Visual Stimulus-Based Cognitive-Motor Agility Exercise in Older Adults

This study was designed as an 8-week, parallel-group randomized controlled exercise intervention in community-dwelling older adults. The study aimed to determine whether adding a brief Light Trainer-assisted visual stimulus-based cognitive-motor agility exercise component to a multicomponent exercise program would provide additional benefits for cognitive, psychomotor, and functional performance.

After completion of baseline assessments, eligible participants were randomized to either an experimental group or an active control group. Both groups participated in supervised exercise sessions twice weekly for 8 weeks, for a total of 16 sessions. Each session lasted 45 minutes. The first 35 minutes of each session consisted of the same multicomponent exercise program in both groups. This program included light-paced walking, mobility exercises, multidirectional stepping, balance tasks, agility exercise, coordination exercises, low-resistance strengthening exercises, and functional movement combinations.

During the final 10 minutes of each session, participants in the experimental group completed visual stimulus-based cognitive-motor agility exercises using the Light Trainer system. These tasks required participants to perceive randomized visual stimuli, select an appropriate motor response, and respond as quickly and accurately as possible using hand or foot movements. The Light Trainer component included 13 repetitions of 30-second task intervals separated by 15-second rest periods. Task difficulty progressed across the 8-week intervention by increasing the number of modules from two to six and by increasing task complexity, stimulus randomness, movement direction changes, response speed requirements, and cognitive-motor demands.

Participants in the active control group completed the same 35-minute multicomponent exercise program followed by a time-matched 10-minute low-intensity activity period. These activities included supervised stretching, mobility, agility, balance, or recovery exercises and did not include visual stimulus-based response tasks, rapid decision-making, reactive agility tasks, or Light Trainer-assisted exercises.

Assessments were performed at baseline and after the 8-week intervention period. The primary outcome was global cognitive performance assessed using the Montreal Cognitive Assessment. Secondary outcomes included hand and foot visual-motor response time, visual working memory performance time and accuracy, Ten-Step Test, 30-second Chair Stand Test, 30-second Arm Curl Test, and 8-Foot Up-and-Go Test. The study was conducted in community-dwelling older adults aged 60 years or older who were able to ambulate independently and follow basic exercise and testing instructions.

Inclusion criteria

• Community-dwelling older adults aged 60 years or older
• Able to ambulate independently
• Able to understand and follow basic exercise and testing instructions
• Montreal Cognitive Assessment score of 23 or higher
• No health condition that would limit safe participation in exercise
• Able to participate regularly in the 8-week exercise program

Exclusion criteria

• Serious cardiovascular, neurological, orthopedic, or vestibular disease that could prevent safe participation in exercise
• Recent surgery
• Uncontrolled hypertension
• Severe visual or hearing problems
• Montreal Cognitive Assessment score below 23
• Use of medications known to substantially affect cognitive, psychomotor, balance, or motor performance
• Very low physical function preventing safe participation in the exercise program