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Table 1 Step training (dynamic balance, cognitive training)

From: The effect of interactive cognitive-motor training in reducing fall risk in older people: a systematic review

Study, sample size Intervention vs control (content, dose) Sample characteristics Main results
  Within-group Between-group
Cognitive-motor only
Schoene 2013 [58] N = 32 IG: DDR + CSRT 8 wk, 2-3/wk, 20 min Independent living (retirement village); age 78 (5), 69–85; able to walk without a walking aid for 20 m, able to step in place unassisted; no disabilities in ADL/IADL functions; no cognitive impairment (MMSE < 24); no neurodegenerative disease; no other health problems affecting stepping ability; no unstable health conditions Unpublished  
+ +
CSRT RT pre 754 (81) post 679 (67) p = .008, CSRT (F31,1) = 18.203, p < .001,
CG: Passive
CSRT MT pre 252 (44) post 210 (47) p = .035 PPA (F31,1) = 12.706, p < .001,
PPA pre 1.75 (0.64) post 1.15 (0.85) p < .001 sway velocity (F31,1) = 4.226, p = .049
Sway mm pre 386 (132) post 301 (133) p = .001 contrast sensitivity (F31,1) = 4.415, p = .044
proprioception pre 3.0 (1.7) post 2.3 (1.1) p = .091 DT TUG (F31,1) = 4.226, p = .049;
STS pre 11.5 (2.3) post 10.7 (2.8) p = .032 SST p = .094;
DT TUG pre 14.1 (5.6) post 11.6 (3.7) p = .002  
SST pre 50.8 (17.2) post 42.0 (6.8) p = .05
No hand RT, contrast sensitivity, lower limb strength, AST, TUG, icon-FES, TMT A + B No proprioception, hand RT, lower limb strength, STS, AST, TUG, icon-FES, TMT A + B
Studenski 2010 [55] N= 25 IG: DDR 12 wk, 2/wk, 30 min Community-dwelling; age 80.2 (5.4), 65+; healthy; able to walk 0.5 miles + narrow walk time pre 5.2 (1.7) change −0.5 (1.6), p = .03 and ABC pre 84.5 (13) change 4.9 (10.1), p = .01;  
CG: N/A   No change DSST -balance subscore SPPB
Lai 2012 [50] N = 30 IG: XMSS 6 wk, 3/wk, 30 min Community-dwelling; age 72.1 (4.8), 65+; ambulant without walking aids; no neurological disorder; no arthritis or visual or cardiac impairment that affects walking +  
BBS pre 50.53(4.75) post 53.87(3.56), p = .001,
TUG pre 9.54(3.52) post 8.54(2.85), p = .046, sway area eyes open and closed pre (320.80(273.45) post 191.00(70.31), p = .052, pre 342.54(213.67) post 262.20(142.11), p = .092 respectively) sway velocity eyes open and closed pre (9.37(2.30) post 8.10(1.62), p = .046, pre 13.11(5.12) post 11.28(3.55), p = .024 respectively)
CG: Passive
OLS pre 31.80(18.39) post 48.74(26.67), p = .062
MFES pre 131.13(6.56) post 136(6.07), p = .001
Cognitive-motor plus other components
De Bruin 2011 [59] N = 28 IG: DDR + strength and balance 12 wk, 2/wk, 45-60 min Assisted living facilities; age 86.2 (7.1), 65+; ambulant without walking aids; no neurological disorder; no arthritis or visual or cardiac impairment that affects walking + +
DTC: gait speed pre 22 (12.1) post 14.4 (8.6), p = .006, cadence pre 15.8 (13.7) post 10 (7.3), p = .06; stride time pre 20.7 (14.5) post 11.6 (10) p = .004, and step length pre 11.1 (8.3) post 5.5 (5.4) p = .001; FES-I: pre 24.9 (4.5) post 21.9 (5.2), p = .005 DTC: gait speed F(1,26) = 6.25, p = .019, stride time (s) F(1,26) = 5.7, p = .025, step length (cm) F(1,26) = 11.51, p = .002, FES-I: F(1,26) = 2.95, p = .098
CG: Mostly seated exercises 12 wk, 1/wk, 30-45 min
No No
ETGUG, DT step time DTC Cadence, DTC of step time, ETGUG
Pichierri IG: Hostels for the + +
2012a [62] N = 31 DDR + strength and balance 12 wk, 2/wk, 50-60 min elderly; age 86.2 (4.6), 65+; 50% considered high fall-risk; no major cognitive impairment (MMSE ≥ 22); able to walk 8 m; no acute or chronic unstable illness; adequate vision ST and DT Improvements throughout most walking conditions; DT gait speed (U = 26, p = .041, r = .45) and single support time (U = 24, p = .029, r = .48) fast walking condition No ST gait, and some parameters DT gait
DTC decreased throughout most parameters in ST and DT walking No FES-I
FES-I
CG: Strength and balance 12 wk, 2/wk, 40 min
Pichierri 2012b [61] N = 15 IG: DDR + strength and balance 12 wk, 2/wk, 60 min Care homes; age 84.6 (4), 65+; no major cognitive impairment (MMSE ≥ 22); able to stand upright for 5 min; no acute or chronic unstable illness; adequate vision + +
step reaction time: time reduction in all assessed temporal parameters ST: −15.7%; DT: −20.1%; step directions with significance and step directions with a trend to significance for step initiation, foot off, and foot contact times for most variables step reaction time: initiation time of forward steps under DT (U = 9, p = .034, r = .55) and backward steps under DT conditions (U = 10, p = .045, r = .52)
CG: Non-specific physical activities depending on activity
No
ST conditions step reaction time
DT most other variables of step initiation, lift-off and movement speed
  1. IG intervention group, CG control group, wk week, DDR Dance Dance Revolution, XMSS Xavi measured step system, ADL activities of daily living, IADL instrumental activities of daily living, MMSE Minimental state examination, CSRT choice stepping reaction time, RT reaction time, MT movement time, PPA Physiological Profile Assessment, STS sit-to-stand, TUG timed up & go test, AST alternate step test, icon-FES iconographical falls-efficacy scale, DT dual task, TMT Trailmaking test, SST Stroop Stepping Test, ABC Activities-specific Balance Confidence Scale, DSST Digit Symbol Substitution Test, SPPB Short Physical Performance Battery, BBS Berg Balance Scale, OLS One Leg Stance, MFES Modified Falls Efficacy Scale, DTC dual task costs, FES-I Fall-Efficacy Scale International, ETGUG Extended Timed Get-up-and-go test, ST single task, M-L medio-lateral, A-P anterio-posterior.