Technology-assisted motor-cognitive training among older adults : rapid systematic review of randomized controlled trials

Abstract

Background: Age-related physiological changes in older adults involve a rapid decline in motor exercise ability; some older adults may also experience difficulties in maintaining focus, memory loss, and a decline in reaction time, which consequently impair their ability to perform dual tasks. Motor-cognitive training (MCT) refers to a blend of motor activity and cognitive training that occurs simultaneously and can assist older adults in enhancing their physical function, cognitive abilities, and dual-task performance. In recent years, the use of technology for delivering MCT has become increasingly popular in research. This has been achieved through various technologies that simplify MCT for older adults. Objective: This study aimed to systematically examine the feasibility and effectiveness studies on technology-assisted MCT among older adults. Methods: This rapid review was conducted following the updated PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) 2020 standards, and the Synthesis Without Meta-analysis (SWiM) in systematic reviews reporting guideline. Four databases were searched, including CINAHL, Embase, PubMed, and Scopus, from January 2013 to March 2025. Search strategies were constructed based on three main topics: (1) older adults, (2) MCT, and (3) technology. Inclusion criteria followed the population, intervention, comparator, outcome, and study design framework as follows: older adults (population); technology-assisted MCT (intervention); standard treatment control, active control, partial intervention control, placebo control, and dose-response control (comparator); various measures of physical, cognitive, and dual-task performance (outcome); and randomized controlled trials (RCTs) and pilot RCTs (study design). The Cochrane Risk of Bias Tool was applied for quality appraisal of the included studies. The feasibility of the included studies was assessed using completion rates and attrition rates. Descriptive statistics were used to describe the demographic and clinical characteristics of the groups, while narrative methods were used to categorize and synthesize their effectiveness. Results: In total, 20 studies were included, comprising 16 RCTs and 4 pilot RCTs, most of which were conducted within a 6-week period. Each session typically lasted between 10 and 30 minutes and was held 2 to 3 times per week. Feasibility analysis showed that technology-assisted MCT was generally feasible. While the workload was high, the perceived usability was also high, with a considerable amount of positive feedback and very few reported adverse events. The types of MCT varied in terms of components, duration, and frequency. The majority of studies (18/20, 90%) demonstrated statistically significant improvements in physical, cognitive, and dual-task performance because of technology-assisted MCT. Conclusions: The feasibility of technology-assisted MCT among older adults was high regardless of the perceived high workload, and most studies showed statistical effectiveness in improving physical, cognitive, and dual-task performance.