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Saimpont A, Métais A, Collet C. Learning by motor imagery in older adults. Aging (Albany NY) 2023; 15:9894-9895. [PMID: 37837469 PMCID: PMC10599735 DOI: 10.18632/aging.205185] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Accepted: 08/04/2023] [Indexed: 10/16/2023]
Affiliation(s)
- Arnaud Saimpont
- Université Lyon, UCBL-Lyon 1, Laboratoire Interuniversitaire de Biologie de la Motricité, UR 7424, France
| | - Angèle Métais
- Université Lyon, UCBL-Lyon 1, Laboratoire Interuniversitaire de Biologie de la Motricité, UR 7424, France
| | - Christian Collet
- Université Lyon, UCBL-Lyon 1, Laboratoire Interuniversitaire de Biologie de la Motricité, UR 7424, France
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Šlosar L, Puš K, Marušič U. Validation of the Slovenian Version of the Movement Imagery Questionnaire for Children (MIQ-C): A Measurement Tool to Assess the Imagery Ability of Motor Tasks in Children. Zdr Varst 2023; 62:113-120. [PMID: 37327132 PMCID: PMC10263371 DOI: 10.2478/sjph-2023-0016] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Accepted: 03/17/2023] [Indexed: 06/18/2023] Open
Abstract
Purpose The ability to perform motor imagery has been shown to influence individual athletic performance and rehabilitation. Recent evidence supports its potential as a training tool to improve motor skills in children. Although there is a standardized assessment of the imagery abilities in Slovenian-speaking adults, there is currently no validated instrument for use with Slovenian children. Therefore, the aim of the present study was to conduct a linguistic validation study of the movement imagery questionnaire for children (MIQ-C). Methods A total of 100 healthy children (mean age 10.3±1.3 years; 50 female) were assessed with a Slovenian version of the MIQ-C at Day 1 and Day 8. Inter-day agreement was examined using intraclass correlation coefficients (ICC). Construct validity and internal consistency were assessed using a Cronbach's alpha coefficient and exploratory - confirmatory factor analysis, respectively. Results The test-retest ICC were very high for all three scales examined (ICCKI=0.90; ICCIVI=0.92; ICCEVI=0.90). Excellent internal consistency (up to 0.90) was found for kinaesthetic and both visual imageries. Confirmatory analysis confirmed a three-factorial structure of the MIQ-C. Conclusions The Slovenian version of the MIQ-C proved to be highly reliable and valid in assessing children's motor imagery abilities, and as such for use with Slovene-speaking children. Moreover, this standardized instrument can be a helpful tool in training and rehabilitation practice with children aged 7-12 years.
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Affiliation(s)
- Luka Šlosar
- Science and Research Centre Koper, Institute for Kinesiology Research, Kozlovičeva 23, 6000Koper, Slovenia
- Alma Mater Europaea – ECM, Department of Health Sciences, Slovenska 17, 2000Maribor, Slovenia
| | - Katarina Puš
- Science and Research Centre Koper, Institute for Kinesiology Research, Kozlovičeva 23, 6000Koper, Slovenia
- Alma Mater Europaea – ECM, Department of Health Sciences, Slovenska 17, 2000Maribor, Slovenia
- Faculty of Sport, University of Ljubljana, Gortanova 22, 1000Ljubljana, Slovenia
| | - Uroš Marušič
- Science and Research Centre Koper, Institute for Kinesiology Research, Kozlovičeva 23, 6000Koper, Slovenia
- Alma Mater Europaea – ECM, Department of Health Sciences, Slovenska 17, 2000Maribor, Slovenia
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Šlosar L, Peskar M, Pišot R, Marusic U. Environmental enrichment through virtual reality as multisensory stimulation to mitigate the negative effects of prolonged bed rest. Front Aging Neurosci 2023; 15:1169683. [PMID: 37674784 PMCID: PMC10477372 DOI: 10.3389/fnagi.2023.1169683] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2023] [Accepted: 08/07/2023] [Indexed: 09/08/2023] Open
Abstract
Prolonged bed rest causes a multitude of deleterious physiological changes in the human body that require interventions even during immobilization to prevent or minimize these negative effects. In addition to other interventions such as physical and nutritional therapy, non-physical interventions such as cognitive training, motor imagery, and action observation have demonstrated efficacy in mitigating or improving not only cognitive but also motor outcomes in bedridden patients. Recent technological advances have opened new opportunities to implement such non-physical interventions in semi- or fully-immersive environments to enable the development of bed rest countermeasures. Extended Reality (XR), which covers augmented reality (AR), mixed reality (MR), and virtual reality (VR), can enhance the training process by further engaging the kinesthetic, visual, and auditory senses. XR-based enriched environments offer a promising research avenue to investigate the effects of multisensory stimulation on motor rehabilitation and to counteract dysfunctional brain mechanisms that occur during prolonged bed rest. This review discussed the use of enriched environment applications in bedridden patients as a promising tool to improve patient rehabilitation outcomes and suggested their integration into existing treatment protocols to improve patient care. Finally, the neurobiological mechanisms associated with the positive cognitive and motor effects of an enriched environment are highlighted.
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Affiliation(s)
- Luka Šlosar
- Science and Research Centre Koper, Institute for Kinesiology Research, Koper, Slovenia
- Alma Mater Europaea – ECM, Department of Health Sciences, Maribor, Slovenia
| | - Manca Peskar
- Science and Research Centre Koper, Institute for Kinesiology Research, Koper, Slovenia
- Biological Psychology and Neuroergonomics, Department of Psychology and Ergonomics, Faculty V: Mechanical Engineering and Transport Systems, Technische Universität Berlin, Berlin, Germany
| | - Rado Pišot
- Science and Research Centre Koper, Institute for Kinesiology Research, Koper, Slovenia
| | - Uros Marusic
- Science and Research Centre Koper, Institute for Kinesiology Research, Koper, Slovenia
- Alma Mater Europaea – ECM, Department of Health Sciences, Maribor, Slovenia
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Ajdžanović VZ, Šošić-Jurjević BT, Ranin JT, Filipović BR. Biologia Futura: does the aging process contribute to the relativity of time? Biol Futur 2023:10.1007/s42977-023-00167-2. [PMID: 37213056 DOI: 10.1007/s42977-023-00167-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Accepted: 05/01/2023] [Indexed: 05/23/2023]
Abstract
In his Theory of relativity, Einstein determined that the time is relative to the reference frame of the observer. Under specific conditions, there is a difference in the elapsed time between two clocks, known as time dilation. A similar relativistic effect could be attributed to the brain operating at different frequencies, e.g., while it is slow and during the thought process. Time flow and the aging process are causally linked. Herein, we introduce physical relativity into the mind/thought context and elaborate changed perception of the time flow (the impression of the time acceleration) with aging. The phenomenology of time is observed in the context of physical and biological clock, as well as by introducing the category of 'mind time.' Mental processing impairment is crucial for the "aging-caused relativity of time," while adjusting of its' perception seems to be a matter of body/mind rest, mental hygiene and physical activity of the aging subject. We also provide a brief overview of the perception of time flow in some disease states that coincide with aging. Our main idea has a perspective for future development in the interdisciplinary synergy of philosophy, physical-mathematical elaboration, experimental biology and clinical investigations.
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Affiliation(s)
- Vladimir Z Ajdžanović
- Department of Cytology, Institute for Biological Research "Siniša Stanković"-National Institute of Republic of Serbia, University of Belgrade, Belgrade, Serbia.
| | - Branka T Šošić-Jurjević
- Department of Cytology, Institute for Biological Research "Siniša Stanković"-National Institute of Republic of Serbia, University of Belgrade, Belgrade, Serbia
| | - Jovan T Ranin
- Clinic for Infectious and Tropical Diseases, Clinical Center of Serbia, Faculty of Medicine, University of Belgrade, Belgrade, Serbia
| | - Branko R Filipović
- Department of Cytology, Institute for Biological Research "Siniša Stanković"-National Institute of Republic of Serbia, University of Belgrade, Belgrade, Serbia
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Sprague BN, Ross LA, Ball KK. Does Cognitive Training Reduce Falls across Ten Years?: Data from the ACTIVE Trial. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:4941. [PMID: 36981850 PMCID: PMC10048914 DOI: 10.3390/ijerph20064941] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/10/2023] [Revised: 03/06/2023] [Accepted: 03/08/2023] [Indexed: 06/18/2023]
Abstract
The purpose of this study was to examine the effect of cognitive training on the risk of experiencing a fall across 10 years. The study used data from the Advanced Cognitive Training for Independent and Vital Elderly (ACTIVE) randomized controlled trial. Older adults aged 65-94 were randomly assigned to speed of processing, memory, or reasoning training or to a no-contact control group (n = 2802). The experience of a fall in the prior two months was assessed at baseline and at 1, 2, 3, 5, and 10 years posttest. Cox proportional hazards explored group differences in the total sample, as well as group differences for participants classified as low risk (n = 2360) and high risk (n = 442) for future falls. The data were censored at the first reported fall postbaseline. After baseline, 983 (35.08%) participants across the full sample reported a fall. There were no significant effects of the training in the full sample or in the low-risk sample of participants. However, the participants at greater risk for future falls in the speed of processing training group were 31% less likely (HR = 0.69; 95% CI = 0.48, 0.998, p = 0.049) to experience a subsequent fall across ten years compared to the control group. Reasoning and memory training did not reduce a future fall in the high-risk sample. The speed of processing training reduced the risk of future falls across ten years in the high-risk participants. Future work should examine moderators and mediators of training in at-risk samples.
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Affiliation(s)
- Briana N. Sprague
- Division of General Internal Medicine & Geriatrics, University of Indiana School of Medicine, Indianapolis, IN 46202, USA
- Center for Aging Research, Regenstrief Institute, Indianapolis, IN 46202, USA
| | - Lesley A. Ross
- Department of Psychology, Clemson University, Clemson, SC 29634, USA
| | - Karlene K. Ball
- Department of Psychology, University of Alabama at Birmingham, Birmingham, AL 35233, USA
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Metais A, Muller CO, Boublay N, Breuil C, Guillot A, Daligault S, Di Rienzo F, Collet C, Krolak-Salmon P, Saimpont A. Anodal tDCS does not enhance the learning of the sequential finger-tapping task by motor imagery practice in healthy older adults. Front Aging Neurosci 2022; 14:1060791. [PMID: 36570544 PMCID: PMC9780548 DOI: 10.3389/fnagi.2022.1060791] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2022] [Accepted: 11/22/2022] [Indexed: 12/14/2022] Open
Abstract
Background Motor imagery practice (MIP) and anodal transcranial direct current stimulation (a-tDCS) are innovative methods with independent positive influence on motor sequence learning (MSL) in older adults. Objective The present study investigated the effect of MIP combined with a-tDCS over the primary motor cortex (M1) on the learning of a finger tapping sequence of the non-dominant hand in healthy older adults. Methods Thirty participants participated in this double-blind sham-controlled study. They performed three MIP sessions, one session per day over three consecutive days and a retention test 1 week after the last training session. During training / MIP, participants had to mentally rehearse an 8-element finger tapping sequence with their left hand, concomitantly to either real (a-tDCS group) or sham stimulation (sham-tDCS group). Before and after MIP, as well as during the retention test, participants had to physically perform the same sequence as fast and accurately as possible. Results Our main results showed that both groups (i) improved their performance during the first two training sessions, reflecting acquisition/on-line performance gains, (ii) stabilized their performance from one training day to another, reflecting off-line consolidation; as well as after 7 days without practice, reflecting retention, (iii) for all stages of MSL, there was no significant difference between the sham-tDCS and a-tDCS groups. Conclusion This study highlights the usefulness of MIP in motor sequence learning for older adults. However, 1.5 mA a-tDCS did not enhance the beneficial effects of MIP, which adds to the inconsistency of results found in tDCS studies. Future work is needed to further explore the best conditions of use of tDCS to improve motor sequence learning with MIP.
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Affiliation(s)
- Angèle Metais
- Univ Lyon, Université Claude Bernard Lyon 1, Laboratoire Interuniversitaire de Biologie de la Motricité, LIBM, Villeurbanne, France
| | - Camille O. Muller
- Univ Lyon, Université Claude Bernard Lyon 1, Laboratoire Interuniversitaire de Biologie de la Motricité, LIBM, Villeurbanne, France,EuroMov Digital Health in Motion, Université Montpellier, IMT Mines Alès, Montpellier, France
| | - Nawale Boublay
- Centre de Recherche Clinique Vieillissement Cerveau - Fragilité, Hospices Civils de Lyon, Lyon, France
| | - Caroline Breuil
- Univ Lyon, Université Claude Bernard Lyon 1, Laboratoire Interuniversitaire de Biologie de la Motricité, LIBM, Villeurbanne, France
| | - Aymeric Guillot
- Univ Lyon, Université Claude Bernard Lyon 1, Laboratoire Interuniversitaire de Biologie de la Motricité, LIBM, Villeurbanne, France
| | - Sébastien Daligault
- Centre de Recherche Multimodal et Pluridisciplinaire en Imagerie du Vivant (CERMEP), Département de MagnétoEncéphalographie, Bron, France
| | - Franck Di Rienzo
- Univ Lyon, Université Claude Bernard Lyon 1, Laboratoire Interuniversitaire de Biologie de la Motricité, LIBM, Villeurbanne, France
| | - Christian Collet
- Univ Lyon, Université Claude Bernard Lyon 1, Laboratoire Interuniversitaire de Biologie de la Motricité, LIBM, Villeurbanne, France
| | - Pierre Krolak-Salmon
- Centre de Recherche Clinique Vieillissement Cerveau - Fragilité, Hospices Civils de Lyon, Lyon, France
| | - Arnaud Saimpont
- Univ Lyon, Université Claude Bernard Lyon 1, Laboratoire Interuniversitaire de Biologie de la Motricité, LIBM, Villeurbanne, France,*Correspondence: Arnaud Saimpont,
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Yao L, Sun G, Wang J, Hai Y. Effects of Baduanjin imagery and exercise on cognitive function in the elderly: A functional near-infrared spectroscopy study. Front Public Health 2022; 10:968642. [PMID: 36249264 PMCID: PMC9557749 DOI: 10.3389/fpubh.2022.968642] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Accepted: 09/12/2022] [Indexed: 01/25/2023] Open
Abstract
Objective Cognitive function is essential in ensuring the quality of life of the elderly. This study aimed to investigate the effects of Baduanjin imagery and Baduanjin movement (a traditional Chinese health exercise, TCHE) on cognitive function in the elderly using functional near-infrared spectroscopy (fNIRS). Methods 72 participants with a mean age of 66.92 years (SD = 4.77) were recruited for this study. The participants were randomly assigned to three groups: the Baduanjin imagery, the Baduanjin exercise, and the Control. Stroop task was used to record the accuracy and reaction times, and a near-infrared spectral brain imaging system was used to monitor the brain's oxy-hemoglobin concentration responses. Results (1) For the reaction times of Stroop incongruent tasks, the main effect of the test phase (F = 114.076, p < 0.001) and the interaction effect between test phase and group (F = 10.533, p < 0.001) were all significant. The simple effect analysis further demonstrated that the reaction times of the Baduanjin imagery group and Baduanjin exercise group in the post-test was faster than that in the pre-test (ps < 0.001); (2) Analysis of fNIRS data showed the significant interaction effect (F = 2.554, p = 0.013) between the test phase and group in the left dorsolateral prefrontal cortex. Further analysis showed that, during the post-test incongruent tasks, the oxy-Hb variations were significantly higher in participants of the Baduanjin imagery group (p = 0.005) and Baduanjin exercise group (p = 0.002) than in the control group; For the right inferior frontal gyrus, the interaction between the test phase and group was significant (F = 2.060, p = 0.044). Further analysis showed that, during the post-test incongruent tasks, the oxy-Hb variations were significantly higher in participants of the Baduanjin imagery group than in the control group (p = 0.001). Conclusion Baduanjin imagery and exercise positively affect cognitive performance; Baduanjin imagery and exercise activated the left dorsolateral prefrontal cortex; Baduanjin imagery activated the right inferior frontal gyrus, while Baduanjin exercise could not.
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Nanbancha A, Mawhinney C, Sinsurin K. The effect of motor imagery and action observation in the rehabilitation of lower limb injuries: A scoping review. Clin Rehabil 2022; 37:145-161. [PMID: 36050928 DOI: 10.1177/02692155221123546] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVE To synthesize research literature, which has investigated the application of motor imagery and action observation in rehabilitation protocols. Specifically, we aimed to review the implementation of motor imagery and action observation in the rehabilitation of lower limb injuries. METHODS This scoping review followed Arksey and O'Malley's framework and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension guidelines for scoping reviews checklist. The Medline (PubMed), Cochrane Library, Scopus, and Web of Science databases were searched for controlled clinical trials published between 2010 and 2021 using key search terms. Primary articles were screened for inclusion based upon applying motor imagery and action observation as a rehabilitation protocol (independently or in combination) after sustaining an injury or undergoing surgery. Data were charted by extracting the exercise duration, frequency, and the number of weeks from the rehabilitative intervention protocols, and the measured clinical outcomes (pain, range of motion, muscle activity, and functional outcomes). RESULTS The initial database search resulted in 1367 articles, with 1352 excluded after screening, resulting in a total of 15 articles eligible for inclusion in the review. Six of the included articles included an action observation intervention, eight studies a motor imagery intervention, and a single study included combined motor imagery and action observation approach. The motor imagery and action observation techniques were able to improve clinical outcomes, including daily activity, functional movement, rage of motion, pain, and muscle strength. CONCLUSION Motor imagery and action observation interventions may be effective to improve rehabilitative outcomes of lower limb injuries, thus its application should be considered alongside standard treatment protocols.
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Affiliation(s)
- Ampika Nanbancha
- College of Sports Science and Technology, 26685Mahidol University, Salaya, Thailand
| | - Chistopher Mawhinney
- College of Sports Science and Technology, 26685Mahidol University, Salaya, Thailand
| | - Komsak Sinsurin
- Biomechanics and Sports Research Unit, Faculty of Physical Therapy, 26685Mahidol University, Salaya, Thailand
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Teraz K, Šlosar L, Paravlić AH, de Bruin ED, Marusic U. Impact of Motor-Cognitive Interventions on Selected Gait and Balance Outcomes in Older Adults: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Front Psychol 2022; 13:837710. [PMID: 35783735 PMCID: PMC9245546 DOI: 10.3389/fpsyg.2022.837710] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2021] [Accepted: 04/25/2022] [Indexed: 12/02/2022] Open
Abstract
Background Efficient performance of most daily activities requires intact and simultaneous execution of motor and cognitive tasks. To mitigate age-related functional decline, various combinations of motor and cognitive training have shown promising results. The aim of this systematic review and meta-analysis of randomized controlled trials (RCTs) was to evaluate the efficacy of different types of motor-cognitive training interventions (e.g., sequential and simultaneous) on selected functional outcomes in healthy older adults. Methods Six online academic databases were used to retrieve eligible RCTs up to April 2021, following PRISMA guidelines and PICO criteria. A random-effects model was used for all meta-analyses conducted on selected functional outcomes: single- and dual-task gait speed, the Timed Up and Go Test (TUG), and Berg Balance Scale (BBS) score. Effect size (ES) was calculated as Hedges' g and interpreted as: trivial: <0.20, small: 0.20–0.60, moderate: 0.61–1.20, large: 1.21–2.00, very large: 2.01–4.00 or extremely large >4.00. Results From 2,546 retrieved records, 91 RCTs were included for meta-analysis (n = 3,745 participants; 64.7–86.9 years). The motor-cognitive interventions included differed according to the type of training (e.g., sequential, simultaneous with additional cognitive task or exergame training. The results showed that motor-cognitive interventions can improve gait speed under single-task conditions (small ES = 0.34, P = 0.003). The effect of the intervention was moderated by the type of control group (Q = 6.203, P = 0.013): passive (moderate ES = 0.941, P = 0.001) vs. active controls (trivial ES = 0.153, P = 0.180). No significant effect was found for dual-task walking outcomes (P = 0.063). Motor-cognitive intervention had a positive effect on TUG (small ES = 0.42, P < 0.001), where the effect of intervention was moderated by control group [passive (moderate ES = 0.73, P = 0.001) vs. active (small ES = 0.20, P = 0.020)], but not by the type of training (P = 0.064). Finally, BBS scores were positively affected by motor-cognitive interventions (small ES = 0.59, P < 0.001) with however no significant differences between type of control group (P = 0.529) or intervention modality (P = 0.585). Conclusions This study provides evidence for the effectiveness of various types of motor-cognitive interventions on performance-based measures of functional mobility in healthy older adults. With respect to significant effects, gait speed under single-task condition was improved by motor-cognitive interventions, but the evidence shows that this type of intervention is not necessarily more beneficial than motor training alone. On the other hand, motor-cognitive interventions are better at improving multicomponent tasks of dynamic balance and mobility function, as measured by the TUG. Because of substantial heterogeneity and the current limited availability of different types of interventions, the conclusions should be interpreted with caution.
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Affiliation(s)
- Kaja Teraz
- Institute for Kinesiology Research, Science and Research Centre Koper, Koper, Slovenia
- Faculty of Sport, University of Ljubljana, Ljubljana, Slovenia
| | - Luka Šlosar
- Institute for Kinesiology Research, Science and Research Centre Koper, Koper, Slovenia
| | - Armin H. Paravlić
- Institute for Kinesiology Research, Science and Research Centre Koper, Koper, Slovenia
- Faculty of Sport, University of Ljubljana, Ljubljana, Slovenia
- Faculty of Sports Studies, Masaryk University, Brno, Czechia
| | - Eling D. de Bruin
- Institute of Human Movement Sciences and Sport, Department of Health Sciences and Technology, ETH Zurich, Zurich, Switzerland
- Division of Physiotherapy, Department of Neurobiology, Care Sciences and Society, Karolinska Institute, Stockholm, Sweden
- *Correspondence: Eling D. de Bruin
| | - Uros Marusic
- Institute for Kinesiology Research, Science and Research Centre Koper, Koper, Slovenia
- Department of Health Sciences, Alma Mater Europaea – ECM, Maribor, Slovenia
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Paravlic AH. Motor Imagery and Action Observation as Appropriate Strategies for Home-Based Rehabilitation: A Mini-Review Focusing on Improving Physical Function in Orthopedic Patients. Front Psychol 2022; 13:826476. [PMID: 35310255 PMCID: PMC8928581 DOI: 10.3389/fpsyg.2022.826476] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Accepted: 01/19/2022] [Indexed: 12/25/2022] Open
Abstract
Dynamic stability of the knee and weakness of the extensor muscles are considered to be the most important functional limitations after anterior cruciate ligament (ACL) injury, probably due to changes at the central (cortical and corticospinal) level of motor control rather than at the peripheral level. Despite general technological advances, fewer contraindicative surgical procedures, and extensive postoperative rehabilitation, up to 65% of patients fail to return to their preinjury level of sports, and only half were able to return to competitive sport. Later, it becomes clear that current rehabilitation after knee surgery is not sufficient to address the functional limitations after ACL reconstruction even years after surgery. Therefore, new therapeutic tools targeting the central neural system, i.e., the higher centers of motor control, should be investigated and integrated into current rehabilitation practice. To improve motor performance when overt movement cannot be fully performed (e.g., due to pain, impaired motor control, and/or joint immobilization), several techniques have been developed to increase physical and mental activation without the need to perform overt movements. Among the most popular cognitive techniques used to increase physical performance are motor imagery and action observation practices. This review, which examines the available evidence, presents the underlying mechanisms of the efficacy of cognitive interventions and provides guidelines for their use at home.
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Affiliation(s)
- Armin H. Paravlic
- Faculty of Sport, Institute of Kinesiology, University of Ljubljana, Ljubljana, Slovenia
- Science and Research Centre Koper, Institute for Kinesiology Research, Koper, Slovenia
- *Correspondence: Armin H. Paravlic,
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Physical inactivity – The human health’s greatest enemy. Zdr Varst 2021; 61:1-5. [PMID: 35111260 PMCID: PMC8776290 DOI: 10.2478/sjph-2022-0002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Accepted: 12/02/2021] [Indexed: 12/03/2022] Open
Abstract
For decades, research has been highlighting the positive impact of physical activity on health. Despite the immense efforts made by many professional and scientific organizations to raise individual and societal awareness about the role of a sufficient quantity and intensity of physical activity in everyday life and to increase the level of adherence, the situation is still very worrying. Even more worrying is the fact that increasingly prolonged periods of physical inactivity are insidiously and aggressively taking over modern people’s lives – at school, at work, at home, even at leisure. It is probably incomprehensible and difficult for many to accept, but physical inactivity is becoming the first and worst enemy of health in today’s society.
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Sprague BN, Phillips CB, Ross LA. Cognitive Training Attenuates Decline in Physical Function Across 10 Years. J Gerontol B Psychol Sci Soc Sci 2021; 76:1114-1124. [PMID: 32484891 DOI: 10.1093/geronb/gbaa072] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2019] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVES Poor physical function is associated with negative health and cognitive outcomes. Although nine studies demonstrated that cognitive training reduces age-related declines in physical function, only one study has examined the effects beyond immediate posttest changes. The first aim of this study was to assess the impact of three cognitive training programs on physical function measures across 10 years and the second aim was to examine whether baseline cognitive self-efficacy or depressive symptoms moderated training effects. METHOD Using data from the Advanced Cognitive Training for Independent and Vital Elderly (ACTIVE) randomized controlled trial, older adults in a no-contact control condition (n = 698) were compared to those receiving processing speed (n = 702), memory (n = 703), or reasoning (n = 694) training. Intention-to-treat (ITT) and dosage analyses were conducted for grip strength and Turn 360. Participants were followed up to 10 years posttest. RESULTS There were no significant ITT effects of processing speed, memory, or reasoning training assignment to any physical function outcome (p > .05). Dosage models indicated that there were small age-related attenuation effects in Turn 360 decline with more processing speed training (b = -.011, p < .001), memory training (b = -.011, p < .001), and reasoning training (b = -.012, p < .001). There was no significant transfer to grip strength. These training gains were greater for those with more baseline depressive symptoms who received more processing speed training (b = -.001, p < .001). DISCUSSION This is the first study to demonstrate the effects of cognitive training to complex physical function across 10 years.
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Affiliation(s)
- Briana N Sprague
- Department of Human Development and Family Studies, The Pennsylvania State University, University Park
| | | | - Lesley A Ross
- Department of Human Development and Family Studies, The Pennsylvania State University, University Park.,Department of Psychology, Clemson University, South Carolina
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Marusic U, Narici M, Simunic B, Pisot R, Ritzmann R. Nonuniform loss of muscle strength and atrophy during bed rest: a systematic review. J Appl Physiol (1985) 2021; 131:194-206. [PMID: 33703945 DOI: 10.1152/japplphysiol.00363.2020] [Citation(s) in RCA: 44] [Impact Index Per Article: 14.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Muscle atrophy and decline in muscle strength appear very rapidly with prolonged disuse or mechanical unloading after acute hospitalization or experimental bed rest. The current study analyzed data from short-, medium-, and long-term bed rest (5-120 days) in a pooled sample of 318 healthy adults and modeled the mathematical relationship between muscle strength decline and atrophy. The results show a logarithmic disuse-induced loss of strength and muscle atrophy of the weight-bearing knee extensor muscles. The greatest rate of muscle strength decline and atrophy occurred in the earliest stages of bed rest, plateauing later, and likely contributed to the rapid neuromuscular loss of function in the early period. In addition, during the first 2 wk of bed rest, muscle strength decline is much faster than muscle atrophy: on day 5, the ratio of muscle atrophy to strength decline as a function of bed rest duration is 4.2, falls to 2.4 on day 14, and stabilizes to a value of 1.9 after ∼35 days of bed rest. Positive regression revealed that ∼79% of the muscle strength loss may be explained by muscle atrophy, while the remaining is most likely due to alterations in single fiber mechanical properties, excitation-contraction coupling, fiber architecture, tendon stiffness, muscle denervation, neuromuscular junction damage, and supraspinal changes. Future studies should focus on neural factors as well as muscular factors independent of atrophy (single fiber excitability and mechanical properties, architectural factors) and on the role of extracellular matrix changes. Bed rest results in nonuniform loss of isometric muscle strength and atrophy over time, where the magnitude of change was greater for muscle strength than for atrophy. Future research should focus on the loss of muscle function and the underlying mechanisms, which will aid in the development of countermeasures to mitigate or prevent the decline in neuromuscular efficiency.NEW & NOTEWORTHY Our study contributes to the characterization of muscle loss and weakness processes reflected by a logarithmic decline in muscle strength induced by chronic bed rest. Acute short-term hospitalization (≤5 days) associated with periods of disuse/immobilization/prolonged time in the supine position in the hospital bed is sufficient to significantly decrease muscle mass and size and induce functional changes related to weakness in maximal muscle strength. By bringing together integrated evaluation of muscle structure and function, this work identifies that 79% of the loss in muscle strength can be explained by muscle atrophy, leaving 21% of the functional loss unexplained. The outcomes of this study should be considered in the development of daily countermeasures for preserving neuromuscular integrity as well as preconditioning interventions to be implemented before clinical bed rest or chronic gravitational unloading (e.g., spaceflights).
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Affiliation(s)
- Uros Marusic
- Institute for Kinesiology Research, Science and Research Centre Koper, Koper, Slovenia.,Department of Health Sciences, Alma Mater Europaea-European Center of Maribor, Maribor, Slovenia
| | - Marco Narici
- Institute for Kinesiology Research, Science and Research Centre Koper, Koper, Slovenia.,Department of Biomedical Sciences, University of Padua, Padua, Italy
| | - Bostjan Simunic
- Institute for Kinesiology Research, Science and Research Centre Koper, Koper, Slovenia
| | - Rado Pisot
- Institute for Kinesiology Research, Science and Research Centre Koper, Koper, Slovenia
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Angulo J, El Assar M, Álvarez-Bustos A, Rodríguez-Mañas L. Physical activity and exercise: Strategies to manage frailty. Redox Biol 2020; 35:101513. [PMID: 32234291 PMCID: PMC7284931 DOI: 10.1016/j.redox.2020.101513] [Citation(s) in RCA: 230] [Impact Index Per Article: 57.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2020] [Revised: 03/13/2020] [Accepted: 03/17/2020] [Indexed: 12/25/2022] Open
Abstract
Frailty, a consequence of the interaction of the aging process and certain chronic diseases, compromises functional outcomes in the elderly and substantially increases their risk for developing disabilities and other adverse outcomes. Frailty follows from the combination of several impaired physiological mechanisms affecting multiple organs and systems. And, though frailty and sarcopenia are related, they are two different conditions. Thus, strategies to preserve or improve functional status should consider systemic function in addition to muscle conditioning. Physical activity/exercise is considered one of the main strategies to counteract frailty-related physical impairment in the elderly. Exercise reduces age-related oxidative damage and chronic inflammation, increases autophagy, and improves mitochondrial function, myokine profile, insulin-like growth factor-1 (IGF-1) signaling pathway, and insulin sensitivity. Exercise interventions target resistance (strength and power), aerobic, balance, and flexibility work. Each type improves different aspects of physical functioning, though they could be combined according to need and prescribed as a multicomponent intervention. Therefore, exercise intervention programs should be prescribed based on an individual's physical functioning and adapted to the ensuing response.
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Affiliation(s)
- Javier Angulo
- Servicio de Histología-Investigación, Unidad de Investigación Traslacional en Cardiología (IRYCIS-UFV), Hospital Universitario Ramón y Cajal, Madrid, Spain; Centro de Investigación Biomédica en Red de Fragilidad y Envejecimiento Saludable (CIBERFES), Instituto de Salud Carlos III, Madrid, Spain
| | - Mariam El Assar
- Centro de Investigación Biomédica en Red de Fragilidad y Envejecimiento Saludable (CIBERFES), Instituto de Salud Carlos III, Madrid, Spain; Fundación para la Investigación Biomédica del Hospital Universitario de Getafe, Getafe, Spain
| | | | - Leocadio Rodríguez-Mañas
- Centro de Investigación Biomédica en Red de Fragilidad y Envejecimiento Saludable (CIBERFES), Instituto de Salud Carlos III, Madrid, Spain; Servicio de Geriatría, Hospital Universitario de Getafe, Getafe, Spain.
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15
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Paravlic AH, Kovač S, Pisot R, Marusic U. Neurostructural correlates of strength decrease following total knee arthroplasty: A systematic review of the literature with meta-analysis. Bosn J Basic Med Sci 2020; 20:1-12. [PMID: 30640590 PMCID: PMC7029198 DOI: 10.17305/bjbms.2019.3814] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2018] [Accepted: 09/25/2018] [Indexed: 11/16/2022] Open
Abstract
Recent literature suggests that alterations in both neural and structural components of the neuromuscular system are major determinants of knee extensor muscle weakness after total knee arthroplasty (TKA). Therefore, the goal of this study was to investigate the maximal voluntary strength (MVS), voluntary muscle activation (VMA), and the cross-sectional area (CSA) of the muscle, up to 33 months after the TKA. We searched relevant scientific databases and literature for outcomes of interest, including quadriceps MVS, VMA, and CSA. Ten studies met the inclusion criteria and involved a total of 289 patients. The quality of the studies was evaluated by Methodological Index for Non-Randomized Studies (MINORS). Results showed that quadriceps MVS markedly declines in the early postoperative period, after which it slowly and linearly recovers over time. However, the same phenomenon was not observed for VMA and CSA, which were not significantly altered after the TKA. Furthermore, a meta-regression analysis revealed that the change in VMA accounted for 39% of the relative change in quadriceps strength (R2=0.39; p=0.015) in the early postoperative period. Patients treated with TKA had considerable weakness of the quadriceps muscle, which was detectable up to 3 months after surgery. Although the change in VMA largely explains quadriceps weakness, this change and CSA differences were not significant, suggesting that other neural correlates, such as hamstrings coactivation, might alter quadriceps muscle function. Thus, more attention should be paid to address VMA failure and coactivation of antagonist muscles. More comprehensive rehabilitation approaches may be required to target the whole neural circuit controlling the motor action.
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Affiliation(s)
- Armin H Paravlic
- Science and Research Centre Koper, Institute for Kinesiology Research, Koper, Slovenia
| | - Simon Kovač
- Valdoltra Orthopaedic Hospital, Ankaran, Slovenia
| | - Rado Pisot
- Science and Research Centre Koper, Institute for Kinesiology Research, Koper, Slovenia
| | - Uros Marusic
- Science and Research Centre Koper, Institute for Kinesiology Research, Koper, and Department of Health Sciences, Alma Mater Europaea - ECM, Maribor, Slovenia.
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16
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Müller MLTM, Marusic U, van Emde Boas M, Weiss D, Bohnen NI. Treatment options for postural instability and gait difficulties in Parkinson's disease. Expert Rev Neurother 2019; 19:1229-1251. [PMID: 31418599 DOI: 10.1080/14737175.2019.1656067] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
Introduction: Gait and balance disorders in Parkinson's disease (PD) represent a major therapeutic challenge as frequent falls and freezing of gait impair quality of life and predict mortality. Limited dopaminergic therapy responses implicate non-dopaminergic mechanisms calling for alternative therapies.Areas covered: The authors provide a review that encompasses pathophysiological changes involved in axial motor impairments in PD, pharmacological approaches, exercise, and physical therapy, improving physical activity levels, invasive and non-invasive neurostimulation, cueing interventions and wearable technology, and cognitive interventions.Expert opinion: There are many promising therapies available that, to a variable degree, affect gait and balance disorders in PD. However, not one therapy is the 'silver bullet' that provides full relief and ultimately meaningfully improves the patient's quality of life. Sedentariness, apathy, and emergence of frailty in advancing PD, especially in the setting of medical comorbidities, are perhaps the biggest threats to experience sustained benefits with any of the available therapeutic options and therefore need to be aggressively treated as early as possible. Multimodal or combination therapies may provide complementary benefits to manage axial motor features in PD, but selection of treatment modalities should be tailored to the individual patient's needs.
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Affiliation(s)
- Martijn L T M Müller
- Functional Neuroimaging, Cognitive and Mobility Laboratory, Department of Radiology, University of Michigan, Ann Arbor, MI, USA.,Morris K. Udall Center of Excellence for Parkinson's Disease Research, University of Michigan, Ann Arbor, MI, USA
| | - Uros Marusic
- Institute for Kinesiology Research, Science and Research Centre of Koper, Koper, Slovenia.,Department of Health Sciences, Alma Mater Europaea - ECM, Maribor, Slovenia
| | - Miriam van Emde Boas
- Functional Neuroimaging, Cognitive and Mobility Laboratory, Department of Radiology, University of Michigan, Ann Arbor, MI, USA
| | - Daniel Weiss
- Centre for Neurology, Department for Neurodegenerative Diseases and Hertie Institute for Clinical Brain Research, University of Tübingen, Tübingen, Germany
| | - Nicolaas I Bohnen
- Functional Neuroimaging, Cognitive and Mobility Laboratory, Department of Radiology, University of Michigan, Ann Arbor, MI, USA.,Morris K. Udall Center of Excellence for Parkinson's Disease Research, University of Michigan, Ann Arbor, MI, USA.,Geriatric Research Education and Clinical Center, Veterans Affairs Ann Arbor Healthcare System, Ann Arbor, MI, USA.,Department of Neurology, University of Michigan, Ann Arbor, USA
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17
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Romano Smith S, Wood G, Coyles G, Roberts JW, Wakefield CJ. The effect of action observation and motor imagery combinations on upper limb kinematics and EMG during dart‐throwing. Scand J Med Sci Sports 2019; 29:1917-1929. [DOI: 10.1111/sms.13534] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2019] [Revised: 07/10/2019] [Accepted: 08/01/2019] [Indexed: 12/21/2022]
Affiliation(s)
| | - Greg Wood
- Research Centre for Musculoskeletal Science and Sports Medicine, Department of Sport and Exercise Science Manchester Metropolitan University UK
| | - Ginny Coyles
- School of Health Sciences Liverpool Hope University Liverpool UK
| | - James W. Roberts
- School of Health Sciences Liverpool Hope University Liverpool UK
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18
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Paravlic AH, Pisot R, Marusic U. Specific and general adaptations following motor imagery practice focused on muscle strength in total knee arthroplasty rehabilitation: A randomized controlled trial. PLoS One 2019; 14:e0221089. [PMID: 31412056 PMCID: PMC6693761 DOI: 10.1371/journal.pone.0221089] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2018] [Accepted: 07/16/2019] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Motor imagery (MI) has been a widely used strategy in the past two decades to enhance physical capabilities among orthopaedic patients. However, its effectiveness is still questioned, since the demonstrated effects were likely task-dependent, with little evidence of transfer to tasks not specifically trained with MI. OBJECTIVE The aim of this study was to investigate whether an MI practice focused on maximal isometric knee extension strength, causes additional specific and general adaptations upon neuromuscular and functional variables when compared to conventional rehabilitation only, in patients submitted to total knee arthroplasty (TKA). DESIGN Parallel group randomized controlled clinical trial. PARTICIPANTS Thirty-four patients (56% man) submitted to TKA. PROGRAM Patients were randomly assigned to an MI practice group (MIp: 15 minutes per day/5 days per week in addition to routine physical therapy) or control group (CON) that performed routine physical therapy alone for four weeks. OUTCOME MEASURES The maximal isometric knee extension strength of the operated leg was defined as the primary outcome. Secondary outcomes were spatial and temporal gait parameters, 30-second chair sit-to-stand performance, a self-reported physical function assessed by the Lower Extremity Functional Scale (LEFS) questionnaire, and an MI ability score. All measurements were conducted before and one month after TKA. RESULTS Significant differences in treatment effects were observed for the MIp group compared to CON: the MIp showed less strength decrease (ES = 1.15, 95% CI: 0.32, 1.99, p = 0.022); faster self-selected speed under single (ES = 2.12, 95% CI: 1.16, 3.08, p = 0.001) and dual task (ES = 1.59, large, 95% CI: 0.67, 2.50, p = 0.002) conditions; brisk-pace gait speed during single (ES = 1.32, 95% CI: 0.47, 2.17, p = 0.020) and dual task conditions (ES = 1.31, large, 95% CI: 0.38, 2.23, p = 0.013); improved chair sit-to-stand (ES = 1.45, large, 95% CI: 0.58, 2.31, p = 0.004) performance; and a higher score on MI ability questionnaires for kinaesthetic imagery (KI) (ES = 0.55, 95% CI: -0.23, 1.34, p = 0.010) and internal visual imagery (EVI) (ES = 0.99, 95% CI: 0.18, 1.80, p = 0.039) scales, respectively. In addition, only MIp showed unaltered single and double support periods, as well as stride length and cadence during single task self-selected gait condition. Finally, analysis showed that the improved MI ability score achieved at the end of MI training was significantly correlated with the changes in the strength of the operated leg (kinaesthetic imagery: r = 0.741, p = 0.004; and internal visual imagery: r = 0.623, p = 0.023). CONCLUSIONS MI training, when added in a corollary to routine physical therapy, led to improvements in both specific and general adaptations that were related to patients' physical capabilities. While future studies must also evaluate the long-term effects, conducting MI training during acute and post-acute rehabilitation phases is advised, especially when the extent and range of physical exercise is limited or made impossible. TRIAL REGISTRATION ClinicalTrials.gov NCT03684148.
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Affiliation(s)
- Armin H. Paravlic
- Science and Research Centre, Institute for Kinesiology Research, Garibaldijeva 1, Slovenia
| | - Rado Pisot
- Science and Research Centre, Institute for Kinesiology Research, Garibaldijeva 1, Slovenia
- Faculty of Sport, University of Ljubljana, Slovenia
| | - Uros Marusic
- Science and Research Centre, Institute for Kinesiology Research, Garibaldijeva 1, Slovenia
- Department of Health Sciences, Alma Mater Europaea-ECM, Maribor, Slovenia
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19
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Marusic U, Kavcic V, Pisot R, Goswami N. The Role of Enhanced Cognition to Counteract Detrimental Effects of Prolonged Bed Rest: Current Evidence and Perspectives. Front Physiol 2019; 9:1864. [PMID: 30728781 PMCID: PMC6351441 DOI: 10.3389/fphys.2018.01864] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2018] [Accepted: 12/11/2018] [Indexed: 12/29/2022] Open
Abstract
Prolonged periods of physical inactivity or bed rest can lead to a significant decline of functional and cognitive functions. Different kinds of countermeasures (e.g., centrifugation, nutritional, and aerobic interventions) have been developed to attempt to mitigate negative effects related to bed rest confinement. The aim of this report is to provide an overview of the current evidence related to the effectiveness of computerized cognitive training (CCT) intervention during a period of complete physical inactivity in older adults. CCT, using a virtual maze navigation task, appears to be effective and has long-lasting benefits (up to 1.5 years after the study). Moreover, enhanced cognition (executive control) reduces decline in the ability to perform complex motor-cognitive dual-tasks after prolonged period of bed rest. It has been demonstrated that CCT administration in older adults also prevents bed rest stress-related physiological changes [these groups showed minimal changes in vascular function and an unchanged level of brain-derived neurotrophic factor (BDNF)] while control subjects showed decreased peripheral vascularization and increased plasma level of the neurotrophin BDNF during a 14-day bed rest. In addition, the effects of CCT are evident also from the brain electrocortical findings: CCT group revealed a decreased power in lower delta and theta bands while significant increases in the same EEG spectral bands power were found in control subjects. If we consider an increase of power in delta band as a marker of cortical aging, then the lack of shift of EEG power to lower band indicates a preventive role of CCT on the cortical level during physiological deconditioning induced by 2-week bed rest immobilization. However, replication on a larger sample is required to confirm the observed findings. Applications derived from these findings could be appropriate for implementation of hospital treatment for bed ridden patients as well as for fall prevention programs.
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Affiliation(s)
- Uros Marusic
- Institute for Kinesiology Research, Science and Research Centre Koper, Koper, Slovenia.,Department of Health Sciences, Alma Mater Europaea - European Center Maribor, Maribor, Slovenia
| | - Voyko Kavcic
- Institute of Gerontology, Wayne State University, Detroit, MI, United States
| | - Rado Pisot
- Institute for Kinesiology Research, Science and Research Centre Koper, Koper, Slovenia
| | - Nandu Goswami
- Department of Health Sciences, Alma Mater Europaea - European Center Maribor, Maribor, Slovenia.,Head of Research Unit: "Gravitational Physiology, Aging and Medicine", Otto Loewi Research Center of Vascular Biology, Immunity and Inflammation, Medical University of Graz, Graz, Austria
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20
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Kyriazis M. Four Principles Regarding an Effective Treatment of Aging. Curr Aging Sci 2018; 11:149-154. [PMID: 30362423 PMCID: PMC6388426 DOI: 10.2174/1874609811666181025170059] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2018] [Revised: 09/07/2018] [Accepted: 10/16/2018] [Indexed: 12/28/2022]
Abstract
The question whether aging is a disease or not, has been asked by many professionals who are involved in the study of age-related degeneration. However, not only an agreement on this remains elusive, but also effective clinical treatments against human aging have not been forthcoming. In this Opinion paper I suggest that the complexity involved in aging is such that we need to remodel our thinking to involve a much more 'systems-oriented' approach. I explore four main principles which should be employed by those who are working on finding treatments against agerelated degeneration. First, I discuss the problems encountered in translating laboratory research into effective therapies for humans. Second, I propose that a 'systems-thinking' method needs to be more extensively employed, instead of relying exclusively on the current reductionist one. Third, it is submitted that we must learn from the history of life-extension research, and not blindly follow contemporary paradigms, which may lead us into yet more 'dead ends' with regards to therapies. Finally, I suggest that, we may need to employ certain universal notions and use these in order to gain insights into the mechanics of a possible therapy against age-related degeneration. Examples may be the principle of hormesis, those of degeneracy, exaptation, and others from cybernetic or systems science domains. By using this four-pronged approach we liberate our thinking from the shackles of existing common mistakes and fallacies, and we open the way for a fresh approach that may lead us towards entirely new paradigms for providing clinically effective therapies against agerelated degeneration.
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