Skip to main content

Advertisement

SpringerLink
Log in

Effects of balance training on cognitive function and activities of daily living in older adult patients with heart failure: a randomized controlled trial

  • Original Article
  • Published:
Irish Journal of Medical Science (1971 -) Aims and scope Submit manuscript

Abstract

Background

The potential of the effect of balance training on improving cognitive functions and functional activities in vulnerable groups, including the older adults with heart failure (HF), is unknown.

Aim

The aim of the present study was to determine the effect of a simple balance training supervised by nurses on cognitive functions and activities of daily living (ADLs) of the older adults with HF.

Methods

In this clinical trial study, 75 older adults with HF were allocated to two groups of balance training (BT) and usual care (UC) using stratified block randomization. The intervention consisted of a set of dynamic and static BT, 4 times/session per week, each session lasting 30 min, for 8 weeks, which was performed at the participant’s home under the supervision of a nurse. For the control group, UC was provided. The outcomes of the study, including cognitive function, basic ADLs, and instrumental ADLs (IADLs), were measured by the Montreal cognitive assessment-basic (MoCA-B), Barthel index-ADL, and Lawton scale-IADL before and after the intervention.

Results

The between-group analysis showed, in two groups, a statistically significant difference between the changes in the mean scores: all subscales of cognitive function and MoCA-B total score (P < 0.001), as well as basic ADLs and IADLs (P < 0.001), before and after the intervention. Compared with the control group/UC, the cognitive function, basic ADL, and IADL of the intervention group/BT were improved significantly at 8 weeks.

Conclusion

The results suggested that home-based balance training led by nurse can improve global cognitive function and basic ADL and IADL in the older adults with HF.

Trial registration

Clinical trials registration number IRCT20150919024080N18.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

Data availability

The data sets generated during and/or analyzed during the current study are available from the corresponding author on reasonable request.

References

  1. Van Nguyen T, Dang HT, Burns MJ et al (2021) Impairment in activities of daily living and readmission in older patients with heart failure: a cohort study. BMJ Open 11(2):e044416

    Article  PubMed  PubMed Central  Google Scholar 

  2. Takabayashi K, Kitaguchi S, Iwatsu K et al (2019) A decline in activities of daily living due to acute heart failure is an independent risk factor of hospitalization for heart failure and mortality. J Cardiol 73(6):522–529

    Article  PubMed  Google Scholar 

  3. Vidán MT, Martín Sánchez FJ, Sánchez E et al (2019) Most elderly patients hospitalized for heart failure lack the abilities needed to perform the tasks required for self-care: impact on outcomes. Eur J Heart Fail 21(11):1434–1442

    Article  PubMed  Google Scholar 

  4. Saito H, Yamashita M, Endo Y et al (2020) Cognitive impairment measured by Mini-Cog provides additive prognostic information in elderly patients with heart failure. J Cardiol 76(4):350–356

    Article  PubMed  Google Scholar 

  5. Gary RA, Paul S, Corwin E et al (2019) Exercise and cognitive training as a strategy to improve neurocognitive outcomes in heart failure: a pilot study. Am J Geriatr Psychiatry 27(8):809–819

    Article  PubMed  PubMed Central  Google Scholar 

  6. Zuo W, Wu J (2022) The interaction and pathogenesis between cognitive impairment and common cardiovascular diseases in the elderly. Ther Adv Chronic Dis 13:20406223211063020

    Article  PubMed  PubMed Central  Google Scholar 

  7. Kua ZJ, Valenzuela M, Dong Y (2019) Can computerized cognitive training improve cognition in patients with heart failure?: A review. J Cardiovasc Nurs 34(2):E19–E27

    Article  PubMed  Google Scholar 

  8. Kraiwong R, Vongsirinavarat M, Rueankam M, Sumalrot T (2021) Effects of physical-cognitive training on physical and psychological functions among older adults with type 2 diabetes and balance impairment: a randomized controlled trial. J Exerc Rehabil 17(2):120

    Article  PubMed  PubMed Central  Google Scholar 

  9. Kewcharoen J, Trongtorsak A, Kanitsoraphan C et al (2019) Cognitive impairment and 30-day rehospitalization rate in patients with acute heart failure: a systematic review and meta-analysis. Indian Heart J 71(1):52–59

    Article  PubMed  PubMed Central  Google Scholar 

  10. McDougall GJ, Han A, Staggs VS et al (2019) Predictors of instrumental activities of daily living in community-dwelling older adults. Arch Psychiatr Nurs 33(5):43–50

    Article  PubMed  PubMed Central  Google Scholar 

  11. Obata H, Izumi T, Yamashita M et al (2021) Characteristics of elderly patients with heart failure and impact on activities of daily living: a registry report from super-aged society. J Cardiac Fail 27(11):1203–1213

    Article  Google Scholar 

  12. Feng Z, Li Q, Zhou L et al (2021) The relationship between depressive symptoms and activity of daily living disability among the elderly: results from the China Health and Retirement Longitudinal Study (CHARLS). Public Health 198:75–81

    Article  CAS  PubMed  Google Scholar 

  13. Hashimoto K, Hirashiki A, Ozaki K et al (2022) Benefits of a balance exercise assist robot in the cardiac rehabilitation of older adults with cardiovascular disease: a preliminary study. J Cardiovasc Dev Dis 9(6):191

    CAS  PubMed  PubMed Central  Google Scholar 

  14. Hickman L, Ferguson C, Davidson PM et al (2020) Key elements of interventions for heart failure patients with mild cognitive impairment or dementia: a systematic review. Eur J Cardiovasc Nurs 19(1):8–19

    Article  PubMed  Google Scholar 

  15. Sok S, Shin E, Kim S, Kim M (2021) Effects of cognitive/exercise dual-task program on the cognitive function, health status, depression, and life satisfaction of the elderly living in the community. Int J Environ Res Public Health 18(15):7848

    Article  PubMed  PubMed Central  Google Scholar 

  16. Noh H-J, Lee S-H, Bang D-H (2019) Three-dimensional balance training using visual feedback on balance and walking ability in subacute stroke patients: a single-blinded randomized controlled pilot trial. J Stroke Cerebrovasc Dis 28(4):994–1000

    Article  PubMed  Google Scholar 

  17. Domínguez-Navarro F, Igual-Camacho C, Silvestre-Muñoz A et al (2018) Effects of balance and proprioceptive training on total hip and knee replacement rehabilitation: a systematic review and meta-analysis. Gait Posture 62:68–74

    Article  PubMed  Google Scholar 

  18. Dunsky A (2019) The effect of balance and coordination exercises on quality of life in older adults: a mini-review. Front Aging Neurosci 11:318

    Article  PubMed  PubMed Central  Google Scholar 

  19. Rogge A-K, Röder B, Zech A, Hötting K (2018) Exercise-induced neuroplasticity: balance training increases cortical thickness in visual and vestibular cortical regions. Neuroimage 179:471–479

    Article  PubMed  Google Scholar 

  20. Rogge A-K, Röder B, Zech A et al (2017) Balance training improves memory and spatial cognition in healthy adults. Sci Rep 7(1):5661

    Article  PubMed  PubMed Central  Google Scholar 

  21. Conradsson D, Halvarsson A (2019) The effects of dual-task balance training on gait in older women with osteoporosis: a randomized controlled trial. Gait Posture 68:562–568

    Article  PubMed  Google Scholar 

  22. Burton E, Hill K, Ellis KA et al (2022) Balance on the brain: a randomised controlled trial evaluating the effect of a multimodal exercise programme on physical performance, falls, quality of life and cognition for people with mild cognitive impairment—study protocol. BMJ Open 12(4):e054725

    Article  PubMed  PubMed Central  Google Scholar 

  23. Hollenberg SM, Lindenfeld J, Masoudi FA et al (2016) 2016 ACC/AHA/HFSA focused update on new pharmacological therapy for heart failure: an update of the 2013 ACCF/AHA guideline for the management of heart failure. J Card Fail 22(9)

  24. Aartolahti E, Lönnroos E, Hartikainen S, Häkkinen A (2020) Long-term strength and balance training in prevention of decline in muscle strength and mobility in older adults. Aging Clin Exp Res 32:59–66

    Article  PubMed  Google Scholar 

  25. Sörlén N, Hult A, Nordström P et al (2021) Short-term balance training and acute effects on postural sway in balance-deficient older adults: a randomized controlled trial. BMC Sports Sci Med Rehabil 13(1):1–9

    Article  Google Scholar 

  26. Thiamwong L, Suwanno J (2014) Effects of simple balance training on balance performance and fear of falling in rural older adults. Int J Gerontol 8(3):143–146

    Article  Google Scholar 

  27. Julayanont P, Tangwongchai S, Hemrungrojn S et al (2015) The Montreal cognitive assessment—basic: a screening tool for mild cognitive impairment in illiterate and low-educated elderly adults. J Am Geriatr Soc 63(12):2550–2554

    Article  PubMed  Google Scholar 

  28. Rashedi V, Foroughan M, Chehrehnegar N (2021) Psychometric properties of the Persian Montreal Cognitive Assessment in mild cognitive impairment and Alzheimer disease. Dement Geriatr Cogn Disord Extra 11(1):51–57

    Article  Google Scholar 

  29. Graf C (2008) The Lawton instrumental activities of daily living scale. AJN Am J Nurs 108(4):52–62

    Article  PubMed  Google Scholar 

  30. Alosco ML, Brickman AM, Spitznagel MB et al (2016) Smaller brain volume is associated with poorer instrumental ADL performance in heart failure. J Cardiovasc Nurs 31(1):31

    Article  PubMed  PubMed Central  Google Scholar 

  31. Hormozi S, Alizadeh-Khoei M, Sharifi F et al (2019) Iranian version of barthel index: validity and reliability in outpatients’ elderly. Int J Prev Med

  32. Albanese AM, Bartz-Overman C, Parikh T, Thielke SM (2020) Associations between activities of daily living independence and mental health status among medicare managed care patients. J Am Geriatr Soc 68(6):1301–1306

    Article  PubMed  Google Scholar 

  33. Palmgren A, Ståhle A, Skavberg Roaldsen K et al (2020) “Stay balanced”–effectiveness of evidence-based balance training for older adults transferred into a physical therapy primary care setting–a pilot study. Disabil Rehabil 42(13):1797–1802

    Article  PubMed  Google Scholar 

  34. Alizadehsaravi L, Koster RA, Muijres W et al (2022) The underlying mechanisms of improved balance after one and ten sessions of balance training in older adults. Hum Mov Sci 81:102910

    Article  PubMed  Google Scholar 

  35. Capato TT, Nonnekes J, de Vries NM et al (2020) Effects of multimodal balance training supported by rhythmical auditory stimuli in people with advanced stages of Parkinson’s disease: a pilot randomized clinical trial. J Neurol Sci 418:117086

    Article  PubMed  Google Scholar 

  36. Kewcharoen J, Prasitlumkum N, Kanitsoraphan C et al (2019) Cognitive impairment associated with increased mortality rate in patients with heart failure: a systematic review and meta-analysis. J Saudi Heart Assoc 31(4):170–178

    Article  PubMed  PubMed Central  Google Scholar 

  37. Kure CE, Rosenfeldt FL, Scholey AB et al (2016) Relationships among cognitive function and cerebral blood flow, oxidative stress, and inflammation in older heart failure patients. J Cardiac Fail 22(7):548–559

    Article  CAS  Google Scholar 

  38. Rollman BL (2019) Exercise and cognitive training to improve neurocognitive outcomes in patients with heart failure: can cardiac rehabilitation deliver? Am J Geriatr Psychiatry 27(8):820–822

    Article  PubMed  Google Scholar 

Download references

Acknowledgements

The authors would like to thank all the patients and physiotherapists who contributed to this work.

Author information

Authors and Affiliations

  1. Social Determinants of Health Research Center, School of Nursing and Midwifery, Lorestan University of Medical Sciences, Khorramabad, Iran

    Mohammad Gholami

  2. Student Research Committee, Lorestan University of Medical Sciences, Khorramabad, Iran

    Faezeh Zohrabi Salari, Reza Yarahmadi & Atefeh Veiskaramian

  3. Cardiovascular Research Center, Shahid Rahimi Hospital, Lorestan University of Medical Sciences, Khorramabad, Iran

    Yaser Mokhayeri

  4. Cardiovascular Research Center, Shahid Madani Hospital, Lorestan University of Medical Sciences, Khorramabad, Iran

    Arash Amin

Authors
  1. Mohammad Gholami
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Faezeh Zohrabi Salari
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Reza Yarahmadi
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Yaser Mokhayeri
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Atefeh Veiskaramian
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Arash Amin
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

MG, YM, and AA designed the study. FZS, RY, and AV collected the data. MG and YM analyzed the data and prepared the manuscript. All authors approved the final version for submission.

Corresponding author

Correspondence to Mohammad Gholami.

Ethics declarations

Conflict of interest

The authors declare no competing interests.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Gholami, M., Zohrabi Salari, F., Yarahmadi, R. et al. Effects of balance training on cognitive function and activities of daily living in older adult patients with heart failure: a randomized controlled trial. Ir J Med Sci 193, 111–121 (2024). https://doi.org/10.1007/s11845-023-03436-0

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11845-023-03436-0

Keywords

Search

Navigation