balance improvement in eldely after motor and cognitive training pompeu, je; mendes, f; keith;...
TRANSCRIPT
BALANCE IMPROVEMENT IN ELDELY AFTER MOTOR AND COGNITIVE TRAINING
Pompeu, JE; Mendes, F; Keith; Alexandra,;Tatiana; Peterson, A;
Piemonte, MEP
BACKGROUND
MOTOR DEFICIENCY - LACK IN AUTOMATIC
CONTROL
COGNITIVE DEFICIENCY - DISRUPTION IN EXECUTIVE
FUNCTION
BALANCE AND GAIT IMPAIRMENT IN DAILY
LIVING ACTIVITIES
BACKGROUND
REDUCED MOTOR AND COGNITIVE FUNCTION
INCREASED IATTENTION IN GAIT SUPERVISION
DECREASED EFFICIENCY IN AUTOMATIC MOTOR CONTROL
COMPETITION FOR CORTICAL RESOURCES TO CONTROL GAIT AND OTHER TASKS
REDUCED ABILITY TO WALK IN MULTI TASK CONDITIONS – FALLS
PURPOSE
• The aim of this study was to compare the effectiveness of motor and cognitive training versus motor training alone for improving balance and functional performance in elderly.
METHODS
• PARTICIPANTS– 10 elderly, mean age of 65.7 years (S.D = 8.24), 12
men and 8 women– All participants were asymptomatic for depression
and dementia– All participants signed the HCFMUSP informed
consent term.
OUTCOME MEASURES
• PRIMARY– BALANCE TASK
• SINGLE TASK• MULTI-TASK
– GAIT• SINGLE TASK• MULTI-TASK
• SECUNDARY– BEST
METHODS
• Elderly underwent a total of 14 (2 per week) motor and cognitive training sessions (MCT).
• Training session were preceded by 30 minutes of general mobility exercises.
• Following the warm up, elderly were taken to another room where they trained with the aid of the Nintendo Wii Fit Plus® videogame. This comprised 10 different tasks, performed 5 per session, which elicited different motor responses requiring compensatory and anticipatory balance responses associated with cognitive tasks of attention, memory, perceptual judgment, decision making and response inhibition.
BALANCE PERF O RMANCE W IT H VISIO N
ST DT
BT AT
EVALUAT IO N
10
15
20
25
30
35
40
45
50
55T
IME
IN
SE
CO
ND
S
BALANCE PERF O RMANCE W IT HO UT VISIO N
ST DT
BT AT
EVALUAT IO N
1
2
3
4
5
6
7
8
9
10
11
12T
IME
IN
SE
CO
ND
S
G AIT PERF O RMANCE IN DUAL T ASK (HAND T ASK)
ST DT
BT AT
EVALUAT IO N
0,086
0,088
0,090
0,092
0,094
0,096
0,098
0,100
0,102
0,104
0,106
0,108
0,110D
IST
AN
CE
G AIT PERF O RMANCE IN DUAL T ASK (VERBAL F LUENCY)
ST DT
BT AT
EVALUAT IO N
0,075
0,080
0,085
0,090
0,095
0,100
0,105
0,110D
IST
AN
CE
G AIT PERF O RMANCE IN DUAL T ASK (HAND T ASK)
CO ND 1 CO ND 2
BT AT
EVALUAT IO N
65
66
67
68
69
70
71
72
73
74
75
76
77N
UM
BE
R O
F S
TE
PS
G AIT PERF O RMANCE IN DUAL-T ASK (VERBAL F LUENCY)Curren t e ffect: F (1 , 8 )=69,704 , p=,00003
CO ND 1 CO ND 2
BT AT
EVALUAT IO N
60
62
64
66
68
70
72
74
76
78
80
82
84N
UM
BE
R O
F S
TE
PS
PERF O RMANCE IN BEST
BT AT
EVALUAT IO N
28,0
28 ,5
29 ,0
29 ,5
30 ,0
30 ,5
31 ,0
31 ,5M
EA
N S
CO
RE
CONCLUSION
• MCT was found to be efficient for improving balance and gait performance in dual task condition for elderly.
IMPLICATIONS
• Balance and gait performance in elderly can be improved by stimulating automatic control through training which combines both motor and cognitive tasks.