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Reducing fall risk with combined motor and cognitive training in elderly fallers
Barban F, Annicchiarico R, Melideo M, Federici A, Lombardi MG, Giuli S, Ricci C, Adriano F, Griffini I, Silvestri M, Chiusso M, Neglia S, Arino-Blasco S, Cuevas Perez R, Dionyssiotis Y, Koumanakos G, Kovaceic M, Montero-Fernandez N, Pino O, Boye N, Cortes U, Barrue C, Cortes A, Levene P, Pantelopoulos S, Rosso R, Serra-Rexach JA, Sabatini AM, Caltagirone C
Brain Sciences 2017 Feb;7(2):19
clinical trial
7/10 [Eligibility criteria: Yes; Random allocation: Yes; Concealed allocation: Yes; Baseline comparability: Yes; Blind subjects: No; Blind therapists: No; Blind assessors: Yes; Adequate follow-up: Yes; Intention-to-treat analysis: No; Between-group comparisons: Yes; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed*

BACKGROUND: Falling is a major clinical problem in elderly people, demanding effective solutions. At present, the only effective intervention is motor training of balance and strength. Executive function-based training (EFt) might be effective at preventing falls according to evidence showing a relationship between executive functions and gait abnormalities. The aim was to assess the effectiveness of a motor and a cognitive treatment developed within the EU co-funded project I-DONT-FALL. METHODS: In a sample of 481 elderly people at risk of falls recruited in this multicenter randomised controlled trial, the effectiveness of a motor treatment (pure motor or mixed with EFt) of 24 one-hour sessions delivered through an i-Walker with a non-motor treatment (pure EFt or control condition) was evaluated. Similarly, a 24 one-hour session cognitive treatment (pure EFt or mixed with motor training), delivered through a touch-screen computer was compared with a non-cognitive treatment (pure motor or control condition). RESULTS: Motor treatment, particularly when mixed with EFt, reduced significantly fear of falling (F[1,478] = 6.786, p = 0.009) although to a limited extent (ES -0.25) restricted to the period after intervention. CONCLUSIONS: This study suggests the effectiveness of motor treatment empowered by EFt in reducing fear of falling.

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