Table 3.
Characteristics of included randomised controlled trials
| Author, year | Study design | Country | Disease/condition | Diagnostic criteria | Mean age (years) (T) | Mean age (years) (C) | Sample size total (T/C) | Frequency and duration of intervention (T) | Control group | Outcome/measurement |
|---|---|---|---|---|---|---|---|---|---|---|
| Okuyan and Deveci (2020) [26] | RCT | Turkey | Mild cognitive impairment | MMSE and MoCA of < 25 points | 74.21 (6.93) | 74.21 (6.93) | 42 (20/22) | 2 × 35–40 min/week for 12 weeks | Not subjected to any physical practice |
1) Risk of falling: TAT (gait and balance) 2) Physical activity: PASE 3) Fear of movement: TSK 4) Behaviours related to falls: FaB scale |
| Lam et al. (2012) [25] | Single-blind cluster RCT | China | Risk of cognitive decline | CDR of 0.5 or Neuropsychological criteria for amnestic-mild cognitive impairment | 77.2 (6.3) | 78.3 (6.6) | 261(92/169) | At least 3 × 30 min/week for 12 months | Muscle-stretching and toning exercises |
1) Primary outcome: progression to dementia measured by DSM-IV criteria; cognitive test scores of Cantonese version of the ADAS-Cog, DS, delay recall, CVFT, TMT, MMSE 2) Secondary outcomes: CSDD assessed depressive symptoms in persons with cognitive impairment; NPI was used to assess changes in neuropsychiatric symptoms; BBS assessed functional balance |
| Sungkarat et al. (2017) [27] | Single-blind RCT | Thailand | Amnestic multiple-domain MCI (a-MCI) | Petersen’s criteria for diagnosing amnestic a-MCI, had a score of ≥ 24 on MMSE and < 26 on MCA | 68.3 (6.7) | 67.5 (7.3) | 66 (33/33) | 3 × 50 min/week for 15 weeks | Educational material covering information related to cognitive impairment and fall prevention |
1) Primary outcome: Episodic memory was measured by LM-delayed recall; Visuospatial ability was assessed using the Block Design Test; Executive function was assessed using DSF, DSB, and TMT Part B–A 2) Secondary outcome: PPA composite fall-risk and component scores; edge contrast sensitivity was assessed using the Melbourne Edge Test; Proprioception was assessed using a lower limb matching test; Knee extension strength of the dominant leg was measured using a spring gauge; Simple hand reaction time was measured in milliseconds; postural sway was assessed using a sway meter that measured displacement of the body |
| Sungkarat et al. (2018) [28] | Assessor-blinded, prospective interventional RCT | Thailand | Amnestic multiple-domain MCI (a-MCI) | Petersen’s criteria for diagnosing amnestic a-MCI, had a score of ≥ 24 on MMSE and < 26 on MCA | 68.3 (6.7) | 67.5 (7.3) | 56 (29/27) | 3 × 50 min/week for 6 months | Educational material covering information related to cognitive impairment and fall prevention |
1) Primary outcome: Memory was assessed using LM delayed recall; Visuospatial ability was assessed using the Block Design Test; executive function was assessed using DSF, DSB, and TMT B minus A (B-A) 2) Secondary outcome: plasma BDNF, TNF-α, and IL-10 levels |
| Tsai et al. (2013) [29] | Cluster-randomized clinical trial | USA | Moderate, mild, or subtle cognitive impairment | MMSE score of 18–28 | 78.89 (6.91) | 78.93 (8.30) | 55 (28/27) | 3 × 20–40 min/week for 20 weeks | Health education, culture-related activities, and other social activities (e.g. sharing travel experiences, hobbies, and collections) |
1) WOMAC was used to measure subjective pain, physical functioning, and stiffness 2) A modified GUG test was used to measure the elder’s speed in getting up from an armchair, walking as fast as he or she could for 50 feet, returning to the chair, and sitting down 3) STS test was modified for our elderly participants by asking participants, with arms across the chest, to rise five times from a chair as fast as possible 4) Cognitive functioning was measured by the MMSE |
| Tsai et al. (2015) [30] | Cluster-randomized clinical trial | USA | Moderate, mild, or subtle cognitive impairment | MMSE score of 18–28 | 78.89 (6.91) | 78.93 (8.30) | 55 (28/27) | 3 × 20–40 min/week for 20 weeks | Attention control education group (instructor-led educational activities) |
1) VDS for measuring pain in elders with cognitive impairment 2) Observation of pain behaviour: participants engaged in a series of daily tasks (sitting, standing, walking, and reclining), using Keefe’s observational method for OA knee pain 3) Analgesic intake: examined changes in analgesic intake |
Abbreviations: a-MCI multiple-domain MCI, RCT randomised controlled trial, TAT Tinetti assessment tool, PASE physical activity scale for the elderly, TSK Tampa scale of kinesiophobia, FaB falls behavioral, MMSE Mini-Mental Status Exam, BP blood pressure, PEF peak expiratory flow, COPD chronic obstructive pulmonary disease, CDR Clinical Dementia Rating, DAD Disability Assessment for Dementia, CSDD Cornell Scale for Depression in Dementia, NPI Neuropsychiatric Inventory, BBS Berg Balance Scale, MIC Memory Inventory for Chinese Questionnaire, ADAS-cog Alzheimer Disease Assessment Scale—Cognitive Subscale, CVFT category verbal fluency test, CMMSE Cantonese version of mini-mental state examination, NP neuropsychiatric, LM Logical memory, DS Digit Span, DSF Digit Span forward, DSB Digit Span backward, TMT Trial-Making Test, PPA Physiological Profile Assessment, BDNF brain-derived neurotrophic factor, TNF-α tumor necrosis factor-α, IL-10 interleukin-10, WOMAC Western Ontario and McMaster Universities Osteoarthritis Index, GUG get up and go, STS sit-to-stand, GDS Geriatric Depression Scale, HK-MoCA Montreal Cognitive Assessment Hong Kong version, EQ-5D EuroQoL 5-D Questionnaire, EQ-VAS EuroQoL visual analogue scale, GDS-15 Geriatric Depression Scale with a maximum score of 15, GAS-20 Geriatric Anxiety Scale with a maximum score of 20, Mattis DRS Mattis Dementia Rating Scale, DQoL Dementia Quality of Life, VDS Verbal descriptive scale