Balance and Mobility Training With or Without Simultaneous Cognitive Training Reduces Attention Demand But Does Not Improve Obstacle Clearance in Older Adults

in Motor Control

Click name to view affiliation

Deborah A.M. JehuUniversity of Ottawa

Search for other papers by Deborah A.M. Jehu in
Current site
Google Scholar
PubMed
Close
*
,
Nicole PaquetUniversity of Ottawa

Search for other papers by Nicole Paquet in
Current site
Google Scholar
PubMed
Close
*
, and
Yves LajoieUniversity of Ottawa

Search for other papers by Yves Lajoie in
Current site
Google Scholar
PubMed
Close
*
Restricted access

The purpose of this study was to determine whether balance and mobility training (BMT) or balance and mobility plus cognitive training (BMT + C) would improve obstacle clearance and reaction time (RT); whether further improvements would be exposed in the BMT + C group relative to the BMT group; and whether possible improvements would be sustained at the follow-up. Healthy older adults were allocated to the BMT (n = 15; age: 70.2 ± 3.2), BMT + C (n = 14; age: 68.7 ± 5.5), or control group (n = 13; age: 66.7 ± 4.2). The BMT and BMT + C groups trained one-on-one, three times per week for 12 weeks on a balance obstacle course. The BMT + C group also completed cognitive training. Participants walked onto and over six obstacles of varying heights while completing no RT, simple RT, and choice RT tasks at baseline, posttraining, and at the 12-week follow-up. Both the BMT and BMT + C groups improved RT and maintained these improvements at the follow-up. No meaningful improvements in obstacle clearance emerged following training. Thus, dual-task balance training likely reduces attention demand.

Jehu and Lajoie are with the School of Human Kinetics, University of Ottawa, Ottawa, Ontario, Canada. Paquet is with the School of Rehabilitation Sciences, University of Ottawa, Ottawa, Ontario, Canada.

Address author correspondence to Yves Lajoie at ylajoie@uottawa.ca.
  • Collapse
  • Expand
  • Austin, G.P., Garrett, G.E., & Bohannon, R.W. (1999). Kinematic analysis of obstacle clearance during locomotion. Gait & Posture, 10, 109120. PubMed doi:10.1016/S0966-6362(99)00022-3

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Baddeley, A.D., & Hitch, G.J. (1974). Working memory. In G.A. Bower (Ed.), Recent advances in learning and motivation (pp. 4789). New York, NY: Academic Press.

    • Search Google Scholar
    • Export Citation
  • Barrett, R.S., Mills, P.M., & Begg, R.K. (2010). A systematic review of the effect of ageing and falls history on minimum foot clearance characteristics during level walking. Gait & Posture, 32, 429435. PubMed doi:10.1016/j.gaitpost.2010.07.010

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Begg, R.K., Best, R., Dell’Oro, L., & Taylor, S. (2007). Minimum foot clearance during walking: Strategies for the minimisation of trip-related falls. Gait & Posture, 25, 191198. PubMed doi:10.1016/j.gaitpost.2006.03.008

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Berg, W.P., Alessio, H.M., Mills, E.M., & Tong, C. (1997). Circumstances and consequences of falls in independent community-dwelling older adults. Age and Ageing, 26, 261268. PubMed doi:10.1093/ageing/26.4.261

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Brown, L.A., McKenzie, N.C., & Doan, J.B. (2005). Age-dependent differences in the attentional demands of obstacle negotiation. The Journals of Gerontology: Series A, Biological Sciences & Medical Sciences, 60, 924927. PubMed doi:10.1093/gerona/60.7.924

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Chen, H.C., Ashton-Miller, J.A., Alexander, N.B., & Schultz, A.B. (1991). Stepping over obstacles: Gait patterns of healthy young and old adults. The Journals of Gerontology, Series A: Biological Sciences & Medical Sciences, 46, 196203. PubMed doi:10.1093/geronj/46.6.M196

    • Search Google Scholar
    • Export Citation
  • Chen, H.C., Schultz, A.B., Ashton-Miller, J.A., Giordani, B., Alexander, N.B., & Guire, K.E. (1996). Stepping over obstacles: Dividing attention impairs performance of old more than young adults. The Journals of Gerontology, Series A: Biological Sciences and Medical Sciences, 51, M116M122. PubMed doi:10.1093/gerona/51A.3.M116

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Chou, L., & Draganich, L.F. (1998). Placing the trailing foot closer to an obstacle reduces flexion of the hip, knee, and ankle to increase the risk of tripping. Journal of Biomechanics, 31, 685691. PubMed doi:10.1016/S0021-9290(98)00081-5

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Folstein, M., Folstein, S.E., & McHugh, P.R. (1975). “Mini-mental state”: A practical method for grading the cognitive state of patients for the clinician. Journal of Psychiatric Research, 12, 189198. PubMed doi:10.1016/0022-3956(75)90026-6

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Forner-Cordero, A., Garcia, V.D., Rodrigues, S.T., & Duysens, J. (2016). Obstacle crossing differences between blind and blindfolded subjects after haptic exploration. Journal of Motor Behavior, 48, 468478 PubMed doi:10.1080/00222895.2015.1134434

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Hortobagyi, T., Lesinski, M., Gabler, M., Jessie, M., VanSwearingen, J.M., Malatesta, D., & Granacher, U. (2015). Effects of three types of exercise interventions on healthy old adults’ gait speed: A systematic review and meta-analysis. Sports Medicine, 45, 16271643. PubMed doi:10.1007/s40279-015-0371-2

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Jehu, D.A., Desponts, A., Paquet, N., & Lajoie, Y. (2015). Prioritizing attention on a reaction time task improves postural control and reaction time. International Journal of Neuroscience, 125, 100106. PubMed doi:10.3109/00207454.2014.907573

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Jehu, D.A., Lajoie, Y., & Paquet, N. (in press). Improvements in obstacle clearance parameters and reaction time over a series of obstacles revealed after 5 repeated testing sessions in older adults. Motor Control.

    • Search Google Scholar
    • Export Citation
  • Jehu, D.A., Paquet, N., & Lajoie, Y. (2017a). Balance and mobility training with or without concurrent cognitive training improves the timed up & go (TUG), TUG cognitive and TUG manual in healthy older adults. Aging Clinical and Experimental Research, 29, 711720. doi:10.1007/s40520-016-0618-2

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Jehu, D.A., Paquet, N., & Lajoie, Y. (2017b). Balance and mobility training with or without concurrent cognitive training does not improve posture but improves reaction time in healthy older adults. Gait & Posture, 52, 227232. doi:10.1016/j.gaitpost.2016.12.006

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Lajoie, Y., Jehu, D.A., Richer, N., & Tran, Y. (2016). Reaction time is slower when walking at a slow pace in young adults. Journal of Motor Behavior, 48, 153154. PubMed doi:10.1080/00222895.2015.1056767

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Lamoureux, E., Sparrow, W.A., Murphy, A., & Newton, R.U. (2003). The effects of improved strength on obstacle negotiation in community-living older adults. Gait & Posture, 17, 273283. PubMed doi:10.1016/S0966-6362(02)00101-7

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Lezak, M.D., Howieson, D.B., Bigler, E.D., & Tranel, D. (2012). Neuropsychological assessment (5th ed.). New York, NY: Academic Press.

  • Li, K.Z., Roudaia, E., Lussier, M., Bherer, L., Leroux, A., & McKinley, P.A. (2010). Benefits of cognitive dual-task training on balance performance in healthy older adults. The Journals of Gerontology, Series A: Biological Sciences & Medical Sciences, 65, 13441352. doi:10.1093/gerona/glq151

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Lim, H.S., & Yoon, S. (2014a). The influence of short-term aquatic training on obstacle crossing in gait by the elderly. Journal of Physical Therapy Science, 26, 12191222. doi:10.1589/jpts.26.1219

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Lim, H.S., & Yoon, S. (2014b). The training and detraining effects of 8 weeks of water exercise on obstacle avoidance in gait by the elderly. Journal of Physical Therapy Science, 26, 12151218. doi:10.1589/jpts.26.1215

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Makizako, H., Furuna, T., Shimada, H., Ihira, H., Kimura, M., Uchiyama, E., & Oddsson, L.I. (2010). Association between a history of falls and the ability to multi-task in community dwelling older people. Aging Clinical and Experimental Research, 22, 427432. doi:10.1007/BF03337738

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Marusic, U., Giordani, B., Moffat, S.D., Petrič, M., Dolenc, P., Pišot, R., & Kavcic, V. (2016). Computerized cognitive training during physical inactivity improves executive functioning in older adults. Neuropsychology, Development, and Cognition. Section B, Aging, Neuropsychology and Cognition, 121. Advance online publication. doi:10.1080/13825585.2016.1263724

    • Search Google Scholar
    • Export Citation
  • McFadyen, B.J., & Carnahan, H. (1997). Anticipatory locomotor adjustments for accommodating versus avoiding level changes in humans. Experimental Brain Research, 114(3), 500506. PubMed doi:10.1007/PL00005659

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Mohagheghi, A.A., Moraes, R., & Patla, A.E. (2004). The effects of distant and on-line visual information on the control of approach phase and step over an obstacle during locomotion. Experimental Brain Research, 155(4), 459468. PubMed doi:10.1007/s00221-003-1751-7

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Pan, H.F., Hsu, H.C., Chang, W.N., Renn, J.H., & Wu, H.W. (2016). Strategies for obstacle crossing in older adults with high and low risk of falling. Journal of Physical Therapy Science, 28(5), 16141620. PubMed doi:10.1589/jpts.28.1614

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Parasuraman, R. (1998). The attentive brain: Issues and prospects. In R. Parasurament (Ed.), The attentive brain. (pp. 187424) Cambridge, MA: MIT Press.

    • Search Google Scholar
    • Export Citation
  • Plummer-D’Amato, P., Cohen, Z., Daee, N.A., Lawson, S.E., Lizotte, M.R., & Padilla, A. (2012). Effects of once weekly dual-task training in older adults: A pilot randomized controlled trial. Geriatrics & Gerontology International, 12, 622629. doi:10.1111/j.1447-0594.2011.00825.x

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Sparrow, W.A., Shinkfield, A.J., Chow, S., & Begg, R.K. (1996). Characteristics of gait in stepping over obstacles. Human Movement Science, 15, 605622. doi:10.1016/0167-9457(96)00022-X

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Stobach, T., Frensch, P., Hermann, M., & Schubert, T. (2012a). Age- and practice-related influences on dual-task costs and compensation mechanisms under optimal conditions of dual-task performance. Aging, Neuropsychology, and Cognition, 19, 222247. doi:10.1080/13825585.2011.630973

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Stobach, T., Frensch, P., Hermann, M., & Schubert, T. (2012b). Testing the limits of optimizing dual-task performance in younger and older adults. Frontiers in Human Neuroscience, 6, 112. doi:10.3389/fnhum.2012.00039

    • Search Google Scholar
    • Export Citation
  • Tinetti, M., Doucette, J., Claus, E., & Marottoli, R. (1995). Risk factors for serious injury during falls by older persons in the community. Journal of the American Geriatrics Society, 43, 12141221. PubMed doi:10.1111/j.1532-5415.1995.tb07396.x

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Tombu, M., & Jolicoeur, P. (2005). Testing the predictions of the central capacity sharing model. Journal of Experimental Psychology: Human Perception and Performance, 31, 790802. PubMed

    • Search Google Scholar
    • Export Citation
  • Weerdesteyn, V., Rijken, H., Geurts, A.C., Smits-Engelsman, B.C., Mulder, T., & Duysens, J. (2006). A five-week exercise program can reduce falls and improve obstacle avoidance in the elderly. Gerontology, 52, 131141. PubMed doi:10.1159/000091822

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Woollacott, M., & Shumway-Cook, A. (2002). Attention and the control of posture and gait: A review of an emerging area of research. Gait & Posture, 16, 114. PubMed doi:10.1016/S0966-6362(01)00156-4

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Zhang, C., Mao, D., Riskowski, J.L., & Song, Q. (2011). Strategies of stepping over obstacles: The effects of long-term exercise in older adults. Gait & Posture, 34, 191196. PubMed doi:10.1016/j.gaitpost.2011.04.008

    • Crossref
    • Search Google Scholar
    • Export Citation
All Time Past Year Past 30 Days
Abstract Views 2330 1456 141
Full Text Views 31 3 0
PDF Downloads 26 4 0