Abstract
Falling is a frequent and major clinical problem among older adults, as well as in patients with chronic cerebrovascular diseases (CVD). At present, sequential (mixed) and simultaneously (dual-task) motor-cognitive trainings are the best approaches to affording patients more autonomy in their everyday motor independence while reducing fall risks and consequences. The objective of this study was to evaluate the efficacy of an advanced and innovative dual-task motor-cognitive rehabilitation program on fall risks in vulnerable older persons with chronic CVD. To this purpose, 26 consecutive older fallers with chronic CVD were recruited, and completed a mixed motor-cognitive or a dual-task motor-cognitive training program. Each patient also underwent two test evaluations to assess balance, gait, fear of falling, and walking performance at pre-and post-intervention. We found that our experimental motor-cognitive dual-task rehabilitation program could be an effective method to improve walking balance, gait, walking speed, and fear of falling, while reducing the risk of falls in older people with chronic CVD. Furthermore, results show that the simultaneous motor-cognitive training is more effective than the sequential motor-cognitive training. Therefore, our study brings innovative data, which can contribute positively to the management of this population.
Highlights
Falling is a frequent and major clinical problem with potentially severe consequences in the elderly [1]
We aimed to evaluate the efficacy of our experimental, motor-cognitive, dual-task rehabilitation program (DTT), developed within a dual-task room, on the risk of falling in vulnerable older patients with chronic cerebrovascular diseases (CVD), compared to a conventional mixed motor-cognitive training (MixT)
It is known that both combined motor and cognitive training (MixT) and dual-task motor-cognitive training (DTT) are effective in improving physical performance and fear of falling in older adults and stroke patients [6,16,30,31,32,33]
Summary
Falling is a frequent and major clinical problem with potentially severe consequences in the elderly [1]. Falls in patients with CVD are usually attributed to a combination of factors that may or may not be related to CVD, and CVD is just one of the many significant comorbidities that affect older adults [8]. Falls can lead to limitations in the performance of daily living activities, increased dependence, development of fear of falling, and low fall self-efficacy [10,11,12,13]. Both serious and non-serious falls are still among the most common complications in CVD patients, and their increasing incidence poses a challenge for rehabilitation [4]
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