BACKGROUND
Cognitive-motor dual-task (CMDT) is defined as the parallel processing of motor (e.g., gait) and cognitive (e.g., executive functions) activity and is an essential ability in our daily life. Older adults living with frailty, chronic conditions (e.g., neurodegenerative diseases), or multimorbidity pay high costs during CMDT. This can have serious consequences on the health and safety of older people with chronic age-related conditions. However, CMDT rehabilitation can provide useful and effective therapies for these patients, particularly if delivered through technological devices.
OBJECTIVE
This review aims at describing the current technological applications, CMDT rehabilitative procedures, target populations, condition assessment, and efficacy/effectiveness of technology assisted CMDT rehabilitation in chronic age-related conditions.
METHODS
We performed this systematic review following PRISMA guidelines on three databases (Web of Science, Embase, PubMed). Original articles in English involving older adults (65+) with one or more than a chronic condition and/or frailty that tested, with a clinical trial, a technology assisted CMDT rehabilitation against a control condition were included. Risk of bias (Cochrane tool) and rating of included trials on the efficacy-effectiveness spectrum (RITES tool) were used to evaluate the included studies.
RESULTS
A total of 1097 papers were screened, and eight studies met the predefined inclusion criteria for this review. Target conditions for technology assisted CMDT rehabilitation included Parkinson’s disease and dementia. However, little information regarding multimorbidity, chronicity, or frailty status is available. The primary outcomes included falls, balance, gait parameters, dual-task performance, and executive functions/attention. CMDT technology mainly consisted of a motion tracking system combined with virtual reality. CMDT rehabilitation involved different types of tasks (e.g., obstacle negotiation, CMDT exercises). Compared to control conditions, CMDT training was found to be pleasant, safe, and effective particularly for dual-task performances, falls, gait, and cognition and the effects were maintained also at mid-term follow-ups.
CONCLUSIONS
Despite further research being mandatory, technology assisted CMDT rehabilitation is a promising method to enhance motor-cognitive functions in older people with chronic conditions.
CLINICALTRIAL
PROSPERO registration number: CRD42022329783