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Castellote-Caballero Y, Del Carmen Carcelén Fraile M, Aibar-Almazán A, Afanador-Restrepo DF, González-Martín AM. Effect of combined physical-cognitive training on the functional and cognitive capacity of older people with mild cognitive impairment: a randomized controlled trial. BMC Med 2024; 22:281. [PMID: 38972988 PMCID: PMC11229192 DOI: 10.1186/s12916-024-03469-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2024] [Accepted: 06/05/2024] [Indexed: 07/09/2024] Open
Abstract
BACKGROUND The increase in population aging highlights the growing prevalence of mild cognitive impairment, prompting the adoption of interventions that combine physical exercise and cognitive training to improve health and cognitive performance in older adults. The aim of this study was to analyze the efficacy of a combined program on physical and cognitive health in older people with cognitive impairment. METHODS A 12-week randomized controlled clinical trial involving 95 participants (aged 72.12 ± 4.25 years), 47 individuals participated in a control group (CG) that only underwent cognitive stimulation, while 48 individuals were in an experimental group (EG) that participated in a combined program. Balance was measured using the Tinetti scale, upper body strength was assessed with the arm curl test, lower body strength was evaluated with the 30-s chair stand test, flexibility was tested using the back scratch test and chair sit-and-reach test, physical function was measured with the Timed Up and Go test, cognitive function was assessed using the Mini Mental State Examination, cognitive impairment was evaluated with the Montreal Cognitive Assessment, verbal fluency was tested with the Isaac test, and executive functions were assessed using the Trail Making Test. RESULTS The results of the study show significant improvements in both physical and cognitive aspects, such as balance, gait, upper and lower body strength, flexibility, physical function, cognitive function, cognitive impairment, verbal fluency, and executive functions in the group that carried out the intervention compared to the control group. CONCLUSION A combined program for older individuals with mild cognitive impairment leads to enhancements in physical and cognitive health. These improvements underscore the importance of integrating physical exercise with cognitive training as an effective strategy for enhancing overall health and quality of life in older adults. TRIAL REGISTRATION NCT05503641.
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Affiliation(s)
- Yolanda Castellote-Caballero
- Department of Health Sciences, Faculty of Health Sciences, University of Jaén, Jaén, 23071, Spain
- Department of Health Sciences, Faculty of Health Sciences, University of Atlántico Medio, Las Palmas de Gran Canaria, 35017, Spain
| | - María Del Carmen Carcelén Fraile
- Department of Education and Psychology, Faculty of Social Sciences, University of Atlántico Medio, Las Palmas de Gran Canaria, 35017, Spain.
| | - Agustín Aibar-Almazán
- Department of Health Sciences, Faculty of Health Sciences, University of Jaén, Jaén, 23071, Spain
- Department of Health Sciences, Faculty of Health Sciences, University of Atlántico Medio, Las Palmas de Gran Canaria, 35017, Spain
| | | | - Ana María González-Martín
- Department of Education and Psychology, Faculty of Social Sciences, University of Atlántico Medio, Las Palmas de Gran Canaria, 35017, Spain
- Department of Psychology, Centro de Educación Superior de Enseñanza e Investigación Educativa, Plaza de San Martín, 4, Madrid, 28013, Spain
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Ben Waer F, Chaari F, Fendri T, Laatar R, Rebai H, Sahli S. The relationship between postural control and cognitive functioning following Zumba dancing in middle-aged women: A randomized clinical trial. J Women Aging 2024; 36:273-285. [PMID: 38506650 DOI: 10.1080/08952841.2024.2325195] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Accepted: 02/26/2024] [Indexed: 03/21/2024]
Abstract
This study aimed to investigate the effect of 12-week Zumba dancing on postural control and cognitive parameters and the correlations between these parameters in middle-aged women. Thirty-eight women, aged between 50 and 60 years, were randomly allocated to a Zumba group (ZG) or control group. Postural control and cognitive functions [working memory (WM) and reaction time (RT)] were assessed before and after 12 weeks of a Zumba dancing program using a stabilometric force platform, Corsi Block-Tapping Task and Simple RT tests, respectively. The results indicate that ZG showed significantly (p<.01) better balance performances when standing on a stable surface in both visual conditions [firm surface with eyes opened (EO) (20,9%) and eyes closed (EC) (12.3%)]. However, when standing on an unstable surface in both visual conditions (foam surface with EO/EC), the ZG showed no significant improvement in postural control. It seems that the benefits of Zumba on postural control depend on the sensory condition. Besides, 12-week Zumba dancing was not sufficient to significantly enhance cognitive performances (RT/WM) performances. These cognitive performances were related to postural control in challenging conditions and can be considered an effective tool for monitoring postural performances following an intervention program. Clinicians should, therefore, focus on interventions that boost cognitive functions in middle-aged women to achieve optimal postural control, mainly in challenging conditions, in order to prevent the risk and fear of falls as well as the incidence of falling.
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Affiliation(s)
- Fatma Ben Waer
- Research Laboratory Education, Motricité, Sport et Santé, LR19JS01, High Institute of Sport and Physical Education of Sfax, University of Sfax, Tunisia
| | - Fatma Chaari
- Research Laboratory Education, Motricité, Sport et Santé, LR19JS01, High Institute of Sport and Physical Education of Sfax, University of Sfax, Tunisia
| | - Thouraya Fendri
- Research Laboratory Education, Motricité, Sport et Santé, LR19JS01, High Institute of Sport and Physical Education of Sfax, University of Sfax, Tunisia
| | - Rabeb Laatar
- Research Laboratory Education, Motricité, Sport et Santé, LR19JS01, High Institute of Sport and Physical Education of Sfax, University of Sfax, Tunisia
| | - Haithem Rebai
- Research Laboratory Sports Performance Optimization (LR09SEP01), National Center of Medicine and Science in Sports, Tunis, Tunisia
| | - Sonia Sahli
- Research Laboratory Education, Motricité, Sport et Santé, LR19JS01, High Institute of Sport and Physical Education of Sfax, University of Sfax, Tunisia
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Kantola M, Ilves O, Honkanen S, Hakonen H, Yli-Ikkelä R, Köyhäjoki A, Anttila MR, Rintala A, Korpi H, Sjögren T, Karvanen J, Aartolahti E. The Effects of Virtual Reality Training on Cognition in Older Adults: A Systematic Review, Meta-Analysis, and Meta-Regression of Randomized Controlled Trials. J Aging Phys Act 2024; 32:321-349. [PMID: 38242114 DOI: 10.1123/japa.2023-0217] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Revised: 10/29/2023] [Accepted: 10/31/2023] [Indexed: 01/21/2024]
Abstract
The aim of this systematic review, meta-analysis, and meta-regression was to examine the effects of virtual reality-based training on global cognition and executive function compared with conventional training or information-based treatment in older adults, regardless of cognitive level. A systematic literature search was conducted using four databases. A total of 31 randomized controlled trials were identified. Pooled effect sizes were calculated, the risk of bias was assessed, and evidence was graded. The primary analyses showed a small but statistically significant effect of virtual reality-based training compared with control on global cognition (Hedges' g 0.42, 95% confidence interval [0.17, 0.68], I2 = 70.1%, n = 876, 20 randomized controlled trials, low evidence) and executive function (Hedges' g 0.35, 95% confidence interval [0.06, 0.65], I2 = 68.4%, n = 810, 16 randomized controlled trials, very low evidence). Meta-regression yielded inconclusive results. Virtual reality-based training may be more effective than control in improving cognition in older adults; however, more high-quality studies are needed.
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Affiliation(s)
- Mirjami Kantola
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | - Outi Ilves
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
- Department of Sports and Rehabilitation, South-Eastern Finland University of Applied Sciences, Savonlinna, Finland
| | - Sari Honkanen
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | - Harto Hakonen
- Jamk University of Applied Sciences, LIKES, Jyväskylä, Finland
| | - Riku Yli-Ikkelä
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | - Anna Köyhäjoki
- Central Ostrobothnia Well-Being Service County "Soite", Kokkola, Finland
| | - Marjo-Riitta Anttila
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | - Aki Rintala
- Physical Activity and Functional Capacity Research Group, Faculty of Health Care and Social Services, LAB University of Applied Sciences, Lahti, Finland
| | - Hilkka Korpi
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
- Social and Healthcare Unit, Vaasa University of Applied Sciences, Vaasa, Finland
- Well-being and Culture Unit, Oulu University of Applied Sciences, Oulu, Finland
| | - Tuulikki Sjögren
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | - Juha Karvanen
- Faculty of Mathematics and Science, University of Jyväskylä, Jyväskylä, Finland
| | - Eeva Aartolahti
- Institute of Rehabilitation, Jamk University of Applied Sciences, Jyväskylä, Finland
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Aminirakan D, Losekamm B, Wollesen B. Effects of combined cognitive and resistance training on physical and cognitive performance and psychosocial well-being of older adults ≥65: study protocol for a randomised controlled trial. BMJ Open 2024; 14:e082192. [PMID: 38643006 PMCID: PMC11033638 DOI: 10.1136/bmjopen-2023-082192] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2023] [Accepted: 03/28/2024] [Indexed: 04/22/2024] Open
Abstract
INTRODUCTION With increasing life expectancy of older adult population, maintaining independence and well-being in later years is of paramount importance. This study aims to investigate the impact of three distinct interventions: cognitive training, resistance training and a combination of both, compared with an inactive control group, on cognitive performance, mobility and quality of life in adults aged ≥65 years. METHODS AND ANALYSIS This trial will investigate healthy older adults aged ≥65 years living independently without cognitive impairments. Participants will be randomly assigned to one of four groups: (1) cognitive training, (2) resistance training, (3) combined cognitive and resistance training, and (4) control group (n=136 participants with 34 participants per group). The interventions will be conducted over 12 weeks. The cognitive training group will receive group-based activities for 45-60 min two times a week. The resistance training group exercises will target six muscle groups and the combined group will integrate cognitive tasks into the resistance training sessions. Primary outcomes are: Short Physical Performance Battery, Sit-to-Stand Test, Montreal Cognitive Assessment, Trail Making Test and Stroop Test combined with gait on a treadmill (dual task). Life satisfaction will be measured by the Satisfaction With Life Scale. Secondary outcomes encompass hand grip strength and the Functional Independence Measure. ETHICS AND DISSEMINATION Ethical approval was provided by the local Ethics Committee at the University of Hamburg (no. 2023_009). Informed consent will be obtained from all study participants. The results of the study will be distributed for review and discussion in academic journals and conferences. TRIAL REGISTRATION NUMBER DRKS00032587.
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Affiliation(s)
- Deniz Aminirakan
- Department of Human Movement Science, Universität Hamburg, Hamburg, Germany
| | - Björn Losekamm
- Department of Human Movement Science, Universität Hamburg, Hamburg, Germany
| | - Bettina Wollesen
- Department of Human Movement Science, Universität Hamburg, Hamburg, Germany
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Sturnieks DL, Hicks C, Smith N, Ratanapongleka M, Menant J, Turner J, Lo J, Chaplin C, Garcia J, Valenzuela MJ, Delbaere K, Herbert RD, Sherrington C, Toson B, Lord SR. Exergame and cognitive training for preventing falls in community-dwelling older people: a randomized controlled trial. Nat Med 2024; 30:98-105. [PMID: 38228913 DOI: 10.1038/s41591-023-02739-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2023] [Accepted: 11/27/2023] [Indexed: 01/18/2024]
Abstract
Exergame training, in which video games are used to promote exercise, can be tailored to address cognitive and physical risk factors for falls and is a promising method for fall prevention in older people. Here, we performed a randomized clinical trial using the smart±step gaming system to examine the effectiveness of two home-based computer game interventions, seated cognitive training and step exergame training, for fall prevention in community-dwelling older people, as compared with a minimal-intervention control group. Participants aged 65 years or older (n = 769, 71% female) living independently in the community were randomized to one of three arms: (1) cognitive training using a computerized touchpad while seated, (2) exergame step training on a computerized mat or (3) control (provided with an education booklet on healthy ageing and fall prevention). The rate of falls reported monthly over 12 months-the primary outcome of the trial-was significantly reduced in the exergame training group compared with the control group (incidence rate ratio = 0.74, 95% confidence interval = 0.56-0.98), but was not statistically different between the cognitive training and control groups (incidence rate ratio = 0.86, 95% confidence interval = 0.65-1.12). No beneficial effects of the interventions were found for secondary outcomes of physical and cognitive function, and no serious intervention-related adverse events were reported. The results of this trial support the use of exergame step training for preventing falls in community-dwelling older people. As this intervention can be conducted at home and requires only minimal equipment, it has the potential for scalability as a public health intervention to address the increasing problem of falls and fall-related injuries. Australian and New Zealand Clinical Trial Registry identifier: ACTRN12616001325493 .
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Affiliation(s)
- Daina L Sturnieks
- Neuroscience Research Australia, Randwick, New South Wales, Australia.
- School of Biomedical Sciences, University of New South Wales, Sydney, New South Wales, Australia.
- UNSW Ageing Futures Institute, Sydney, New South Wales, Australia.
| | - Cameron Hicks
- Neuroscience Research Australia, Randwick, New South Wales, Australia
- School of Population Health, University of New South Wales, Sydney, New South Wales, Australia
| | - Natassia Smith
- Neuroscience Research Australia, Randwick, New South Wales, Australia
| | | | - Jasmine Menant
- Neuroscience Research Australia, Randwick, New South Wales, Australia
- UNSW Ageing Futures Institute, Sydney, New South Wales, Australia
- School of Population Health, University of New South Wales, Sydney, New South Wales, Australia
| | - Jessica Turner
- Neuroscience Research Australia, Randwick, New South Wales, Australia
| | - Joanne Lo
- Neuroscience Research Australia, Randwick, New South Wales, Australia
| | - Carly Chaplin
- Neuroscience Research Australia, Randwick, New South Wales, Australia
| | - Jaime Garcia
- UTS Games Studio, Faculty of Engineering and IT, University of Technology Sydney, Sydney, New South Wales, Australia
| | - Michael J Valenzuela
- Centre for Healthy Brain Ageing, University of New South Wales, Sydney, New South Wales, Australia
- Skin2Neuron Pty Ltd, Sydney, New South Wales, Australia
| | - Kim Delbaere
- Neuroscience Research Australia, Randwick, New South Wales, Australia
- UNSW Ageing Futures Institute, Sydney, New South Wales, Australia
- School of Population Health, University of New South Wales, Sydney, New South Wales, Australia
| | - Robert D Herbert
- Neuroscience Research Australia, Randwick, New South Wales, Australia
- School of Biomedical Sciences, University of New South Wales, Sydney, New South Wales, Australia
| | - Catherine Sherrington
- Sydney Musculoskeletal Health, Sydney School of Public Health, Sydney Local Health District, University of Sydney, Sydney, New South Wales, Australia
| | - Barbara Toson
- College of Medicine and Public Health, Flinders University, Adelaide, South Australia, Australia
| | - Stephen R Lord
- Neuroscience Research Australia, Randwick, New South Wales, Australia
- UNSW Ageing Futures Institute, Sydney, New South Wales, Australia
- School of Population Health, University of New South Wales, Sydney, New South Wales, Australia
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Forte R, Trentin C, Tocci N, Lucia S, Aydin M, Di Russo F. Motor-cognitive exercise with variability of practice and feedback improves functional ability and cognition in older individuals. Aging Clin Exp Res 2023; 35:2797-2806. [PMID: 37853304 DOI: 10.1007/s40520-023-02568-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Accepted: 09/14/2023] [Indexed: 10/20/2023]
Abstract
BACKGROUND Motor-cognitive dual-task training seems the most favorable form of exercise for functional and cognitive improvements in older individuals. The optimal exercise regime is still uncertain, and the potential benefits of qualitative parameters of exercise prescription such as feedback provision and practice variability are mostly unknown. AIMS To verify the effects of a motor-cognitive dual-task training with feedback provision and variability of practice for improving functional ability and cognition in older individuals. METHODS Thirty individuals (3 men) aged over 65 years were tested on walking speed, static and dynamic balance, lower limb strength, and cognition before and after a 5-week motor-cognitive intervention. Training consisted of twice weekly, 30 min gross-motor coordination exercises with variable practice conditions combined with stimulus-response cognitive tasks generated by an interactive device. Participants were divided into an experimental group and a control group, respectively receiving and nonreceiving feedback during training. A 2 × 2 ANOVA was used to verify the effects of training. RESULTS Both groups improved static and dynamic balance (p < 0.05), walking speeds (p < 0.05), lower limb strength (p < 0.05) and cognitive functions with greater gains observed in the experimental group (p < 0.01). DISCUSSION Variability of practice applied to motor-cognitive dual-task training is effective for improving, in only 5 weeks, functional ability and cognitive processing in older individuals. These changes were possibly afforded through motor and cognitive enhancement induced by exercise complexity. Provision of feedback seems to particularly benefit cognitive functions. CONCLUSIONS Brief motor-cognitive dual-task training using practice variability and feedback seems effective for counteracting the age-related cognitive and functional decline.
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Affiliation(s)
- Roberta Forte
- Department of Movement, Human and Health Sciences, University of Rome "Foro Italico", Rome, Italy.
| | - Chiara Trentin
- Department of Movement, Human and Health Sciences, University of Rome "Foro Italico", Rome, Italy
| | - Nicoletta Tocci
- Department of Movement, Human and Health Sciences, University of Rome "Foro Italico", Rome, Italy
| | - Stefania Lucia
- Department of Movement, Human and Health Sciences, University of Rome "Foro Italico", Rome, Italy
| | - Merve Aydin
- Department of Movement, Human and Health Sciences, University of Rome "Foro Italico", Rome, Italy
| | - Francesco Di Russo
- Department of Movement, Human and Health Sciences, University of Rome "Foro Italico", Rome, Italy
- Santa Lucia Foundation IRCCS, Rome, Italy
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Azadian E, Dadgar SA, Majlesi M, Jafarnezhadgero AA, Jalilvand M, Bijarchian MH. The effects of cognitive intervention on inter-joint coordination during walking in the older adults with balance impairment. Gait Posture 2023; 106:72-79. [PMID: 37672966 DOI: 10.1016/j.gaitpost.2023.08.030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2022] [Revised: 04/07/2023] [Accepted: 08/30/2023] [Indexed: 09/08/2023]
Abstract
BACKGROUND Cognitive interventions are among the effective training-on-gait parameters; however, the effects of such trainings on inter-joints coordination has not been much considered. RESEARCH QUESTION Can dual task and executive function training affect inter-joint coordination during walking in elderly with poor balance? METHODS Thirty elderly men were purposefully divided into three groups: 1) dual-task training group (DTG), 2) executive function training group (EFG) and 3) control group. After the pre-test, the experimental groups participated in 24 training sessions while the control group were required to do their normal daily tasks. VICON three-dimensional motion analysis system with four T20 series cameras was used to evaluate inter-joints coordination during the experiment. Participants had to walk a 12-meter path while kinematics of their joints was recorded. The inter-joint coordination at the sagittal plane and in four phases were assessed using the vector coding technique. RESULTS The findings of this study showed that the greatest effect of the intervention on the coordination between the joints was in the loading and mid-stance phases (p < 0.05). Also, the variability in the coupling angle showed a significant decrease in most phases (p < 0.05). SIGNIFICANCE Based on the obtained results, it can be argued that the loading and mid-stance are more involved in postural control and balance because the center of gravity is transferred between the legs and the person is normally on single-leg stance in these phases.
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Affiliation(s)
- Elaheh Azadian
- Department of Motor Behavior, Hamedan Branch, Islamic Azad University, Hamedan, Iran.
| | | | - Mahdi Majlesi
- Department of Sport Biomechanics, Hamedan Branch, Islamic Azad University, Hamedan, Iran.
| | - Amir Ali Jafarnezhadgero
- Department of Sport Biomechanics, Faculty of Educational Science and Psychology, University of Mohaghegh Ardabili, Ardabil, Iran.
| | - Mohammad Jalilvand
- Department of Motor Behavior, Hamedan Branch, Islamic Azad University, Hamedan, Iran.
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Benitez-Lugo ML, Vazquez-Marrufo M, Pinero-Pinto E, Chamorro-Moriana G, Perez-Cabezas V, Suarez-Serrano C. Analysis of Physical-Cognitive Tasks Including Feedback-Based Technology for Alzheimer's Disorder in a Randomized Experimental Pilot Study. J Clin Med 2023; 12:5484. [PMID: 37685549 PMCID: PMC10488299 DOI: 10.3390/jcm12175484] [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: 07/25/2023] [Revised: 08/17/2023] [Accepted: 08/22/2023] [Indexed: 09/10/2023] Open
Abstract
INTRODUCTION Alzheimer's disease causes great changes, with the prefrontal cortex being the most frequently damaged zone; these changes affect physical and cognitive behavior and compromise autonomy. OBJECTIVE The objective of this study was to evaluate the effects of physical-cognitive tasks on memory, attention, balance, gait, and risk of falling in Alzheimer's by using feedback-based technology. METHODS Forty patients with Alzheimer's were recruited from an Alzheimer's Association; of these, 15 met the inclusion criteria and were included in the pilot RCT (eight in the control group; seven in the experimental group). ASSESSMENT TOOLS The Cognitive Mini-Examination Scale, Oddball Test and Attention Network, Berg Scale, Tinetti, Timed Up and Go, and Geriatric Deterioration Scale. The experimental group was treated with physical-cognitive tasks by using combined feedback-based technology (visual, acoustic, simultaneous, immediate, and terminal feedback, as well as knowledge of the results and performance) under the supervision of physiotherapists twice per week for 16 thirty-minute sessions. The control group underwent their usual care (pharmacological treatment, mobility exercises, and cognitive stimulation sessions). RESULT In the experimental group, the contrast tests showed differences for the re-test (except in attention), with the significative Timed Up and Go test being significant (p = 0.020). The interaction between groups showed significant differences for the experimental group according to the MEC (p = 0.029; d = 0.14) and Tinetti (p = 0.029; d = 0.68). DISCUSSION/CONCLUSION Memory, balance, gait, and risk of falling improved in the Alzheimer's patients through the use of physical-cognitive tasks involving combined feedback-based technology. The effects on attention were inconclusive. The outcomes should be treated with caution due to the sample. This can promote intergenerational bonds, use at home, and adherence to treatment.
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Affiliation(s)
- Maria-Luisa Benitez-Lugo
- Department of Physiotherapy, Faculty of Nursery, Physiotherapy and Podiatry, University of Seville, 41009 Seville, Spain; (M.-L.B.-L.); (C.S.-S.)
| | - Manuel Vazquez-Marrufo
- Department of Experimental Phycology, Faculty of Phycology, University of Seville, 41018 Seville, Spain
| | - Elena Pinero-Pinto
- Department of Physiotherapy, Faculty of Nursery, Physiotherapy and Podiatry, University of Seville, 41009 Seville, Spain; (M.-L.B.-L.); (C.S.-S.)
| | - Gema Chamorro-Moriana
- Department of Physiotherapy, Faculty of Nursery, Physiotherapy and Podiatry, University of Seville, 41009 Seville, Spain; (M.-L.B.-L.); (C.S.-S.)
| | - Veronica Perez-Cabezas
- Department of Physiotherapy, Faculty of Nursery and Physiotherapy, University of Cadiz, 11009 Cadiz, Spain;
| | - Carmen Suarez-Serrano
- Department of Physiotherapy, Faculty of Nursery, Physiotherapy and Podiatry, University of Seville, 41009 Seville, Spain; (M.-L.B.-L.); (C.S.-S.)
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Karunakaran KK, Pamula S, Ibironke O, Nolan KJ. Motor-Cognitive Virtual Reality Training to Improve Gait and Balance in Young Adults with TBI. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2023; 2023:1-4. [PMID: 38083726 DOI: 10.1109/embc40787.2023.10341060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/18/2023]
Abstract
Traumatic Brain Injury (TBI) is one of the leading causes of motor and cognitive deficits in adults, and often results in motor control and balance impairments. Motor deficits include gait dysfunction and decreased postural control & coordination; leading to compromised functional ambulation and reduced quality of life. Research has shown that cognitive (attention and executive) function contributes to motor deficits and recovery. Hence, targeting the motor and the cognitive domains simultaneously by increasing cognitive and motor effort to perform the task may lead to improved ambulation recovery. The objective of this investigation was to evaluate the efficacy of simultaneous motor & cognitive training (MCT) using virtual reality to improve ambulation; assessed using biomechanical, cognitive, and functional outcomes. Preliminary data is presented for three participants with chronic TBI who received MCT. The results show improved cognition, speed, endurance, step length, gait cycle time, static & reactive balance, dual-task performance, and progression towards healthy ambulation. These preliminary results suggest that integrated cognitive motor training has the potential to induce functional recovery in young adults with TBI.Clinical Relevance - Preliminary data provides initial evidence for MCT as a therapeutic intervention for gait and balance rehabilitation in young adults with TBI.
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Buele J, Palacios-Navarro G. Cognitive-motor interventions based on virtual reality and instrumental activities of daily living (iADL): an overview. Front Aging Neurosci 2023; 15:1191729. [PMID: 37396651 PMCID: PMC10311491 DOI: 10.3389/fnagi.2023.1191729] [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: 03/22/2023] [Accepted: 05/30/2023] [Indexed: 07/04/2023] Open
Abstract
Non-invasive, non-pharmacological interventions utilizing virtual reality (VR) represent a promising approach to enhancing cognitive function in patients with degenerative cognitive disorders. Traditional "pen and paper" therapies often lack the practical engagement in everyday activities that older individuals encounter in their environment. These activities pose both cognitive and motor challenges, underscoring the necessity of understanding the outcomes of such combined interventions. This review aimed to assess the advantages of VR applications that integrate cognitive-motor tasks, simulating instrumental activities of daily living (iADLs). We systematically searched five databases-Scopus, Web of Science, Springer Link, IEEE Xplore, and PubMed, from their inception until January 31, 2023. Our review revealed that motor movements, coupled with VR-based cognitive-motor interventions, activate specific brain areas and foster improvements in general cognition, executive function, attention, and memory. VR applications that meld cognitive-motor tasks and simulate iADLs can offer significant benefits to older adults. Enhanced cognitive and motor performance can promote increased independence in daily activities, thereby contributing to improved quality of life.
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Affiliation(s)
- Jorge Buele
- SISAu Research Group, Facultad de Ingeniería, Industria y Producción, Universidad Indoamérica, Ambato, Ecuador
- Department of Electronic Engineering and Communications, University of Zaragoza, Teruel, Spain
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Parveen S, Noohu MM. Association between P300 parameters and cognitive function in people with diabetic neuropathy. J Diabetes Metab Disord 2023; 22:347-354. [PMID: 37255838 PMCID: PMC10225418 DOI: 10.1007/s40200-022-01148-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Revised: 10/06/2022] [Accepted: 10/11/2022] [Indexed: 06/01/2023]
Abstract
Purpose The purpose of this study was to investigate the association between event-related potential (ERP) P300 with cognitive function in people with diabetic peripheral neuropathy (DPN). Methods We performed a cross-sectional analysis of 19 type 2 diabetes mellitus (T2DM) patients, aged 18 and older with DPN. The participants were assessed for neuropathy, cognitive function, & dual-task performance. DPN was examined via the administration of diabetic neuropathy symptom score (DNSS) and vibration perception threshold (VPT). Cognitive dysfunction was evaluated using Mini-mental state examination (MMSE), trail making test-B (TMT-B), and ERP P300 wave latency & amplitude. For assessing dual-task performance, the dual-task cost (DTC) was calculated using the timed-up and go (TUG) test and TUG with dual task (TUG-DT). Results P300 latency was linearly related to TMT-B (R = 0.31, p = 0.01) and DTC (R = 0.22, p = 0.04). A similar trend was observed in TMT-B (R = 0.13, p = 0.04) & DTC (R =0 .67, p = 0.001) with respect to P300 amplitude. MMSE did not relate with P300 latency (R = 0.14, p = 0.58) & amplitude (R = 0.63, p = .44). Conclusion P300 latency and amplitude are associated with cognitive function and DTC of individuals with DPN.
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Affiliation(s)
- Sarah Parveen
- Centre for Physiotherapy & Rehabilitation Sciences, Jamia Millia Islamia, New Delhi, India
| | - Majumi M. Noohu
- Centre for Physiotherapy & Rehabilitation Sciences, Jamia Millia Islamia, New Delhi, India
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Effect of Exercise Cognitive Combined Training on Physical Function in Cognitively Healthy Older Adults: A Systematic Review and Meta-Analysis. J Aging Phys Act 2023; 31:155-170. [PMID: 35961648 DOI: 10.1123/japa.2021-0475] [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: 12/06/2021] [Revised: 04/20/2022] [Accepted: 06/04/2022] [Indexed: 02/03/2023]
Abstract
This study aimed to evaluate the effects of exercise cognitive combined training (ECCT) compared with non-ECCT on physical function in cognitively healthy older adults. Databases were searched for randomized controlled trials from inception to December 2, 2021, and 22 studies (1,091 participants, Mage = 74.90) were included in the meta-review. The Cochrane Risk of Bias and Grading of Recommendations Assessment, Development, and Evaluation tools were used for quality assessments. ECCT improved gait speed (mean difference: 0.06 m/s, 95% CI [confidence interval] [0.02, 0.11]; 446 participants, 11 studies) and balance (standardized mean difference: 0.38, 95% CI [0.14, 0.61]; 292 participants, seven studies). Simultaneous ECCT, but not nonsimultaneous ECCT, improved gait speed (mean difference: 0.11 m/s, 95% CI [0.07, 0.15]), balance (standardized mean difference: 0.40, 95% CI [0.16, 0.64]), and functional mobility (mean difference: -0.85 s, 95% CI [-1.63, -0.07]; 327 participants, nine studies). Future research should focus on the duration and form of ECCT intervention optimal for improving the functional activities of older individuals.
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Khan MJ, Kannan P, Wong TWL, Fong KNK, Winser SJ. A Systematic Review Exploring the Theories Underlying the Improvement of Balance and Reduction in Falls Following Dual-Task Training among Older Adults. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:16890. [PMID: 36554771 PMCID: PMC9778940 DOI: 10.3390/ijerph192416890] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Revised: 12/07/2022] [Accepted: 12/08/2022] [Indexed: 06/17/2023]
Abstract
BACKGROUND Balance impairment causes frequent falls in older adults, and preventing falls remains challenging. Dual-task (DT) training reduces falls by improving balance, but the precise theory is not fully understood. This review aims to explore the theories underlying the effectiveness of DT in improving balance and reducing falls in older adults. METHODS Eleven electronic databases were searched from database inception to June 2022. Two reviewers independently performed study screening and data extraction. The risk of bias (RoB) in the included studies was assessed using the Cochrane Collaboration RoB 2 tool. RESULTS The searches yielded 1478 citations, of which 30 studies met the inclusion criteria and were included in the review. Twenty-two of the 30 included studies utilized the motor-cognitive type of DT for training, while six used motor-motor and two utilized cognitive-cognitive DT. The included studies reported 20 different theories to explain the effectiveness of DT for improving balance and reducing falls in older adults. The predominant theory identified in the included studies was attention theory (n = 14). Overall, 26 studies reported improved balance and five studies found a reduction in fall incidence following DT training. Balance and falls improved significantly in 15 motor-cognitive DT intervention studies. CONCLUSION Attention shifting between two tasks is reported to occur following DT training. Motor-cognitive DT training improves balance and reduces fall incidence in older adults by shifting attention based on the difficulty and priority of a task from the motor to the cognitive task.
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Tao X, Sun R, Han C, Gong W. Cognitive-motor dual task: An effective rehabilitation method in aging-related cognitive impairment. Front Aging Neurosci 2022; 14:1051056. [PMID: 36329873 PMCID: PMC9623044 DOI: 10.3389/fnagi.2022.1051056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2022] [Accepted: 10/05/2022] [Indexed: 11/24/2022] Open
Affiliation(s)
- Xue Tao
- Department of Research, Beijing Rehabilitation Hospital, Capital Medical University, Beijing, China
| | - Ruifeng Sun
- Beijing Rehabilitation Medicine Academy, Capital Medical University, Beijing, China
| | - Conglin Han
- Rehabilitation Medicine Academy, Weifang Medical University, Weifang, China
| | - Weijun Gong
- Department of Neurological Rehabilitation, Beijing Rehabilitation Hospital, Capital Medical University, Beijing, China
- *Correspondence: Weijun Gong
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Bian M, Shen Y, Huang Y, Wu L, Wang Y, He S, Huang D, Mao Y. A non-immersive virtual reality-based intervention to enhance lower-extremity motor function and gait in patients with subacute cerebral infarction: A pilot randomized controlled trial with 1-year follow-up. Front Neurol 2022; 13:985700. [PMID: 36267888 PMCID: PMC9577285 DOI: 10.3389/fneur.2022.985700] [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: 07/04/2022] [Accepted: 09/15/2022] [Indexed: 11/23/2022] Open
Abstract
Introduction This study was conducted to evaluate whether a non-immersive virtual reality (VR)-based intervention can enhance lower extremity movement in patients with cerebral infarction and whether it has greater short-term and long-term effectiveness than conventional therapies (CTs). Materials and methods This was a single-blinded, randomized clinical controlled trial. Forty-four patients with subacute cerebral infarction were randomly allocated to the VR or CT group. All intervention sessions were delivered in the inpatient unit for 3 weeks. Outcomes were measured before (baseline) and after the interventions and at 3-month, 6-month and 1-year follow-ups. The outcomes included clinical assessments of movement and balance function using the Fugl–Meyer Assessment of Lower Extremity (FMA-LE) and Berg Balance Scale (BBS), and gait parameters in the sagittal plane. Results In the VR group, the walking speed after intervention, at 3-month, 6-month, and 1-year follow-ups were significantly greater than baseline (p = 0.01, <0.001, 0.007, and <0.001, respectively). Compared with baseline, BBS scores after intervention, at 3-month, 6-month, and 1-year follow-ups were significantly greater in both the VR group (p = 0.006, 0.002, <0.001, and <0.001, respectively) and CT group (p = <0.001, 0.002, 0.001, and <0.001, respectively), while FMA-LE scores after intervention, at 3-month, 6-month, and 1-year follow-ups were significant increased in the VR group (p = 0.03, <0.001, 0.003, and <0.001, respectively), and at 3-month, 6-month, and 1-year follow-ups in the CT group (p = 0.02, 0.004 and <0.001, respectively). In the VR group, the maximum knee joint angle in the sagittal plane enhanced significantly at 6-month follow-up from that at baseline (p = 0.04). Conclusion The effectiveness of the non-immersive VR-based intervention in our study was observed after the intervention and at the follow-ups, but it was not significantly different from that of CTs. In sum, our results suggest that non-immersive VR-based interventions may thus be a valuable addition to conventional physical therapies to enhance treatment efficacy. Clinical trial registration http://www.chictr.org.cn/showproj.aspx?proj=10541, ChiCTR-IOC-15006064.
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Affiliation(s)
- Minjie Bian
- Department of Rehabilitation Medicine, The Seventh Affiliated Hospital, Sun Yat-sen University, Shenzhen, China
| | - Yuxian Shen
- Department of Rehabilitation Medicine, The Seventh Affiliated Hospital, Sun Yat-sen University, Shenzhen, China
| | - Yijie Huang
- Department of Rehabilitation Medicine, The Seventh Affiliated Hospital, Sun Yat-sen University, Shenzhen, China
| | - Lishan Wu
- Department of Rehabilitation Medicine, The Seventh Affiliated Hospital, Sun Yat-sen University, Shenzhen, China
| | - Yueyan Wang
- Department of Rehabilitation Medicine, The Seventh Affiliated Hospital, Sun Yat-sen University, Shenzhen, China
| | - Suyue He
- Department of Rehabilitation Medicine, The Seventh Affiliated Hospital, Sun Yat-sen University, Shenzhen, China
| | - Dongfeng Huang
- Department of Rehabilitation Medicine, The Seventh Affiliated Hospital, Sun Yat-sen University, Shenzhen, China
- Guangdong Engineering and Technology Research Center for Rehabilitation Medicine and Translation, Guangzhou, China
- *Correspondence: Dongfeng Huang
| | - Yurong Mao
- Department of Rehabilitation Medicine, The Seventh Affiliated Hospital, Sun Yat-sen University, Shenzhen, China
- Guangdong Engineering and Technology Research Center for Rehabilitation Medicine and Translation, Guangzhou, China
- Yurong Mao
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Embon-Magal S, Krasovsky T, Doron I, Asraf K, Haimov I, Gil E, Agmon M. The effect of co-dependent (thinking in motion [TIM]) versus single-modality (CogniFit) interventions on cognition and gait among community-dwelling older adults with cognitive impairment: a randomized controlled study. BMC Geriatr 2022; 22:720. [PMID: 36045345 PMCID: PMC9429752 DOI: 10.1186/s12877-022-03403-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2021] [Accepted: 08/17/2022] [Indexed: 11/17/2022] Open
Abstract
Background Cognition and motor skills are interrelated throughout the aging process and often show simultaneous deterioration among older adults with cognitive impairment. Co-dependent training has the potential to ameliorate both domains; however, its effect on the gait and cognition of older adults with cognitive impairment has yet to be explored. The aim of this study is to compare the effects of the well-established single-modality cognitive computerized training program, CogniFit, with “Thinking in Motion (TIM),” a co-dependent group intervention, among community-dwelling older adults with cognitive impairment. Methods Employing a single-blind randomized control trial design, 47 community-dwelling older adults with cognitive impairment were randomly assigned to 8 weeks of thrice-weekly trainings of TIM or CogniFit. Pre- and post-intervention assessments included cognitive performance, evaluated by a CogniFit battery, as a primary outcome; and gait, under single- and dual-task conditions, as a secondary outcome. Results CogniFit total Z scores significantly improved from baseline to post-intervention for both groups. There was a significant main effect for time [F (1, 44) = 17.43, p < .001, ηp2 = .283] but not for group [F (1, 44) = 0.001, p = .970]. No time X group interaction [F (1, 44) = 1.29, p = .261] was found. No changes in gait performance under single and dual-task performance were observed in both groups. Conclusions The findings show that single-modality (CogniFit) and co-dependent (TIM) trainings improve cognition but not gait in older adults with cognitive impairment. Such investigations should be extended to include various populations and a broader set of outcome measurements. Trial registration ACTRN12616001543471. Date: 08/11/2016.
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Mack M, Stojan R, Bock O, Voelcker-Rehage C. Cognitive-motor multitasking in older adults: a randomized controlled study on the effects of individual differences on training success. BMC Geriatr 2022; 22:581. [PMID: 35840893 PMCID: PMC9284902 DOI: 10.1186/s12877-022-03201-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Accepted: 06/09/2022] [Indexed: 11/15/2022] Open
Abstract
Background Multitasking is an essential part of our everyday life, but performance declines typically in older age. Many studies have investigated the beneficial effects of cognitive, motor and combined cognitive-motor training on multitasking performance in older adults. Previous work, however, has not regarded interindividual differences in cognitive functioning and motor fitness that may affect training benefits. The current study aims to identify whether different training programs may have differential effects on multitasking performance depending on the initial level of cognitive functioning and motor fitness. Methods We conduct a 12-week single-blinded randomized controlled trial. A total of N = 150 healthy older adults are assigned to either a single cognitive, a single motor, or a simultaneous cognitive-motor training. Participants are trained twice per week for 45 min. A comprehensive test battery assesses cognitive functions, motor and cardiovascular fitness, and realistic multitasking during walking and driving in two virtual environments. We evaluate how multitasking performance is related not only to the training program, but also to participants’ initial levels of cognitive functioning and motor fitness. Discussion We expect that multitasking performance in participants with lower initial competence in either one or both domains (cognitive functioning, motor fitness) benefits more from single-task training (cognitive training and/or motor training). In contrast, multitasking performance in participants with higher competence in both domains should benefit more from multitask training (simultaneous cognitive-motor training). The results may help to identify whether tailored training is favorable over standardized one-size-fits all training approaches to improve multitasking in older adults. In addition, our findings will advance the understanding of factors that influence training effects on multitasking. Trial registration DRKS (German Clinical Trials Register), DRKS00022407. Registered 26/08/2020 - Retrospectively registered at https://www.drks.de/drks_web/setLocale_EN.do
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Affiliation(s)
- Melanie Mack
- Department of Neuromotor Behavior and Exercise, Institute of Sport and Exercise Sciences, University of Münster, Wilhelm-Schickard-Straße 8, 48149, Muenster, Germany
| | - Robert Stojan
- Department of Neuromotor Behavior and Exercise, Institute of Sport and Exercise Sciences, University of Münster, Wilhelm-Schickard-Straße 8, 48149, Muenster, Germany.,Institute of Human Movement Science and Health, Chemnitz University of Technology, Thueringer Weg 11, 09126, Chemnitz, Germany
| | - Otmar Bock
- Institute of Human Movement Science and Health, Chemnitz University of Technology, Thueringer Weg 11, 09126, Chemnitz, Germany.,Institute of Exercise Training and Sport Informatics, German Sport University, Am Sportpark Muengersdorf 6, 50927, Cologne, Germany
| | - Claudia Voelcker-Rehage
- Department of Neuromotor Behavior and Exercise, Institute of Sport and Exercise Sciences, University of Münster, Wilhelm-Schickard-Straße 8, 48149, Muenster, Germany. .,Institute of Human Movement Science and Health, Chemnitz University of Technology, Thueringer Weg 11, 09126, Chemnitz, Germany.
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Zheng Y, You T, Du R, Zhang J, Peng T, Liang J, Zhao B, Ou H, Jiang Y, Feng H, Yilifate A, Lin Q. The Effect of Non-immersive Virtual Reality Exergames Versus Band Stretching on Cardiovascular and Cerebral Hemodynamic Response: A Functional Near-Infrared Spectroscopy Study. Front Hum Neurosci 2022; 16:902757. [PMID: 35903784 PMCID: PMC9314640 DOI: 10.3389/fnhum.2022.902757] [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: 03/23/2022] [Accepted: 06/13/2022] [Indexed: 11/13/2022] Open
Abstract
Background Exercise is one of the effective ways to improve cognition. Different forms of exercises, such as aerobic exercise, resistance exercise, and coordination exercise, have different effects on the improvement of cognitive impairment. In recent years, exergames based on Non-Immersive Virtual Reality (NIVR-Exergames) have been widely used in entertainment and have gradually been applied to clinical rehabilitation. However, the mechanism of NIVR-Exergames on improving motor cognition has not been clarified. Therefore, the aim of this study is to find whether NIVR-Exergames result in a better neural response mechanism to improve the area of the cerebral cortex related to motor cognition under functional near-infrared spectroscopy (fNIRS) dynamic monitoring in comparison with resistance exercise (resistance band stretching). Methods A cross-over study design was adopted in this study, and 15 healthy young subjects (18–24 years old) were randomly divided into group A (n = 8) and group B (n = 7) according to a computerized digital table method. Task 1 was an NIVR-Exergame task, and Task 2 was resistance band stretching. Group A first performed Task 1, rested for 30 min (i.e., a washout period), and then performed Task 2. Group B had the reverse order. The fNIRS test was synchronized in real time during exercise tasks, and heart rate measurements, blood pressure measurements, and 2-back task synchronization fNIRS tests were performed at baseline, Post-task 1, and Post-task 2. The primary outcomes were beta values from the general linear model (GLM) in different regions of interest (ROIs), and the secondary outcomes were heart rate, blood pressure, reaction time of 2-back, and accuracy rate of 2-back. Results The activation differences of Task 1 and Task 2 in the right premotor cortex (PMC) (P = 0.025) and the left PMC (P = 0.011) were statistically significant. There were statistically significant differences in the activation of the right supplementary motor area (SMA) (P = 0.007), left dorsolateral prefrontal cortex (DLPFC) (P = 0.031), left and right PMC (P = 0.005; P = 0.002) between baseline and Post-task 1. The differences in systolic pressure (SBP) between the two groups at three time points among women were statistically significant (P1 = 0.009, P2 < 0.001, P3 = 0.044). Conclusion In this study, we found that NIVR-Exergames combined with motor and challenging cognitive tasks can promote the activation of SMA, PMC and DLPFC in healthy young people compared with resistance exercise alone, providing compelling preliminary evidence of the power for the rehabilitation of motor and cognitive function in patients with central nervous system diseases.
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Affiliation(s)
- Yuxin Zheng
- Department of Rehabilitation Medicine, The Fifth Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
- Department of Rehabilitation Medicine, The Fifth College of Guangzhou Medical University, Guangzhou, China
| | - Tingting You
- Department of Rehabilitation Medicine, The Fifth Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
- Department of Rehabilitation Medicine, The Fifth College of Guangzhou Medical University, Guangzhou, China
| | - Rongwei Du
- Department of Rehabilitation Medicine, The Fifth Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
- Department of Rehabilitation Medicine, The Fifth College of Guangzhou Medical University, Guangzhou, China
| | - Jiahui Zhang
- Department of Rehabilitation Medicine, The Fifth Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
- Department of Rehabilitation Medicine, The Fifth College of Guangzhou Medical University, Guangzhou, China
| | - Tingting Peng
- Department of Rehabilitation Medicine, The Fifth Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
- Department of Rehabilitation Medicine, The Fifth College of Guangzhou Medical University, Guangzhou, China
| | - Junjie Liang
- Department of Rehabilitation Medicine, The Fifth Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
- Department of Rehabilitation Medicine, The Fifth College of Guangzhou Medical University, Guangzhou, China
| | - Biyi Zhao
- Department of Rehabilitation Medicine, The Fifth Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
- Department of Rehabilitation Medicine, The Fifth College of Guangzhou Medical University, Guangzhou, China
| | - Haining Ou
- Department of Rehabilitation Medicine, The Fifth Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
- Department of Rehabilitation Medicine, The Fifth College of Guangzhou Medical University, Guangzhou, China
| | - Yongchun Jiang
- Department of Rehabilitation Medicine, The Fifth Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
- Department of Rehabilitation Medicine, The Fifth College of Guangzhou Medical University, Guangzhou, China
| | - Huiping Feng
- Department of Clinical Nutrition, The Fifth Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
- Huiping Feng,
| | - Anniwaer Yilifate
- Department of Rehabilitation Medicine, The Fifth Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
- Department of Rehabilitation Medicine, The Fifth College of Guangzhou Medical University, Guangzhou, China
- Anniwaer Yilifate,
| | - Qiang Lin
- Department of Rehabilitation Medicine, The Fifth Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
- Department of Rehabilitation Medicine, The Fifth College of Guangzhou Medical University, Guangzhou, China
- *Correspondence: Qiang Lin,
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Ziegler DA, Anguera JA, Gallen CL, Hsu WY, Wais PE, Gazzaley A. Leveraging technology to personalize cognitive enhancement methods in aging. NATURE AGING 2022; 2:475-483. [PMID: 35873177 PMCID: PMC9302894 DOI: 10.1038/s43587-022-00237-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/29/2023]
Abstract
As population aging advances at an increasing rate, efforts to help people maintain or improve cognitive function late in life are critical. Although some studies have shown promise, the question of whether cognitive training is an effective tool for improving general cognitive ability remains incompletely explored, and study results to date have been inconsistent. Most approaches to cognitive enhancement in older adults have taken a 'one size fits all' tack, as opposed to tailoring interventions to the specific needs of individuals. In this Perspective, we argue that modern technology has the potential to enable large-scale trials of public health interventions to enhance cognition in older adults in a personalized manner. Technology-based cognitive interventions that rely on closed-loop systems can be tailored to individuals in real time and have the potential for global testing, extending their reach to large and diverse populations of older adults. We propose that the future of cognitive enhancement in older adults will rely on harnessing new technologies in scientifically informed ways.
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Affiliation(s)
- David A. Ziegler
- Department of Neurology, University of California San Francisco, San Francisco, CA, USA
- Neuroscape, University of California San Francisco, San Francisco, CA, USA
- Weill Institute for Neurosciences, University of California San Francisco, San Francisco, CA, USA
- Correspondence should be addressed to David A. Ziegler or Adam Gazzaley. ;
| | - Joaquin A. Anguera
- Department of Neurology, University of California San Francisco, San Francisco, CA, USA
- Neuroscape, University of California San Francisco, San Francisco, CA, USA
- Weill Institute for Neurosciences, University of California San Francisco, San Francisco, CA, USA
- Department of Psychiatry, University of California San Francisco, San Francisco, CA, USA
| | - Courtney L. Gallen
- Department of Neurology, University of California San Francisco, San Francisco, CA, USA
- Neuroscape, University of California San Francisco, San Francisco, CA, USA
- Weill Institute for Neurosciences, University of California San Francisco, San Francisco, CA, USA
| | - Wan-Yu Hsu
- Department of Neurology, University of California San Francisco, San Francisco, CA, USA
- Weill Institute for Neurosciences, University of California San Francisco, San Francisco, CA, USA
| | - Peter E. Wais
- Department of Neurology, University of California San Francisco, San Francisco, CA, USA
- Neuroscape, University of California San Francisco, San Francisco, CA, USA
- Weill Institute for Neurosciences, University of California San Francisco, San Francisco, CA, USA
| | - Adam Gazzaley
- Department of Neurology, University of California San Francisco, San Francisco, CA, USA
- Neuroscape, University of California San Francisco, San Francisco, CA, USA
- Weill Institute for Neurosciences, University of California San Francisco, San Francisco, CA, USA
- Department of Psychiatry, University of California San Francisco, San Francisco, CA, USA
- Department of Physiology, University of California San Francisco, San Francisco, CA, USA
- Correspondence should be addressed to David A. Ziegler or Adam Gazzaley. ;
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Wollesen B, Janssen TI, Müller H, Voelcker-Rehage C. Effects of cognitive-motor dual task training on cognitive and physical performance in healthy children and adolescents: A scoping review. Acta Psychol (Amst) 2022; 224:103498. [PMID: 35091209 DOI: 10.1016/j.actpsy.2022.103498] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Revised: 12/18/2021] [Accepted: 01/04/2022] [Indexed: 12/16/2022] Open
Abstract
Simultaneous dual- or multitasking training has been used in manifold ways to improve cognitive-motor performance in different age groups. Dual task (DT) training is assumed to improve both, single task (ST) motor and cognitive performance, but particularly, performance under dual tasking conditions. Further, DT interventions have been shown to be beneficial for motor skill learning and cognitive performance as well as academic achievements in children and adolescents. The aim of this scoping review was to summarize current evidence on different cognitive-motor interventions that practice motor and cognitive performance simultaneously in children and adolescents and to identify training regimes that are most effective to improve cognitive or motor performance in this target group. METHODS Four electronic databases were searched (Pubmed, MEDLINE, Web of Science and APA Psycinfo) until May 2021. Following the PRISMA guidelines, title, abstract, and full-text screening as well as quality assessment was done by two independent reviewers. Studies were eligible if they (1) were published in English or German language, (2) accessible as a full-text version, (3) included at least one group of children or adolescents with a mean age of 4 to 21 years, (4) used dual-tasks as part of the intervention, (5) conducted one or more training sessions, and (6) reported at least one cognitive or motor outcome. The main outcome measures were cognitive and motor as well as cognitive-motor DT performance. Due to the heterogeneity in the characteristics of the included studies, we designed this review as a scoping review. RESULTS Seven studies met the inclusion criteria (n = 543, age four to 14 years, 47.1% female). One study reported two intervention experiments. Studies differed in sample size (20-189) as well as in type of training (specific or general DT training) and dose (frequency: one session/week to 110 sessions within 22 weeks). Overall, task-specific improvements in physical and cognitive functions were found, but not consistently across all interventions. Two interventions out of five interventions that measured motor performance demonstrated improvement in that domain, especially in balance. Three out of five interventions that measured cognitive functions found improved cognition. Only one study examined DT performance post training but failed to gain significant improvements in comparison to a control group. Studies only occasionally integrated training principles like individualization or progression in the design of their intervention. DISCUSSION The results indicate that DT training interventions may improve physical and/or cognitive functions in children and adolescents. Best practice recommendations for training regimes cannot be derived as outcomes differed a lot and were not systematically assessed across studies. Future studies should integrate more principles of training monitoring and aspects like individualization and progression to provide ideal training control and achieve better DT training results. Further, more high-quality trials are needed that adhere to the previous concepts. PSYCINFO CLASSIFICATION 2340 Cognitive Processes 2820 Cognitive & Perceptual Development. 3720 Sports.
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Ghadiri F, Bahmani M, Paulson S, Sadeghi H. Effects of fundamental movement skills based dual-task and dance training on single- and dual-task walking performance in older women with dementia. Geriatr Nurs 2022; 45:85-92. [PMID: 35364479 DOI: 10.1016/j.gerinurse.2022.03.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2021] [Revised: 03/07/2022] [Accepted: 03/09/2022] [Indexed: 11/19/2022]
Abstract
OBJECTIVE The purpose of this study was to compare the effects of fundamental movement skills (FMS)-based dual-task training and dance training on spatio-temporal characteristics of gait performance under single- and dual-task walking conditions among older women with dementia. METHOD Thirty-eight elderly females with dementia were randomly assigned to one of two groups: (1) dual-task intervention (DTI, age: 73 ± 6.5 years) or (2) Iranian dance intervention (IDI, age: 72.52 ± 6.01 years). Both groups participated in a 10-week intervention program (3 sessions per week, each lasting 50 min). Gait performance parameters (gait speed, cadence, and stride length) and dual-task costs (DTC) were examined using a gait analysis system. The participants completed three walking trials under two conditions: single- and dual-task. The video data was analyzed using motion analysis software (Frame-DIAS II, DKH, DKH Inc., Tokyo, Japan). RESULTS The results showed that both groups significantly improved in terms of all gait variables, and DTC decreased (p < .001) from pre- to post-test for both conditions. However, the main effects for the group and the group-by-time interactions were not significantly different between the two groups (p > .05). CONCLUSION These findings showed that DTI and IDI effectively improved gait performance following a 10-week intervention for older women with dementia. Therefore, it is suggested that either training program could decrease DTC and increase gait speed, stride length, and cadence among older females with dementia.
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Affiliation(s)
- Farhad Ghadiri
- Department of Motor behavior, Faculty of Physical Education and Sport Sciences, Kharazmi University, Tehran, Iran.
| | - Moslem Bahmani
- Department of Motor behavior, Faculty of Physical Education and Sport Sciences, Kharazmi University, Tehran, Iran
| | | | - Hassan Sadeghi
- Department of Biomechanics and Sport Injuries, Faculty of Physical Education and Sport Sciences, Kharazmi University, Tehran, Iran
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22
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Huberty S, Mattle M, Theiler R, Freystätter G. [Evidence of Physical Training Programs for Fall Prevention in Seniors]. PRAXIS 2022; 111:815-821. [PMID: 36285409 DOI: 10.1024/1661-8157/a003922] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
Evidence of Physical Training Programs for Fall Prevention in Seniors Abstract. It has been shown that physical exercise reduced fall risk by 23-42% in community-dwelling adults aged 65+. This is particularly true for physical exercises with functional, balance and strength components. Growing evidence shows that functional training is particularly effective in reducing fall risk. Functional training is composed by exercises which reflect activities of daily life, supported by weights and other aids.
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Affiliation(s)
- Sarah Huberty
- Universitäre Altersmedizin, Felix Platter Spital, Basel, Schweiz
| | - Michèle Mattle
- Zentrum Alter und Mobilität, Universität Zürich und Stadtspital Zürich Waid, Zürich, Schweiz
| | - Robert Theiler
- Zentrum Alter und Mobilität, Universität Zürich und Stadtspital Zürich Waid, Zürich, Schweiz
- Klinik für Altersmedizin, Universitätsspital Zürich, Zürich, Schweiz
| | - Gregor Freystätter
- Zentrum Alter und Mobilität, Universität Zürich und Stadtspital Zürich Waid, Zürich, Schweiz
- Klinik für Altersmedizin, Universitätsspital Zürich, Zürich, Schweiz
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23
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Thalmann M, Ringli L, Adcock M, Swinnen N, de Jong J, Dumoulin C, Guimarães V, de Bruin ED. Usability Study of a Multicomponent Exergame Training for Older Adults with Mobility Limitations. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182413422. [PMID: 34949028 PMCID: PMC8705921 DOI: 10.3390/ijerph182413422] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/27/2021] [Revised: 12/08/2021] [Accepted: 12/14/2021] [Indexed: 11/28/2022]
Abstract
The global population aged 60 years and over rises due to increasing life expectancy. More older adults suffer from “geriatric giants”. Mobility limitations, including immobility and instability, are usually accompanied by physical and cognitive decline, and can be further associated with gait changes. Improvements in physical and cognitive functions can be achieved with virtual reality exergame environments. This study investigated the usability of the newly developed VITAAL exergame in mobility-impaired older adults aged 60 years and older. Usability was evaluated with a mixed-methods approach including a usability protocol, the System Usability Scale, and a guideline-based interview. Thirteen participants (9 female, 80.5 ± 4.9 years, range: 71–89) tested the exergame and completed the measurement. The System Usability Scale was rated in a marginal acceptability range (58.3 ± 16.5, range: 30–85). The usability protocol and the guideline-based interview revealed general positive usability. The VITAAL exergame prototype received positive feedback and can be considered usable by older adults with mobility limitations. However, minor improvements to the system in terms of design, instructions, and technical aspects should be taken into account. The results warrant testing of the feasibility of the adapted multicomponent VITAAL exergame, and its effects on physical and cognitive functions, in comparison with conventional training, should be studied.
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Affiliation(s)
- Melanie Thalmann
- Department of Health Sciences and Technology, Institute of Human Movement Science and Sport, ETH Zürich, 8093 Zurich, Switzerland; (M.T.); (L.R.); (M.A.)
| | - Lisa Ringli
- Department of Health Sciences and Technology, Institute of Human Movement Science and Sport, ETH Zürich, 8093 Zurich, Switzerland; (M.T.); (L.R.); (M.A.)
| | - Manuela Adcock
- Department of Health Sciences and Technology, Institute of Human Movement Science and Sport, ETH Zürich, 8093 Zurich, Switzerland; (M.T.); (L.R.); (M.A.)
| | - Nathalie Swinnen
- Department of Rehabilitation Sciences, KU Leuven, 3001 Leuven, Belgium;
- University Psychiatric Centre, KU Leuven, 3070 Kortenberg, Belgium
| | | | - Chantal Dumoulin
- School of Rehabilitation, Faculty of Medicine, Université de Montréal, Montreal, QC H3T 1J4, Canada;
| | | | - Eling D. de Bruin
- Department of Health Sciences and Technology, Institute of Human Movement Science and Sport, ETH Zürich, 8093 Zurich, Switzerland; (M.T.); (L.R.); (M.A.)
- Division of Physiotherapy, Department of Neurobiology, Care Sciences and Society, Karolinska Institute, 171 77 Stockholm, Sweden
- Department of Health, OST—Eastern Swiss University of Applied Sciences, 9001 St. Gallen, Switzerland
- Correspondence: ; Tel.: +41-44-632-40-18
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24
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Song Y, Amimoto K, Meidian AC. The effect of a concomitant stroop task during sit-to-stand tasks on postural control. J Phys Ther Sci 2021; 33:917-923. [PMID: 34873374 PMCID: PMC8636917 DOI: 10.1589/jpts.33.917] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2021] [Accepted: 09/20/2021] [Indexed: 11/24/2022] Open
Abstract
[Purpose] This study aimed to explain the effect of a dual-task technology that utilizes
motor and/or cognitive skills on the performance of major tasks, postural control, and
gait consistency. [Participants and Methods] Eighteen healthy adults were divided into two
groups: the single-word dual-task group and the control group (study 1). We enrolled 32
healthy adults to perform four-word Stroop (study 2) and sit-to-stand tasks simultaneously
to determine the attentional demand for postural control and locomotion. [Results] The
dynamic condition of postural control differed significantly between the single-task and
single-word dual-task groups in Study 1. In Study 2, postural control in the four-word
dual-task condition improved under both static and dynamic conditions. On comparing the
results of studies 1 and 2, we found that during a four-word dual-task, healthy
participants experienced a more significant decrease in postural sway than that
experienced during the single-word dual-task. [Conclusion] Dual task of Stroop task with
sit-to-stand could improve a postural control.
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Affiliation(s)
- Yige Song
- Department of Physical Therapy, Graduate School of Human Health Sciences, Tokyo Metropolitan University: 7-2-10 Higashi-Ogu, Arakawa-ku, Tokyo 116-8551, Japan
| | - Kazu Amimoto
- Department of Physical Therapy, Graduate School of Human Health Sciences, Tokyo Metropolitan University: 7-2-10 Higashi-Ogu, Arakawa-ku, Tokyo 116-8551, Japan
| | - Abdul Chalik Meidian
- Department of Physical Therapy, Graduate School of Human Health Sciences, Tokyo Metropolitan University: 7-2-10 Higashi-Ogu, Arakawa-ku, Tokyo 116-8551, Japan
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25
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Ahmed U, Karimi H, Amir S, Ahmed A. Effects of intensive multiplanar trunk training coupled with dual-task exercises on balance, mobility, and fall risk in patients with stroke: a randomized controlled trial. J Int Med Res 2021; 49:3000605211059413. [PMID: 34812070 PMCID: PMC8647262 DOI: 10.1177/03000605211059413] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023] Open
Abstract
OBJECTIVE We determined whether an exercise regime comprising high-intensity training, multiplanar trunk movements, and dual-task practice could improve trunk control, balance, functional mobility, and reduce fall risk in patients with hemiplegic stroke. METHODS In this randomized controlled trial, 74 patients (mean age 61.71 years) were randomly assigned to the experimental and comparison groups. Primary outcome was trunk impairment scale (TIS) scores. Secondary outcomes were scores on the Berg balance scale, 10-meter walk test, Timed-up-and-go test, timed-Up-Go-cognitive, and Stroke Impact Scale-16 to measure between-group changes from baseline. We used linear mixed modeling to identify changes over time within and between groups on each scale and whether changes persisted at 6- and 12-month follow-ups. RESULTS We observed significantly increased mean TIS scores from baseline to 3 months post-treatment (7.74); the increased scores were maintained at 6- and 12-month follow-ups (8.60 and 8.43, respectively). In the experimental group, all secondary outcomes showed significant and clinically meaningful results. Fall risk between groups was significantly reduced at 6 and 12 months. CONCLUSIONS Intensive multiplanar trunk movements coupled with dual-task practice promoted trunk control, balance, and functional recovery in patients with stroke, reduced fall risk, and improved independent mobility.Trial registration: #IRCT20200127046275N1.
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Affiliation(s)
- Umair Ahmed
- University Institute of Physical Therapy, University of Lahore, Lahore, Pakistan
| | - Hossein Karimi
- University Institute of Physical Therapy, University of Lahore, Lahore, Pakistan.,Istanbul Gelisim University, Istanbul, Turkey
| | - Syed Amir
- Istanbul Gelisim University, Istanbul, Turkey
| | - Ashfaq Ahmed
- University Institute of Physical Therapy, University of Lahore, Lahore, Pakistan.,Allied Health Sciences, The University of Lahore, Lahore, Pakistan
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26
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Swinnen N, de Bruin ED, Dumoulin C, Thalmann M, Guimarães V, De Jong J, Vandenbulcke M, Vancampfort D. The VITAAL Stepping Exergame Prototype for Older Adults With Major Neurocognitive Disorder: A Usability Study. Front Aging Neurosci 2021; 13:701319. [PMID: 34803650 PMCID: PMC8600328 DOI: 10.3389/fnagi.2021.701319] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2021] [Accepted: 09/28/2021] [Indexed: 11/13/2022] Open
Abstract
Purpose: This study investigates the usability of a stepping exergame in older adults with major neurocognitive disorder (MNCD) residing in a long-term care facility. Materials and Methods: A mixed methods study was conducted. Participants played exergames for 30 min on one try-out session. During the exergames, the think aloud method was used, and field notes were taken by the facilitator. Following the exergames, participants completed the System Usability Scale (SUS) and a semi-structured in-depth interview about usability including their personal experiences. Audio files were transcribed and a thematic content analysis of the think aloud data, field notes and interviews were performed using NVivo 12. Results: Twenty-two participants with MNCD were included [mean age = 84.3 ± 5.5 (70–95) years; 81.8% women; Short Physical Performance Battery score = 7.5 ± 3.2 (1–12), Montreal Cognitive Assessment score = 11.9 ± 4.4 (2–19)]. System usability was rated “ok to good” with a mean SUS score of 57.8 (SD = 12.3) with scores ranging from 37.5 to 90.0. Five main themes emerged from the thematic content analysis: (1) perceived user friendliness and acceptability of the exergames; (2) interactional experience; (3) motivational factors; (4) training modalities; and (5) risks. There were no adverse events nor dropouts. Conclusion: Participants evaluated the usability of the exergames positively. The results indicate that the stepping exergame is usable in older adults with MNCD.
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Affiliation(s)
- Nathalie Swinnen
- Department of Rehabilitation Sciences, KU Leuven, Leuven, Belgium
| | - Eling D de Bruin
- Department of Health Sciences and Technology, Institute of Human Movement Sciences and Sport, ETH Zürich, Zurich, Switzerland.,Division of Physiotherapy, Department of Neurobiology, Care Sciences and Society, Karolinska Institute, Stockholm, Sweden
| | - Chantal Dumoulin
- Faculty of Medicine, University of Montreal, Montreal, QC, Canada.,Montreal University Geriatrics Institute, Montreal, QC, Canada
| | - Melanie Thalmann
- Department of Health Sciences and Technology, Institute of Human Movement Sciences and Sport, ETH Zürich, Zurich, Switzerland
| | - Vânia Guimarães
- Fraunhofer Portugal Research Center for Assistive Information and Communication Solutions, Porto, Portugal
| | | | - Mathieu Vandenbulcke
- University Psychiatric Centre, KU Leuven, Leuven, Belgium.,Department of Neurosciences, KU Leuven, Leuven, Belgium
| | - Davy Vancampfort
- Department of Rehabilitation Sciences, KU Leuven, Leuven, Belgium.,University Psychiatric Centre, KU Leuven, Leuven, Belgium
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Amini A, Vaezmousavi M, Shirvani H. The effectiveness of cognitive-motor training on reconstructing cognitive health components in older male adults, recovered from the COVID-19. Neurol Sci 2021; 43:1395-1403. [PMID: 34328579 PMCID: PMC8322109 DOI: 10.1007/s10072-021-05502-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2021] [Accepted: 07/22/2021] [Indexed: 11/09/2022]
Abstract
Objective The incidence of COVID-19 disease in the elderly can accelerate normal degenerative process of cognitive functions. Interactive cognitive-motor training (CMT) is an intervention that integrates cognitive and motor tasks to promote individuals’ physical and psychological health. The present study aimed to examine the effect of CMT on reconstructing cognitive health components in older men, who have recently recovered from COVID-19. Materials and methods This study is a quasi-experimental repeated measure (without control group). Participants were 42 elderly men (65–80 years) who recovered from the COVID-19 disease that individually participated in a 4-week CMT program twice a week. The cognitive health components of the participants were assessed by the General Health Questionnaire (GHQ-2) and the Mini-Mental State Examination (MMSE) at 3 stages before the beginning of the intervention (baseline assessment); 2 weeks after the intervention (short-term follow-up); and 3 months after the intervention (long-term follow-up). Results The results showed that the scores of depression, anxiety, physical symptoms, and social performance components and the overall GHQ score improved significantly in short-term follow-up (P < 0.05) and also in long-term follow-up compared to baseline assessment (P < 0.05). It was also found that attention and calculation, recall, lingual skill, and action performance components and the overall score of MMSE were also improved at three stages of assessments. Other components did not differ among stages. Conclusions This study adds to the research on the effectiveness of using CMT for reconstructing cognitive health components in older adults, recovered from the COVID-19, and supports CMT as a viable intervention practice.
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Affiliation(s)
- Amin Amini
- Department of Knowledge and Cognitive Intelligence, Imam Hossein University, Tehran, Iran
| | - Mohammad Vaezmousavi
- Department of Knowledge and Cognitive Intelligence, Imam Hossein University, Tehran, Iran
| | - Hossein Shirvani
- Exercise Physiology Research Center, Life Style Institute, Baqiyatallah University of Medical Sciences, Tehran, Iran.
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28
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Bischoff LL, Cordes T, Meixner C, Schoene D, Voelcker-Rehage C, Wollesen B. Can cognitive-motor training improve physical functioning and psychosocial wellbeing in nursing home residents? A randomized controlled feasibility study as part of the PROCARE project. Aging Clin Exp Res 2021; 33:943-956. [PMID: 32537707 DOI: 10.1007/s40520-020-01615-y] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2020] [Accepted: 05/28/2020] [Indexed: 01/06/2023]
Abstract
BACKGROUND A multi-component training program holds promises for the elderly, but still has to be tested on its feasibility and effect in nursing homes. AIMS The aim of this study was (1) to design a multi-component training program which improves physical functioning and psychosocial wellbeing and (2) to evaluate the feasibility of this intervention in nursing home residents. METHODS This study is a two-arm, stratified-randomized controlled feasibility trail. Twenty-four nursing home residents (aged 83.7 ± 6.4, 21 women) were divided into an intervention and a waiting-list control group. The intervention group completed a multi-component training (including dual-task, dynamic balance, endurance and strength exercises) for 16 weeks (twice per week for 45-60 min). Primary outcomes were lower extremity functionality (SPPB), gait performance (GAITRite), health-related quality of life (SF-12) as well as life satisfaction (SWLS). RESULTS Life satisfaction (SWLS) and physical functioning (SPPB) increased in the intervention group after training whereas the control group showed a decrease. Gait parameters could only be analyzed for n = 5 participants of the intervention group and n = 2 of the control group and showed no time differences for the intervention group. The mean number of participants was 12.5 ± 1.9 per session (attendance ranged between 66% and 90%). CONCLUSION A multi-component training seems (1) to lead to clinically relevant improvements in physical functioning as well as in psychosocial wellbeing and (2) to be feasible and well accepted in nursing home residents. Nevertheless, the complexity and progression of the program as well as the testing protocol have to be adapted. Further research should test the effectiveness of this adapted program in a larger sample size.
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Affiliation(s)
- Laura L Bischoff
- Institute of Human Movement Science, University of Hamburg, Mollerstraße 10, 20148, Hamburg, Germany.
| | - Thomas Cordes
- Institute of Human Movement Science, University of Hamburg, Mollerstraße 10, 20148, Hamburg, Germany
| | - Charlotte Meixner
- Institute of Human Movement Science, University of Hamburg, Mollerstraße 10, 20148, Hamburg, Germany
| | - Daniel Schoene
- Institute of Medical Physics, Friedrich-Alexander University, Erlangen-Nuernberg, Germany
- Department of Geriatric Rehabilitation, Robert-Bosch Hospital, Stuttgart, Germany
| | | | - Bettina Wollesen
- Institute of Human Movement Science, University of Hamburg, Mollerstraße 10, 20148, Hamburg, Germany
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29
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Pothier K, Vrinceanu T, Intzandt B, Bosquet L, Karelis AD, Lussier M, Vu TTM, Nigam A, Li KZH, Berryman N, Bherer L. A comparison of physical exercise and cognitive training interventions to improve determinants of functional mobility in healthy older adults. Exp Gerontol 2021; 149:111331. [PMID: 33774144 DOI: 10.1016/j.exger.2021.111331] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Revised: 03/12/2021] [Accepted: 03/22/2021] [Indexed: 12/19/2022]
Abstract
OBJECTIVES Mobility is a complex but crucial clinical outcome in older adults. Past observational studies have highlighted that cardiorespiratory fitness (CRF), energy cost of walking (ECW), and cognitive switching abilities are associated with mobility performance, making these key determinants of mobility intervention targets to enhance mobility in older adults. The objective of this study was to compare, in the same design, the impact of three training methods - each known to improve either CRF, ECW, or cognitive switching abilities - on mobility in healthy older adults. METHODS Seventy-eight participants (69.28 ± 4.85yo) were randomly assigned to one of three twelve-week interventions: Aerobic Exercise (AE; n = 26), Gross Motor Abilities (GMA; n = 27), or Cognitive (COG; n = 25) training. Each intervention was designed to improve one of the three key determinants of mobility (CRF, ECW, and cognitive switching). Primary outcomes (usual gait speed, and TUG performance) and the three mobility determinants were measured before and after the intervention. RESULTS Repeated-measures ANOVAs showed a time effect for TUG performance (F(1,75) = 14.92, p < .001): all groups equally improved after the intervention (ΔTUGpost-pre, in seconds, with 95% CI: AE = -0.44 [-0.81 to -0.08]; GMA = -0.60 [-1.10 to -0.10]; COG = -0.33 [-0.71 to 0.05]). No significant between group differences were observed. CRF was improved in the AE group only (Hedges' G = 0.27, small effect), ECW and cognitive switching improved the most in the GMA (Hedges' G = -0.78, moderate effect) and COG groups (Hedges' G = -1.93, large effect) respectively. Smaller improvements in ECW were observed following AE and COG trainings (Hedges' G: AE = -0.39, COG = -0.36, both small effects) as well as in cognitive switching following AE and GMA training (Hedges' G: AE = -0.42, GMA = -0.21, both small effects). DISCUSSION This study provides further support to the notion that multiple interventional approaches (aerobic, gross motor exercise, or cognitive training) can be employed to improve functional mobility in older adults, giving them, and professionals, more options to promote healthy ageing.
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Affiliation(s)
- Kristell Pothier
- Research Centre, Institut Universitaire de Gériatrie de Montréal, Montréal, Canada; PERFORM Centre, Concordia University, Montréal, Canada; EA 2114, Psychologie des Âges de la Vie et Adaptation, University of Tours, Tours, France.
| | - Tudor Vrinceanu
- Research Centre, Institut Universitaire de Gériatrie de Montréal, Montréal, Canada; Research Centre, Montreal Heart Institute, Montréal, Canada; Department of Medicine, University of Montréal, Montréal, Canada
| | - Brittany Intzandt
- Research Centre, Institut Universitaire de Gériatrie de Montréal, Montréal, Canada; PERFORM Centre, Concordia University, Montréal, Canada; Research Centre, Montreal Heart Institute, Montréal, Canada
| | - Laurent Bosquet
- Laboratory MOVE (EA 6314), Faculty of Sport Sciences, University of Poitiers, Poitiers, France
| | - Antony D Karelis
- Research Centre, Institut Universitaire de Gériatrie de Montréal, Montréal, Canada; Département des Sciences de l'Activité Physique, Université du Québec à Montréal, Montréal, QC, Canada
| | - Maxime Lussier
- Research Centre, Institut Universitaire de Gériatrie de Montréal, Montréal, Canada; Rehabilitation Science, Faculty of Medicine, University of Montréal, Montréal, Canada
| | - T T Minh Vu
- Department of Medicine, University of Montréal, Montréal, Canada; Research Centre, Centre hospitalier de l'Université de Montréal, Montréal, Canada
| | - Anil Nigam
- Research Centre, Montreal Heart Institute, Montréal, Canada; Department of Medicine, University of Montréal, Montréal, Canada
| | - Karen Z H Li
- PERFORM Centre, Concordia University, Montréal, Canada; Department of Psychology, Concordia University, Montreal, QC, Canada; Centre for Research in Human Development, Concordia University, Montreal, QC, Canada
| | - Nicolas Berryman
- Research Centre, Institut Universitaire de Gériatrie de Montréal, Montréal, Canada; Laboratory MOVE (EA 6314), Faculty of Sport Sciences, University of Poitiers, Poitiers, France; Département des Sciences de l'Activité Physique, Université du Québec à Montréal, Montréal, QC, Canada; Department of Sports Studies, Bishop's University, Sherbrooke, Canada
| | - Louis Bherer
- Research Centre, Institut Universitaire de Gériatrie de Montréal, Montréal, Canada; PERFORM Centre, Concordia University, Montréal, Canada; Research Centre, Montreal Heart Institute, Montréal, Canada; Department of Medicine, University of Montréal, Montréal, Canada.
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30
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de Bruin ED, Baur H, Brülhart Y, Luijckx E, Hinrichs T, Rogan S. Combining Stochastic Resonance Vibration With Exergaming for Motor-Cognitive Training in Long-Term Care; A Sham-Control Randomized Controlled Pilot Trial. Front Med (Lausanne) 2020; 7:507155. [PMID: 33330519 PMCID: PMC7734185 DOI: 10.3389/fmed.2020.507155] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2019] [Accepted: 11/09/2020] [Indexed: 01/06/2023] Open
Abstract
Purpose: Physical and mental functions allow classifying older adults as “Go-Go” (independent functioning); “Slow-Go” (in need of care with a slight handicap); and “No-Go” (in need of care with severe functional limitation). The latter group exhibits reduced exercise tolerance. More recently technology-based motor-cognitive types of training services emerged as a possible training service. This study examined the use of technology including stochastic resonance whole-body vibration and Exergame-dance training for motor-cognitive training in care home dwelling adults. Methods: Seventeen older adults (10 women, 7 men, age range: 79–98) were randomly assigned to the intervention (IG, n = 9) or the sham group (SG, n = 8). IG performed five sets of 1-min whole-body vibration with 1-min rest in between, three times a week for the first 4 weeks of the training period with varying frequency. From weeks five to eight the Exergame-dance training was conducted after the vibration sessions. SG performed a stochastic resonance whole-body vibration training with the same terms applied, however, with a fixed frequency of 1 Hz, Noise 1. From weeks five to eight a passive trampoline-programme of 5 min was applied following the vibration sessions. Primary outcome was the Short Physical Performance Battery (SPPB). Secondary outcomes were the Trail Making Test A and B (TMT A & B) and the Falls Efficacy Scale–International (FES-I). Outcomes were measured at baseline, after 4 and 8 weeks of intervention and at follow-up (4 weeks after the intervention). The non-parametric Puri and Sen rank-order test was applied, followed by an ANOVA for repeated measures to analyse main and interaction effects. Mann–Whitney U-Test was used to determine differences between the groups. Results: The post-hoc analysis showed significant effects on the SPPB total score with large effect sizes from baseline to 8 weeks (+72%, p = 0.005, η2 = 0.423). The TMT part B displayed significant improvements with large effect sizes from baseline to 8 weeks (+17.5%, p = 0.002, η2 = 0.779) and to follow-up (+21%, p = 0.001, η2 = 0.827). Conclusion: The technology based 8-week training programme consisting of a combination of stochastic resonance whole-body vibration and Exergame-dance training showed beneficial effects on both physical and cognitive performance in older care home dwelling adults.
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Affiliation(s)
- Eling D de Bruin
- Department of Health Sciences and Technology, Institute of Human Movement Sciences and Sport, ETH Zurich, Zurich, Switzerland.,Division of Physiotherapy, Department of Neurobiology, Care Sciences and Society, Karolinska Institute, Stockholm, Sweden
| | - Heiner Baur
- Department of Health Professions, Bern University of Applied Sciences, Bern, Switzerland
| | - Yvonne Brülhart
- Department of Health Professions, Bern University of Applied Sciences, Bern, Switzerland
| | - Eefje Luijckx
- Department of Health Professions, Bern University of Applied Sciences, Bern, Switzerland
| | - Timo Hinrichs
- Division of Sports and Exercise Medicine, Department of Sport, Exercise and Health, University of Basel, Basel, Switzerland
| | - Slavko Rogan
- Department of Health Professions, Bern University of Applied Sciences, Bern, Switzerland
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Pereira Oliva HN, Mansur Machado FS, Rodrigues VD, Leão LL, Monteiro-Júnior RS. The effect of dual-task training on cognition of people with different clinical conditions: An overview of systematic reviews. IBRO Rep 2020; 9:24-31. [PMID: 33336101 PMCID: PMC7733129 DOI: 10.1016/j.ibror.2020.06.005] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2020] [Accepted: 06/20/2020] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND The number of patients with cognitive impairment increases as the population becomes older. This perspective may persist a burden on health care systems unless considered new options of prevention and treatment. The aim of this meta-synthesis is to analyze different systematic reviews on the effectiveness of dual-task training (DTT) on cognition and motor function of different people. METHODS A systematic search of systematic reviews published until October 2019 was conducted in PubMed/Medline, Scopus and Cochrane databases addressing studies which investigated the effect of DTT compared to control or other intervention on cognitive functions of healthy or unhealthy individuals. Three steps were followed to retrieve studies: reading title, abstract and full text. Checklist Assessing the Methodological Quality of Systematic Reviews (AMSTAR) was used to assess the quality of selected articles. RESULTS In terms of quality of evidence, according to AMSTAR, 62.5 % of the reviews were rated as being "low" and 37.5 % were graded as "moderate" quality. Two main themes were identified among the studies' outcomes: Improvement on mobility performance or postural stability; and beneficial effect on cognitive function. In terms of effect size, there were reported an important variation, having more significant results for findings involving mobility and modest effect for findings regarding cognitive function. CONCLUSION People with different clinical conditions could benefit from dual-task training. The benefits may encompass general cognitive functions, memory, physical performance, gait and balance, to name a few aspects.
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Affiliation(s)
- Henrique Nunes Pereira Oliva
- Centro Universitario FIPMoc (UNIFIPMoc), Montes Claros, MG, Brazil
- Grupo de Estudos em Neurociência, Exercício, Saúde e Esporte (GENESEs) of UNIMONTES, Montes Claros, MG, Brazil
| | - Frederico Sander Mansur Machado
- Post-Graduate Program of Health Sciences (PPGCS), State University of Montes Claros (UNIMONTES), Montes Claros, MG, Brazil
- Grupo de Estudos em Neurociência, Exercício, Saúde e Esporte (GENESEs) of UNIMONTES, Montes Claros, MG, Brazil
- Departamento de Educação Física e Desporto da UNIMONTES, Montes Claros, MG, Brazil
| | - Vinícius Dias Rodrigues
- Grupo de Estudos em Neurociência, Exercício, Saúde e Esporte (GENESEs) of UNIMONTES, Montes Claros, MG, Brazil
- Departamento de Educação Física e Desporto da UNIMONTES, Montes Claros, MG, Brazil
| | - Luana Lemos Leão
- Post-Graduate Program of Health Sciences (PPGCS), State University of Montes Claros (UNIMONTES), Montes Claros, MG, Brazil
- Grupo de Estudos em Neurociência, Exercício, Saúde e Esporte (GENESEs) of UNIMONTES, Montes Claros, MG, Brazil
| | - Renato Sobral Monteiro-Júnior
- Post-Graduate Program of Health Sciences (PPGCS), State University of Montes Claros (UNIMONTES), Montes Claros, MG, Brazil
- Grupo de Estudos em Neurociência, Exercício, Saúde e Esporte (GENESEs) of UNIMONTES, Montes Claros, MG, Brazil
- Departamento de Educação Física e Desporto da UNIMONTES, Montes Claros, MG, Brazil
- Post-Graduate Program of Medicine (Neurology/Neuroscience), Federal Fluminense University, Niteroi, RJ, Brazil
- Neuroscience of Exercise Institute, Aroldo Tourinho Hospital, Montes Claros, MG, Brazil
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Sagari A, Kanao H, Mutai H, Iwanami J, Sato M, Kobayashi M. Cerebral Hemodynamics During a Cognitive-Motor Task Using the Limbs. Front Hum Neurosci 2020; 14:568030. [PMID: 33240062 PMCID: PMC7683383 DOI: 10.3389/fnhum.2020.568030] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2020] [Accepted: 08/24/2020] [Indexed: 11/13/2022] Open
Abstract
Background: Antagonistic tasks are cognitive-motor task trainings. Intervention programs involving antagonistic exercise tasks are being employed to help prevent falls and reduce the need for nursing care in older populations. Meanwhile, the effects of such tasks on blood flow in the brain remain obscure. This study aimed to clarify the effects of antagonistic tasks on prefrontal cortical cerebral hemodynamics. Materials and Methods: We assessed 13 healthy adults (two men, 11 women; mean age, 21.4 ± 1.0 years). Participants imitated each of the antagonistic tasks presented on a PC monitor placed at a 120-mm viewing distance. All participants performed six tasks, consisting of upper-limb tasks (non-antagonism, simple antagonism, and complex antagonism) and upper- and lower-limb tasks (tasks combining lower-limb opening and closing movements with each upper-limb task). We used near-infrared spectroscopy (NIRS) to measure cerebral blood flow dynamics, with oxygenated hemoglobin (Oxy-Hb) concentration changes as the main outcome. A 10-channel probe was placed on the participants’ forehead, focusing on the prefrontal cortex. We first obtained a baseline NIRS measurement for 10 s; the participants then imitated the task presented on the PC monitor for 90 s. We measured the number of errors and the subjective difficulty of each task. Results: The increase in prefrontal cortex Oxy-Hb concentration was significantly higher in the complex antagonist conditions than in the non-antagonistic and simple antagonistic conditions. There were no significant prefrontal cortex Oxy-Hb differences between the upper limb and upper- and lower-limb conditions (increasing number of motor limbs). Conclusions: The study findings support that an increase in finger-shaped complexity has a greater effect on cerebral blood flow dynamics in the prefrontal cortex than does an increase in the number of motor limbs involved in the task.
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Affiliation(s)
- Akira Sagari
- Division of Occupational Therapy School of Health Science, Faculty of Medicine, Shinshu University, Matsumoto, Japan
| | - Hiroyo Kanao
- Rehabilitation Division, Kami-iida Rehabilitation Hospital, Nagoya, Japan
| | - Hitoshi Mutai
- Division of Occupational Therapy School of Health Science, Faculty of Medicine, Shinshu University, Matsumoto, Japan
| | - Jun Iwanami
- Division of Occupational Therapy School of Health Science, Faculty of Medicine, Shinshu University, Matsumoto, Japan
| | - Masaaki Sato
- Division of Occupational Therapy School of Health Science, Faculty of Medicine, Shinshu University, Matsumoto, Japan
| | - Masayoshi Kobayashi
- Division of Occupational Therapy School of Health Science, Faculty of Medicine, Shinshu University, Matsumoto, Japan
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Gallou-Guyot M, Mandigout S, Combourieu-Donnezan L, Bherer L, Perrochon A. Cognitive and physical impact of cognitive-motor dual-task training in cognitively impaired older adults: An overview. Neurophysiol Clin 2020; 50:441-453. [DOI: 10.1016/j.neucli.2020.10.010] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2020] [Revised: 10/12/2020] [Accepted: 10/12/2020] [Indexed: 12/11/2022] Open
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Venema DM, Hansen H, High R, Goetsch T, Siu KC. Minimal Detectable Change in Dual-Task Cost for Older Adults With and Without Cognitive Impairment. J Geriatr Phys Ther 2020; 42:E32-E38. [PMID: 29864048 DOI: 10.1519/jpt.0000000000000194] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND AND PURPOSE Dual-task (DT) training has become a common intervention for older adults with balance and mobility limitations. Minimal detectable change (MDC) of an outcome measure is used to distinguish true change from measurement error. Few studies reporting on reliability of DT outcomes have reported MDCs. In addition, there has been limited methodological DT research on persons with cognitive impairment (CI), who have relatively more difficulty with DTs than persons without CI. The purpose of this study was to describe test-retest reliability and MDC for dual-task cost (DTC) in older adults with and without CI and for DTs of varying difficulty. METHODS Fifty participants 65 years and older attended 2 test sessions within 7 to 19 days. Participants were in a high cognitive group (n = 27) with a Montreal Cognitive Assessment (MoCA) score of 26 or more, or a low cognitive group (n = 23) with a MoCA score of less than 26. During both sessions, we used a pressure-sensing walkway to collect gait data from participants. We calculated motor DTC (the percent decline in motor performance under DT relative to single-task conditions) for 4 DTs: the Timed Up and Go (TUG) while counting forward by ones (TUG1) and counting backward by threes (TUG3); and self-selected walking speed (SSWS) with the same secondary tasks (SSWS1 and SSWS3). Intraclass correlation coefficients (ICCs) and MDCs were calculated for DTC for the time to complete the TUG and spatiotemporal gait variables during SSWS. A 3-way analysis of variance was used to compare differences in mean DTC between groups, tasks, and sessions. RESULTS AND DISCUSSION ICCs varied across groups and tasks, ranging from 0.02 to 0.76. MDCs were larger for individuals with low cognition and for DTs involving counting backward by threes. For example, the largest MDC was 503.1% for stride width during SSWS3 for individuals with low cognition, and the smallest MDC was 5.6% for cadence during SSWS1 for individuals with high cognition. Individuals with low cognition demonstrated greater DTC than individuals with high cognition. SSWS3 and TUG3 resulted in greater DTC than SSWS1 and TUG1. There were no differences in DTC between sessions for any variable. CONCLUSIONS Our study provides MDCs for DTC that physical therapists may use to assess change in older adults who engage in DT training. Persons with low cognition who are receiving DT training must exhibit greater change in DTC before one can be confident the change is real. Also, greater change must be observed for more challenging DTs. Thus, cognitive level and task difficulty should be considered when measuring change with DT training.
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Affiliation(s)
- Dawn M Venema
- Division of Physical Therapy Education, College of Allied Health Professions, University of Nebraska Medical Center, Omaha
| | | | - Robin High
- Department of Biostatistics, College of Public Health, University of Nebraska Medical Center, Omaha
| | - Troy Goetsch
- Lincoln Physical Therapy and Sports Rehab, LLC, Nebraska
| | - Ka-Chun Siu
- Division of Physical Therapy Education, College of Allied Health Professions, University of Nebraska Medical Center, Omaha
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Varela-Vásquez LA, Minobes-Molina E, Jerez-Roig J. Dual-task exercises in older adults: A structured review of current literature. J Frailty Sarcopenia Falls 2020; 5:31-37. [PMID: 32510028 PMCID: PMC7272776 DOI: 10.22540/jfsf-05-031] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/08/2020] [Indexed: 01/14/2023] Open
Abstract
Considerable attention has recently focused on the role of dual-task exercises (DT) in the older adult. The aim was to conduct a review to describe the dual-task exercises that have been shown to be effective in improving balance and other physical characteristics such as decreased falling and walking speed in older adults. Review of intervention studies, in the Pubmed, PEDro, CINAHL and Web of Science databases. The search produced 498 references, 11 of which were identified with the description of the dual-task exercises, finding a wide variety of exercises, as well as great variability of outcome measures, discovering that the dual task is predominantly used for balance and walking speed training. All studies presented at least one group performing a double cognitive-motor task, some studies used the fixed priority modality in one group and variable in another, finding greater improvements in variable prioritisation. It can be said that dual-task training in older adults can improve balance and walking speed, which in turn reduces the risk of falling only if the planned dual-task training meets certain characteristics, such as training in specific concepts crucial in motor learning and dual-task training modalities.
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Affiliation(s)
- Luz A Varela-Vásquez
- Research group on Methodology, Methods, Models and Outcomes of Health and Social Sciences (M3O). Faculty of Health Sciences and Welfare. Centre for Health and Social Care Research (CESS). University of Vic-Central University of Catalonia (UVic-UCC), Vic, Spain
| | - Eduard Minobes-Molina
- Research group on Methodology, Methods, Models and Outcomes of Health and Social Sciences (M3O). Faculty of Health Sciences and Welfare. Centre for Health and Social Care Research (CESS). University of Vic-Central University of Catalonia (UVic-UCC), Vic, Spain
| | - Javier Jerez-Roig
- Research group on Methodology, Methods, Models and Outcomes of Health and Social Sciences (M3O). Faculty of Health Sciences and Welfare. Centre for Health and Social Care Research (CESS). University of Vic-Central University of Catalonia (UVic-UCC), Vic, Spain
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Gallardo-Meza C, Simon K, Bustamante-Ara N, Ramirez-Campillo R, García-Pinillos F, Keogh JWL, Izquierdo M. Effects of 4 Weeks of Active Exergames Training on Muscular Fitness in Elderly Women. J Strength Cond Res 2020; 36:427-432. [PMID: 32483059 DOI: 10.1519/jsc.0000000000003560] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Gallardo-Meza, C, Simon, K, Bustamante-Ara, N, Ramirez-Campillo, R, García-Pinillos, F, Keogh, JWL, and Izquierdo, M. Effects of 4 weeks of active exergames training on muscular fitness in elderly women. J Strength Cond Res XX(X): 000-000, 2020-To analyze the effects of 4 weeks of an active exergames training program on muscular fitness in older women, 2 groups of community dwelling physically active subjects were formed by block-design randomization. One was deemed the control group (CG, n = 37; age 68.1 ± 3.3 years), and a second group completed 4 weeks of an active exergames training program (ExG, n = 35; age, 69.2 ± 3.7 years). Training included active exergames (Wii Fit Plus) performed on the Wii Balanceboard, 2 sessions per week. The exergames required mainly balance-related movements, such as leaning forward, leftward, and rightward, also requiring isometric squat positions and explosive leg extension. A supervisor-to-subject ratio method of 2:1 was used. An intensity-based individual progressive overload was applied. There were no significant (all p > 0.05, d = 0.01-0.07) baseline differences between-groups for all dependent variables. For the ExG, significant improvements were observed in static balance right leg test (Δ75.5%, d = 0.89), static balance left leg (Δ33.7%, d = 0.57), timed up-and-go test (Δ14.8%, d = 0.85) and sit-to-stand velocity test (Δ83.8%, d = 1.62). For the control group, trivial to small decrements in performance were observed across all tests (Δ -2.1 to -8.4%, d = -0.08 to 0.32). Group × time interactions were observed for the static balance right and left leg, timed up-and-go test, and the mean velocity achieved in the 5-repetition sit-to-stand test (all p < 0.001; d = 0.33-0.60). In conclusion, exergames training improves muscular fitness in older women. These results should be considered when designing appropriate and better exercise training programs for older women.
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Affiliation(s)
| | - Kristel Simon
- School of Kinesiology, University Santo Tomas, Osorno, Chile
| | | | - Rodrigo Ramirez-Campillo
- Laboratory of Human Performance, Quality of Life and Wellness Research Group, Department of Physical Activity Sciences, University of Los Lagos, Osorno, Chile
| | - Felipe García-Pinillos
- Department of Physical Education, Sports and Recreation, University of La Frontera, Temuco, Chile
| | - Justin W L Keogh
- Faculty of Health Sciences and Medicine, Bond University, Gold Coast, Australia.,Sports Performance Research Center New Zealand, AUT University, Auckland, New Zealand.,Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal, India
| | - Mikel Izquierdo
- GICAEDS Group, Physical Culture, Sports and Recreation Program, University of Santo Tomás, Bogotá, D.C Colombia.,Navarra Biomed, Hospital Complex of Navarra-Public University of Navarra, IDISNA, Pamplona, [ZERO WIDTH SPACE][ZERO WIDTH SPACE]Navarra, Spain.,CIBER of Frailty and Healthy Aging (CIBERFES), Carlos Health Institute III, Madrid, Spain
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Burcal CJ, Needle AR, Custer L, Rosen AB. The Effects of Cognitive Loading on Motor Behavior in Injured Individuals: A Systematic Review. Sports Med 2020; 49:1233-1253. [PMID: 31066022 DOI: 10.1007/s40279-019-01116-7] [Citation(s) in RCA: 33] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
BACKGROUND Research suggests that individuals with musculoskeletal injury may have difficulty negotiating physical tasks when they are combined with cognitive loads. OBJECTIVE Our objective was to conduct a systematic review to understand the effects of increased cognitive demand on movement patterns among individuals with musculoskeletal injuries. METHODS A comprehensive search of PubMed, MEDLINE, the Cumulative Index for Nursing and Allied Health Literature (CINAHL), and SPORTDiscus was conducted to find research reports that included a population that had previously experienced an ankle, knee, or low back injury, included an uninjured control group, and assessed a dual-task paradigm. RESULTS Forty-five full-text research reports were assessed, of which 28 studies (six ankle injury, nine knee injury, and 13 low back pain studies) were included in the review. Included studies were assessed for methodological quality and the study design extracted for analysis including the participants, cognitive and physical tasks performed, as well as outcome measures (e.g., three-dimensional kinematics, center of pressure, etc.). All studies included were cross-sectional or case-control with methodological quality scores of 17.8 ± 2.2 out of a possible 22. Twenty-five of the 28 studies found changes in motor performance with dual-task conditions compared with single tasks. Furthermore, 54% of studies reported a significant group by task interaction effect, reporting at least one alteration in injured groups' motor performance under dual-task conditions when compared with an uninjured group. CONCLUSION The results of this systematic review indicate that motor performance is further impaired by placing a cognitive load on individuals in populations with musculoskeletal injury. More demanding tasks such as gait appear to be more affected in injured individuals than simple balance tasks. Future investigators may want to consider the difficulty of the tasks included as well as the impact of dual-task paradigms on rehabilitation programs.
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Affiliation(s)
| | - Alan R Needle
- Department of Health and Exercise Science, Appalachian State University, ASU Box 32071, Boone, NC, 28608, USA.
| | - Lisa Custer
- Department of Kinesiology, Towson University, Towson, MD, USA
| | - Adam B Rosen
- School of Health and Kinesiology, University of Nebraska-Omaha, Omaha, NE, USA
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Xiao T, Yang L, Smith L, Loprinzi PD, Veronese N, Yao J, Zhang Z, Yu JJ. Correlation Between Cognition and Balance Among Middle-Aged and Older Adults Observed Through a Tai Chi Intervention Program. Front Psychol 2020; 11:668. [PMID: 32328017 PMCID: PMC7153433 DOI: 10.3389/fpsyg.2020.00668] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2019] [Accepted: 03/19/2020] [Indexed: 01/01/2023] Open
Abstract
Background Age-associated decline in cognition and balance may cause severe ability loss for daily living activities among middle-aged and older adults. The relationship between cognition and balance in this aging population remains to be explored. Objective The present study Is exploratory in nature and aimed to examine the relationship between balance (both static and dynamic components) and global cognitive function among middle-aged and older adults through Tai Chi (TC) practice as a research avenue. Methods A short-term (12 weeks) intervention of TC was conducted among middle-aged and older adults in the community setting. Global cognitive function (using the Chinese version of the Montreal Cognitive Assessment score (MoCA) and balance (i.e., one leg standing test score; Timed Up and Go Test score, TUGT) of all participants were assessed before and after the intervention. Age, body mass index (BMI), sex, and physical fitness variables (Chair Stand Test, CST; the 6-Meter Walk Test, 6MWT) were also collected as confounding factors. Results Significant moderator effects of baseline CST on the association between the dichotomized baseline MoCA score and the baseline left leg balance score (p = 0.0247), the baseline right leg balance score (p = 0.0140) and the baseline TUGT score (p = 0.0346) were found. Change score of left score balance (p = 0.0192) and change score of TUGT (p = 0.0162) were found to be significantly associated with change score of cognitive function. Conclusion Cognitive function and balance are interrelated in middle-aged and older adults. The association between global cognitive function and balance Is moderated by strength of lower limbs. The change scores of cognitive function and balance introduced by TC training were found to be positively correlated. Future research Is warranted to further confirm the cause-effect relationship of cognitive function and balance and its influencing factors among middle-aged and older adults utilizing intervention studies with larger sample sizes.
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Affiliation(s)
- Tao Xiao
- College of Mathematics and Statistics, Shenzhen University, Shenzhen, China
| | - Lin Yang
- Cancer Epidemiology and Prevention Research, Alberta Health Services, Calgary, AB, Canada.,Departments of Oncology and Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Lee Smith
- Cambridge Centre for Sport and Exercise Sciences, Anglia Ruskin University, Cambridge, United Kingdom
| | - Paul D Loprinzi
- Department of Health, Exercise Science and Recreation Management School of Applied Sciences, The University of Mississippi, Oxford, MS, United States
| | - Nicola Veronese
- Geriatrics Division, Department of Medicine-DIMED, University of Padova, Padua, Italy
| | - Jie Yao
- School of Humanities and Social Sciences, Harbin Institute of Technology (Shenzhen), Shenzhen, China
| | - Zonghao Zhang
- College of Physical Education, Soochow University, Suzhou, China
| | - Jane Jie Yu
- Department of Sports Science and Physical Education, The Chinese University of Hong Kong, Hong Kong, China
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Evaluation of Immediate Interference After Intervention With Double Tasks in Elderly Individuals. TOPICS IN GERIATRIC REHABILITATION 2020. [DOI: 10.1097/tgr.0000000000000261] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Ji Z, Feng T, Wang H. The Effects of 12-Week Physical Exercise Tapping High-level Cognitive Functions. Adv Cogn Psychol 2020; 16:59-66. [PMID: 32676132 PMCID: PMC7352119 DOI: 10.5709/acp-0284-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
The purpose of this study was to investigate the effects of physical exercise tapping high-level cognitive functions on both cognitive function and fitness in older adults. In total, 96 healthy older adults took part in the study. Participants were randomly assigned to four groups: a cognitive training group (CG), physical exercise group (PG), simultaneous cognitive training and physical exercise group (C+PG), and the healthy control group (HG; received physical exercise materials but did not participate in a cognitive or exercise programme). The outcomes were the changes in the 6-minute walk test (6MWT), timed up-and-go (TUG) test, and the computerized modified Stroop task, which included two conditions, a naming condition (nonexecutive) and an executive condition. The results showed that the dynamic balance, cardiorespiratory endurance, and physical activity levels of the PG and C+PG were significantly better than those of the HG after the 12-week intervention. The times of the TUG test in these two groups were also significantly faster than those in the HG. Additionally, the C+PG exhibited better dual-task function than the PG. Over 12 weeks, the CG, PG, and C+PG demonstrated improved performance of executive function, but only the C+PG showed a general facilitative effect on nonexecutive control. Physical exercise tapping high-level cognitive functions and cognitive training can thus improve executive function more quickly than physical exercise alone. Moreover, physical exercise tapping high-level cognitive functions showed better fitness improvement than cognitive training alone, especially in dynamic balance.
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Affiliation(s)
- Zhiguang Ji
- Shanghai University of Medicine and Health Sciences, Shanghai, China
| | - Tian Feng
- Physical Education College of Zhengzhou University, Zhengzhou, China
| | - Hongbiao Wang
- Shanghai University of Medicine and Health Sciences, Shanghai, China
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Adcock M, Sonder F, Schättin A, Gennaro F, de Bruin ED. A usability study of a multicomponent video game-based training for older adults. Eur Rev Aging Phys Act 2020; 17:3. [PMID: 31938075 PMCID: PMC6955093 DOI: 10.1186/s11556-019-0233-2] [Citation(s) in RCA: 36] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2019] [Accepted: 12/19/2019] [Indexed: 12/31/2022] Open
Abstract
Background Aging is often accompanied by a decline in sensory, motor and cognitive functions. These age- and lifestyle-related impairments may lead to reduced daily life functioning including gait disturbances, falling and injuries. Most daily life activities, e.g. walking, are tasks which require the concurrent interplay of physical and cognitive functions. Promising options for combined physical-cognitive training are video game-based physical exercises, so-called exergames. This study aimed to [i] determine the usability of a newly developed multicomponent exergame and [ii] explore its effects on physical functions, cognition and cortical activity. Methods Twenty-one healthy and independently living older adults were included (10 female, 71.4 ± 5.8 years, range: 65–91) and performed 21 training sessions (each 40 min) over seven weeks. The multicomponent exergame included strength and balance training with Tai Chi-inspired and dance exercises. Participants rated the usability of the exergame (System Usability Scale) and reported on their emotional experience (Game Experience Questionnaire). Attendance and attrition rates were calculated to determine training compliance. Before and after the intervention, physical and cognitive functions as well as resting state electroencephalography (EEG) were assessed. Results Results showed a high training attendance rate (87.1%, 18/21 training sessions on average) and a low attrition rate (9.5%, 2 drop-outs). System usability was rated high with a mean score of 75/100. Affective game experience was rated favorable. Gait speed under dual-task condition, lower extremity muscle strength and reaction times in a cognitive task (divided attention) showed significant improvements (p < .05). No significant pre-post differences were found for resting state EEG. Conclusions The newly developed exergame seems usable for healthy older adults. Nevertheless, some aspects of the exergame prototype can and should be improved. The training showed to positively influence physical and cognitive functions in a small convenience sample. Future trials are warranted which evaluate the feasibility and usability of the exergame training in a more “real-life” in-home setting and assess the behavioral and neuroplastic changes in a larger population after a longer training period with comparison to a control group.
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Affiliation(s)
- Manuela Adcock
- 1Department of Health Sciences and Technology, Institute of Human Movement Sciences and Sport, ETH Zurich, Leopold-Ruzicka-Weg 4, 8093 Zurich, Switzerland
| | - Floriana Sonder
- 1Department of Health Sciences and Technology, Institute of Human Movement Sciences and Sport, ETH Zurich, Leopold-Ruzicka-Weg 4, 8093 Zurich, Switzerland
| | - Alexandra Schättin
- 1Department of Health Sciences and Technology, Institute of Human Movement Sciences and Sport, ETH Zurich, Leopold-Ruzicka-Weg 4, 8093 Zurich, Switzerland
| | - Federico Gennaro
- 1Department of Health Sciences and Technology, Institute of Human Movement Sciences and Sport, ETH Zurich, Leopold-Ruzicka-Weg 4, 8093 Zurich, Switzerland
| | - Eling D de Bruin
- 1Department of Health Sciences and Technology, Institute of Human Movement Sciences and Sport, ETH Zurich, Leopold-Ruzicka-Weg 4, 8093 Zurich, Switzerland.,2Department of Neurobiology, Care Sciences and Society, Karolinska Institute, Alfred Nobels Alle 23, 14183 Huddinge, Sweden
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Terra MB, Barboza NM, Almeida IAD, Bueno MEB, Smaili SM. Does physiotherapy plus cognitive training improve balance in Parkinson's disease? Randomized clinical trial. MOTRIZ: REVISTA DE EDUCACAO FISICA 2020. [DOI: 10.1590/s1980-6574202000020160] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
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Wippert PM, Drießlein D, Beck H, Schneider C, Puschmann AK, Banzer W, Schiltenwolf M. The Feasibility and Effectiveness of a New Practical Multidisciplinary Treatment for Low-Back Pain: A Randomized Controlled Trial. J Clin Med 2019; 9:E115. [PMID: 31906224 PMCID: PMC7019545 DOI: 10.3390/jcm9010115] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2019] [Revised: 12/20/2019] [Accepted: 12/27/2019] [Indexed: 12/13/2022] Open
Abstract
Low-back pain is a major health problem exacerbated by the fact that most treatments are not suitable for self-management in everyday life. Particularly, interdisciplinary programs consist of intensive therapy lasting several weeks. Additionally, therapy components are rarely coordinated regarding reinforcing effects, which would improve complaints in persons with higher pain. This study assesses the effectiveness of a self-management program, firstly for persons suffering from higher pain and secondly compared to regular routines. Study objectives were treated in a single-blind multicenter controlled trial. A total of n = 439 volunteers (age 18-65 years) were randomly assigned to a twelve-week multidisciplinary sensorimotor training (3-weeks-center- and 9-weeks-homebased) or control group. The primary outcome pain (Chronic-Pain-Grade) as well as mental health were assessed by questionnaires at baseline and follow-up (3/6/12/24 weeks, M2-M5). For statistical analysis, multiple linear regression models were used. N = 291 (age 39.7 ± 12.7 years, female = 61.1%, 77% CPG = 1) completed training (M1/M4/M5), showing a significantly stronger reduction of mental health complaints (anxiety, vital exhaustion) in people with higher than those with lower pain in multidisciplinary treatment. Compared to regular routines, the self-management-multidisciplinary treatment led to a clinically relevant reduction of pain-disability and significant mental health improvements. Low-cost exercise programs may provide enormous relief for therapeutic processes, rehabilitation aftercare, and thus, cost savings for the health system.
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Affiliation(s)
- Pia-Maria Wippert
- Sociology of Health and Physical Activity, University of Potsdam, 14469 Potsdam, Germany;
- Department of Health Sciences and Technology, Laboratory of Movement Biomechanics, ETH Zürich, CH-8092 Zurich, Switzerland
| | - David Drießlein
- Statistical Consulting Unit StaBLab, Ludwig-Maximilians-Universität München, 80539 Munich, Germany;
| | - Heidrun Beck
- University Hospital Carl Gustav Carus at Technical University Dresden, 01307 Dresden, Germany;
| | | | - Anne-Katrin Puschmann
- Sociology of Health and Physical Activity, University of Potsdam, 14469 Potsdam, Germany;
| | - Winfried Banzer
- Department of Sports Medicine, Goethe University Frankfurt, 60323 Frankfurt am Main, Germany;
| | - Marcus Schiltenwolf
- Pain Management, Centre of Orthopaedics and Trauma Surgery, Conservative Orthopaedics and Pain Management, Heidelberg University Hospital, 69120 Heidelberg, Germany;
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Adcock M, Thalmann M, Schättin A, Gennaro F, de Bruin ED. A Pilot Study of an In-Home Multicomponent Exergame Training for Older Adults: Feasibility, Usability and Pre-Post Evaluation. Front Aging Neurosci 2019; 11:304. [PMID: 31824295 PMCID: PMC6882741 DOI: 10.3389/fnagi.2019.00304] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2019] [Accepted: 10/24/2019] [Indexed: 11/13/2022] Open
Abstract
Aging is associated with sensory, motor and cognitive impairments that may lead to reduced daily life functioning including gait disturbances, falls, injuries and mobility restrictions. A strong need exists for implementing effective evidence-based interventions for healthy aging. Therefore, the aim of this study was to (i) evaluate the feasibility and usability of an in-home multicomponent exergame training and (ii) explore its effects on physical functions, cognition and cortical activity. Twenty-one healthy and independently living older adults were included (11 female, 74.4 ± 7.0 years, range: 65-92 years) and performed 24 trainings sessions (each 40 min) over eight weeks. The first part was conducted in a living lab (home-like laboratory environment), the second part at participants' home. The multicomponent exergame included Tai Chi-inspired exercises, dance movements and step-based cognitive games to train strength, balance and cognition. Attendance and attrition rates were calculated and safety during training was evaluated to determine feasibility. Participants rated the usability of the exergame (System Usability Scale) and reported on their game experience (Game Experience Questionnaire). Physical and cognitive functions and cortical activity (resting state electroencephalopathy) were assessed pre and post intervention. Results showed a high training attendance rate for the living lab and the home-based setting (91.7 and 91.0%, respectively) with a rather high attrition rate (28.6%, six drop-outs). Half of the drop-out reasons were related to personal or health issues. System usability was rated acceptable with a mean score of 70.6/100. Affective game experience was rated favorable. Significant improvements were found for minimal toe clearance, short-term attentional span, and information processing speed (p < 0.05). No significant pre-post differences were found for cortical activity. To summarize, the exergame is generally feasible and usable for healthy older adults applied in an in-home setting and provides an overall positive emotional game experience. Nevertheless, flawless technical functionality should be a mandatory consideration. Additionally, the training might have potential positive influence on specific functions in older adults. However, the efficacy has to be evaluated in a future randomized controlled trial assessing the behavioral and neuroplastic changes in a larger population after a longer training period.
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Affiliation(s)
- Manuela Adcock
- Institute of Human Movement Science and Sport, Department of Health Sciences and Technology, ETH Zürich, Zurich, Switzerland
| | - Melanie Thalmann
- Institute of Human Movement Science and Sport, Department of Health Sciences and Technology, ETH Zürich, Zurich, Switzerland
| | - Alexandra Schättin
- Institute of Human Movement Science and Sport, Department of Health Sciences and Technology, ETH Zürich, Zurich, Switzerland
| | - Federico Gennaro
- Institute of Human Movement Science and Sport, Department of Health Sciences and Technology, ETH Zürich, Zurich, Switzerland
| | - Eling D. de Bruin
- Institute of Human Movement Science and Sport, Department of Health Sciences and Technology, ETH Zürich, Zurich, Switzerland
- Division of Physiotherapy, Department of Neurobiology, Care Sciences and Society, Karolinska Institute, Stockholm, Sweden
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45
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Norouzi E, Vaezmosavi M, Gerber M, Pühse U, Brand S. Dual-task training on cognition and resistance training improved both balance and working memory in older people. PHYSICIAN SPORTSMED 2019; 47:471-478. [PMID: 31155997 DOI: 10.1080/00913847.2019.1623996] [Citation(s) in RCA: 38] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Objectives: With increasing age, declines in executive functions and basic motor skills such as posture control, muscle strength, and balance performance have been observed. However, no intervention has focused on enhancing both executive functions and balance performance concomitantly. Accordingly, the aim of the present study is to investigate whether and to what extent two different dual-task interventions improved both working memory and balancing. Specifically, we examined whether either a motor-cognitive dual task training (mCdtt) or a motor-motor dual-task training (mMdtt) impacted more favorably on working memory and on balance performance among a sample of older adults.Methods: A total of 60 older males (mean age: 68.31 years; SD = 3.83) were randomly assigned either to the mCdtt, the mMdtt or to control condition. Balance performance and working memory performance were tested at baseline, four weeks later at study completion, and again 12 weeks later at follow-up.Results: Balance and working memory improved from baseline to post-intervention and to follow-up (significant Time effect), but more so in the mCdtt compared to the mMdtt condition (significant Time × Group interaction). Further, compared to the mMdtt condition, higher scores were observed in the mCdtt condition (significant Group effect).Conclusion: Dual-task interventions improved both balance performance and working memory, but more so if cognitive performance was specifically trained along with resistance training.
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Affiliation(s)
- Ebrahim Norouzi
- Department of Motor Behavior, Faculty of Sport Science, Urmia University, Urmia, Iran
| | | | - Markus Gerber
- Department of Sport, Exercise and Health, Division of Sport and Psychosocial Health, University of Basel, Basel, Switzerland
| | - Uwe Pühse
- Department of Sport, Exercise and Health, Division of Sport and Psychosocial Health, University of Basel, Basel, Switzerland
| | - Serge Brand
- Department of Sport, Exercise and Health, Division of Sport and Psychosocial Health, University of Basel, Basel, Switzerland.,Substance Abuse Prevention Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran.,Sleep Disorders Research Centre, Kermanshah University of Medical Sciences, Kermanshah, Iran.,Psychiatric Clinics (UPK), Centre for Affective, Stress and Sleep Disorders, University of Basel, Basel, Switzerland
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46
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Pang MYC, Yang L, Ouyang H, Lam FMH, Huang M, Jehu DA. Dual-Task Exercise Reduces Cognitive-Motor Interference in Walking and Falls After Stroke. Stroke 2019; 49:2990-2998. [PMID: 30571419 DOI: 10.1161/strokeaha.118.022157] [Citation(s) in RCA: 42] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
Background and Purpose- Functional community ambulation requires the ability to perform mobility and cognitive task simultaneously (dual-tasking). This single-blinded randomized controlled study aimed to examine the effects of dual-task exercise in chronic stroke patients. Methods- Eighty-four chronic stroke patients (24 women; age, 61.2±6.4 years; time since stroke onset, 75.3±64.9 months) with mild to moderate motor impairment (Chedoke-McMaster leg motor score: median, 5; interquartile range, 4-6) were randomly allocated to the dual-task balance/mobility training group, single-task balance/mobility group, or upper-limb exercise (control) group. Each group exercised for three 60-minute sessions per week for 8 weeks. The dual-task interference effect was measured for the time to completion of 3 mobility tests (forward walking, timed-up-and-go, and obstacle crossing) and for the correct response rate during serial-3-subtractions and verbal fluency task. Secondary outcomes included the Activities-specific Balance Confidence Scale, Frenchay Activities Index, and Stroke-specific Quality of Life Scale. The above outcomes were measured at baseline, immediately after, and 8 weeks after training. Fall incidence was recorded for a 6-month period posttraining. Results- Only the dual-task group exhibited reduced dual-task interference in walking time posttraining (forward walking combined with verbal fluency [9.5%, P=0.014], forward walking with serial-3-subtractions [9.6%, P=0.035], and the timed-up-and-go with verbal fluency [16.8%, P=0.001]). The improvements in dual-task walking were largely maintained at the 8-week follow-up. The dual-task cognitive performance showed no significant changes. The dual-task program reduced the risk of falls and injurious falls by 25.0% (95% CI, 3.1%-46.9%; P=0.037) and 22.2% (95% CI, 4.0%-38.4%; P=0.023), respectively, during the 6-month follow-up period compared with controls. There was no significant effect on other secondary outcomes ( P>0.05). Conclusions- The dual-task program was effective in improving dual-task mobility, reducing falls and fall-related injuries in ambulatory chronic stroke patients with intact cognition. It had no significant effect on activity participation or quality of life. Clinical trial registration- URL: https://www.clinicaltrials.gov . Unique identifier: NCT02270398.
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Affiliation(s)
- Marco Yiu Chung Pang
- From the Department of Rehabilitation Sciences, Hong Kong Polytechnic University, China (M.Y.C.P., L.Y., H.O., F.M.H.L., M.H.)
| | - Lei Yang
- From the Department of Rehabilitation Sciences, Hong Kong Polytechnic University, China (M.Y.C.P., L.Y., H.O., F.M.H.L., M.H.).,Department of Rehabilitation Medicine, The Second Affiliated Hospital of Kunming Medical University, Yunnan Province, China (L.Y.).,Institute of Disaster Management and Reconstruction, Sichuan University-Hong Kong Polytechnic University, Chengdu, China (L.Y.)
| | - Huixi Ouyang
- From the Department of Rehabilitation Sciences, Hong Kong Polytechnic University, China (M.Y.C.P., L.Y., H.O., F.M.H.L., M.H.).,Department of Physical Therapy, Guangdong Provincial Work Injury Rehabilitation Hospital, Guangzhou, China (H.O.)
| | - Freddy Man Hin Lam
- From the Department of Rehabilitation Sciences, Hong Kong Polytechnic University, China (M.Y.C.P., L.Y., H.O., F.M.H.L., M.H.).,Department of Medicine and Therapeutics, Chinese University of Hong Kong, China (F.M.H.L.)
| | - Meizhen Huang
- From the Department of Rehabilitation Sciences, Hong Kong Polytechnic University, China (M.Y.C.P., L.Y., H.O., F.M.H.L., M.H.)
| | - Deborah Ann Jehu
- Physical Therapy Department, Faculty of Medicine, University of British Columbia, Vancouver, Canada (D.A.J.)
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47
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Sturnieks DL, Menant J, Valenzuela M, Delbaere K, Sherrington C, Herbert RD, Lampit A, Broadhouse K, Turner J, Schoene D, Lord SR. Effect of cognitive-only and cognitive-motor training on preventing falls in community-dwelling older people: protocol for the smart±step randomised controlled trial. BMJ Open 2019; 9:e029409. [PMID: 31377709 PMCID: PMC6687022 DOI: 10.1136/bmjopen-2019-029409] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2019] [Revised: 04/23/2019] [Accepted: 06/11/2019] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Physical and cognitive impairments are important risk factors for falls in older people. However, no studies have been adequately powered to examine whether cognitive or cognitive-motor training can prevent falls in older people. This is despite good evidence of improvements in fall-related cognitive and physical functions following both intervention types. This manuscript describes the study protocol for a three-arm randomised controlled trial to evaluate the effectiveness of home-based cognitive and cognitive-motor training interventions, compared to a minimal-intervention control group, in preventing falls in older people. This trial was prospectively registered with the Australia New Zealand Clinical Trial Registry, number ACTRN12616001325493. METHODS AND ANALYSIS Community-dwelling adults aged 65 years and over, residing in Sydney Australia, will be recruited. Participants (n=750) will be randomly allocated to (1) cognitive-only training, (2) cognitive-motor training or (3) control groups. Both training interventions involve the use of the smart±step home-based computerised game playing system for a recommended 120 min/week for 12 months. Cognitive training group participants will use a desktop electronic touch pad to play games with the smart±step system while seated and using both hands. The cognitive-motor training group participants will use a wireless electronic floor step mat that requires accurate stepping using both legs for playing the same smart±step games, hence incorporating balance exercises. All groups will receive an education booklet on fall prevention. The primary outcome will be rate of falls, reported by monthly diaries during the 12-month duration of the study and analysis will be by intention-to-treat. Secondary outcomes include the proportion of fallers, physical and cognitive performance in 300 participants, and brain structure and function in 105 participants who will undertake MRI scans at baseline and 6 months. Cost-effectiveness will be determined using intervention and health service costs. ETHICS AND DISSEMINATION Ethical approval was obtained from UNSW Ethics Committee in September 2015 (ref number HC15203). Outcomes will be disseminated through publication in peer-reviewed journals and presentations at international conferences. TRIAL REGISTRATION NUMBER ACTRN12616001325493.
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Affiliation(s)
- Daina L Sturnieks
- Falls, Balance and Injury Research Centre, Neuroscience Research Australia, Randwick, New South Wales, Australia
- School of Medical Sciences, University of New South Wales, Sydney, New South Wales, Australia
| | - Jasmine Menant
- Falls, Balance and Injury Research Centre, Neuroscience Research Australia, Randwick, New South Wales, Australia
- School of Public Health and Community Medicine, University of New South Wales, Sydney, New South Wales, Australia
| | - Michael Valenzuela
- Brain and Mind Centre, The University of Sydney, Sydney, New South Wales, Australia
| | - Kim Delbaere
- Falls, Balance and Injury Research Centre, Neuroscience Research Australia, Randwick, New South Wales, Australia
- School of Public Health and Community Medicine, University of New South Wales, Sydney, New South Wales, Australia
| | - Catherine Sherrington
- Sydney School of Public Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Robert D Herbert
- Falls, Balance and Injury Research Centre, Neuroscience Research Australia, Randwick, New South Wales, Australia
- School of Medical Sciences, University of New South Wales, Sydney, New South Wales, Australia
| | - Amit Lampit
- Academic Unit for Psychiatry of Old Age, University of Melbourne, Melbourne, Victoria, Australia
| | - Kathryn Broadhouse
- Sunshine Coast Mind and Neuroscience Thompson Institute, University of the Sunshine Coast, Birtinya, Queensland, Australia
- Central Clinical School, The University of Sydney, Sydney, New South Wales, Australia
| | - Jessica Turner
- Falls, Balance and Injury Research Centre, Neuroscience Research Australia, Randwick, New South Wales, Australia
| | - Daniel Schoene
- Institute for Medical Physics, Friedrich-Alexander University Erlangen-Nuremberg University Library Erlangen-Nürnberg, Erlangen, Bayern, Germany
| | - Stephen R Lord
- Falls, Balance and Injury Research Centre, Neuroscience Research Australia, Randwick, New South Wales, Australia
- School of Public Health and Community Medicine, University of New South Wales, Sydney, New South Wales, Australia
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Feng T, Li Y, Ji Z, Zhang Z. The Role of Time Constraints in Athletes' Egocentric Mental Rotation Performance. Adv Cogn Psychol 2019; 15:225-235. [PMID: 32395189 PMCID: PMC7204408 DOI: 10.5709/acp-0270-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
A selective effect of motor expertise on mental rotation is revealed by a high correlation between the performance of sports experts and ability on a mental rotation task. Evidence is shown by studies involving a spatial factor, such as image interference or a movement constraint. Alternatively, the time constraint, as another performance factor, is considered critical in the effect of sport expertise on mental rotation. Three experiments were conducted to examine the role of time constraints in egocentric mental rotation and the stage performance of athletes (divers) and nonathletes. In Experiment 1, an egocentric mental rotation task in an untimed condition was conducted, and reaction times (RTs), error rates (ERs), RTs at 0 °, and mental rotation speed were assessed. The results indicated that divers outperformed nonathletes in terms of RT, as well as perceptual and decision stages and rotation stages. Experiments 2 and 3 added a relative time constraint (subtracting 1/2 SD of all the subjects' RT from the M of each group's RT) and an absolute time constraint (subtracting 1/2 SD of all the subjects' RT from the M of all the subjects' RT) to the task, respectively. Superior RT and lower ER were observed for the divers in the time constraint condition. Moreover, the results illustrated that divers were faster than nonathletes in both stages when facing time pressure. In general, the present study has, for the first time, confirmed the role of time in the relationship between sports expertise and mental rotation.
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Affiliation(s)
- Tian Feng
- Physical Education College of Zhengzhou University, Zhengzhou, China
| | - Yawei Li
- Physical Education College of Zhengzhou University, Zhengzhou, China
| | - Zhiguang Ji
- Shanghai University of Medicine and Health Science, Shanghai, China
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Reis E, Postolache G, Teixeira L, Arriaga P, Lima ML, Postolache O. Exergames for motor rehabilitation in older adults: an umbrella review. PHYSICAL THERAPY REVIEWS 2019. [DOI: 10.1080/10833196.2019.1639012] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Affiliation(s)
- Eduardo Reis
- CIS-IUL/ISCTE-Instituto Universitário de Lisboa, Lisbon, Portugal
| | - Gabriela Postolache
- Researcher at Instituto de Telecomunicaçőes, Avenida Rovisco Pais 1, Lisbon, Portugal
| | - Luís Teixeira
- CIS-IUL/ISCTE-Instituto Universitário de Lisboa, Lisbon, Portugal
- Champalimaud Foundation, Lisbon, Portugal
| | - Patrícia Arriaga
- CIS-IUL/ISCTE-Instituto Universitário de Lisboa, Lisbon, Portugal
| | - Maria Luísa Lima
- CIS-IUL/ISCTE-Instituto Universitário de Lisboa, Lisbon, Portugal
| | - Octavian Postolache
- CIS-IUL/ISCTE-Instituto Universitário de Lisboa, Lisbon, Portugal
- Instituto de Telecomunicações, Lisbon, Portugal
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50
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Park MO, Lee SH. Effect of a dual-task program with different cognitive tasks applied to stroke patients: A pilot randomized controlled trial. NeuroRehabilitation 2019; 44:239-249. [PMID: 31006694 DOI: 10.3233/nre-182563] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Dual-task training using one walking and one cognitive task is effective in improving post-stroke motor functions. OBJECTIVE We aimed to investigate the effectiveness of dual-task training using various cognitive tasks for the assessment of attention, executive function, and motor function in stroke patients. METHODS This was a single-center, randomized trial involving 30 stroke patients who were divided into a dual-task (test) group (n = 15) using different cognitive tests, and a conventional occupational therapy (control) group (n = 15). In both groups, interventions were conducted 18 times, at 30 minutes per session, 3 sessions per week, for 6 weeks. Primary outcome measures were the Trail Making Test A&B, the Digit Span Test (DST) Forward and Backward, and the Stroop (ST) Color and Word test. Secondary outcome measures were the Fugl-Meyer Assessment, the Modified Functional Reach Test, and the Berg Balance Scale. Each test was applied pre-and post- intervention. RESULTS Post-intervention, the dual-task group showed a significantly stronger effect than the occupational therapy group in the DST-Forward (p = 0.04), DST-Backward (p = 0.001), ST-Color (p = 0.023), and Berg Balance Scale (p = 0.009) assessments. CONCLUSIONS Dual-task training using various cognitive tasks had a greater positive effect than conventional occupational therapy on auditory attention, memory span, executive function, and balance.
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Affiliation(s)
- Myoung-Ok Park
- Department of Occupational Therapy, Division of Health Science, Baekseok University, Cheonan-si, Chungcheongnam-do, Republic of Korea
| | - Sang-Heon Lee
- Department of Occupational Therapy, College of Medical Science, Soonchunhyang University, Asan-si, Chungcheongnam-do, Republic of Korea
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