Group-based exercise combined with dual-task training improves gait but not vascular health in active older adults without dementia

Michael A Gregory; Dawn P Gill; Guangyong Zou; Teresa Liu-Ambrose; Ryosuke Shigematsu; Clara Fitzgerald; Vladimir Hachinski; Kevin Shoemaker; Robert J Petrella

doi:10.1016/j.archger.2015.11.008

Group-based exercise combined with dual-task training improves gait but not vascular health in active older adults without dementia

Arch Gerontol Geriatr. 2016 Mar-Apr:63:18-27. doi: 10.1016/j.archger.2015.11.008. Epub 2015 Dec 2.

Authors

Michael A Gregory¹, Dawn P Gill², Guangyong Zou³, Teresa Liu-Ambrose⁴, Ryosuke Shigematsu⁵, Clara Fitzgerald⁶, Vladimir Hachinski⁷, Kevin Shoemaker⁸, Robert J Petrella⁹

Affiliations

¹ Health & Rehabilitation Sciences, Faculty of Health Sciences, Western University, London, ON, Canada; Lawson Health Research Institute, London, ON, Canada. Electronic address: mgregor7@uwo.ca.
² Health & Rehabilitation Sciences, Faculty of Health Sciences, Western University, London, ON, Canada; Lawson Health Research Institute, London, ON, Canada; Department of Family Medicine, Schulich School of Medicine & Dentistry, Western University, ON, Canada; Department of Epidemiology, School of Public Health, University of Washington, Seattle, WA, USA. Electronic address: dawn.gill@uwo.ca.
³ Department of Epidemiology and Biostatistics, Schulich School of Medicine & Dentistry, Western University, London, ON, Canada; Robarts Clinical Trials, Robarts Research Institute, Western University, London, ON, Canada. Electronic address: gzou@robarts.ca.
⁴ Department of Physical Therapy, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada; Djavad Mowafaghian Centre for Brain Health, Vancouver, BC, Canada. Electronic address: teresa.ambrose@ubc.ca.
⁵ Faculty of Education, Mie University, Japan. Electronic address: rshige@edu.mie-u.ac.jp.
⁶ Canadian Centre for Activity and Aging, Faculty of Health Sciences, Western University, London, ON, Canada. Electronic address: cfitzge4@uwo.ca.
⁷ Department of Clinical Neurological Sciences, Schulich School of Medicine & Dentistry, Western University, London, ON, Canada. Electronic address: vladimir.hachinski@lhsc.on.ca.
⁸ Department of Kinesiology, Faculty of Health Sciences, Western University, London, ON, Canada. Electronic address: kshoemak@uwo.ca.
⁹ Health & Rehabilitation Sciences, Faculty of Health Sciences, Western University, London, ON, Canada; Lawson Health Research Institute, London, ON, Canada; Department of Family Medicine, Schulich School of Medicine & Dentistry, Western University, ON, Canada; Canadian Centre for Activity and Aging, Faculty of Health Sciences, Western University, London, ON, Canada; Department of Kinesiology, Faculty of Health Sciences, Western University, London, ON, Canada. Electronic address: petrella@uwo.ca.

PMID: 26791167
DOI: 10.1016/j.archger.2015.11.008

Abstract

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 [0.10mm (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.

Keywords: Dual-task training; Exercise; Gait; Group-based programs; Randomized controlled trial; Vascular health.

Publication types

Randomized Controlled Trial
Research Support, Non-U.S. Gov't

MeSH terms

Aged
Aged, 80 and over
Carotid Intima-Media Thickness*
Exercise / psychology
Exercise Therapy / methods*
Female
Gait / physiology*
Geriatric Assessment / methods*
Humans
Male
Motor Skills*
Physical Therapy Modalities
Postural Balance / physiology*
Residence Characteristics
Task Performance and Analysis
Treatment Outcome

Abstract

Publication types

MeSH terms

Grants and funding