Effects of balance-based visual reaction time exercises on cognitive and physical performance in older adults: a randomized controlled trial

Çekok, Fatma Kübra; Anaforoğlu, Bahar · 2025 · Crossref

DOI: 10.1038/s41598-025-20418-7

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Summary

This randomized controlled trial investigated the efficacy of balance-based visual reaction time exercises on cognitive and physical performance in older adults. Motivated by the interconnected decline of motor and cognitive functions in aging, which increases fall risk and reduces independence, the study aimed to determine if integrating visual stimuli with balance training could yield superior outcomes compared to traditional functional balance exercises. The researchers hypothesized that such dual-task training would enhance executive function, reaction time, and physical mobility. The study enrolled 31 nursing home residents aged 65 and older, randomly assigning them to an intervention group (n=16) or a control group (n=15). The intervention group underwent an 8-week program consisting of twice-weekly, 40-minute sessions using the BlazePod™ system. This technology required participants to respond to visual stimuli with rapid hand and foot movements while maintaining balance in various positions, such as standing on one leg or transitioning from sitting to standing. The control group received a comparable 8-week functional balance training program focusing on standard exercises like weight shifting and walking. Outcomes were assessed pre- and post-intervention using the Montreal Cognitive Assessment (MoCA) for global cognition, the Stroop Test for executive function, BlazePod and New Test devices for reaction time, and physical metrics including the Timed Up and Go (TUG), Four Square Step Test (FSST), Five Times Sit-to-Stand (FTSS), Short Physical Performance Battery (SPPB), and Falls Efficacy Scale (FES). Results indicated that while both groups improved, the intervention group demonstrated significantly greater gains in specific domains. Participants in the intervention group exhibited significantly faster reaction times and made fewer errors on the Stroop test compared to the control group (p < 0.05). They also showed superior improvements in physical performance measures, including TUG, FTSS, FSST, and SPPB, and reported a significantly reduced fear of falling (FES). Regression analysis revealed that improvements in BlazePod reaction time and stroke count were predictive of enhancements in TUG, FES, and FSST scores. However, no significant between-group differences were observed in global cognitive function as measured by the MoCA, nor in Stroop interference scores, suggesting that the intervention did not broadly alter global cognition or complex inhibitory control beyond basic processing speed. The study concludes that balance-based visual reaction time exercises are an effective strategy for improving reaction time, physical performance, and confidence in older adults. The findings support the use of visually guided dual-task training as a feasible rehabilitation approach to mitigate fall risk and enhance functional mobility. By targeting the integration of sensory processing and motor execution, this method offers a promising alternative to traditional physical therapy for maintaining independence in aging populations.

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• age related perceptual decline