Background: Older adults, who are living in nursing homes that provide a high level of long-term nursing care, are characterized by multimorbidity and a high prevalence of dependency in activities of daily living. Results of recent studies indicate positive effects of structured exercise programs during long-term care for physical functioning, cognition, and psychosocial well-being. However, for frail elderly the evidence remains inconsistent. There are no evidence-based guidelines for exercises for nursing home residents that consider their individual deficits and capacities. Therefore, high-quality studies are required to examine the efficacy of exercise interventions for this multimorbid target group. The purpose of this study is to determine the feasibility and efficacy of a multicomponent exercise intervention for nursing home residents that aims to improve physical and cognitive functioning as well as quality of life. Methods: A two-arm single-blinded multicenter randomized controlled trial will be conducted, including 48 nursing homes in eight regions of Germany with an estimated sample size of 1120 individuals. Participants will be randomly assigned to either a training or a waiting time control group. For a period of 16 weeks the training group will meet twice a week for group-based sessions (45–60 min each), which will contain exercises to improve physical functioning (strength, endurance, balance, flexibility) and cognitive-motor skills (dual-task). The intervention is organized as a progressive challenge which is successively adapted to the residents’ capacities. Physical functioning, cognitive performance, and quality of life will be assessed in both study groups at baseline (pre-test), after 16-weeks (post-treatment), and after 32-weeks (retention test, intervention group only). Discussion: This study will provide information about the efficacy of a multicomponent exercise program in nursing homes (performance, recruitment). Results from this trial will contribute to the evidence of multicomponent exercises, which specifically focus on cognitive-motor approaches in the maintenance of mental and physical functioning. In addition, it will help to encourage older adults to actively engage in social life. Furthermore, the findings will lead to recommendations for health promotion interventions for frail nursing home residents. Trial registration: The trial was prospectively registered at DRKS.de with the registration number DRKS00014957 on October 9, 2018.

Although several studies have shown that dual-tasking (DT) mobility is impaired in Alzheimer's disease, studies on the effects of DT conditions in probable Mild Cognitive Impairment (pMCI) have not yielded unequivocal results. The objectives of the study were to (1) examine the effect of a concurrent task on a complex walking task in adults with cognitive impairment; and (2) determine whether the effect varied with different difficulty levels of the concurrent task. Furthermore, the study was designed to evaluate the Trail-Walking Test (TWT) as a potential detection tool for MCI. We examined DT performance in 42 young adults (mean age 23.9 ± 1.98), and 43 older adults (mean age 68.2 ± 6.42). The MoCA was used to stratify the subjects into those with and without pMCI. DT was assessed using the TWT: participants completed 5 trials each of walking along a fixed pathway, stepping on targets with increasing sequential numbers (i.e., 1-2-…-15), and increasing sequential numbers and letters (i.e., 1-A-2-B-3-…-8). Motor and cognitive DT effects (DTE) were calculated for each task. ROC curves were used to distinguish younger and healthy older adults from older adults with pMCI. The TWT showed excellent test-retest reliability across all conditions and groups (ICC : 0.83–0.97). SEM% was also low (<11%) as was the MDC95% (0.7, p < 0.05). The TWT is a reliable DT mobility measure in people with pMCI. However, the condition with high cognitive load is more sensitive than the condition with low cognitive load in identifying pMCI. The TWT-3 thus could serve as a screening tool for early detection of individuals with pMCI. Future studies need to determine the neural correlates for cognitive-motor interference in older adults with pMCI.

The evidence supporting the effects of age on the ability to coordinate a motor and a cognitive task show inconsistent results in children and adolescents, where the Dual-Task Effects (DTE) – if computed at all – range from either being lower or comparable or higher in younger children than in older children, adolescents and adults. A feasible reason for the variability in such findings is the wide range of cognitive tasks (and to some extend of motor tasks) used to study Cognitive-Motor Interference (CMI). Our study aims at determining the differences in CMI when performing cognitive tasks targeting different cognitive functions at varying walking pathways. 69 children and adolescents (boys, n = 45; girls, n = 24; mean age, 11.5 ± 1.50 years) completed higher-level executive function tasks (2-Back, Serial Subtraction, Auditory Stroop, Clock Task, TMT-B) in comparison to non-executive distracter tasks [Motor Response Task (MRT), TMT-A] to assess relative effects on gait during straight vs. repeated Change of Direction (COD) walking. DT during COD walking was assessed using the Trail-Walking-Test (TWT). The motor and cognitive DTE were calculated for each task. There were significant differences between 5th and 8th graders on single gait speed on the straight (p = 0.016) and the COD pathway (p = 0.023), but not on any of the DT conditions. The calculation of DTEs revealed that motor DTEs were lowest for the MRT and highest for the TWT in the numbers/letters condition (p < 0.05 for all comparisons). In contrast, there were cognitive benefits for the higher-order cognitive tasks on the straight pathways, but cognitive costs for both DT conditions on the COD pathway (p < 0.01 for all comparisons). Our findings demonstrate that DT changes in walking when completing a secondary task that involve higher-level cognition are attributable to more than low-level divided attention or motor response processes. These results specifically show the direct competition for higher-level executive function resources important for walking, and are in agreement with previous studies supporting the cognitive-motor link in relation to gait in children. This might be in line with the idea that younger children may not have adequate cognitive resources.

Soccer is a competitive sport that relies on distinct motor skills and cognitive processes. However, cognitive aspects are often overlooked, with a focus mainly on motor skills. Limited research has explored screening tests within motor-cognitive navigation dual-task (DT) paradigms. This study aims to validate a sensitive approach for assessing soccer-specific dribbling by evaluating the Trail-Dribbling Test (TDT) as a method to differentiate high-performance (HP) from low-performance (LP) players. Two hundred and seventy-five participants (41 females) aged between 12 and 34 completed the Trail-Making Test (TMT), the Trail-Walking Test (TWT), and the soccer-specific TDT under three levels of cognitive load. Results indicated shorter TDT durations for HP compared to LP players, with increased cognitive load accentuating differences (TDT-M: p = 0.044, d = 0.260; TDT-A: p < 0.001, d = 0.449; TDT-B: p < 0.001, d = 0.653). The TDT effectively discriminated between HP and LP players in the 14–15 (AUC = 0.712–0.820) and 16–17 age groups (AUC = 0.634–0.839). In conclusion, the ecologically valid TDT demonstrates the potential for quantifying soccer-specific dribbling, offering insights into motor and cognitive aspects of dribbling performance, especially among soccer players aged 14–17.