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Table 1 A Summary of studies (n = 19) examining the effect of physical exercise intervention on cognitive and motor functions in older adults

From: The beneficial effects of different types of exercise interventions on motor and cognitive functions in older age: a systematic review

Study
(Authors/Year/Ref.)
Intervention Training protocol Demographic properties Endpoint outcomes
Group Number of participants/Female Age Mean (SD) years
Berryman et al., 2014 [82] 3 groups:
Combined aerobic and strength lower body (LBS-A),
Combined aerobic and strength upper body (UBS-A)
Gross motor activities (GMA).
All groups received training 3 times/week for 8 weeks.
LBS-A and UBS-A: 60 min of strength exercises followed by 20-min cycling at 60–65% of max aerobic power.
GMA: 60 min exercises of flexibility, walking & ball manipulation.
LBS-A
UBS-A
GMA
16/9
15/8
16/12
69.8 (3.9)
69.5 (6.1)
72.7 (6.3)
Motor: Significant gains on TUG, chair stands, walking speed (10MWT) walking distance (6MWT), and grip strength for LSB-A and USB-A groups. No significant gains for GMA group. Significant group differences in pre/post gains (LBS-A and UBS-A > GMA).
Cognitive: Significant gains on both inhibition and working memory elements of the RNG in dual-task conditions (walking at different speeds). Significant gains on the inhibition elements of the RNG in single task condition (rest) for all three groups. No significant group differences in pre/post gains.
de Bruin et al., 2013 [83] 2 groups:
Combined motor- cognitive training (M-CG)
Motor training alone (MG)
M-CG and MG: 45 min of combined strength & balance training; twice a week for 12 weeks.
M-CG: additional 10 min training of divided and selective attention abilities; 3–5 times/week for10 weeks.
M-CG
MG
7/5
6/3
> 65NA Motor: Significant decrease in hand reaction time for both M-CG and MG but no group differences. M-CG also showed significant decrease in foot reaction time. No significant group differences in pre/post gains.
Cognitive: Both groups showed significant reduce in dual task cost but effects were more prominent for M-CG than for MG. No significant group differences in pre/post gains.
Falbo et al., 2016 [84] 2 groups:
Physical single task training (STG)
Physical-cognitive dual task training (DTG)
STG and DTG: 60 min of combined physical training (aerobic, balance, resistance, and stretching); twice a week, for 12 weeks.
DTG: participants received continuous perceptual-motor cues to adapt their motion patterns during training.
STG
DTG
16/14
20/18
73.7 (4.5)
71.5 (6.7)
Motor: Significant gains on gait stability for both STG and DTG. No significant changes in mean gait speed, mean stride time, and mean stride length. No significant group differences in pre/post gains.
Cognitive: Marginal gain on the inhibition elements of the RNG task for DTG. Significant decrease of inhibitory performance for STG. No significant group differences in pre/post gains. No significant gains in dual task cost for both groups.
Fragala et al., 2014 [85] 2 groups:
Resistance exercise (RE)
Passive Control (PC).
RG: 7–8 sets for upper and lower limb musculatures at moderate intensity with 8–15 repetition per set; twice a week, for 6 weeks.
PCG: No intervention.
RE
PC
13NA
12NA
70.6 (6.1)NA Motor: Likely beneficial effects (probability >75%) on reaction time (76%) and response time (80%) and unclear beneficial effect on movement time (61%) for RE group. No pre/post differences for PC group.
Cognitive: Likely beneficial effect (85%) in spatial awareness (Neurotracker threshold speed), indicating possible gains on attention and processing speed for RE group. No pre/post differences for PC group.
Granacher et al., 2010 [86] 2 groups:
Balance training (BT)
Passive Control (PC).
BTG: 60 min session of postural stabilization tasks (including warmup and cooldown on a bicycle ergometer); 3 sessions per week for 6 weeks.
PCG: No intervention.
BT
PC
11/7
9/7
72
(5.0)
75
(6.0)
Motor: Significant gains on gait stability but not gait velocity for BT group in FES-I. No pre/post differences for PC group. Significant Group x Time interaction.
Cognitive: Significant gains on dual task cost of the secondary motor task but not for cognitive interference task (subtraction mistakes made during the task) for BT group. No pre/post differences for PC group. Significant Group x Time interaction.
Hackney et al., 2015 [87] 2 groups:
90 min Tango classes (TG)
90 min Health education classes (HEG).
Both groups underwent 20 classes over 12 weeks.
TG: 20-min standing warm-up followed by 70 min dance exercise.
HEG: 90-min seminar classes at local university.
TG
HEG
62/48
12/5
82.3 (8.8)
84.1 (7.9)
Motor: Significant gains on mobility (Four Square Step, backward gait, and gait speeds) but not balance (Berg Balance Scale) for TG. Significant gains on backward gait speed but not for outcome measures for HEG. All gains maintained 3 months after the intervention.
Cognitive: Neither group showed any gains on processing speed, working memory, or attention. Cognitive assessments included: Montreal Cognitive Assessment, the Reverse & Corsi Blocks, the Brooks Spatial Task, and the Trail-Making Test (TMT) Part B.
Hamacher et al., 2015 [88] 2 groups:
90 min Dancing session (DG)
90 min Health-related exercise session (HRG).
Both group receive training twice a week for 6 months. Training included 15 min of warm-up and 15 min of cool-down, stretching, and relaxation.
DG: learning choreographies of five different dance genres.
HRG: 60 min session of combined endurance, strength-endurance, and flexibility training.
DG
HRG
19/11
16/10
67.2
(3.4)
68.5
(3.1)
Motor: Both groups showed significant gains on mobility but pre/post effects were mixed across group: (i) significant increase of gait speed for DG and (ii) significant decrease of gait variability for HRG. Main effect for GROUP and the GROUP × TIME interaction were not significant for neither outcome measures.
Cognitive: Significant gains on performance of a serial three subtractions test while walking (shorter successive-subtraction times and higher correct answer counts on) and dual-task cost for DG. No pre/post differences for HRG. No significant gains on dual task cost for both groups.
Iuliano et al., 2015 [89] 4 groups:
Resistance (RG),
Cardiovascular (CVG)
Postural (PG)
Passive control (CG).
Exercises were performed over the course of 12 weeks.
RG: 30 min session of high intensity strength training for 6 muscle groups.
CVG: 30 min session of high intensity CVG training on ergometer machines
PG: 20 min session of flexibility, core-stability and respiratory exercises.
CG: No intervention
RG
CVG
PG
CG
20/11
20/12
20/13
20/12
65.8
(6.3)
68.4
(6.4)
(66.7)
(5.8)
66.5
(6.3)
Motor: Assessment test battery: (i) 1MWT for mobility, (ii) 1RM of shoulder, arm, leg, back, chest, and abdomen muscles for strength and (iii) SBST for balance. RG: significantly gains on 1RM test for all six muscles and marginal gains on SBST but not on 1MWT. CVG: significantly gains on 1MWT but not on 1RM and SBST. PG: significant gain on SBST but not on 1MWT and 1RM. CG: no gains on all elements of the test battery.
Cognitive: Assessment test battery: AMT, RPMT, Stroop test), TMT, and Drawing Copy Test. RG: significantly gains on Time element of the Drawing Copy Test but not on AMT, RPMT, Stroop test and TMT. CVG: significant gains on all elements of the RPMT and the target element of AMT but not on elements of the Stroop test and TMT. PG and CG: no significant gains on all elements of the cognitive test battery.
Kamegaya et al., 2014 [90] 2 groups:
Physical and Leisure Activity intervention (INT)
Passive control (CG)
INT: a weekly 2-h intervention for 12 weeks.
45 min of combined physical training (muscle-stretching & aerobic exercise) followed by leisure activities such as cooking, handcrafts, and competitive-games.
CG: No intervention.
INT
CG
26/242
26/232
73.6a (5.6)
76.2a (6.1)
2Post intervention analysis was conducted with 19 participants in INT group and 20 participants in PCG.
Motor: Motor assessment included (i) grip test for strength and (ii) time up-and-go, 5-m maximum walking times test, and functional reach test for mobility. No significant gains on all elements of strength and mobility were observed for neither group.
Cognitive: Cognitive assessment included the Five-Cog test for evaluation of attention, memory, visuospatial function, language, and reasoning. Significant Group differences on the reasoning ability element, with significant gains observed only for INT group. Both groups showed significant gains on attention and memory items and the Wechsler Digit Symbol Substitution.
Leon et al., 2015 [91] 3 groups:
Physical exercise (PE),
Combined physical and cognitive (PE-C) and
Passive control (CG)
PE and PE-C received 60 min training sessions twice a week for 12 weeks.
PE: Combined physical training (warmup, strength, aerobic, and relaxation).
PE-C: physical training (as PE group) combined with psychomotor tasks, dual tasks, and memory tasks.
CG: No intervention
PE
PE-C
CG
46/38
56/51
35/17
72.6 (5.0)
70.5 (5.5)
71.1 (6.2)
Motor: assessment was based on RT and MT measures of the simple element of the VTS. PC-E and PE and PE-C: significant gains on both MT and RT. Pre/post gains were significantly higher for PC-E than PE and CG (all effects: p < .01). Note: CG showed significant gain (p < .01) on MT in choice but not simple element of VST.
Cognitive: assessment was based on the choice RT element of the VTS (=high cognitive involvement) as an indicator for gains on processing speed, attention, and dual-task cost. PC-E: significant gains on RT in both simple and choice elements of VTS. PE: significant gains on RT only in the simple element of VTS. Pre/post gains were significantly higher for PC-E than PE and CG. GC: no significant gains.
Maki et al., 2012 [92] 2 groups:
Community-based walking-program (CBW)
Health education classes (HEG)
CBW: 90-min intervention once a week for 12 weeks.
30-min exercise period and 60-min group work.
Participants in CBW group planned and executed walking events (excursion) with other group members.
HEG: received educational lectures on food, nutrition, and oral care.
CBW
HEG
75/522
75/542
71.9a
(4.1)
72.0a
(3.9)
2Post intervention analysis was conducted with 66 participants in CBW group and 67 participants in HEG.
Motor: both CBW and HEG showed significant gains on Timed Up and Go and Walking Speed. HEG showed significant gain on Grip Force (all effects: p < .001). No significant group differences.
Cognitive: Both CBW and HEG showed significant gains on elements of the Dual task test, Delayed recall test, Digit-Symbol Substitution test, and Yamaguchi Kanji-Symbol Substitution Test (all, p ≤ .008). Only CBW group improved on Categorical word fluency (p = .003).
Marmeleira et al., 2009 [93] 2 groups:
Exercise group (EG)
Passive control group (CG)
EG: 60 min exercise of physical (aerobic) and cognitive (psychomotor, dual-tasking, problem solving. 3 days a week for 12 weeks.
CG: No intervention
EG
CG
16/3
16/4
68.4 (6.7)
68.2 (6.5)
Motor: Significant gains on RT, MT, and response time in simulated driving scenarios under single and dual task conditions for EG. No gains on all elements for CG. Between groups differences were found for MT and response time in single task and RT and response time in dual task.
Cognitive: Significant gains on speed of visual processing, but not in divided attention, selective attention, or Stroop (neither incongruent, nor interference scores) for EG. No significant gains for CG. Between groups differences were found only for speed of visual processing.
Schoene et al., 2013 [94] 2 groups:
Home-based step-training intervention of Dance-Dance Revolution video game (DDR)
Passive control (CG)
DDR: Training for a recommended time of 15–20 min, 2–3 times per week for 8 weeks.
CG: No intervention
DDR
CG
15NA
17NA
77.5
(4.5)
78.4
(4.5)
Motor: assessments were based on elements of the PPA test battery for fall risk, CSRT, TUG, 5STS, and ATS. DDR: significant gains on CSRT and balance control. No significant gains were observed for mobility and strength. CG: no significant gains.
Cognitive: assessments were based on elements of TMT; parts A and B and dual task performance (verbal fluency during TUG). IG: gain on dual-task ability. No significant gains on all elements of TMT. CG: no significant gains.
Smiley-Oyen et al., 2008 [95] 2 groups:
Cardiovascular training (CARDIO)
Strength, Flexibility & Balance training (FLEX-TONE).
Both groups trained 3 times per week for 10 months.
CARDIO: 25–30 min of aerobic training at 45–60% of HRR.
FLEX-TONE: 25–30 min of yoga, Tai Chi, Flex bands, free hand weights, and stability balls.
CARDIO
FLEX-TONE
28/21
29/20
69.9
(4.6)
70.5 (4.5)
Neurocognitive test battery was administered: (i) RT tests (simple, choice & Go-NoGo), (ii) Stroop test (Word, Color, and Word–
Color conflict), and (iii) WCST.
Motor: No significant gains on simple/choice reaction times for both groups.
Cognitive: Significant gain for CARDIO group and marginal gain for the FLEX-TONE group on RT of the Word–Color conflict element of the Stroop test. Significant gain for CARDIO on error scores of the Word–Color conflict element of the Stroop (p < .05). Neither group showed significant gains on the other elements of the neurocognitive assessment tests.
Theill et al., 2013 [96] 3 groups:
Aerobic-Cognitive (A-CG),
Single Cognitive (S-CG),
Passive Control (CG).
A-CG and S-CG participated in 1.5-2 h training sessions twice a week for 10 weeks.
A-CG: Cognitive test battery followed by a motor-cognitive dual task while walking +40 min aerobic training (60–80% HHR).
S-CG: Cognitive test battery, followed by motor-cognitive dual task while sitting.
A-CG
S-CG
CG
18/FNA
12/FNA
21/FNA
72.4 (4.2)
73.3 (6.1)
70.9 (4.8)
Motor: gait performance was assessed under single- and dual-task conditions while performing a working memory task. Both training groups (A-CG and S-CG) showed significant gains on gait step-to-step variability during dual task but not during single task. CG: no gains.
Cognitive: test battery consisted of six computer-based tests to assess for: selective attention, paired-associates learning, executive control, reasoning (Standard Progressive Matrices test), memory span, and information processing speed (Wechsler DSST). Both training groups (A-CG and S-CG) showed significant gains on elements of the executive control task and the Paired Associates task (both involve strong elements of working memory) but not in other elements of test battery. CG: no gains.
van het Reve & de Bruin, 2014 [97] 2 groups:
Stability-Balance training (SB),
Stability-Balance-Cognitive training (SB-C).
SB: 30 min progressive resistance training and 10 min balance training, twice a week for 12 weeks.
SB-C: Received in addition to SB training a cognitive training, with the CogniPlus [REF] training program 3 times a week for 10 min.
SB
SB-C
98/FNA
84/FNA
81.9a
(6.3)
81.1a
(8.3)
Post intervention analysis was conducted with 77 participants in SB group and 74 participants in SB-C group.
Motor: Significant gain on performances of balance, gait initiation, chair rise, and simple RT for both groups. No significant group differences were observed.
Cognitive: Significant gain on (i) dual task cost of step length (in both preferred walking speed and fast walking speed) and (ii) dual task costs of the standard deviation of step length for SB-C. Significant gains on attention and processing speed (as estimated with TMT parts A and B) for both groups. No group differences.
Vaughan et al. 2014 [98] 2 groups:
Combined Strength-Aerobic-Balance training (CTG)
Passive Control (CG)
CTG: 60-min class session, twice a week, for 16 weeks. Each session included cardiovascular, strength and motor fitness (balance, co-ordination, flexibility and agility) training + warm-up/cool-down routine.
CG: received no training but were on a waiting list to attend the 16-week program.
CTG
CG
25/25
24/24
69.0 (3.1)
68.8 (3.5)
Motor: Significant gains for CTG on mobility (6MWT, TUG, One-legged Stance test) and hand and foot simple RT. Group differences were significant only for simple RT of the right foot.
Cognitive: Significant gains for CTG on dual task cost and on all elements of cognitive tests (TMT A and B tests, COAST,Word-Interference and Total time measures, and Controlled Oral Word Association Test measures). Group differences were not significant or marginal.
Williamson et al., 2009 [99] 2 Groups:
Combined Strength-Aerobic-Balance-Flexibility training (CTG)
Successful Aging health education (SAG).
A 12 mounts intervention program for both groups.
CTG: Three center-based exercise sessions (40–60 min) per week for the first two mounts. 2 center-based training and 3 or more home-based training per week for the 4 next mounts. 150 min home-based training for the remaining time.
SAG: Meeting sessions on health related topics. Weekly meetings for the first 26 weeks followed by monthly meetings.
CTG
SAG
50/36
52/36
76.8 (4.4)
78.1 (4.1)
A complete set of endpoint measurements was conducted on 92 participants (44 CTG and 48 SAG). Only neurocognitive outcome measures (DSST, Rey Auditory Verbal Learning Test, Modified MMSE, and Stroop) and correlations between neurocognitive measures and physical performance measures consisted of SPPB for Grip, Chair stand, Balance, Gait Speed were reported.
Cognitive: CTG slightly improved on the DSST but group differences were not significant.
Correlations between neurocognitive Physical performance gains for CTG: Post intervention DSST scores (in both groups) significantly correlated with improvements on the Short Physical Performance Battery score (r = .3, chair stand score (r = .26, and balance score (r = .21) but not grip force and gait speed. The Stroop test was marginally associated with the balance score (r = − .20).
Yamada et al., 2011 [100] 2 Groups:
Strength -Balance-Flexibility training combined with Aerobic stepping exercise in single task (ST) or dual task (DT) conditions.
One training session per week for 24 weeks. Both groups received 20 min of moderate-intensity aerobic exercise (seated stepping), 20 min of progressive strength training, and 10 min of flexibility and balance exercises while seated. Participants in DT were asked to perform a verbal fluency task during seated stepping exercise. ST
DT
26/FNA
26/FNA
>65
>65
Motor: DT demonstrated significant gains on functional mobility tests (10-m gait speed, 10-m walking cadence) as compared to ST. No significant gains on outcome measures of TUG and functional reaching task were observed.
Cognitive: DT demonstrated significant gains on dual task cost of the cognitive task (counting numbers aloud in reverse order) during the functional test but group differences were not significant. No gains were observed for ST.
  1. aDemographic characteristics of trial participants available only after randomization; NA Information was not available
  2. 2refers to a smaller number of participants and described in the outcome column
  3. The bold type in the endpoint outcomes column represent the groups
  4. 1MWT One Mile Walk Test, 1RM One Repetition Maximum, 5STS Five Times Sit-Tostand, 6MWT Six Minutes Walk Test, 10MWT Ten Minutes Walk Test, AMT Attentive Matrices Test, ATS Alternate Step Test, COAST California Older Adult Stroop Test, CSRT Choice Stepping Reaction Time test, DSST Digit Symbol Substitution Test, FES-I Fall Efficacy International Test, MMSE Mini Mental State Examination, PPA Physiological Profile Assessment, MT Movement Time, RNG Random Number Generator Task, RPMT Revan’s Progressive Matrices Test, RT Reaction Time, SBST Stork Balance Stand Test, SPPB Short Physical Performance Battery, TMT Trail Making Test, TUG Time Up & Go test, VTS Vienna Test System, WCST Wisconsin Card Sort Test