis leading to poor balance performance. Although balance impairment increases in adults with osteoporosis, falls and fall-related injuries have been shown to occur mainly during the dual-task performance. Several studies have shown that dual-task performance was improved with specific repetitive dual-task exercises. Introduction: The aims of this study were to compare the effect of single- and dual-task balance exercise programs on static balance, dynamic balance, and activity-specific balance confidence in adults with osteoporosis and to assess the effectiveness of dual-task balance training on gait speed under dual-task conditions. Methods: Older adults ( N = 42) (age range, 45-88 years) with osteoporosis were randomly assigned into two groups. Single-task balance training group was given single-task balance exercises for 4 weeks, whereas dual-task balance training group received dual-task balance exercises. Participants received 45-min individualized training session, three times a week. Static balance was evaluated by one-leg stance (OLS) and a kinesthetic ability trainer (KAT) device. Dynamic balance was measured by the Berg Balance Scale (BBS), Time Up and Go (TUG) test, and gait speed. Self-confidence was assessed with the Activities-specific Balance Confidence (ABC-6) scale. Assessments were performed at baseline and after the 4-week program. Results: At the end of the treatment periods, KAT score, BBS score, time in OLS and TUG, gait speeds under single- and dual-task conditions, and ABC-6 scale scores improved significantly in all patients ( p < 0.05). However, BBS and gait speeds under single- and dual-task conditions showed significantly greater improvement in the dual-task balance training group than in the single-task balance training group ( p < 0.05). ABC-6 scale scores improved more in the single-task balance training group than in the dual-task balance training group ( p < 0.05). Conclusions: A 4-week single- and dual-task balance exercise programs are effective in improving static balance, dynamic balance, and balance confidence during daily activities in older adults with osteoporosis. However, single- and dual-task gait speeds showed greater improvement following the application of a specific type of dual-task exercise programs. Clinical trial registration number: 24102014-2. [ABSTRACT FROM AUTHOR]

Background Gait abnormalities and vascular disease risk factors are associated with cognitive impairment in aging. Objective To determine the impact of group-based exercise and dual-task training on gait and vascular health, in active community-dwelling older adults without dementia. Methods Participants [ n = 44, mean (SD) age: 73.5 (7.2) years, 68% female] were randomized to either intervention (exercise + dual-task; EDT) or control (exercise only; EO). Each week, for 26 weeks, both groups accumulated 50 or 75 min of aerobic exercise from group-based classes and 45 min of beginner-level square stepping exercise (SSE). Participants accumulating only 50 min of aerobic exercise were instructed to participate in an additional 25 min each week outside of class. The EDT group also answered cognitively challenging questions while performing SSE (i.e., dual-task training). The effect of the interventions on gait and vascular health was compared between groups using linear mixed effects models. Results At 26 weeks, the EDT group demonstrated increased dual-task (DT) gait velocity [difference between groups in mean change from baseline (95% CI): 0.29 m/s (0.16–0.43), p < 0.001], DT step length [5.72 cm (2.19–9.24), p = 0.002], and carotid intima-media thickness [0.10 mm (0.003–0.20), p = 0.04], as well as reduced DT stride time variability [8.31 coefficient of variation percentage points (−12.92 to −3.70), p < 0.001], when compared to the EO group. Conclusions Group-based exercise combined with dual-task training can improve DT gait characteristics in active older adults without dementia. [ABSTRACT FROM AUTHOR]

• Persons with MS may benefit from cognitive-motor dual-task training to improve cognitive functions. • However, this benefit seems to be limited to executive functions for now. • There are non-significant improvements in cognitive processing speed and working memory following the cognitive-motor dual-task training. • Further larger sample size studies are necessary to explore the effects of dual-task training on cognitive functions in persons with MS. To summarize the effectiveness of cognitive-motor dual-task training (DTT) on cognitive functions in persons with MS (pwMS). The systematic search was conducted in PubMed, Web of Science, Physiotherapy Evidence Database, and Scopus databases in January 2022. The methodological quality was assessed using the Physiotherapy Evidence Database Scale. The pooled effect sizes (ES) and 95% confidence interval (CI) were calculated by random-effect models. A total of 186 participants (age ranges from 35 to 56.7) from six studies were analyzed. DTT improves executive function assessed by Frontal Assessment Battery [ES=1.32 (95% CI 0.76 to 1.87); p<0.001]. The non-significant beneficial effects on cognitive processing speed, sustained attention, and working memory were evaluated using the Symbol Digit Modalities Test [ES=0.30 (95% CI -0.06 to 0.66); p=0.102] and Paced Auditory Serial Addition Test [ES=0.19 (95% CI -0.33 to 0.71); p=0.474] were also found. PwMS may benefit from cognitive-motor DTT to improve cognitive functions. This benefit seems to be limited to executive functions for now, and larger sample randomized controlled trials are needed. [ABSTRACT FROM AUTHOR]

We aimed to examine the effect of 2-year cognitive–motor dual-task (DT) training on cognitive functions and motor ability of healthy elderly people without marked cognitive impairment. From the 25 participants of our 12-week DT trial conducted in 2014, we recruited 8 subjects who voluntarily participated in a new DT training program once a week for 2 years (exercise (EX) group). Their cognitive functions were evaluated by the Modified Mini-Mental State (3MS) examination and the Trail Making Test, and results were compared with those of the 11 subjects who discontinued the training and did not perform any types of exercise for 2 years (non-exercise (NO) group). Subjects in the NO group showed deterioration in the 3MS examination results, especially in the cognitive domain of attention. Meanwhile, participation in DT training maintained the scores in almost all domains of cognitive function, as well as the total 3MS scores. However, both groups had impaired quadriceps muscle strength and motor ability after the 2-year observation period. These results suggest that participating in exercise program comprising DT training for 2 years may be beneficial for maintaining the broad domains of cognitive function in healthy elderly people, although further verification is needed. [ABSTRACT FROM AUTHOR]