Multimodal exercise intervention improves frontal cognitive functions and gait in Alzheimer's disease: A controlled trial


Professor Flávia Gomes de Melo Coelho MD, Avenue 4-A, number 513, Cidade Nova., Rio Claro, São Paulo 13506-770, Brazil. Email:


Aim:  The objective of the present study was to investigate the effect of a multimodal exercise intervention on frontal cognitive functions and kinematic gait parameters in patients with Alzheimer's disease.

Methods:  A sample of elderly patients with Alzheimer's disease (n = 27) were assigned to a training group (n = 14; aged 78.0 ± 7.3 years) and a control group (n = 13; aged 77.1 ± 7.4 years). Multimodal exercise intervention includes motor activities and cognitive tasks simultaneously. The participants attended a 1-h session three times a week for 16 weeks, and the control participants maintained their regular daily activities during the same period. The frontal cognitive functions were evaluated using the Frontal Assessment Battery, the Clock Drawing Test and the Symbol Search Subtest. The kinematic parameters of gait-cadence, stride length and stride speed were analyzed under two conditions: (i) free gait (single task); and (ii) gait with frontal cognitive task (walking and counting down from 20 – dual task).

Results and discussion:  The patients in the intervention group significantly increased the scores in frontal cognitive variables, Frontal Assessment Battery (P < 0.001) and Symbol Search Subtest (P < 0.001) after the 16-week period. The control group decreased the scores in the Clock Drawing Test (P = 0.001) and increased the number of counting errors during the dual task (P = 0.008) after the same period.

Conclusion:  The multimodal exercise intervention improved the frontal cognitive functions in patients with Alzheimer's disease. Geriatr Gerontol Int 2013; 13: 198–203.