Combined Motor and Cognitive Rehabilitation: The Impact on Motor Performance in Patients with Mild Cognitive Impairment. Systematic Review and Meta-Analysis

Autori

Kiper Pawel [IRCCS San Camillo Hospital, Venice, Italy]

Richard Michelle [LUNEX University, Differdange, Luxembourg]

Stefanutti Françoise [LUNEX University, Differdange, Luxembourg]

Pierson-Poinsignon Romain [LUNEX University, Differdange, Luxembourg]

Cacciante Luisa [IRCCS San Camillo Hospital, Venice, Italy]

Perin Cecilia [University of Milano-Bicocca, Milan, Italy]

Mazzucchelli Miryam [University of Milano-Bicocca, Milan, Italy]

Viganò Barbara [University of Milano-Bicocca, Milan, Italy]

Meroni Roberto [LUNEX University, Differdange, Luxembourg]

Background and aims

While cognitive stimulation and physical exercise have been individually proposed as effective non-pharmacological interventions, the combined effect of physical and cognitive training (PCT) on motor performance in MCI remains underexplored. This systematic review and meta-analysis aimed to evaluate whether PCT can improve motor function and activities of daily living (ADL) in individuals with MCI.

Methods

A comprehensive electronic search was conducted across five databases (PubMed, Scopus, Embase, Web of Science, and Cochrane Library), according to PRISMA guidelines. Studies were included if they were randomized controlled trials (RCTs) comparing PCT versus physical training alone or no intervention, and if they assessed motor outcomes. Nine studies met inclusion criteria, of which six were eligible for meta-analysis. Risk of bias was assessed using the Cochrane RoB2 tool. Meta-analyses were performed using Review Manager 5.3 software, applying random or fixed-effects models depending on heterogeneity.

Results

The meta-analysis revealed that PCT significantly improved balance compared to physical training alone (SMD = 0.56; 95% CI 0.07 to 1.06; I² = 59%; 160 participants). A significant improvement in mobility (Timed Up and Go Test) was observed when PCT was compared to no intervention (MD = −1.80; 95% CI −2.70 to −0.90; I² = 0%; 81 participants). However, PCT did not demonstrate significant effects on gait speed, ADL, or quality of life when compared to control groups. Considerable heterogeneity was noted in intervention types and outcome measures across studies.

Conclusion

Combined motor and cognitive training appears to be a promising intervention for improving specific motor outcomes, particularly balance and mobility in individuals with mild cognitive impairment. While no significant benefits were observed for gait speed, activities of daily living, or quality of life, the positive effects on balance suggest that integrating cognitive tasks into physical rehabilitation may enhance motor control through dual-task mechanisms. These findings highlight the potential of PCT as a feasible, non-pharmacological strategy to delay functional decline in this population. However, the current evidence is constrained by methodological heterogeneity and limited sample sizes. Future research should focus on well-powered, standardized trials with long-term follow-up to better understand the efficacy, optimal structure, and sustainability of combined training programs for people with MCI.

REFERENCES

Kiper, P.; Richard, M.; Stefanutti, F.; Pierson-Poinsignon, R.; Cacciante, L.; Perin, C.; Mazzucchelli, M.; Viganò, B.; Meroni, R. Combined Motor and Cognitive Rehabilitation: The Impact on Motor Performance in Patients with Mild Cognitive Impairment. Systematic Review and Meta-Analysis. J. Pers. Med. 2022, 12, 276. https://doi.org/10.3390/jpm12020276