Effects of an In-home Multicomponent Exergame Training on Physical Functions, Cognition, and Brain Volume of Older Adults: A Randomized Controlled Trial.

Author: Adcock M1, Fankhauser M1, Post J1, Lutz K2, Zizlsperger L2, Luft AR2,3, Guimarães V4, Schättin A1, de Bruin ED1,5
1Institute of Human Movement Sciences and Sport, Department of Health Sciences and Technology, ETH Zurich, Zurich, Switzerland.
2Cereneo, Center for Neurology and Rehabilitation, Vitznau, Switzerland.
3Department of Neurology, University Hospital of Zurich, Zurich, Switzerland.
4Fraunhofer Portugal AICOS, Porto, Portugal.
5Division of Physiotherapy, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden.
Conference/Journal: Front Med (Lausanne).
Date published: 2020 Jan 28
Other: Volume ID: 6 , Pages: 321 , Special Notes: doi: 10.3389/fmed.2019.00321. eCollection 2019. , Word Count: 350

Aging is associated with a decline in physical functions, cognition and brain structure. Considering that human life is based on an inseparable physical-cognitive interplay, combined physical-cognitive training through exergames is a promising approach to counteract age-related impairments. The aim of this study was to assess the effects of an in-home multicomponent exergame training on [i] physical and cognitive functions and [ii] brain volume of older adults compared to a usual care control group. Thirty-seven healthy and independently living older adults aged 65 years and older were randomly assigned to an intervention (exergame training) or a control (usual care) group. Over 16 weeks, the participants of the intervention group absolved three home-based exergame sessions per week (à 30-40 min) including Tai Chi-inspired exercises, dancing and step-based cognitive games. The control participants continued with their normal daily living. Pre- and post-measurements included assessments of physical (gait parameters, functional muscle strength, balance, aerobic endurance) and cognitive (processing speed, short-term attention span, working memory, inhibition, mental flexibility) functions. T1-weighted magnetic resonance imaging was conducted to assess brain volume. Thirty-one participants (mean age = 73.9 ± 6.4 years, range = 65-90 years, 16 female) completed the study. Inhibition and working memory significantly improved post-intervention in favor of the intervention group [inhibition: F (1) = 2.537, p = 0.046, n p 2 = 0.11, working memory: F (1) = 5.872, p = 0.015, n p 2 = 0.02]. Two measures of short-term attentional span showed improvements after training in favor of the control group [F(1) = 4.309, p = 0.038, n p 2 = 0.03, F (1) = 8.504, p = 0.004, n p 2 = 0.04]. No significant training effects were evident for physical functions or brain volume. Both groups exhibited a significant decrease in gray matter volume of frontal areas and the hippocampus over time. The findings indicate a positive influence of exergame training on executive functioning. No improvements in physical functions or brain volume were evident in this study. Better adapted individualized training challenge and a longer training period are suggested. Further studies are needed that assess training-related structural brain plasticity and its effect on performance, daily life functioning and healthy aging.

Copyright © 2020 Adcock, Fankhauser, Post, Lutz, Zizlsperger, Luft, Guimarães, Schättin and de Bruin.

KEYWORDS: brain volume; cognition; exergame; healthy aging; physical functions; physical-cognitive training

PMID: 32047751 PMCID: PMC6997483 DOI: 10.3389/fmed.2019.00321