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Brain Sci. 2017 Feb 10;7(2). pii: E19. doi: 10.3390/brainsci7020019.

Reducing Fall Risk with Combined Motor and Cognitive Training in Elderly Fallers.

Author information

1
Clinical and Behavioral Neurology Laboratory, IRCCS Fondazione Santa Lucia, Rome 00179, Italy. francesco.barban@gmail.com.
2
Berlin School of Mind and Brain, Humboldt-Universität zu Berlin, Berlin 10117, Germany. francesco.barban@gmail.com.
3
Clinical and Behavioral Neurology Laboratory, IRCCS Fondazione Santa Lucia, Rome 00179, Italy. r.annicchiarico@hsantalucia.it.
4
Engineering Ingegneria Informatica SpA, Rome 00185, Italy. matteo.melideo@eng.it.
5
Clinical and Behavioral Neurology Laboratory, IRCCS Fondazione Santa Lucia, Rome 00179, Italy. a.federici@hsantalucia.it.
6
Clinical and Behavioral Neurology Laboratory, IRCCS Fondazione Santa Lucia, Rome 00179, Italy. mg.lombardi@hsantalucia.it.
7
Clinical and Behavioral Neurology Laboratory, IRCCS Fondazione Santa Lucia, Rome 00179, Italy. s.giuli@hsantalucia.it.
8
Clinical and Behavioral Neurology Laboratory, IRCCS Fondazione Santa Lucia, Rome 00179, Italy. c.ricci@hsantalucia.it.
9
Clinical and Behavioral Neurology Laboratory, IRCCS Fondazione Santa Lucia, Rome 00179, Italy. f.adriano@hsantalucia.it.
10
Clinical and Behavioral Neurology Laboratory, IRCCS Fondazione Santa Lucia, Rome 00179, Italy. i.griffini@hsantalucia.it.
11
Clinical and Behavioral Neurology Laboratory, IRCCS Fondazione Santa Lucia, Rome 00179, Italy. silvestri-manuel@hotmail.it.
12
Clinical and Behavioral Neurology Laboratory, IRCCS Fondazione Santa Lucia, Rome 00179, Italy. massimochiusso@gmail.com.
13
Engineering Ingegneria Informatica SpA, Rome 00185, Italy. sergio.neglia@eng.it.
14
Hospital General de Granollers, Barcelona 8400, Spain. sarinoblasco@gmail.com.
15
Hospital General de Granollers, Barcelona 8400, Spain. rcuevas@fhag.es.
16
Social Policy Center, Municipality of Kifissia, Athens-Kifissia 14562, Greece. yannis_dionyssiotis@hotmail.com.
17
Frontida Zois Home Care Agency, Patras 25002, Greece. info@frontidazois.gr.
18
Municipality of Stari Grad, Belgrade 11000, Serbia. milo.kovacevic@starigrad.org.rs.
19
Geriatric Department, Hospital General Universitario Gregorio Marañón, Instituto de Investigación Sanitaria Gregorio Marañón, Madrid 28007, Spain. nmonterof@yahoo.es.
20
Benito Menni CASM, Sant Boi de Llobregat-Barcelona 08830, Spain. opino1@gmail.com.
21
Klinisk Informatik, Aarhus 8000, Denmark. niels.boye@kliniskinformatik.dk.
22
Knowledge Engineering & Machine Learning Group Computer Software Department, Universitat Politècnica de Catalunya-BarcelonaTech, Barcelona 08034, Spain. ia@lsi.upc.edu.
23
Knowledge Engineering & Machine Learning Group Computer Software Department, Universitat Politècnica de Catalunya-BarcelonaTech, Barcelona 08034, Spain. cbarrue@lsi.upc.edu.
24
Knowledge Engineering & Machine Learning Group Computer Software Department, Universitat Politècnica de Catalunya-BarcelonaTech, Barcelona 08034, Spain. atia.cm@gmail.com.
25
Docobo Ltd., Bookham, Leatherhead KT23 4AA, UK. Peter.Levene@docobo.co.uk.
26
Singular Logic, Athens 145 64, Greece. spantelopoulos@singularlogic.eu.
27
Elettronica Bio Medicale S.r.l., Foligno 06034, Italy. rosso@tesan.it.
28
Geriatric Department, Hospital General Universitario Gregorio Marañón, Instituto de Investigación Sanitaria Gregorio Marañón, Madrid 28007, Spain. joseantonio.serra@salud.madrid.org.
29
Facultad de Medicina, Universidad Complutense, CIBERFES, Madrid 28040, Spain. joseantonio.serra@salud.madrid.org.
30
The BioRobotics Institute, Scuola Superiore Sant'Anna, Pisa 56127, Italy. angelo.sabatini@sssup.it.
31
Clinical and Behavioral Neurology Laboratory, IRCCS Fondazione Santa Lucia, Rome 00179, Italy. c.caltagirone@hsantalucia.it.
32
Systems Medicine Department, University of Rome "Tor Vergata", Rome 00173, Italy. c.caltagirone@hsantalucia.it.

Abstract

BACKGROUND:

Falling is a major clinical problem in elderly people, demanding effective solutions. At present, the only effective intervention is motor training of balance and strength. Executive function-based training (EFt) might be effective at preventing falls according to evidence showing a relationship between executive functions and gait abnormalities. The aim was to assess the effectiveness of a motor and a cognitive treatment developed within the EU co-funded project I-DONT-FALL.

METHODS:

In a sample of 481 elderly people at risk of falls recruited in this multicenter randomised controlled trial, the effectiveness of a motor treatment (pure motor or mixed with EFt) of 24 one-hour sessions delivered through an i-Walker with a non-motor treatment (pure EFt or control condition) was evaluated. Similarly, a 24 one-hour session cognitive treatment (pure EFt or mixed with motor training), delivered through a touch-screen computer was compared with a non-cognitive treatment (pure motor or control condition).

RESULTS:

Motor treatment, particularly when mixed with EFt, reduced significantly fear of falling (F(1,478) = 6.786, p = 0.009) although to a limited extent (ES -0.25) restricted to the period after intervention.

CONCLUSIONS:

This study suggests the effectiveness of motor treatment empowered by EFt in reducing fear of falling.

KEYWORDS:

cognitive training; elderly; executive functions; fall risk; fear of falling; motor training

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