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Huber SK, Manser P, de Bruin ED. PEMOCS: theory derivation of a concept for PErsonalized MOtor-Cognitive exergame training in chronic Stroke-a methodological paper with an application example. Front Sports Act Living 2024; 6:1397949. [PMID: 38915297 PMCID: PMC11194322 DOI: 10.3389/fspor.2024.1397949] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2024] [Accepted: 05/27/2024] [Indexed: 06/26/2024] Open
Abstract
Background Coping with residual cognitive and gait impairments is a prominent unmet need in community-dwelling chronic stroke survivors. Motor-cognitive exergames may be promising to address this unmet need. However, many studies have so far implemented motor-cognitive exergame interventions in an unstructured manner and suitable application protocols remain yet unclear. We, therefore, aimed to summarize existing literature on this topic, and developed a training concept for motor-cognitive exergame interventions in chronic stroke. Methods The development of the training concept for personalized motor-cognitive exergame training for stroke (PEMOCS) followed Theory Derivation procedures. This comprised (1.1) a thorough (narrative) literature search on long-term stroke rehabilitation; (1.2) a wider literature search beyond the topic of interest to identify analogies, and to induce creativity; (2) the identification of parent theories; (3) the adoption of suitable content or structure of the main parent theory; and (4) the induction of modifications to adapt it to the new field of interest. We also considered several aspects of the "Framework for Developing and Evaluating Complex Interventions" by the Medical Research Council. Specifically, a feasibility study was conducted, and refining actions based on the findings were performed. Results A training concept for improving cognitive functions and gait in community-dwelling chronic stroke survivors should consider the principles for neuroplasticity, (motor) skill learning, and training. We suggest using a step-based exergame training for at least 12 weeks, 2-3 times a week for approximately 45 min. Gentile's Taxonomy for Motor Learning was identified as suitable fundament for the personalized progression and variability rules, and extended by a third cognitive dimension. Concepts and models from related fields inspired further additions and modifications to the concept. Conclusion We propose the PEMOCS concept for improving cognitive functioning and gait in community-dwelling chronic stroke survivors, which serves as a guide for structuring and implementing motor-cognitive exergame interventions. Future research should focus on developing objective performance parameters that enable personalized progression independent of the chosen exergame type.
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Affiliation(s)
- Simone K. Huber
- Physiotherapy and Occupational Therapy Research Centre, Directorate of Research and Education, University Hospital Zurich, Zurich, Switzerland
- Motor Control and Learning Group, Institute of Human Movement Sciences and Sport, Department of Health Sciences and Technology, ETH Zurich, Zurich, Switzerland
| | - Patrick Manser
- Motor Control and Learning Group, Institute of Human Movement Sciences and Sport, Department of Health Sciences and Technology, ETH Zurich, Zurich, Switzerland
| | - Eling D. de Bruin
- Motor Control and Learning Group, Institute of Human Movement Sciences and Sport, Department of Health Sciences and Technology, ETH Zurich, Zurich, Switzerland
- Department of Health, OST—Eastern Swiss University of Applied Sciences, St. Gallen, Switzerland
- Division of Physiotherapy, Department of Neurobiology, Care Sciences and Society, Karolinska Institute, Stockholm, Sweden
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Hayashi H, Sone T, Iokawa K, Sumigawa K, Fujita T, Kawamata H, Asao A, Kawasaki I, Ogasawara M, Kawakatsu S. Effects of computerized cognitive training on biomarker responses in older adults with mild cognitive impairment: A scoping review. Health Sci Rep 2024; 7:e2175. [PMID: 38895550 PMCID: PMC11182779 DOI: 10.1002/hsr2.2175] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2023] [Revised: 03/08/2024] [Accepted: 05/17/2024] [Indexed: 06/21/2024] Open
Abstract
Background and Aims Mild cognitive impairment (MCI) is a widespread condition in older individuals, posing significant risk of dementia. However, limited research has been conducted to explore effective interventions and clarify their impact at the neural level. Therefore, this study aimed to investigate the effects of computerized cognitive training (CCT) and explore the associated neural mechanisms in preventing dementia in older individuals with MCI, with a view to inform future intervention efforts. Methods We reviewed the effects of CCT on biomarker outcomes in older adults with MCI. The search was conducted for studies published between 2010 and May 10, 2023, using three search engines: PubMed, Scopus, and Cumulative Index to Nursing and Allied Health Literature. The inclusion criteria were as follows: studies that involved participants diagnosed with MCI, included CCT, included quantitative assessment of biomarker results, and conducted randomized controlled trials. Results Sixteen studies that used biomarkers, including magnetic resonance imaging, electroencephalography (EEG), functional near-infrared spectroscopy (fNIRS), and blood or salivary biomarkers, were extracted. The results showed that CCT caused changes in structure and function within the main brain network, including the default mode network, and decreased both theta rhythm activity on EEG and prefrontal activity on fNIRS, with improvement in cognitive function. Furthermore, CCT combined with physical exercise showed more significant structural and functional changes in extensive brain regions compared with CCT alone. Virtual reality-based cognitive training improved not only executive function but also instrumental activities of daily living. Conclusion CCT causes functional and structural changes in extensive brain regions and improves cognitive function in older adults with MCI. Our findings highlight the potential of individualized intervention methods and biomarker assessment according to the specific causes of MCI. Future research should aim to optimize these personalized therapeutic strategies to maximize the benefits of CCT in older adults with MCI.
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Affiliation(s)
- Hiroshi Hayashi
- Department of Occupational TherapyFukushima Medical University School of Health SciencesFukushimaJapan
| | - Toshimasa Sone
- Department of Occupational TherapyFukushima Medical University School of Health SciencesFukushimaJapan
| | - Kazuaki Iokawa
- Department of Occupational TherapyFukushima Medical University School of Health SciencesFukushimaJapan
| | - Koshi Sumigawa
- Department of Occupational TherapyFukushima Medical University School of Health SciencesFukushimaJapan
| | - Takaaki Fujita
- Department of Occupational TherapyFukushima Medical University School of Health SciencesFukushimaJapan
| | - Hironori Kawamata
- Department of Occupational TherapyFukushima Medical University School of Health SciencesFukushimaJapan
| | - Akihiko Asao
- Department of Occupational TherapyFukushima Medical University School of Health SciencesFukushimaJapan
| | - Iori Kawasaki
- Department of Occupational TherapyFukushima Medical University School of Health SciencesFukushimaJapan
| | - Maki Ogasawara
- Department of Occupational TherapyFukushima Medical University School of Health SciencesFukushimaJapan
| | - Shinobu Kawakatsu
- Department of Neuropsychiatry, Aizu Medical CenterFukushima Medical UniversityAizuwakamatsuJapan
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Merceur M, Reilly KT, Bonan I, Holé J, Hummel E, Cogné M, Jacquin-Courtois S. A systematic review of rehabilitation programs for cognitive impairment related to breast cancer: Different programs at different times? Ann Phys Rehabil Med 2024; 67:101832. [PMID: 38537525 DOI: 10.1016/j.rehab.2024.101832] [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: 03/02/2023] [Revised: 12/04/2023] [Accepted: 02/10/2024] [Indexed: 06/11/2024]
Abstract
BACKGROUND "Cancer Related Cognitive Impairment" (CRCI) defines cognitive disorders related to cancer and its treatments. Many people with breast cancer experience signs of CRCI (incidence between 20 and 30 %) and, although several intervention options exist, there is no established standard of care. Our main objective was to provide a detailed description of the methods and results of randomized controlled trials of interventions for CRCI in breast cancer survivors, paying particular attention to the timing of the interventions within the care pathway. METHODS We conducted a systematic literature review following the PRISMA guidelines from 01 to 01-2019 to 16-07-2023 and included randomized controlled trials of interventions for CRCI after breast cancer with at least one objective cognitive assessment as a primary or secondary outcome. RESULTS Among 228 identified studies, 35 (including 2821 participants) were retained for inclusion. The interventions were classified into 4 categories: cognitive rehabilitation, physical activity, complementary therapy and pharmacological treatment. Our analysis revealed that pharmacological interventions have no effect, whereas physical activity interventions proposed in the months following the initial cancer treatment improve Quality of Life and Speed of Information Processing while interventions proposed later improve Memory and Attention (Cognitive Rehabilitation) and Perceived Cognitive Function and Depression/Anxiety/Mood (Complementary Therapies). CONCLUSION CRCI is multifactorial and affected individuals frequently experience high levels of fatigue, pain, anxiety and depression and are most likely to benefit from holistic approaches that include cognition, physical activity, relaxation, psychoeducation, group support and/or psychological counselling. Thus, rehabilitation programs should be designed on multi-modal approaches, using innovative, cost-effective delivery methods that increase access to treatment, and intervention outcomes should be evaluated using measures of participation. DATABASE REGISTRATION The review was recorded on Prospero (01-03-2020), with the registration number 135,627.
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Affiliation(s)
- Marianne Merceur
- Rehabilitation Medicine Unit, University Hospital of Rennes, 2 rue Henri Le Guilloux, 35000 Rennes, France.
| | - Karen T Reilly
- Université Claude Bernard Lyon 1, CNRS, INSERM, Centre de Recherche en Neurosciences de Lyon CRNL U1028 UMR5292, TRAJECTOIRES, 95 Boulevard Pinel, 69500 Bron, France
| | - Isabelle Bonan
- Rehabilitation Medicine Unit, University Hospital of Rennes, 2 rue Henri Le Guilloux, 35000 Rennes, France
| | - Julie Holé
- Physical Medicine and Rehabilitation Department, Henry Gabrielle Hospital, Hospices Civils de Lyon, 20 route de Vourles, 69230 Saint Genis Laval, France
| | - Emilie Hummel
- Hybrid team, Inria, Campus de Beaulieu, 263 Av. Général Leclerc, 35042 Rennes, France
| | - Mélanie Cogné
- Rehabilitation Medicine Unit, University Hospital of Rennes, 2 rue Henri Le Guilloux, 35000 Rennes, France
| | - Sophie Jacquin-Courtois
- Université Claude Bernard Lyon 1, CNRS, INSERM, Centre de Recherche en Neurosciences de Lyon CRNL U1028 UMR5292, TRAJECTOIRES, 95 Boulevard Pinel, 69500 Bron, France; Hybrid team, Inria, Campus de Beaulieu, 263 Av. Général Leclerc, 35042 Rennes, France
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Ip BYM, Ko H, Lam BYK, Au LWC, Lau AYL, Huang J, Kwok AJ, Leng X, Cai Y, Leung TWH, Mok VCT. Current and Future Treatments of Vascular Cognitive Impairment. Stroke 2024; 55:822-839. [PMID: 38527144 DOI: 10.1161/strokeaha.123.044174] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/27/2024]
Affiliation(s)
- Bonaventure Yiu Ming Ip
- Division of Neurology, Department of Medicine and Therapeutics (B.Y.M.I., H.K., B.Y.K.L., L.W.C.A., A.Y.L.L., J.H., A.J.K., X.L., C.Y., T.W.H.L., V.C.T.M.), Faculty of Medicine, The Chinese University of Hong Kong
- Li Ka Shing Institute of Health Sciences (B.Y.M.I., H.K., B.Y.K.L., L.W.C.A., J.H., A.J.K., X.L., C.Y., T.W.H.L., V.C.T.M.), Faculty of Medicine, The Chinese University of Hong Kong
- Margaret K. L. Cheung Research Centre for Management of Parkinsonism (B.Y.M.I., H.K., B.Y.K.L., L.W.C.A., J.H., A.J.K., C.Y., V.C.T.M.), Faculty of Medicine, The Chinese University of Hong Kong
- Lau Tat-Chuen Research Centre of Brain Degenerative Diseases in Chinese (B.Y.M.I., H.K., B.Y.K.L., L.W.C.A., A.Y.L.L., J.H., A.J.K., C.Y., V.C.T.M.), Faculty of Medicine, The Chinese University of Hong Kong
- Gerald Choa Neuroscience Institute, The Chinese University of Hong Kong (B.Y.M.I., H.K., B.Y.K.L., L.W.C.A., J.H., A.J.K., C.Y., V.C.T.M.)
- Kwok Tak Seng Centre for Stroke Research and Intervention, Hong Kong SAR, China (B.Y.M.I., X.L., T.W.H.L.)
| | - Ho Ko
- Division of Neurology, Department of Medicine and Therapeutics (B.Y.M.I., H.K., B.Y.K.L., L.W.C.A., A.Y.L.L., J.H., A.J.K., X.L., C.Y., T.W.H.L., V.C.T.M.), Faculty of Medicine, The Chinese University of Hong Kong
- Li Ka Shing Institute of Health Sciences (B.Y.M.I., H.K., B.Y.K.L., L.W.C.A., J.H., A.J.K., X.L., C.Y., T.W.H.L., V.C.T.M.), Faculty of Medicine, The Chinese University of Hong Kong
- Margaret K. L. Cheung Research Centre for Management of Parkinsonism (B.Y.M.I., H.K., B.Y.K.L., L.W.C.A., J.H., A.J.K., C.Y., V.C.T.M.), Faculty of Medicine, The Chinese University of Hong Kong
- Lau Tat-Chuen Research Centre of Brain Degenerative Diseases in Chinese (B.Y.M.I., H.K., B.Y.K.L., L.W.C.A., A.Y.L.L., J.H., A.J.K., C.Y., V.C.T.M.), Faculty of Medicine, The Chinese University of Hong Kong
- Gerald Choa Neuroscience Institute, The Chinese University of Hong Kong (B.Y.M.I., H.K., B.Y.K.L., L.W.C.A., J.H., A.J.K., C.Y., V.C.T.M.)
| | - Bonnie Yin Ka Lam
- Division of Neurology, Department of Medicine and Therapeutics (B.Y.M.I., H.K., B.Y.K.L., L.W.C.A., A.Y.L.L., J.H., A.J.K., X.L., C.Y., T.W.H.L., V.C.T.M.), Faculty of Medicine, The Chinese University of Hong Kong
- Li Ka Shing Institute of Health Sciences (B.Y.M.I., H.K., B.Y.K.L., L.W.C.A., J.H., A.J.K., X.L., C.Y., T.W.H.L., V.C.T.M.), Faculty of Medicine, The Chinese University of Hong Kong
- Margaret K. L. Cheung Research Centre for Management of Parkinsonism (B.Y.M.I., H.K., B.Y.K.L., L.W.C.A., J.H., A.J.K., C.Y., V.C.T.M.), Faculty of Medicine, The Chinese University of Hong Kong
- Lau Tat-Chuen Research Centre of Brain Degenerative Diseases in Chinese (B.Y.M.I., H.K., B.Y.K.L., L.W.C.A., A.Y.L.L., J.H., A.J.K., C.Y., V.C.T.M.), Faculty of Medicine, The Chinese University of Hong Kong
- Gerald Choa Neuroscience Institute, The Chinese University of Hong Kong (B.Y.M.I., H.K., B.Y.K.L., L.W.C.A., J.H., A.J.K., C.Y., V.C.T.M.)
| | - Lisa Wing Chi Au
- Division of Neurology, Department of Medicine and Therapeutics (B.Y.M.I., H.K., B.Y.K.L., L.W.C.A., A.Y.L.L., J.H., A.J.K., X.L., C.Y., T.W.H.L., V.C.T.M.), Faculty of Medicine, The Chinese University of Hong Kong
- Li Ka Shing Institute of Health Sciences (B.Y.M.I., H.K., B.Y.K.L., L.W.C.A., J.H., A.J.K., X.L., C.Y., T.W.H.L., V.C.T.M.), Faculty of Medicine, The Chinese University of Hong Kong
- Margaret K. L. Cheung Research Centre for Management of Parkinsonism (B.Y.M.I., H.K., B.Y.K.L., L.W.C.A., J.H., A.J.K., C.Y., V.C.T.M.), Faculty of Medicine, The Chinese University of Hong Kong
- Lau Tat-Chuen Research Centre of Brain Degenerative Diseases in Chinese (B.Y.M.I., H.K., B.Y.K.L., L.W.C.A., A.Y.L.L., J.H., A.J.K., C.Y., V.C.T.M.), Faculty of Medicine, The Chinese University of Hong Kong
- Gerald Choa Neuroscience Institute, The Chinese University of Hong Kong (B.Y.M.I., H.K., B.Y.K.L., L.W.C.A., J.H., A.J.K., C.Y., V.C.T.M.)
| | - Alexander Yuk Lun Lau
- Division of Neurology, Department of Medicine and Therapeutics (B.Y.M.I., H.K., B.Y.K.L., L.W.C.A., A.Y.L.L., J.H., A.J.K., X.L., C.Y., T.W.H.L., V.C.T.M.), Faculty of Medicine, The Chinese University of Hong Kong
- Margaret K. L. Cheung Research Centre for Management of Parkinsonism (B.Y.M.I., H.K., B.Y.K.L., L.W.C.A., J.H., A.J.K., C.Y., V.C.T.M.), Faculty of Medicine, The Chinese University of Hong Kong
- Lau Tat-Chuen Research Centre of Brain Degenerative Diseases in Chinese (B.Y.M.I., H.K., B.Y.K.L., L.W.C.A., A.Y.L.L., J.H., A.J.K., C.Y., V.C.T.M.), Faculty of Medicine, The Chinese University of Hong Kong
| | - Junzhe Huang
- Division of Neurology, Department of Medicine and Therapeutics (B.Y.M.I., H.K., B.Y.K.L., L.W.C.A., A.Y.L.L., J.H., A.J.K., X.L., C.Y., T.W.H.L., V.C.T.M.), Faculty of Medicine, The Chinese University of Hong Kong
- Li Ka Shing Institute of Health Sciences (B.Y.M.I., H.K., B.Y.K.L., L.W.C.A., J.H., A.J.K., X.L., C.Y., T.W.H.L., V.C.T.M.), Faculty of Medicine, The Chinese University of Hong Kong
- Margaret K. L. Cheung Research Centre for Management of Parkinsonism (B.Y.M.I., H.K., B.Y.K.L., L.W.C.A., J.H., A.J.K., C.Y., V.C.T.M.), Faculty of Medicine, The Chinese University of Hong Kong
- Lau Tat-Chuen Research Centre of Brain Degenerative Diseases in Chinese (B.Y.M.I., H.K., B.Y.K.L., L.W.C.A., A.Y.L.L., J.H., A.J.K., C.Y., V.C.T.M.), Faculty of Medicine, The Chinese University of Hong Kong
- Gerald Choa Neuroscience Institute, The Chinese University of Hong Kong (B.Y.M.I., H.K., B.Y.K.L., L.W.C.A., J.H., A.J.K., C.Y., V.C.T.M.)
| | - Andrew John Kwok
- Division of Neurology, Department of Medicine and Therapeutics (B.Y.M.I., H.K., B.Y.K.L., L.W.C.A., A.Y.L.L., J.H., A.J.K., X.L., C.Y., T.W.H.L., V.C.T.M.), Faculty of Medicine, The Chinese University of Hong Kong
- Li Ka Shing Institute of Health Sciences (B.Y.M.I., H.K., B.Y.K.L., L.W.C.A., J.H., A.J.K., X.L., C.Y., T.W.H.L., V.C.T.M.), Faculty of Medicine, The Chinese University of Hong Kong
- Lau Tat-Chuen Research Centre of Brain Degenerative Diseases in Chinese (B.Y.M.I., H.K., B.Y.K.L., L.W.C.A., A.Y.L.L., J.H., A.J.K., C.Y., V.C.T.M.), Faculty of Medicine, The Chinese University of Hong Kong
- Gerald Choa Neuroscience Institute, The Chinese University of Hong Kong (B.Y.M.I., H.K., B.Y.K.L., L.W.C.A., J.H., A.J.K., C.Y., V.C.T.M.)
| | - Xinyi Leng
- Division of Neurology, Department of Medicine and Therapeutics (B.Y.M.I., H.K., B.Y.K.L., L.W.C.A., A.Y.L.L., J.H., A.J.K., X.L., C.Y., T.W.H.L., V.C.T.M.), Faculty of Medicine, The Chinese University of Hong Kong
- Li Ka Shing Institute of Health Sciences (B.Y.M.I., H.K., B.Y.K.L., L.W.C.A., J.H., A.J.K., X.L., C.Y., T.W.H.L., V.C.T.M.), Faculty of Medicine, The Chinese University of Hong Kong
- Kwok Tak Seng Centre for Stroke Research and Intervention, Hong Kong SAR, China (B.Y.M.I., X.L., T.W.H.L.)
| | - Yuan Cai
- Division of Neurology, Department of Medicine and Therapeutics (B.Y.M.I., H.K., B.Y.K.L., L.W.C.A., A.Y.L.L., J.H., A.J.K., X.L., C.Y., T.W.H.L., V.C.T.M.), Faculty of Medicine, The Chinese University of Hong Kong
- Li Ka Shing Institute of Health Sciences (B.Y.M.I., H.K., B.Y.K.L., L.W.C.A., J.H., A.J.K., X.L., C.Y., T.W.H.L., V.C.T.M.), Faculty of Medicine, The Chinese University of Hong Kong
- Margaret K. L. Cheung Research Centre for Management of Parkinsonism (B.Y.M.I., H.K., B.Y.K.L., L.W.C.A., J.H., A.J.K., C.Y., V.C.T.M.), Faculty of Medicine, The Chinese University of Hong Kong
- Lau Tat-Chuen Research Centre of Brain Degenerative Diseases in Chinese (B.Y.M.I., H.K., B.Y.K.L., L.W.C.A., A.Y.L.L., J.H., A.J.K., C.Y., V.C.T.M.), Faculty of Medicine, The Chinese University of Hong Kong
- Gerald Choa Neuroscience Institute, The Chinese University of Hong Kong (B.Y.M.I., H.K., B.Y.K.L., L.W.C.A., J.H., A.J.K., C.Y., V.C.T.M.)
| | - Thomas Wai Hong Leung
- Division of Neurology, Department of Medicine and Therapeutics (B.Y.M.I., H.K., B.Y.K.L., L.W.C.A., A.Y.L.L., J.H., A.J.K., X.L., C.Y., T.W.H.L., V.C.T.M.), Faculty of Medicine, The Chinese University of Hong Kong
- Li Ka Shing Institute of Health Sciences (B.Y.M.I., H.K., B.Y.K.L., L.W.C.A., J.H., A.J.K., X.L., C.Y., T.W.H.L., V.C.T.M.), Faculty of Medicine, The Chinese University of Hong Kong
- Kwok Tak Seng Centre for Stroke Research and Intervention, Hong Kong SAR, China (B.Y.M.I., X.L., T.W.H.L.)
| | - Vincent Chung Tong Mok
- Division of Neurology, Department of Medicine and Therapeutics (B.Y.M.I., H.K., B.Y.K.L., L.W.C.A., A.Y.L.L., J.H., A.J.K., X.L., C.Y., T.W.H.L., V.C.T.M.), Faculty of Medicine, The Chinese University of Hong Kong
- Li Ka Shing Institute of Health Sciences (B.Y.M.I., H.K., B.Y.K.L., L.W.C.A., J.H., A.J.K., X.L., C.Y., T.W.H.L., V.C.T.M.), Faculty of Medicine, The Chinese University of Hong Kong
- Margaret K. L. Cheung Research Centre for Management of Parkinsonism (B.Y.M.I., H.K., B.Y.K.L., L.W.C.A., J.H., A.J.K., C.Y., V.C.T.M.), Faculty of Medicine, The Chinese University of Hong Kong
- Lau Tat-Chuen Research Centre of Brain Degenerative Diseases in Chinese (B.Y.M.I., H.K., B.Y.K.L., L.W.C.A., A.Y.L.L., J.H., A.J.K., C.Y., V.C.T.M.), Faculty of Medicine, The Chinese University of Hong Kong
- Gerald Choa Neuroscience Institute, The Chinese University of Hong Kong (B.Y.M.I., H.K., B.Y.K.L., L.W.C.A., J.H., A.J.K., C.Y., V.C.T.M.)
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Bhattacharya M, Kashyap H, Reddy YJ. Cognitive Training in Obsessive-Compulsive Disorder: A Systematic Review. Indian J Psychol Med 2024; 46:110-118. [PMID: 38725718 PMCID: PMC11076946 DOI: 10.1177/02537176231207781] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/12/2024] Open
Abstract
Background Cognitive training (CT) for illness-linked neuropsychological deficits has been attempted in psychiatric disorders and, more recently, in obsessive-compulsive disorder (OCD). However, studies are few and far between, with a limited understanding of factors contributing to efficacy. This article aims to provide a comprehensive critical review of studies employing CT in OCD. Methods This systematic review follows the Preferred Reporting of Items for Systematic Review and Meta-Analyses Protocols. Empirical studies that used any form of CT/remediation in individuals with OCD were included. Results Eight articles met the criteria for inclusion, of which five were randomized controlled trials, two were case series, and one was an open-label trial. The studies have predominantly demonstrated improved trained cognitive functions, with only two showing generalization to untrained domains like clinical symptoms and socio-occupational functioning. Conclusion There are few controlled trials of CT in OCD, which limits conclusions of efficacy. Given the sparse research in the area, the review summarizes the current status of research and examines important methodological considerations that may inform future studies.
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Affiliation(s)
- Mahashweta Bhattacharya
- Dept. of Clinical Psychology, National Institute of Mental health and Neurosciences (NIMHANS), Bengaluru, Karnataka, India
- Obsessive-Compulsive Disorder Clinic, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, India
- Accelerator Program for Discovery in Brain Disorders using Stem cells (ADBS), Government of India
| | - Himani Kashyap
- Dept. of Clinical Psychology, National Institute of Mental health and Neurosciences (NIMHANS), Bengaluru, Karnataka, India
- Obsessive-Compulsive Disorder Clinic, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, India
| | - Y.C. Janardhan Reddy
- Obsessive-Compulsive Disorder Clinic, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, India
- Accelerator Program for Discovery in Brain Disorders using Stem cells (ADBS), Government of India
- Dept. of Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, Karnataka, India
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Zarei H, Norasteh AA, Dehghani N, Lieberman LJ, Ertel MW, Brian A. Effects of exercise training programs on motor skills of individuals with intellectual disabilities: a systematic review and meta-analysis. Disabil Rehabil 2024:1-10. [PMID: 38375618 DOI: 10.1080/09638288.2024.2318486] [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: 12/08/2023] [Accepted: 02/08/2024] [Indexed: 02/21/2024]
Abstract
PURPOSE Motor skills are involved in many physical activities and are prerequisites for the performance of sport skills. The purpose of this systematic review was to examine the effects of exercise training programs (ETP) on the motor skills of individuals with intellectual disabilities (IwID). METHODS Primary sources were obtained from four databases including PubMed, SCOPUS, CENTRAL, and Web of Science. The search period covered years from inception to October 26th, 2023. Inclusion criteria were as follows: Population: IwID; Intervention: ETP; Comparator: motor skills vs. nontraining control; Outcomes: motor skills outcomes. Standardized mean differences, weighted mean differences, and 95% confidence intervals (CI) were calculated using both random and fixed-effect models for outcomes. RESULTS A total of 14 studies involving 586 participants were included in the systematic review. The results of the present meta-analysis showed that ETP improved composite motor skills (1.28 95% CI: [0.86, 1.70], p = 0.001), gross motor skills (0.91, 95% CI: [0.62,1.19], p = 0.001), fine motor skills (0.74, 95% CI: [0.21,1.27], p = 0.01) and fine-gross motor skills (0.64, 95% CI: [0.29, 1.00], p = 0.001). CONCLUSION The results meta-analysis demonstrated that ETP improves the motor skills of IwID. Therefore, it is recommended to apply ETP to improve the motor skills of the IwID.
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Affiliation(s)
- Hamed Zarei
- PhD Student in Physical Education and Sport Sciences, (Corrective Exercise and Sport Injuries), Corrective Exercises and Sports Injury Department, Faculty of Physical Education and Sport Sciences, University of Guilan, Rasht, Iran
| | - Ali Asghar Norasteh
- Professor, PhD, P.T, Physiotherapy Department, Faculty of Medicine, Guilan University of Medical Sciences, Rasht, Iran
| | - Nastaran Dehghani
- MSc Student in Physical Education and Sport Sciences, (Corrective Exercise and Sport Injuries), Corrective Exercises and Sports Injury Department, Faculty of Physical Education and Sport Sciences, University of Guilan, Rasht, Iran
| | - Lauren J Lieberman
- Department of Kinesiology, Sport Studies and Physical Education, State University of NY (SUNY), Brockport, NY, USA
| | - Michael W Ertel
- Department of Educational and Developmental Science, University of SC, Columbia, SC, USA
| | - Ali Brian
- Department of Educational and Developmental Science, University of SC, Columbia, SC, USA
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Zwingmann K, Schlesinger T, Müller K. The Impact of an Outdoor Motor-Cognitive Exercise Programme on the Health Outcomes of Older Adults in Community Settings: A Pilot and Feasibility Study. Sports (Basel) 2024; 12:49. [PMID: 38393269 PMCID: PMC10892309 DOI: 10.3390/sports12020049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2023] [Revised: 01/12/2024] [Accepted: 01/29/2024] [Indexed: 02/25/2024] Open
Abstract
Physical and cognitive exercises can prevent or at least mitigate the symptoms of certain diseases and help older adults perform a range of daily functions. Yet, most seniors do not meet the World Health Organisation's recommended guidelines for physical activity. The objective of this study is to promote and maintain the physical and cognitive capacity of older adults by implementing a feasible and effective low-threshold, age-appropriate, motor-cognitive training outdoors. In the German city of Chemnitz, citizens aged 60 years and older participated in a quasi-randomised intervention trial. Exercises to train coordination, strength, endurance, and cognition were integrated into a 12-week outdoor motor-cognitive exercise programme. Both the physical (e.g., 6MWT) and cognitive skills (e.g., TMT B) of the intervention group (n = 41) and control group (no intervention, n = 58) were measured before (T1) and after (T2) completion of the exercise programme. Some of the participants' physical and all their cognitive measures improved. Neurocognitive performance (DSST) showed a significant time × group interaction effect (F(1,95) = 6.943, p = 0.010, ηp2 = 0.068). Sex and age were found to be influencing factors. We consider our exercise programme to be successfully implemented, well received by the participants, and feasible and useful to promote the continued exercise of daily functions as part of healthy aging in community-dwelling older adults.
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Affiliation(s)
- Katharina Zwingmann
- Institute of Human Movement Science and Health, Faculty of Behavioral and Social Sciences, Chemnitz University of Technology, 09107 Chemnitz, Germany; (T.S.); (K.M.)
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Zhang R, Liu S, Mousavi SM. Cognitive Dysfunction and Exercise: From Epigenetic to Genetic Molecular Mechanisms. Mol Neurobiol 2024:10.1007/s12035-024-03970-7. [PMID: 38286967 DOI: 10.1007/s12035-024-03970-7] [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: 11/16/2023] [Accepted: 01/19/2024] [Indexed: 01/31/2024]
Abstract
Maintaining good health is crucial, and exercise plays a vital role in achieving this goal. It offers a range of positive benefits for cognitive function, regardless of age. However, as our population ages and life expectancy increases, cognitive impairment has become a prevalent issue, often coexisting with age-related neurodegenerative conditions. This can result in devastating consequences such as memory loss, difficulty speaking, and confusion, greatly hindering one's ability to lead an ordinary life. In addition, the decrease in mental capacity has a significant effect on an individual's physical and emotional well-being, greatly reducing their overall level of contentment and causing a significant financial burden for communities. While most current approaches aim to slow the decline of cognition, exercise offers a non-pharmacological, safe, and accessible solution. Its effects on cognition are intricate and involve changes in the brain's neural plasticity, mitochondrial stability, and energy metabolism. Moreover, exercise triggers the release of cytokines, playing a significant role in the body-brain connection and its impact on cognition. Additionally, exercise can influence gene expression through epigenetic mechanisms, leading to lasting improvements in brain function and behavior. Herein, we summarized various genetic and epigenetic mechanisms that can be modulated by exercise in cognitive dysfunction.
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Affiliation(s)
- Runhong Zhang
- Department of Physical Education, Luliang University, Lishi, 033000, Shanxi, China.
| | - Shangwu Liu
- Department of Physical Education, Luliang University, Lishi, 033000, Shanxi, China
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9
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Winser SJ, Chan AYY, Whitney SL, Chen CH, Pang MYC. Effectiveness and cost of integrated cognitive and balance training for balance and falls in cerebellar ataxia: a blinded two-arm parallel group RCT. Front Neurol 2024; 14:1267099. [PMID: 38313407 PMCID: PMC10834731 DOI: 10.3389/fneur.2023.1267099] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Accepted: 12/27/2023] [Indexed: 02/06/2024] Open
Abstract
Background In patients with cerebellar ataxia (CA), dual-tasking deteriorates the performance of one or both tasks. Objective Evaluate the effects of 4 weeks of cognitive-coupled intensive balance training (CIBT) on dual-task cost, dynamic balance, disease severity, number of falls, quality of life, cognition and cost among patients with CA. Methods This RCT compared CIBT (Group 1) to single-task training (Group 2) among 32 patients with CA. The intervention included either dual-task (CIBT) or single-task training for 4 weeks followed by 6 months of unsupervised home exercises. Dual-task timed up-and-go test (D-TUG) assessed dual-task cost of the physical and cognitive tasks. Assessment time points included baseline 1 (Week 0:T1), baseline 2 (Week 6:T2), post-intervention (Week 10:T3), and follow-up (Week 34:T4). Results Compared to single-task training CIBT improved the dual-task cost of physical task [MD -8.36 95% CI (-14.47 to -2.36, p < 0.01), dual-tasking ability [-6.93 (-13.16 to -0.70); p = 0.03] assessed using D-TUG, balance assessed using the scale for the assessment and rating of ataxia (SARAbal) [-2.03 (-4.04 to -0.19); p = 0.04], visual scores of the SOT (SOT-VIS) [-18.53 (-25.81 to -11.24, p ≤ 0.01] and maximal excursion [13.84 (4.65 to 23.03; p ≤ 0.01] of the Limits of Stability (LOS) in the forward direction and reaction time in both forward [-1.11 (-1.42 to -0.78); p < 0.01] and right [-0.18 (0.05 to 0.31); p < 0.01] directions following 4 weeks of training. CIBT did not have any additional benefits in reducing the number of falls, or improving disease severity, quality of life and cognition. The mean cost of intervention and healthcare costs for 7 months was HKD 33,380 for CIBT group and HKD 38,571 for single-task training group. Conclusion We found some evidence to support the use of CIBT for improving the dual-tasking ability, dual-task cost of physical task and dynamic balance in CA. Future large fully-powered studies are needed to confirm this claim. Clinical trial registration https://clinicaltrials.gov/study/NCT04648501, identifier [Ref: NCT04648501].
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Affiliation(s)
- Stanley J. Winser
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Kowloon, Hong Kong SAR, China
| | - Anne Y. Y. Chan
- Division of Neurology, Prince of Wales Hospital and Department of Medicine and Therapeutics, Chinese University of Hong Kong, Hong Kong SAR, China
| | - Susan L. Whitney
- School of Health and Rehabilitation Sciences, University of Pittsburgh, Pittsburgh, PA, United States
| | - Cynthia H. Chen
- Saw Swee Hock School of Public Health (Primary), National University of Singapore, Singapore, Singapore
| | - Marco Y. C. Pang
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Kowloon, Hong Kong SAR, China
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Seinsche J, de Bruin ED, Saibene E, Rizzo F, Carpinella I, Ferrarin M, Moza S, Ritter T, Giannouli E. A Newly Developed Exergame-Based Telerehabilitation System for Older Adults: Usability and Technology Acceptance Study. JMIR Hum Factors 2023; 10:e48845. [PMID: 38060283 PMCID: PMC10739244 DOI: 10.2196/48845] [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: 05/09/2023] [Revised: 08/08/2023] [Accepted: 10/05/2023] [Indexed: 12/08/2023] Open
Abstract
BACKGROUND Telerehabilitation has gained significance as a tool to deliver and supervise therapy and training as effective as traditional rehabilitation methods yet more accessible and affordable. An exergame-based telerehabilitation system has recently been developed within the scope of the international Continuum-of-Care (COCARE) project. The system comprises training devices for use in clinics (Dividat Senso) and at home (Dividat Senso Flex), an assessment system, and a rehabilitation cockpit, and its focus lies on home-based motor-cognitive training, which is remotely managed by health care professionals (HPs). OBJECTIVE This study aims to analyze the usability, acceptance, and enjoyment of the COCARE system from the perspective of primary (older adults [OAs]) and secondary (HPs) end users. METHODS At 3 trial sites (located in Switzerland, Italy, and Cyprus), participants engaged in a single-session trial of the COCARE system, including testing of exergames and assessments. Mixed methods encompassing qualitative approaches (eg, think aloud) and quantitative measures (eg, Exergame Enjoyment Questionnaire [EEQ], System Usability Scale [SUS], and Unified Theory of Acceptance and Use of Technology [UTAUT] questionnaire) were used to analyze participants' perceptions of the system and identify potential barriers to its implementation in a home setting. In addition, the associations of performance during gameplay and assessments, demographics, and training motivation (Behavioral Regulation in Exercise Questionnaire-3 [BREQ-3]) with usability, acceptance, and enjoyment were explored. RESULTS A total of 45 OAs and 15 HPs participated in this study. The COCARE system achieved good acceptance ratings (OAs: 83%, range 36%-100% and HPs: 81%, range 63.8%-93.3% of the maximum score), and OAs indicated high enjoyment (mean 73.3, SD 12.7 out of 100 points in the EEQ) during the exergame session. The system's usability, assessed with the SUS, received scores of 68.1 (SD 18.8; OAs) and 70.7 (SD 12.3; HPs) out of 100 points, with substantial differences observed between the trial sites. Several requirements for improvement were identified. Commonly mentioned barriers to adoption included the movement-recognition sensitivity of the Senso Flex, its limited markings, and difficulties in understanding certain instructions for assessments and games. Performance in games and assessments showed the highest significant correlations with the SUS (Spearman ρ=0.35, P=.02 to ρ=0.52, P<.001). The BREQ-3 had significant correlations with all usability measures, thereby even large significant correlations with enjoyment (Spearman ρ=0.58; P<.001). Age had moderately significant correlations with the SUS (Spearman ρ=-0.35; P=.02) and the UTAUT total score (ρ=-0.35; P=.02) but no significant correlation with the EEQ. Concerning sex and years of education, no significant correlations were found. CONCLUSIONS The study's findings will inform the further development of the COCARE system toward a user-friendly and widely accepted version, enhancing cognitive and physical functions in OAs. Future randomized controlled trials should evaluate the system's feasibility and effectiveness.
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Affiliation(s)
- Julia Seinsche
- Movement Control and Learning Group, Institute of Human Movement Sciences and Sport, Department of Health Sciences and Technology, ETH Zurich, Zurich, Switzerland
| | - Eling D de Bruin
- Movement Control and Learning Group, Institute of Human Movement Sciences and Sport, Department of Health Sciences and Technology, ETH Zurich, Zurich, Switzerland
- Department of Health, OST - Eastern Swiss University of Applied Sciences, St. Gallen, Switzerland
- Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Huddinge, Sweden
| | - Enrico Saibene
- Istituto di Ricovero e Cura a Carattere Scientifico, Fondazione Don Carlo Gnocchi Onlus, Milan, Italy
| | - Francesco Rizzo
- Istituto di Ricovero e Cura a Carattere Scientifico, Fondazione Don Carlo Gnocchi Onlus, Milan, Italy
| | - Ilaria Carpinella
- Istituto di Ricovero e Cura a Carattere Scientifico, Fondazione Don Carlo Gnocchi Onlus, Milan, Italy
| | - Maurizio Ferrarin
- Istituto di Ricovero e Cura a Carattere Scientifico, Fondazione Don Carlo Gnocchi Onlus, Milan, Italy
| | | | - Tanja Ritter
- Movement Control and Learning Group, Institute of Human Movement Sciences and Sport, Department of Health Sciences and Technology, ETH Zurich, Zurich, Switzerland
| | - Eleftheria Giannouli
- Movement Control and Learning Group, Institute of Human Movement Sciences and Sport, Department of Health Sciences and Technology, ETH Zurich, Zurich, Switzerland
- Division of Sports and Exercise Medicine, Department of Sport, Exercise and Health, University of Basel, Basel, Switzerland
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11
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Seinsche J, de Bruin ED, Saibene E, Rizzo F, Carpinella I, Ferrarin M, Ifanger S, Moza S, Giannouli E. Feasibility and Effectiveness of a Personalized Home-Based Motor-Cognitive Training Program in Community-Dwelling Older Adults: Protocol for a Pragmatic Pilot Randomized Controlled Trial. JMIR Res Protoc 2023; 12:e49377. [PMID: 37943591 PMCID: PMC10667977 DOI: 10.2196/49377] [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: 05/30/2023] [Revised: 08/23/2023] [Accepted: 09/18/2023] [Indexed: 11/10/2023] Open
Abstract
BACKGROUND Exergame-based motor-cognitive training in older adults has been associated with improvements in physical, cognitive, and psychological functioning. The novel Cocare system (Dividat GmbH), developed through a user-centered design process, allows motor-cognitive training in a telerehabilitation setting. It includes (1) a stationary stepping platform for supervised exergame training (Dividat Senso; Dividat GmbH), (2) a home-based version (Dividat Senso Flex, which is a rollable pressure-sensitive mat; Dividat GmbH), (3) an assessment system (including motor-cognitive tests), and (4) a rehabilitation cockpit for remote training supervision and management. OBJECTIVE The aim of this study is to test the feasibility and effectiveness of this novel training system. METHODS A total of 180 older adults from Switzerland, Italy, and Cyprus aged ≥60 years with a prescription for rehabilitation are randomly allocated to an intervention group or a control group. Both groups continue with their usual care, whereas participants in the intervention group additionally perform a 2-week supervised exergame training program at rehabilitation centers, followed by a 10-week home training program under remote supervision. The assessment system is used to indicate the start level of each participant, and, in both intervention periods, standardized progression rules are applied. The measures of feasibility include adherence, attrition, exergame enjoyment, willingness to perform such a training program, and the number and types of help requests. Effectiveness is assessed in terms of cognitive and physical functioning, balance confidence, and quality of life. RESULTS Data collection started in February 2023 and is ongoing. Final measurements are expected to be performed in January 2024. CONCLUSIONS Owing to the user-centered design approach, the Cocare system is expected to be user-friendly and offers several novel features to cover the whole continuum of care. This pragmatic trial will provide valuable information regarding final necessary adaptations and subsequent implementation efforts. TRIAL REGISTRATION ClinicalTrials.gov NCT05751551; https://www.clinicaltrials.gov/study/NCT05751551. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/49377.
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Affiliation(s)
- Julia Seinsche
- Motor Control and Learning Group, Institute of Human Movement Sciences and Sport, Department of Health Sciences and Technology, Eidgenössische Technische Hochschule Zurich, Zurich, Switzerland
| | - Eling D de Bruin
- Motor Control and Learning Group, Institute of Human Movement Sciences and Sport, Department of Health Sciences and Technology, Eidgenössische Technische Hochschule Zurich, Zurich, Switzerland
- Department of Health, OST - Eastern Swiss University of Applied Sciences, St Gallen, Switzerland
- Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Huddinge, Sweden
| | - Enrico Saibene
- Istituto di Ricovero e Cura a Carattere Scientifico, Fondazione Don Carlo Gnocchi Onlus, Milan, Italy
| | - Francesco Rizzo
- Istituto di Ricovero e Cura a Carattere Scientifico, Fondazione Don Carlo Gnocchi Onlus, Milan, Italy
| | - Ilaria Carpinella
- Istituto di Ricovero e Cura a Carattere Scientifico, Fondazione Don Carlo Gnocchi Onlus, Milan, Italy
| | - Maurizio Ferrarin
- Istituto di Ricovero e Cura a Carattere Scientifico, Fondazione Don Carlo Gnocchi Onlus, Milan, Italy
| | - Sarina Ifanger
- Motor Control and Learning Group, Institute of Human Movement Sciences and Sport, Department of Health Sciences and Technology, Eidgenössische Technische Hochschule Zurich, Zurich, Switzerland
| | | | - Eleftheria Giannouli
- Motor Control and Learning Group, Institute of Human Movement Sciences and Sport, Department of Health Sciences and Technology, Eidgenössische Technische Hochschule Zurich, Zurich, Switzerland
- Division of Sports and Exercise Medicine, Department of Sport, Exercise and Health, University of Basel, Basel, Switzerland
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12
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Xue D, Li PWC, Yu DSF, Lin RSY. Combined exercise and cognitive interventions for adults with mild cognitive impairment and dementia: A systematic review and network meta-analysis. Int J Nurs Stud 2023; 147:104592. [PMID: 37769394 DOI: 10.1016/j.ijnurstu.2023.104592] [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: 01/25/2023] [Revised: 08/20/2023] [Accepted: 08/23/2023] [Indexed: 09/30/2023]
Abstract
BACKGROUND Exercise and cognitive interventions are beneficial for adults with preclinical and clinical dementia, but it is unclear whether the combination of these two components could generate synergistic benefits and what intervention designs would optimize this effect. OBJECTIVES This review aims to compare the effects of combined exercise and cognitive interventions on cognitive, psychological, functional outcomes, and health-related quality of life with the corresponding single approach and control groups in adults with mild cognitive impairment and dementia. It also aims to identify the optimal intervention design and factors affecting treatment effects. METHODS A comprehensive search was conducted in ten databases from inception to 23rd November 2022. The methodological quality of studies was evaluated by the Cochrane risk of bias tool. Pairwise meta-analyses were performed to assess the effects of combined interventions relative to the single type of intervention and control groups, with further subgroup analysis to explore the factors affecting treatment effects. Network meta-analyses were used to identify the optimal intervention components. RESULTS Twenty-nine randomized controlled trials involving 2910 participants were included. The results of pairwise meta-analyses indicated that combined interventions were superior to exercise in improving response inhibition, working memory, and delayed recall, but were not superior to cognitive interventions in all outcomes. Combined interventions were superior to active/passive controls in improving global cognition, response inhibition, immediate recall, delayed recall, category fluency, processing speed, and visuospatial ability. Influences of the clinical severity of dementia (mild cognitive impairment vs dementia), combination format (sequential vs simultaneous combination), mode of delivery (group-based vs individual-based vs mixed), training duration (short: ≤12 weeks vs medium: 13-24 weeks vs long: >24 weeks), and types of control (active vs passive control) were not detected. The network meta-analysis results indicated that the optimal intervention components varied across different outcomes, with multimodal exercise combining cognitive training demonstrated the greatest effects among all other combined or single component interventions in improving global cognition. CONCLUSIONS This review suggests the advantage of combined interventions over exercise with comparable effects when compared with cognitive interventions in the population with mild cognitive impairment and dementia. Full scale multi-arm randomized controlled trials to compare the effects of combined interventions with cognitive interventions are warranted.
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Affiliation(s)
- Dandan Xue
- School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong.
| | - Polly W C Li
- School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong.
| | - Doris S F Yu
- School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong.
| | - Rose S Y Lin
- University of Rochester School of Nursing, New York, USA.
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Maeneja R, Silva CR, Ferreira IS, Abreu AM. Aerobic physical exercise versus dual-task cognitive walking in cognitive rehabilitation of people with stroke: a randomized clinical trial. Front Psychol 2023; 14:1258262. [PMID: 37901076 PMCID: PMC10611528 DOI: 10.3389/fpsyg.2023.1258262] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2023] [Accepted: 09/26/2023] [Indexed: 10/31/2023] Open
Abstract
Introduction Stroke is a neurological deficit caused by an acute focal injury to the central nervous system due to vascular injury that can result in loss of neurological function, lasting brain damage, long-term disability and, in some cases, death. The literature reports that aerobic physical exercise, as well as dual-task cognitive walking, are used for the cognitive recovery of people with stroke. We aimed to assess whether aerobic physical exercise influences post-stroke cognitive recovery, namely performance on selective and sustained attention. We tested the hypothesis that post-stroke aerobic physical exercise leads to more significant gains than post-stroke dual-task cognitive walking. Methods We used a Randomized Clinical Trial, single-blind, parallel group, to verify the existence of differences between two groups. A total of 34 patients with subacute to chronic stroke were divided into two groups to train three times a week for 12 weeks: the aerobic physical exercise (PE) group engaged in 20 min on a treadmill, 20 min on a stationary bicycle and 5 min on a desk bike pedal exerciser per session; the dual-task (DT) gait exercise group walked for 45 min while simultaneously performing cognitive tasks per session. All participants were assessed on cognitive functioning with the Mini-Mental State Examination (MMSE) and d2 Test of Attention before acute interventions and post interventions. We have also applied a Visual Analog Scale to monitor the participants' perceived difficulty, pre-, post-acute, and post-chronic interventions. Participants also responded to a Borg Scale of perceived exertion following the acute and the final session of chronic training. Results A mixed model ANOVA revealed a significant interaction effect with a large effect size for most of the cognitive variables under study. The variables associated with the d2 Test of Attention showed significant differences between the groups, mainly from T0 to T2. Also for MMSE, an ANOVA revealed a significant interaction effect with significant improvements from T0 to T2. Our results strongly suggest that aerobic physical exercise is more beneficial than dual-task cognitive-gait exercise since in the PE group, cognitive attention scores increase, and cognitive impairment and perception of exertion decrease, compared to the DT group. Conclusion These findings support that PE provides more significant benefits for patients post-stroke when compared to DT.
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Affiliation(s)
- Reinaldo Maeneja
- Institute of Health Sciences, Universidade Católica Portuguesa, Lisbon, Portugal
- Faculdade de Ciências da Saúde e Desporto, Universidade Save, Maxixe, Mozambique
| | - Cláudia R. Silva
- Institute of Health Sciences, Universidade Católica Portuguesa, Lisbon, Portugal
- Escola Superior de Saúde de Alcoitão, Alcabideche, Portugal
| | - Inês S. Ferreira
- Faculty of Health Sciences, Universidade Europeia, Lisbon, Portugal
- Center for Research in Neuropsychology and Cognitive and Behavioral Intervention (CINEICC), Faculdade de Psicologia e de Ciências da Educação (FPCE), Universidade de Coimbra, Coimbra, Portugal
- Psychological Assessment and Psychometrics Laboratory (PsyAssessmentLab), Faculdade de Psicologia e de Ciências da Educação (FPCE), Universidade de Coimbra, Coimbra, Portugal
| | - Ana Maria Abreu
- Institute of Health Sciences, Universidade Católica Portuguesa, Lisbon, Portugal
- Center for Interdisciplinary Research in Health, Universidade Católica Portuguesa, Lisbon, Portugal
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Li T, Tao X, Sun R, Han C, Li X, Zhu Z, Li W, Huang P, Gong W. Cognitive-exercise dual-task intervention ameliorates cognitive decline in natural aging rats via inhibiting the promotion of LncRNA NEAT1/miR-124-3p on caveolin-1-PI3K/Akt/GSK3β Pathway. Brain Res Bull 2023; 202:110761. [PMID: 37714275 DOI: 10.1016/j.brainresbull.2023.110761] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Revised: 09/09/2023] [Accepted: 09/11/2023] [Indexed: 09/17/2023]
Abstract
Aging-related cognitive impairment (ARCI) is rapidly becoming a healthcare priority. However, there is currently no excellent cure for it. Cognitive-exercise dual-task intervention (CEDI) is a promising method to improve ARCI, while the underlying mechanisms remain unclear. Long non-coding RNAs (lncRNAs) and microRNAs (miRNAs) are involved in the onset, development, and rehabilitation of ARCI. This study aimed to investigate the effects of CEDI and the role of regulation of the lncRNA NEAT1/miR-124-3p on the caveolin-1-PI3K/Akt/GSK3β pathway in CEDI improving cognitive function. Forty 18-month-old natural aging rats were randomly assigned to four groups: exercise training group, cognitive training group, CEDI group, and aging control group, and underwent 12 weeks of intervention. A novel object recognition test was performed to determine the cognitive function, and the hippocampus was separated three days after the behavioral tests for further molecular detection. In an in vitro study, the mouse hippocampal neuronal cell line HT22 was cultured. MiR-124-3p and lncRNA NEAT1 were over-expressed or down-expressed, respectively. The expressions of related proteins, lncRNA, and miRNA were examined by WB and/or qRT-PCR. The results showed that compared with the aging control group, the CEDI group had a higher discrimination index, and significantly decreased the expressions of lncRNA NEAT1, and the protein expressions of caveolin-1 and p-GSK3β, while significantly increased the expressions of miR-124-3p, and the protein expressions of p-PI3K and p-Akt. Inhibition of the lncRNA NEAT1 could significantly increase the protein expressions of p-PI3K and p-Akt in HT22 cells. Upregulation of miR-124-3p decreased the protein expressions of caveolin-1 and p-GSK3β, and increased the protein expressions of p-PI3K and p-Akt significantly. Inhibition of miR-124-3p had the opposite effects. Our study demonstrated that CEDI improved cognitive function in aging rats better than a single intervention. The mechanisms of cognitive improvement could be related to the regulation of the lncRNA NEAT1/miR-124-3p on the caveolin-1-PI3K/Akt/GSK3β pathway.
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Affiliation(s)
- Tiancong Li
- Beijing Rehabilitation Hospital, Beijing Rehabilitation Medicine Academy, Capital Medical University, Beijing, China
| | - Xue Tao
- Department of Research, Beijing Rehabilitation Hospital, Capital Medical University, Beijing, China
| | - Ruifeng Sun
- Beijing Rehabilitation Hospital, Beijing Rehabilitation Medicine Academy, Capital Medical University, Beijing, China
| | - Conglin Han
- Rehabilitation Medicine Academy, Weifang Medical University, Weifang, Shandong, China
| | - Xiaoling Li
- Department of Neurological Rehabilitation, Beijing Rehabilitation Hospital, Capital Medical University, Beijing, China
| | - Ziman Zhu
- Beijing Rehabilitation Hospital, Beijing Rehabilitation Medicine Academy, Capital Medical University, Beijing, China
| | - Wenshan Li
- Beijing Rehabilitation Hospital, Beijing Rehabilitation Medicine Academy, Capital Medical University, Beijing, China
| | - Peiling Huang
- Department of Neurological Rehabilitation, Beijing Rehabilitation Hospital, Capital Medical University, Beijing, China
| | - Weijun Gong
- Beijing Rehabilitation Hospital, Beijing Rehabilitation Medicine Academy, Capital Medical University, Beijing, China; Department of Neurological Rehabilitation, Beijing Rehabilitation Hospital, Capital Medical University, Beijing, China.
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Tao M, Liu H, Cheng J, Yu C, Zhao L. Motor-Cognitive Interventions May Effectively Improve Cognitive Function in Older Adults with Mild Cognitive Impairment: A Randomized Controlled Trial. Behav Sci (Basel) 2023; 13:737. [PMID: 37754015 PMCID: PMC10525591 DOI: 10.3390/bs13090737] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Revised: 08/31/2023] [Accepted: 09/02/2023] [Indexed: 09/28/2023] Open
Abstract
Mild cognitive impairment (MCI) is a syndrome that occurs in the preclinical stage of Alzheimer's disease. Early intervention can be effective in preventing Alzheimer's disease, but further research is needed on intervention methods. To identify interventions that are more suitable for Chinese characteristics and to investigate the effects of motor-cognitive intervention on the cognitive functions of older adults with MCI, we screened 103 community-dwelling older adults with MCI aged 65 years and older in Qingdao, Shandong, China; divided them into an intervention group and a control group; and administered a motor-cognitive intervention to the intervention group for 12 weeks. The study used the Mini-Mental State Examination (MMSE) and the Montreal Cognitive Assessment (MoCA) to assess the initial cognitive level of the MCI participants and detect the effects of the intervention. We found that the cognitive abilities of the intervention group were significantly improved at the end of the intervention, as well as at the end of the follow-up, compared with the control group. The results of the current study suggest that the motor-cognitive intervention we used may improve the cognition of older people with MCI in the Chinese community.
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Affiliation(s)
| | | | - Jinxuan Cheng
- Normal College, Qingdao University, Qingdao 266071, China; (M.T.); (H.L.); (C.Y.); (L.Z.)
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Klimecki OM, Liebscher M, Gaubert M, Hayek D, Zarucha A, Dyrba M, Bartels C, Buerger K, Butryn M, Dechent P, Dobisch L, Ewers M, Fliessbach K, Freiesleben SD, Glanz W, Hetzer S, Janowitz D, Kilimann I, Kleineidam L, Laske C, Maier F, Munk MH, Perneczky R, Peters O, Priller J, Rauchmann BS, Roy N, Scheffler K, Schneider A, Spruth EJ, Spottke A, Teipel SJ, Wiltfang J, Wolfsgruber S, Yakupov R, Düzel E, Jessen F, Wagner M, Roeske S, Wirth M. Long-term environmental enrichment is associated with better fornix microstructure in older adults. Front Aging Neurosci 2023; 15:1170879. [PMID: 37711996 PMCID: PMC10498282 DOI: 10.3389/fnagi.2023.1170879] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Accepted: 08/04/2023] [Indexed: 09/16/2023] Open
Abstract
Background Sustained environmental enrichment (EE) through a variety of leisure activities may decrease the risk of developing Alzheimer's disease. This cross-sectional cohort study investigated the association between long-term EE in young adulthood through middle life and microstructure of fiber tracts associated with the memory system in older adults. Methods N = 201 cognitively unimpaired participants (≥ 60 years of age) from the DZNE-Longitudinal Cognitive Impairment and Dementia Study (DELCODE) baseline cohort were included. Two groups of participants with higher (n = 104) or lower (n = 97) long-term EE were identified, using the self-reported frequency of diverse physical, intellectual, and social leisure activities between the ages 13 to 65. White matter (WM) microstructure was measured by fractional anisotropy (FA) and mean diffusivity (MD) in the fornix, uncinate fasciculus, and parahippocampal cingulum using diffusion tensor imaging. Long-term EE groups (lower/higher) were compared with adjustment for potential confounders, such as education, crystallized intelligence, and socio-economic status. Results Reported participation in higher long-term EE was associated with greater fornix microstructure, as indicated by higher FA (standardized β = 0.117, p = 0.033) and lower MD (β = -0.147, p = 0.015). Greater fornix microstructure was indirectly associated (FA: unstandardized B = 0.619, p = 0.038; MD: B = -0.035, p = 0.026) with better memory function through higher long-term EE. No significant effects were found for the other WM tracts. Conclusion Our findings suggest that sustained participation in a greater variety of leisure activities relates to preserved WM microstructure in the memory system in older adults. This could be facilitated by the multimodal stimulation associated with the engagement in a physically, intellectually, and socially enriched lifestyle. Longitudinal studies will be needed to support this assumption.
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Affiliation(s)
- Olga M Klimecki
- German Center for Neurodegenerative Diseases (DZNE), Dresden, Germany
| | - Maxie Liebscher
- German Center for Neurodegenerative Diseases (DZNE), Dresden, Germany
| | - Malo Gaubert
- German Center for Neurodegenerative Diseases (DZNE), Dresden, Germany
- Department of Neuroradiology, Rennes University Hospital Centre Hospitalier Universitaire (CHU), Rennes, France
| | - Dayana Hayek
- German Center for Neurodegenerative Diseases (DZNE), Magdeburg, Germany
| | - Alexis Zarucha
- German Center for Neurodegenerative Diseases (DZNE), Dresden, Germany
| | - Martin Dyrba
- German Center for Neurodegenerative Diseases (DZNE), Rostock, Germany
| | - Claudia Bartels
- Department of Psychiatry and Psychotherapy, University Medical Center Goettingen, University of Goettingen, Göttingen, Germany
| | - Katharina Buerger
- German Center for Neurodegenerative Diseases (DZNE), Munich, Germany
- Institute for Stroke and Dementia Research, University Hospital, Ludwig-Maximilians-Universität (LMU) Munich, Munich, Germany
| | - Michaela Butryn
- German Center for Neurodegenerative Diseases (DZNE), Magdeburg, Germany
| | - Peter Dechent
- Magnetic Resonance (MR)-Research in Neurosciences, Department of Cognitive Neurology, Georg-August-University Goettingen, Göttingen, Germany
| | - Laura Dobisch
- German Center for Neurodegenerative Diseases (DZNE), Magdeburg, Germany
| | - Michael Ewers
- German Center for Neurodegenerative Diseases (DZNE), Munich, Germany
- Institute for Stroke and Dementia Research, University Hospital, Ludwig-Maximilians-Universität (LMU) Munich, Munich, Germany
| | - Klaus Fliessbach
- German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany
- Department of Neurodegenerative Disease and Geriatric Psychiatry, University of Bonn Medical Center, Bonn, Germany
| | - Silka Dawn Freiesleben
- Department of Psychiatry and Neurosciences, Charité-Universitätsmedizin Berlin, Berlin, Germany
- German Center for Neurodegenerative Diseases (DZNE), Berlin, Germany
| | - Wenzel Glanz
- German Center for Neurodegenerative Diseases (DZNE), Magdeburg, Germany
| | - Stefan Hetzer
- Berlin Center for Advanced Neuroimaging, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Daniel Janowitz
- Institute for Stroke and Dementia Research, University Hospital, Ludwig-Maximilians-Universität (LMU) Munich, Munich, Germany
| | - Ingo Kilimann
- German Center for Neurodegenerative Diseases (DZNE), Rostock, Germany
- Department of Psychosomatic Medicine, Rostock University Medical Center, Rostock, Germany
| | - Luca Kleineidam
- German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany
- Department of Neurodegenerative Disease and Geriatric Psychiatry, University of Bonn Medical Center, Bonn, Germany
| | - Christoph Laske
- German Center for Neurodegenerative Diseases (DZNE), Tübingen, Germany
- Section for Dementia Research, Department of Psychiatry and Psychotherapy, Hertie Institute for Clinical Brain Research, University of Tübingen, Tübingen, Germany
| | - Franziska Maier
- Department of Psychiatry, Medical Faculty, University of Cologne, Cologne, Germany
| | - Matthias H Munk
- German Center for Neurodegenerative Diseases (DZNE), Tübingen, Germany
- Department of Psychiatry and Psychotherapy, University of Tübingen, Tübingen, Germany
| | - Robert Perneczky
- German Center for Neurodegenerative Diseases (DZNE), Munich, Germany
- Department of Psychiatry and Psychotherapy, University Hospital, Ludwig-Maximilians-Universität (LMU) Munich, Munich, Germany
- Munich Cluster for Systems Neurology (SyNergy), Munich, Germany
- Ageing Epidemiology Research Unit (AGE), School of Public Health, Imperial College London, London, United Kingdom
| | - Oliver Peters
- Department of Psychiatry and Neurosciences, Charité-Universitätsmedizin Berlin, Berlin, Germany
- German Center for Neurodegenerative Diseases (DZNE), Berlin, Germany
| | - Josef Priller
- German Center for Neurodegenerative Diseases (DZNE), Berlin, Germany
- Department of Psychiatry and Psychotherapy, Charité-Universitätsmedizin Berlin, Berlin, Germany
- Department of Psychiatry and Psychotherapy, School of Medicine, Technical University of Munich, Munich, Germany
- University of Edinburgh and United Kingdom Dementia Research Institute (UK DRI), Edinburgh, United Kingdom
| | - Boris-Stephan Rauchmann
- Department of Psychiatry and Psychotherapy, University Hospital, Ludwig-Maximilians-Universität (LMU) Munich, Munich, Germany
| | - Nina Roy
- German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany
| | - Klaus Scheffler
- Department for Biomedical Magnetic Resonance, University of Tübingen, Tübingen, Germany
| | - Anja Schneider
- German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany
- Department of Neurodegenerative Disease and Geriatric Psychiatry, University of Bonn Medical Center, Bonn, Germany
| | - Eike Jakob Spruth
- Department of Psychiatry and Neurosciences, Charité-Universitätsmedizin Berlin, Berlin, Germany
- German Center for Neurodegenerative Diseases (DZNE), Berlin, Germany
| | - Annika Spottke
- German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany
- Department of Neurology, University of Bonn, Bonn, Germany
| | - Stefan J Teipel
- German Center for Neurodegenerative Diseases (DZNE), Rostock, Germany
- Department of Psychosomatic Medicine, Rostock University Medical Center, Rostock, Germany
| | - Jens Wiltfang
- Department of Psychiatry and Psychotherapy, University Medical Center Goettingen, University of Goettingen, Göttingen, Germany
- German Center for Neurodegenerative Diseases (DZNE), Göttingen, Germany
- Neurosciences and Signaling Group, Department of Medical Sciences, Institute of Biomedicine (iBiMED), University of Aveiro, Aveiro, Portugal
| | - Steffen Wolfsgruber
- German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany
- Department of Neurodegenerative Disease and Geriatric Psychiatry, University of Bonn Medical Center, Bonn, Germany
| | - Renat Yakupov
- German Center for Neurodegenerative Diseases (DZNE), Magdeburg, Germany
| | - Emrah Düzel
- German Center for Neurodegenerative Diseases (DZNE), Magdeburg, Germany
- Institute of Cognitive Neurology and Dementia Research (IKND), Otto-von-Guericke University, Magdeburg, Germany
| | - Frank Jessen
- German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany
- Department of Psychiatry, Medical Faculty, University of Cologne, Cologne, Germany
- Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases, University of Cologne, Cologne, Germany
| | - Michael Wagner
- German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany
- Department of Neurodegenerative Disease and Geriatric Psychiatry, University of Bonn Medical Center, Bonn, Germany
| | - Sandra Roeske
- German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany
| | - Miranka Wirth
- German Center for Neurodegenerative Diseases (DZNE), Dresden, Germany
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Nuechterlein KH, McEwen SC, Ventura J, Subotnik KL, Turner LR, Boucher M, Casaus LR, Distler MG, Hayata JN. Aerobic exercise enhances cognitive training effects in first-episode schizophrenia: randomized clinical trial demonstrates cognitive and functional gains. Psychol Med 2023; 53:4751-4761. [PMID: 36047035 PMCID: PMC10388302 DOI: 10.1017/s0033291722001696] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/17/2021] [Revised: 04/22/2022] [Accepted: 05/20/2022] [Indexed: 11/06/2022]
Abstract
BACKGROUND Cognitive training (CT) and aerobic exercise both show promising moderate impact on cognition and everyday functioning in schizophrenia. Aerobic exercise is hypothesized to increase brain-derived neurotrophic factor (BDNF) and thereby synaptic plasticity, leading to increased learning capacity. Systematic CT should take advantage of increased learning capacity and be more effective when combined with aerobic exercise. METHODS We examined the impact of a 6-month program of cognitive training & exercise (CT&E) compared to cognitive training alone (CT) in 47 first-episode schizophrenia outpatients. All participants were provided the same Posit Science computerized CT, 4 h/week, using BrainHQ and SocialVille programs. The CT&E group also participated in total body circuit training exercises to enhance aerobic conditioning. Clinic and home-based exercise were combined for a target of 150 min per week. RESULTS The MATRICS Consensus Cognitive Battery Overall Composite improved significantly more with CT&E than with CT alone (p = 0.04), particularly in the first 3 months (6.5 v. 2.2 T-score points, p < 0.02). Work/school functioning improved substantially more with CT&E than with CT alone by 6 months (p < 0.001). BDNF gain tended to predict the amount of cognitive gain but did not reach significance. The cognitive gain by 3 months predicted the amount of work/school functioning improvement at 6 months. The amount of exercise completed was strongly associated with the degree of cognitive and work/school functioning improvement. CONCLUSIONS Aerobic exercise significantly enhances the impact of CT on cognition and functional outcome in first-episode schizophrenia, apparently driven by the amount of exercise completed.
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Affiliation(s)
- Keith H. Nuechterlein
- Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience & Human Behavior, University of California, Los Angeles, USA
- Department of Psychology, University of California, Los Angeles, USA
| | - Sarah C. McEwen
- Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience & Human Behavior, University of California, Los Angeles, USA
| | - Joseph Ventura
- Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience & Human Behavior, University of California, Los Angeles, USA
| | - Kenneth L. Subotnik
- Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience & Human Behavior, University of California, Los Angeles, USA
| | - Luana R. Turner
- Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience & Human Behavior, University of California, Los Angeles, USA
| | - Michael Boucher
- Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience & Human Behavior, University of California, Los Angeles, USA
| | - Laurie R. Casaus
- Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience & Human Behavior, University of California, Los Angeles, USA
| | - Margaret G. Distler
- Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience & Human Behavior, University of California, Los Angeles, USA
| | - Jacqueline N. Hayata
- Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience & Human Behavior, University of California, Los Angeles, USA
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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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Nath K, Ferguson I, Puleio A, Wall K, Stark J, Clark S, Story C, Cohen B, Anderson-Hanley C. Brain Health Indicators Following Acute Neuro-Exergaming: Biomarker and Cognition in Mild Cognitive Impairment (MCI) after Pedal-n-Play (iPACES). Brain Sci 2023; 13:844. [PMID: 37371324 DOI: 10.3390/brainsci13060844] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2023] [Revised: 05/15/2023] [Accepted: 05/19/2023] [Indexed: 06/29/2023] Open
Abstract
Facing an unrelenting rise in dementia cases worldwide, researchers are exploring non-pharmacological ways to ameliorate cognitive decline in later life. Twenty older adults completed assessments before and after a single bout of interactive physical and cognitive exercise, by playing a neuro-exergame that required pedaling and steering to control progress in a tablet-based video game tailored to impact executive function (the interactive Physical and Cognitive Exercise System; iPACES v2). This study explored the cognitive and biomarker outcomes for participants with mild cognitive impairment (MCI) and normative older adults after 20 min of pedal-to-play exercise. Neuropsychological and salivary assessments were performed pre- and post-exercise to assess the impact. Repeated-measures ANOVAs revealed significant interaction effects, with MCI participants experiencing greater changes in executive function and alpha-amylase levels than normative older adults; within-group changes were also significant. This study provides further data regarding cognitive effects and potential mechanisms of action for exercise as an intervention for MCI.
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Affiliation(s)
- Kartik Nath
- Union College, 807 Union Street, Schenectady, NY 12308, USA
| | | | - Alexa Puleio
- Union College, 807 Union Street, Schenectady, NY 12308, USA
| | - Kathryn Wall
- Union College, 807 Union Street, Schenectady, NY 12308, USA
| | - Jessica Stark
- Union College, 807 Union Street, Schenectady, NY 12308, USA
| | - Sean Clark
- Gordon College, 255 Grapevine Rd, Wenham, MA 01984, USA
| | - Craig Story
- Gordon College, 255 Grapevine Rd, Wenham, MA 01984, USA
| | - Brian Cohen
- Union College, 807 Union Street, Schenectady, NY 12308, USA
| | - Cay Anderson-Hanley
- Union College, 807 Union Street, Schenectady, NY 12308, USA
- iPACES LLC, 56 Clifton Country Road, Suite 104 (Box#11), Clifton Park, NY 12065, USA
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Tuena C, Borghesi F, Bruni F, Cavedoni S, Maestri S, Riva G, Tettamanti M, Liperoti R, Rossi L, Ferrarin M, Stramba-Badiale M. Technology-Assisted Cognitive Motor Dual-Task Rehabilitation in Chronic Age-Related Conditions: Systematic Review. J Med Internet Res 2023; 25:e44484. [PMID: 37213200 PMCID: PMC10242476 DOI: 10.2196/44484] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Revised: 03/09/2023] [Accepted: 03/30/2023] [Indexed: 04/01/2023] Open
Abstract
BACKGROUND Cognitive-motor dual-task (CMDT) is defined as the parallel processing of motor (eg, gait) and cognitive (eg, executive functions) activities and is an essential ability in daily life. Older adults living with frailty, chronic conditions (eg, neurodegenerative diseases), or multimorbidity pay high costs during CMDT. This can have serious consequences on the health and safety of older adults with chronic age-related conditions. However, CMDT rehabilitation can provide useful and effective therapies for these patients, particularly if delivered through technological devices. OBJECTIVE This review aims to describe the current technological applications, CMDT rehabilitative procedures, target populations, condition assessment, and efficacy and effectiveness of technology-assisted CMDT rehabilitation in chronic age-related conditions. METHODS We performed this systematic review, following PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines, on 3 databases (Web of Science, Embase, and PubMed). Original articles that were published in English; involved older adults (>65 years) with ≥1 chronic condition and/or frailty; and tested, with a clinical trial, a technology-assisted CMDT rehabilitation against a control condition were included. Risk of bias (Cochrane tool) and the RITES (Rating of Included Trials on the Efficacy-Effectiveness Spectrum) tool were used to evaluate the included studies. RESULTS A total of 1097 papers were screened, and 8 (0.73%) studies met the predefined inclusion criteria for this review. The target conditions for technology-assisted CMDT rehabilitation included Parkinson disease and dementia. However, little information regarding multimorbidity, chronicity, or frailty status is available. The primary outcomes included falls, balance, gait parameters, dual-task performance, and executive functions and attention. CMDT technology mainly consists of a motion-tracking system combined with virtual reality. CMDT rehabilitation involves different types of tasks (eg, obstacle negotiation and CMDT exercises). Compared with control conditions, CMDT training was found to be pleasant, safe, and effective particularly for dual-task performances, falls, gait, and cognition, and the effects were maintained at midterm follow-up. CONCLUSIONS Despite further research being mandatory, technology-assisted CMDT rehabilitation is a promising method to enhance motor-cognitive functions in older adults with chronic conditions.
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Affiliation(s)
- Cosimo Tuena
- Applied Technology for Neuro-Psychology Lab, Istituto Auxologico Italiano, Istituto di Ricovero e Cura a Carattere Scientifico, Milan, Italy
| | | | | | - Silvia Cavedoni
- Applied Technology for Neuro-Psychology Lab, Istituto Auxologico Italiano, Istituto di Ricovero e Cura a Carattere Scientifico, Milan, Italy
| | - Sara Maestri
- Applied Technology for Neuro-Psychology Lab, Istituto Auxologico Italiano, Istituto di Ricovero e Cura a Carattere Scientifico, Milan, Italy
| | - Giuseppe Riva
- Applied Technology for Neuro-Psychology Lab, Istituto Auxologico Italiano, Istituto di Ricovero e Cura a Carattere Scientifico, Milan, Italy
- Humane Technology Lab, Università Cattolica del Sacro Cuore, Milan, Italy
| | - Mauro Tettamanti
- Laboratory of Geriatric Epidemiology, Istituto di Ricerche Farmacologiche Mario Negri, Istituto di Ricovero e Cura a Carattere Scientifico, Milan, Italy
| | - Rosa Liperoti
- Fondazione Policlinico Universitario Agostino Gemelli, Istituto di Ricovero e Cura a Carattere Scientifico, Rome, Italy
| | - Lorena Rossi
- Scientific Direction, IRCCS INRCA, Ancona, Italy
| | - Maurizio Ferrarin
- Fondazione Don Carlo Gnocchi, Istituto di Ricovero e Cura a Carattere Scientifico, Milan, Italy
| | - Marco Stramba-Badiale
- Department of Geriatrics and Cardiovascular Medicine, Istituto Auxologico Italiano, Istituto di Ricovero e Cura a Carattere Scientifico, Milan, Italy
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Anguera JA, Rowe MA, Volponi JJ, Elkurdi M, Jurigova B, Simon AJ, Anguera-Singla R, Gallen CL, Gazzaley A, Marco EJ. Enhancing attention in children using an integrated cognitive-physical videogame: A pilot study. NPJ Digit Med 2023; 6:65. [PMID: 37046040 PMCID: PMC10097690 DOI: 10.1038/s41746-023-00812-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Accepted: 03/27/2023] [Indexed: 04/14/2023] Open
Abstract
Inattention can negatively impact several aspects of a child's life, including at home and school. Cognitive and physical interventions are two promising non-pharmaceutical approaches used to enhance attention abilities, with combined approaches often being marketed to teachers, therapists, and parents typically without research validation. Here, we assessed the feasibility of incorporating an integrated, cognitive-physical, closed-loop video game (body-brain trainer or 'BBT') as an after-school program, and also evaluated if there were attention benefits following its use. Twenty-two children (7-12 years of age) with a range of attention abilities were recruited to participate in this proof of concept, single-arm, longitudinal study (24 sessions over 8 weeks, ~30 min/day). We interrogated attention abilities through a parent survey of their child's behaviors, in addition to objective performance-based and neural measures of attention. Here we observed 95% compliance as well as, significant improvements on the parent-based reports of inattention and on cognitive tests and neural measures of attention that were comparable in scale to previous work. Exploratory measures of other cognitive control abilities and physical fitness also showed similar improvement, with exploratory evaluation of retained benefits on the primary attention-related outcomes being present 1-year later. Lastly, there was no correlation between the baseline parent-rated inattention score and the improvement on the primary task-based measures of attention, suggesting that intervention-based benefits were not solely attained by those who stood the most to gain. These pilot findings warrant future research to replicate and extend these findings.
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Affiliation(s)
- J A Anguera
- Neuroscape Center, Department of Neurology, University of California, San Francisco, USA.
- Department of Psychiatry, University of California, San Francisco, USA.
| | - M A Rowe
- Department of Neurodevelopmental Medicine, Cortica Healthcare, San Rafael, USA
| | - J J Volponi
- Neuroscape Center, Department of Neurology, University of California, San Francisco, USA
- Department of Psychiatry, University of California, San Francisco, USA
| | - M Elkurdi
- Department of Neurodevelopmental Medicine, Cortica Healthcare, San Rafael, USA
| | - B Jurigova
- Department of Psychiatry, University of California, San Francisco, USA
| | - A J Simon
- Neuroscape Center, Department of Neurology, University of California, San Francisco, USA
- Department of Psychiatry, University of California, San Francisco, USA
| | - R Anguera-Singla
- Neuroscape Center, Department of Neurology, University of California, San Francisco, USA
- Department of Psychiatry, University of California, San Francisco, USA
| | - C L Gallen
- Neuroscape Center, Department of Neurology, University of California, San Francisco, USA
| | - A Gazzaley
- Neuroscape Center, Department of Neurology, University of California, San Francisco, USA
- Department of Psychiatry, University of California, San Francisco, USA
| | - E J Marco
- Department of Neurodevelopmental Medicine, Cortica Healthcare, San Rafael, USA
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22
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Ávila-Gámiz F, Pérez-Cano A, Pérez-Berlanga J, Mullor-Vigo R, Zambrana-Infantes E, Santín L, Ladrón de Guevara-Miranda D. Sequential treadmill exercise and cognitive training synergistically increase adult hippocampal neurogenesis in mice. Physiol Behav 2023; 266:114184. [PMID: 37030425 DOI: 10.1016/j.physbeh.2023.114184] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Revised: 03/26/2023] [Accepted: 04/04/2023] [Indexed: 04/09/2023]
Abstract
Combining physical and cognitive training has been suggested to promote further benefits on brain and cognition, which could include synergistic improvement of hippocampal neuroplasticity. In this paper, we investigated whether treadmill exercise followed by a working memory training in the water maze increase adult hippocampal neurogenesis to a greater extent than either treatment alone. Our results revealed that ten days of scheduled running enhance cell proliferation/survival in the short-term as well as performance in the water maze. Moreover, exercised mice that received working memory training displayed more surviving dentate granule cells compared to those untreated or subjected to only one of the treatments. According to these findings, we suggest that combining physical and cognitive stimulation yield synergic effects on adult hippocampal neurogenesis by extending the pool of newly-born cells and subsequently favouring their survival. Future research could take advantage from this non-invasive, multimodal approach to achieve substantial and longer-lasting enhancement in adult hippocampal neurogenesis, which might be relevant for improving cognition in healthy or neurologically impaired conditions.
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Liao X, Shen J, Li M. Effects of multi-domain intervention on intrinsic capacity in older adults: A systematic review of randomized controlled trials (RCTs). Exp Gerontol 2023; 174:112112. [PMID: 36736466 DOI: 10.1016/j.exger.2023.112112] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Revised: 01/28/2023] [Accepted: 01/30/2023] [Indexed: 02/05/2023]
Abstract
Intrinsic capacity is central to the maintenance of function in older adults, and maintaining optimal intrinsic capacity is of great importance to promote healthy aging. The purpose of this systematic review and meta-analysis was to analyze the impact of multi-domain interventions on intrinsic capacity in older adults, intervention components, and potential interactions between components. A total of 6740 published articles were screened until August 2022, and the review included 25 randomized controlled trials that analyzed populations, interventions, control groups, and outcomes. The meta-analysis showed improvements in the primary outcome indicators in the intervention group compared to the control group. These included increased scores on the Mini-Mental State Examination as an indicator of cognitive function, decreased scores on the Geriatric Depression Scale (GDS-15) as an indicator of psychological ability and increased scores on the Short Physical Performance Battery (SPPB) as an indicator of physical performance, with only the SPPB indicator analyzed showing greater heterogeneity. Significant improvements were also seen in the secondary indicators Time-to-Walk Test (TUG), gait speed, Chair Stand Test (CST), grip strength values and BMI. There was insufficient data for the Mini Nutritional Assessment (MNA) as an indicator of vitality to conduct a meta-analysis. Studies were of moderate to high quality. The results of this review indicate that multi-domain interventions can maintain the level of intrinsic capacity in older adults and are equally effective in older adults with declining self-care abilities.
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Affiliation(s)
- Xiaoyan Liao
- Nursing Department, The First Affiliated Hospital of Chongqing Medical University, Yuzhong district, #1 Youyi road, Chongqing 400014, China
| | - Jun Shen
- Nursing Department, The First Affiliated Hospital of Chongqing Medical University, Yuzhong district, #1 Youyi road, Chongqing 400014, China.
| | - Miao Li
- Nursing Department, The First Affiliated Hospital of Chongqing Medical University, Yuzhong district, #1 Youyi road, Chongqing 400014, China
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Lee S, Harada K, Bae S, Harada K, Makino K, Anan Y, Suzuki T, Shimada H. A non-pharmacological multidomain intervention of dual-task exercise and social activity affects the cognitive function in community-dwelling older adults with mild to moderate cognitive decline: A randomized controlled trial. Front Aging Neurosci 2023; 15:1005410. [PMID: 36993908 PMCID: PMC10040752 DOI: 10.3389/fnagi.2023.1005410] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Accepted: 02/20/2023] [Indexed: 03/16/2023] Open
Abstract
The present study aimed to determine the impact of a 10-month multidomain program using dual-task exercise and social activity conducted at a community-based facility on improved cognitive function in older adults with mild to moderate cognitive decline. The participants included 280 community-dwelling older adults (age 71–91 years) with mild to moderate cognitive decline. The intervention group exercised for 90 min/day, once a week. Their routine included aerobic exercise and dual-task training which cognitive tasks were performed in combination with exercise. The control group attended health education classes thrice. Before and after the intervention, we measured their cognitive function, physical function, daily conversation, and physical activity. The mean adherence rate of the intervention class was 83.0%. According to a repeated-measures multivariate analysis of covariance in an intent-to-treat analysis, logical memory and 6-min walking distance demonstrated a significant time and group interaction effect. Regarding daily physical activities, we observed significant differences in the daily step count and moderate-to-vigorous physical activity in the intervention group. Our non-pharmacological multidomain intervention resulted in a modest improvement in the cognitive or physical function and building health behavior. It may be a helpful program with a potential role in preventing dementia.Clinical Trial Registration: http://clinicaltrials.gov Identifier ID: UMIN000013097.
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Affiliation(s)
- Sangyoon Lee
- Department of Preventive Gerontology, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Obu, Japan
- *Correspondence: Sangyoon Lee,
| | - Kenji Harada
- Department of Preventive Gerontology, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Obu, Japan
| | - Seongryu Bae
- Department of Preventive Gerontology, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Obu, Japan
- Department of Health Care and Science, Dong-A University, Busan, Republic of Korea
| | - Kazuhiro Harada
- Department of Preventive Gerontology, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Obu, Japan
- Graduate School of Human Development and Environment, Kobe University, Kobe, Hyogo, Japan
| | - Keitaro Makino
- Department of Preventive Gerontology, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Obu, Japan
- Japan Society for the Promotion of Science, Tokyo, Japan
| | - Yuya Anan
- Department of Preventive Gerontology, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Obu, Japan
- Kwassui Women’s University, Nagasaki, Japan
| | - Takao Suzuki
- Department of Preventive Gerontology, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Obu, Japan
- Institute for Aging and Development, J. F. Oberlin University, Machida, Japan
| | - Hiroyuki Shimada
- Department of Preventive Gerontology, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Obu, Japan
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Chuang IC, Chen IC, Su KH, Wu YR, Wu CY. The effects of high versus low frequency of combined physical and cognitive training on cognitive function in older adults with cognitive decline: a quasi-experimental study. BMC Geriatr 2023; 23:94. [PMID: 36788482 PMCID: PMC9926662 DOI: 10.1186/s12877-023-03802-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Accepted: 02/06/2023] [Indexed: 02/16/2023] Open
Abstract
BACKGROUND The effects of combined training can be affected by training characteristics such as frequency, session length, and duration. No empirical studies to date have directly compared how combined physical and cognitive training offered at different training frequencies affects cognitive function for older adults with cognitive decline. This study investigated the impact of training frequency on cognitive outcomes after combined physical and cognitive training for older adults with cognitive decline. METHODS A quasi-experimental study was conducted in community facilities and day care centers. The study assigned 89 older adults with cognitive decline into high-frequency (HF) or low-frequency (LF) training groups. The participants received 90- to 105-min training sessions, one (LF) or three (HF) times a week, for 12 weeks. Outcome measures were the Montreal Cognitive Assessment, Word List subtest of the Wechsler Memory Scale, Digit Symbol Substitution Test (DSST), and Stroop Color Word Test. RESULTS The HF group demonstrated greater improvement in immediate memory measured by the WL-IM (F = 8.7, P = 0.004) and in executive function measured by the SCWT (F = 5.89, P = 0.017) than the LF group. Compared with the HF group, the LF group showed a great improvement in delayed memory measured by the WL-DM (F = 9.62, P = 0.003). The HF and LF groups both increased in processing speed and global cognitive function. CONCLUSIONS Our study indicated that the different training frequency of combined physical and cognitive training may result in benefits on different cognitive functions in older adults with cognitive decline. These findings may assist clinical practitioners in choosing appropriate training frequencies based on various intervention purposes for the elderly with cognitive decline. TRIAL REGISTRATION ClinicalTrials.gov Identifier NCT03619577 (08/08/2018).
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Affiliation(s)
- I-Ching Chuang
- Department of Occupational Therapy and Graduate Institute of Behavioral Sciences, College of Medicine, Chang Gung University, No. 259 Wen-Hwa 1St Road, Taoyuan, Taiwan.,Department of Neurology, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - I-Chen Chen
- Department of Occupational Therapy, College of Nursing and Health Sciences, Da-Yeh University, Changhua, Taiwan
| | - Ken-Hsien Su
- Department of Occupational Therapy and Graduate Institute of Behavioral Sciences, College of Medicine, Chang Gung University, No. 259 Wen-Hwa 1St Road, Taoyuan, Taiwan
| | - Yih-Ru Wu
- Department of Neurology, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan.,College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Ching-Yi Wu
- Department of Occupational Therapy and Graduate Institute of Behavioral Sciences, College of Medicine, Chang Gung University, No. 259 Wen-Hwa 1St Road, Taoyuan, Taiwan. .,Healthy Aging Research Center, Chang Gung University, Taoyuan, Taiwan. .,Department of Physical Medicine and Rehabilitation, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan.
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26
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Zary N, Eysenbach G, Marie R, Bourgeois M, Mandigout S. Measured and Perceived Exercise Intensity During the Performance of Single-Task, Cognitive-Motor Dual-Task, and Exergame Training: Transversal Study. JMIR Serious Games 2023; 11:e36126. [PMID: 36729572 PMCID: PMC9936361 DOI: 10.2196/36126] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2022] [Revised: 09/13/2022] [Accepted: 10/31/2022] [Indexed: 11/07/2022] Open
Abstract
BACKGROUND The physical and cognitive loads borne during exergaming may differ from more conventional cognitive-motor dual-task trainings. OBJECTIVE The aim of this pilot transversal study was to compare objectively measured and perceived exercise intensity during exergame, cognitive-motor dual-task, and single-task training sessions. METHODS We recruited apparently healthy young adults who carried out one session of each type of training: exergaming, cognitive-motor dual-tasking, and single-tasking. We used a custom-made exergame as support. The sessions lasted 30 minutes, were spaced at least 24 hours apart, and took place in random order for each group of 4 participants. We used heart rates to assess exercise intensity and the modified Borg scale to assess perception of intensity. In all, 16 apparently healthy young participants carried out all sessions. RESULTS There was no difference between the different types of training in mean heart rates (P=.27), peak heart rates (P=.50), or Borg scale scores (P=.40). Our custom-made exergame's objectively measured and perceived physical load did not differ between cognitive-motor dual-task and single-task training. CONCLUSIONS As a result, our exergame can be considered to be as challenging as more traditional physical training. Future studies should be conducted in older adults with or without cognitive impairments and incorporate an assessment of cognitive performance.
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Kujala J, Maria Alexandrou A, Lapinkero HM, Stigsdotter-Neely A, Sipilä S, Parviainen T. Beta-band MEG signal power changes in older adults after physical exercise program with and without additional cognitive training. Brain Cogn 2023; 165:105929. [PMID: 36436387 DOI: 10.1016/j.bandc.2022.105929] [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: 06/21/2022] [Revised: 10/26/2022] [Accepted: 11/03/2022] [Indexed: 11/25/2022]
Abstract
Physical exercise has been considered to be an efficient mean of preserving cognitive function and it influences both the structural and functional characteristics of the brain. It has especially been shown to increase brain plasticity, the capacity to re-structure brain properties in response to interaction, such as cognitive practice. Studies have also examined the potential additive effect of cognitive training on the documented benefit of physical exercise, commonly, however, not at the neural level. We monitored, using magnetoencephalography (MEG), the brain processes associated with executive functions in older individuals who participated in a 12-month randomized controlled trial including two research arms: physical and cognitive training vs physical training alone. Measurements were conducted at 0 months, 6 months, and 12 months. The addition of cognitive training was associated with better performance in the Stroop test that reflects executive control. The extra benefit of cognitive training was also manifested as decreased modulation of beta frequency band (15-25 Hz) especially to difficult distractors. As beta band activity is associated with attentional control, this indicates fewer resources needed to inhibit irrelevant sensory inputs. These results imply an enhancing role of cognitive elements integrated with physical training in improving or maintaining executive functions in older individuals.
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Affiliation(s)
- Jan Kujala
- Department of Psychology, University of Jyväskylä, Jyväskylä, Finland; Centre for Interdisciplinary Brain Research (CIBR), Faculty of Education and Psychology, University of Jyväskylä, Jyväskylä, Finland
| | - Anna Maria Alexandrou
- Department of Psychology, University of Jyväskylä, Jyväskylä, Finland; Centre for Interdisciplinary Brain Research (CIBR), Faculty of Education and Psychology, University of Jyväskylä, Jyväskylä, Finland
| | - Hanna-Maija Lapinkero
- Department of Psychology, University of Jyväskylä, Jyväskylä, Finland; Centre for Interdisciplinary Brain Research (CIBR), Faculty of Education and Psychology, University of Jyväskylä, Jyväskylä, Finland
| | - Anna Stigsdotter-Neely
- Department of Health, Learning and Technology, Luleå University of Technology, Luleå, Sweden; Department of Social and Psychological Studies, Karlstad University, Karlstad, Sweden
| | - Sarianna Sipilä
- Gerontology Research Center and Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | - Tiina Parviainen
- Department of Psychology, University of Jyväskylä, Jyväskylä, Finland; Centre for Interdisciplinary Brain Research (CIBR), Faculty of Education and Psychology, University of Jyväskylä, Jyväskylä, Finland.
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28
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Physical-cognitive Training With Dietary Intervention to Improve Cognitive Function and Circulating Biomarkers in Postmenopausal Women With Obesity: Study Protocol for A Randomized Controlled Trial. ADVANCES IN INTEGRATIVE MEDICINE 2023. [DOI: 10.1016/j.aimed.2023.02.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/16/2023]
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Wang M, Yang X, Yu J, Zhu J, Kim HD, Cruz A. Effects of Physical Activity on Inhibitory Function in Children with Attention Deficit Hyperactivity Disorder: A Systematic Review and Meta-Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:1032. [PMID: 36673793 PMCID: PMC9859519 DOI: 10.3390/ijerph20021032] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/12/2022] [Revised: 12/29/2022] [Accepted: 01/04/2023] [Indexed: 06/17/2023]
Abstract
This systematic review and meta-analysis aimed to systematically evaluate the effect of physical activity (PA) on inhibitory function in children with ADHD. Experimental studies on the effect of PA on the inhibitory function of children with ADHD were retrieved. The data were obtained from PubMed, The Cochrane Library, Web of Science, EBSCO (MEDLINE, APA Psyclnfo, ERIC), Embase, Scopus, and ProQuest. The search period was from the date of inception of the respective databases to 4 May 2022, and Reviewer Manager software (version 5.3) was used for analysis. Eleven articles and 713 samples were included in the meta-analysis. Results revealed that PA can significantly improve the inhibitory function of children with ADHD (SMD = 0.78, 95% CI: 0.45−1.10, p < 0.001). Subgroup analysis showed that the effectiveness of PA as an intervention in improving the inhibitory function of children with ADHD was moderated by the frequency, intensity, duration, type, and length of intervention. Based on the findings, PA can effectively improve interference suppression inhibitory function in children with ADHD. Longitudinal open-skill exercise for 60 min or more, two times/week has the best effect on improving inhibitory function in children with ADHD.
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Affiliation(s)
- Meng Wang
- Department of Physical Education, Keimyung University, Daegu 42601, Republic of Korea
| | - Xinyue Yang
- College of Sports Science, Shenyang Normal University, Shenyang 110034, China
| | - Jing Yu
- College of Sports Science, Shenyang Normal University, Shenyang 110034, China
| | - Jian Zhu
- Department of Physical Education, Zhongyuan University of Technology, Zhengzhou 450007, China
| | - Hyun-Duck Kim
- Department of Sport Marketing, Keimyung University, Daegu 42601, Republic of Korea
| | - Angelita Cruz
- Department of Physical Education, Keimyung University, Daegu 42601, Republic of Korea
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McEwen SC, Jarrahi B, Ventura J, Subotnik KL, Nguyen J, Woo SM, Nuechterlein KH. A combined exercise and cognitive training intervention induces fronto-cingulate cortical plasticity in first-episode psychosis patients. Schizophr Res 2023; 251:12-21. [PMID: 36527955 DOI: 10.1016/j.schres.2022.12.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2021] [Revised: 11/02/2022] [Accepted: 12/01/2022] [Indexed: 12/23/2022]
Abstract
OBJECTIVE Schizophrenia (SZ) is characterized by neurobiological and associated cognitive and functional deficits, including pronounced cortical thinning, that lead to acute and long-term functional impairment. Research with older adults supports the role of non-pharmacological interventions, such as exercise (E) and cognitive training (CT), for cognitive impairments. This literature influenced the development of combined CT&E treatments for individuals with SZ. However, the impact of longer combined treatment duration (6 months) on neuroanatomy has yet to be explored in patients in the early course of the illness. The impact of adding exercise to cognitive training for key brain regions associated with higher-order cognition was examined here using magnetic resonance imaging (MRI) in first-episode psychosis (FEP) patients. METHODS UCLA Aftercare Research Program patients with a recent first episode of schizophrenia were randomly assigned to either combined cognitive and exercise training (CT&E) (N = 20) or cognitive training alone (CT) (N = 17) intervention. Cortical thickness was measured longitudinally and analyzed for two regions of interest using FreeSurfer. RESULTS Compared to patients in the CT group, those in the CT&E group demonstrated an increase in cortical thickness within the left anterior cingulate cortex over the six-month treatment period (ACC: F(1, 35) = 4.666, P < .04). Directional tendencies were similar in the left dorsolateral prefrontal cortex (DLPFC: F(1,35) = 4.132, P < .05). CONCLUSIONS These findings suggest that exercise and cognitive training may synergistically increase fronto-cingulate cortical thickness to mitigate progressive neural atrophy in the early course of SZ. This combined intervention appears to be a valuable adjunct to standard pharmacologic treatment in FEP patients.
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Affiliation(s)
- S C McEwen
- Pacific Brain Health Center, Pacific Neuroscience Institute, Santa Monica, CA, 90404, United States of America; atai Life Sciences, San Diego, CA, 92130, United States of America; Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience & Human Behavior, University of California, Los Angeles, Los Angeles, CA 90095, United States of America
| | - B Jarrahi
- Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience & Human Behavior, University of California, Los Angeles, Los Angeles, CA 90095, United States of America; Department of Anesthesia, Stanford University School of Medicine, Palo Alto, CA 94304, United States of America
| | - J Ventura
- Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience & Human Behavior, University of California, Los Angeles, Los Angeles, CA 90095, United States of America
| | - K L Subotnik
- Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience & Human Behavior, University of California, Los Angeles, Los Angeles, CA 90095, United States of America
| | - J Nguyen
- Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience & Human Behavior, University of California, Los Angeles, Los Angeles, CA 90095, United States of America
| | - S M Woo
- Graduate School of Education & Psychology, Pepperdine University, Los Angeles, CA 90045, United States of America
| | - K H Nuechterlein
- Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience & Human Behavior, University of California, Los Angeles, Los Angeles, CA 90095, United States of America; Department of Psychology, University of California, Los Angeles, Los Angeles, CA 90095, United States of America.
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Trombini-Souza F, de Moura VTG, da Silva LWN, Leal IDS, Nascimento CA, Silva PST, Perracini MR, Sacco ICN, de Araújo RC, Nascimento MDM. Effects of two different dual-task training protocols on gait, balance, and cognitive function in community-dwelling older adults: a 24-week randomized controlled trial. PeerJ 2023; 11:e15030. [PMID: 37101796 PMCID: PMC10124542 DOI: 10.7717/peerj.15030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Accepted: 02/19/2023] [Indexed: 04/28/2023] Open
Abstract
Background Although alternating dual-task (ADT) training is functionally easier for older adults, a large part of the motor and cognitive tasks is simultaneously performed, especially during activities of daily living that require maintaining body balance. Objective To evaluate the effects of mixed dual-task training on mobility, cognitive function, and balance in community-dwelling older adults. Methods Sixty participants were randomly allocated at a 1:1 ratio into the experimental group-single motor task (SMT) and simultaneous dual task (SDT) interchangeably in stage 1 (for 12 weeks) and after strictly with SDT in stage 2 (the last 12 weeks)-or into the control group-only SMT and SDT interchangeably in stages 1 and 2. Gait parameters were acquired by two inertial sensors. Physical and cognitive performance were acquired by specific questionnaires. Generalized linear mixed models were used for analyzing interaction and main effects. Results No between-group difference was observed for gait performance. Both protocols improved mobility (mean change ((MC) = 0.74)), dual-task effect (MC = -13.50), lower limb function (MC = 4.44), static (MC = -0.61), and dynamic balance (MC = -0.23), body sway (MC = 4.80), and cognitive function (MC = 41.69). Conclusion Both dual-task training protocols improved these outcomes.
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Affiliation(s)
- Francis Trombini-Souza
- Department of Physical Therapy, University of Pernambuco, Petrolina, Pernambuco, Brazil
- Master’s and Doctoral Programs in Rehabilitation and Functional Performance, University of Pernambuco, Petrolina, Pernambuco, Brazil
| | | | | | - Iara dos Santos Leal
- Department of Physical Therapy, University of Pernambuco, Petrolina, Pernambuco, Brazil
- Master’s and Doctoral Programs in Rehabilitation and Functional Performance, University of Pernambuco, Petrolina, Pernambuco, Brazil
| | | | | | - Monica Rodrigues Perracini
- Master’s and Doctoral Programs in Physical Therapy, Universidade Cidade de São Paulo, São Paulo, São Paulo, Brazil
| | - Isabel CN Sacco
- School of Medicine, Department of Physical Therapy, Universidade de São Paulo, São Paulo, Brazil
| | - Rodrigo Cappato de Araújo
- Department of Physical Therapy, University of Pernambuco, Petrolina, Pernambuco, Brazil
- Master’s and Doctoral Programs in Rehabilitation and Functional Performance, University of Pernambuco, Petrolina, Pernambuco, Brazil
| | - Marcelo de Maio Nascimento
- Department of Physical Education, Federal University of São Francisco Valley, Petrolina, Pernambuco, Brazil
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Chuang IC, Chiau HY, Liao WW, Wu YR, Chang CH, Wu CY. Effects of computer-based cognitive training combined with physical training for older adults with cognitive impairment: A four-arm randomized controlled trial. Digit Health 2023; 9:20552076231203633. [PMID: 37744745 PMCID: PMC10515553 DOI: 10.1177/20552076231203633] [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: 02/18/2023] [Accepted: 09/08/2023] [Indexed: 09/26/2023] Open
Abstract
Objective Combined physical (PHY) and cognitive (COG) training in sequential (SEQ) and simultaneous (SIMUL) sessions may delay the progression of cognitive impairment. To date, no study has directly compared in older adults with cognitive impairment the effects of COG training, PHY training, SEQ motor-cognitive training and SIMUL motor-cognitve training on specific indices of cognitive performance and activities of daily living (ADL). The purpose of this study was to determine whether SEQ and SIMUL motor-cognitive training can improve treatment outcomes compared with PHY or COG training alone. We also aimed to compare the effects of SEQ versus SIMUL motor-cognitive training on cognitive functions and instrumental ADL (IADL) in older adults with cognitive impairment. Methods A cluster randomized controlled trial was conducted. Eighty older adults with cognitive impairment were randomly assigned to COG, PHY, SEQ or SIMUL training groups. The intervention consisted of 90-min training sessions, totaling 36 sessions. Outcome measures were the Montreal Cognitive Assessment, three subtests of the Wechsler Memory Scale (WMS) and the Lawton IADL scale. Results Significant interaction effects between group and time were found in WMS-spatial span (p = 0.04) and WMS-word lists (p = 0.041). For WMS-spatial span, the SIMUL group showed outperformed the COG (p = 0.039), PHY (p = 0.010) and SEQ groups (p = 0.017). For WMS-word lists, the SEQ group improve more than COG (p = 0.013), PHY (p = 0.030) and SIMUL (p = 0.019) groups. No significant differences were found in IADL performance among four groups (p = 0.645). Conclusions Our study showed SEQ and SIMUL motor-cognitive training led to more pronounced improvements in visuospatial working memory or verbal memory compared with isolated COG or PHY training for community-based older adults with cognitive impairment. For enhancing effects on IADL, we suggest the use of sensitive measurement tools and context-enriched cognitive training involving real-life task demands.
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Affiliation(s)
- I-Ching Chuang
- Department of Occupational Therapy and Graduate Institute of Behavioral Sciences, College of Medicine, Chang Gung University, Taoyuan
- Department of Neurology, Linkou Chang Gung Memorial Hospital, Taoyuan
| | - Hui-Yan Chiau
- Institute of Cognitive Neuroscience, National Central University, Taoyuan
| | - Wan-Wen Liao
- Department of Gerontological Health Care, National Taipei University of Nursing and Health Sciences, Taipei City
| | - Yih-Ru Wu
- Department of Neurology, Linkou Chang Gung Memorial Hospital, Taoyuan
- College of Medicine, Chang Gung University, Taoyuan
| | - Chih-Hung Chang
- Program in Occupational Therapy, Washington University in St Louis School of Medicine, St Louis, MO, USA
- Department of Medicine, Washington University in St Louis School of Medicine, St Louis, MO, USA
- Department of Orthopaedic Surgery, Washington University in St Louis School of Medicine, St Louis, MO, USA
| | - Ching-Yi Wu
- Department of Occupational Therapy and Graduate Institute of Behavioral Sciences, College of Medicine, Chang Gung University, Taoyuan
- Healthy Aging Research Center, Chang Gung University, Taoyuan
- Department of Physical Medicine and Rehabilitation, Linkou Chang Gung Memorial Hospital, Taoyuan
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Wu Y, Zang M, Wang B, Guo W. Does the combination of exercise and cognitive training improve working memory in older adults? A systematic review and meta-analysis. PeerJ 2023; 11:e15108. [PMID: 37065695 PMCID: PMC10100799 DOI: 10.7717/peerj.15108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Accepted: 03/01/2023] [Indexed: 04/18/2023] Open
Abstract
Background Cognitive functioning is dependent on working memory and a decline in working memory is the main cause of cognitive aging. Many studies have suggested that physical exercise or cognitive intervention can effectively improve working memory in the elderly. However, it is still unknown whether a combination of exercise and cognitive training (CECT) is more effective than either intervention alone. The present systematic review and meta-analysis were undertaken to evaluate the effect of CECT on working memory in the elderly. Methods The review was registered in the International Prospective Systematic Review (PROSPERO, CRD42021290138). Systematic searches were conducted on Web of Science, Elsevier Science, PubMed and Google Scholar. The data were extracted according to the PICOS framework. Comprehensive meta-analysis (CMA) software was used to perform the meta-analysis, moderator analysis and publication bias testing. Results The current meta-analysis included 21 randomized controlled trials (RCT). Results showed that CECT had a significantly greater impact on working memory in older adults compared to no intervention groups (SMD = 0.29, 95% CI [0.14-0.44], p < 0.01), with no significant difference between CECT and exercise (SMD = 0.16, 95% CI [-0.04-0.35], p = 0.12) or cognitive intervention alone (SMD = 0.08, 95% CI [-0.13-0.30], p = 0.44). Furthermore, the positive effect of CECT was moderated by intervention frequency and cognitive state. Conclusions The CECT can effectively improve working memory of older adults, but the effect of CECT compared to single intervention needs to be further explored.
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Affiliation(s)
- Yiqing Wu
- College of Physical Education, Yangzhou University, Yangzhou, China
| | - Ming Zang
- College of Electrical Engineering, Chuzhou Polytechnic, Chuzhou, China
| | - Biye Wang
- College of Physical Education, Yangzhou University, Yangzhou, China
- Institute of Sports, Exercise and Brain, Yangzhou University, Yangzhou, China
| | - Wei Guo
- College of Physical Education, Yangzhou University, Yangzhou, China
- Institute of Sports, Exercise and Brain, Yangzhou University, Yangzhou, China
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Zhao X, Huang X, Cai Y, Cao T, Wan Q. The relative effectiveness of different combination modes for exercise and cognitive training on cognitive function in people with mild cognitive impairment or Alzheimer's disease: a network meta-analysis. Aging Ment Health 2022; 26:2328-2338. [PMID: 35037809 DOI: 10.1080/13607863.2022.2026879] [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] [Indexed: 01/25/2023]
Abstract
OBJECTIVES To compare and rank the relative effectiveness of different modes for exercise combined cognitive training (ECT) in people with Alzheimer's disease (AD) or Mild Cognitive Impairment (MCI). METHODS We searched PubMed, Web of Science, Embase, Cochrane Central Register of Controlled Trials, SPORTDiscus, PsycInfo, and OpenGrey systematically from inception to May 2020. Studies were included that met the inclusion criteria: randomized controlled trials, involving people with MCI or dementia, performing ECT without other interventions, and assessing global cognitive function, memory function, and executive function. Pairwise and network meta-analyses were performed using a random effects model. RESULTS We included 20 articles from 16 studies with 1180 participants. For global cognition, separate modality had the highest probability of being the optimal approach (the surface under the cumulative ranking curve (SUCRA) value = 77.5%). For memory function, the interactive mode had the greatest probability of being the best choice (SUCRA = 84.7%). Concerning executive function, the dual-task modality and separate modality had similar SUCRA values. Subgroup analysis revealed no differences for the relative effectiveness of ECT among people with MCI or among all participants. CONCLUSIONS Separate and interactive combination modality had the highest probability of being the most effective mode for overall cognition and memory performance. However, the evidence is insufficient to reveal the best combination mode for executive function. UNLABELLED Supplemental data for this article is available online at https://doi.org/10.1080/13607863.2022.2026879 .
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Affiliation(s)
- Xiaoyan Zhao
- School of Nursing, Peking University, Beijing, China
| | - Xiuxiu Huang
- School of Nursing, Peking University, Beijing, China
| | - Ying Cai
- School of Nursing, Peking University, Beijing, China
| | - Ting Cao
- School of Nursing, Peking University, Beijing, China
| | - Qiaoqin Wan
- School of Nursing, Peking University, Beijing, China
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Ahn S, Chung JW, Crane MK, Bassett DR, Anderson JG. The Effects of Multi-Domain Interventions on Cognition: A Systematic Review. West J Nurs Res 2022; 44:1134-1154. [PMID: 34261376 DOI: 10.1177/01939459211032272] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
This review aimed to evaluate the effects of multi-domain interventions on cognition among individuals without dementia. Multi-domain interventions refer to those combining any single preventive measure such as physical activity, cognitive training, and/or nutrition to prevent dementia. Seventeen studies were included (n = 10,056 total participants; mean age = 73 years), eight of which were rated as strong in quality while the other nine showed moderate quality. The standardized mean difference (SMD; d) was used to calculate the effect size for each included study. Multi-domain interventions consisting of physical activity, cognitive training, cardioprotective nutrition, and/or cardiovascular health education exerted beneficial effects on global cognition, episodic memory, and/or executive function with very small to moderate effect sizes (0.16-0.77). Nurses may consider combining these components to potentially stave off dementia. Future research is warranted to identify the optimal multi-domain intervention components that can induce clinically significant beneficial effects on cognition.
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Affiliation(s)
- Sangwoo Ahn
- College of Nursing, University of Tennessee, Knoxville, TN, USA
| | - Jae Woo Chung
- Department of Neurology, University of Minnesota Medical School, Minneapolis, MN, USA
| | | | - David R Bassett
- Department of Kinesiology, Recreation, and Sport Studies, University of Tennessee, Knoxville, TN, USA
| | - Joel G Anderson
- College of Nursing, University of Tennessee, Knoxville, TN, USA
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Moret B, Nucci M, Campana G. Effects of exergames on mood and cognition in healthy older adults: A randomized pilot study. Front Psychol 2022; 13:1018601. [PMID: 36420381 PMCID: PMC9676977 DOI: 10.3389/fpsyg.2022.1018601] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2022] [Accepted: 10/17/2022] [Indexed: 12/02/2023] Open
Abstract
The elderly population is increasing and the implementation of stimulating training to promote active aging has become a research issue. This study aimed at investigating the effects of a cognitive-motor exergame training on cognitive functions and mood, in healthy older adults. A randomized controlled pilot study was conducted to compare a cognitive-motor exergame training with a passive control group. The training consisted of 8 sessions of 45 min each, including 10 interactive activities focused on several cognitive functions such as memory, processing speed and executive functions, all requiring motor planning and execution. A total of 57 participants were administered a battery of cognitive tests before and after the training. A mixed-effect ANOVA with group (experimental vs. control) as between factor and time (pre-and post-test) as within factor, was performed to evaluate the effect of the exergame training on cognitive abilities and mood. Results showed significant interaction effects in processing speed [STROOPC: F (1,53.4) = 9.04, p = 0.004, R 2 = 0.82], inhibition [3backs' false alarms: F (1,47.5) = 5.5, p = 0.02, R 2 = 0.79], and mood [Beck Depression Inventory: F (1,55) = 4.15, p = 0.04, R 2 = 0.6]. Even though post-hoc analyses did not provide statistical evidence supporting the interactions, overall data showed a trend toward better scores only for the experimental group, suggesting a potential improvement in information processing speed, working memory and mood. Exergaming may be a motivating and enjoyable approach to healthy and active aging.
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Affiliation(s)
- Beatrice Moret
- Department of General Psychology, University of Padova, Padova, Italy
| | - Massimo Nucci
- Department of General Psychology, University of Padova, Padova, Italy
| | - Gianluca Campana
- Department of General Psychology, University of Padova, Padova, Italy
- Human Inspired Technology Research Centre, University of Padova, Padova, Italy
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Gómez-Soria I, Marin-Puyalto J, Peralta-Marrupe P, Latorre E, Calatayud E. Effects of multi-component non-pharmacological interventions on cognition in participants with mild cognitive impairment: A systematic review and meta-analysis. Arch Gerontol Geriatr 2022; 103:104751. [PMID: 35839574 DOI: 10.1016/j.archger.2022.104751] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Revised: 06/06/2022] [Accepted: 06/10/2022] [Indexed: 11/02/2022]
Abstract
BACKGROUND AND PURPOSE Mild cognitive impairment (MCI) describes a stage of intermediate cognitive dysfunction where the risk of conversion to dementia is elevated. Given the absence of effective pharmacological treatments for MCI, increasing numbers of studies are attempting to understand how multicomponent non-pharmacological interventions (MNPI) could benefit MCI. The purpose of this systematic review and meta-analysis were to assess the effects of two-component MNPI (simultaneous cognitive intervention based on cognitive stimulation, cognitive training and/or cognitive rehabilitation or combined cognitive and physical interventions) on global cognition and cognitive functions in older adults with MCI and to compare the degree of efficacy between the two interventions. METHODS After searching electronic databases (PubMed, Web of Science, Scopus and Cochrane Central) for randomized controlled trials and clinical trials published from 2010 to 18 January 2021, 562 studies were found. 8 studies were included in this review, with a fair to good quality according to the PEDro scale. RESULTS From a random-effects model meta-analysis, the pooled standardized MMSE mean difference between the intervention and control groups showed a significant small-to-medium effect in global cognition in MMSE score (0.249; 95% CI = [0.067, 0.431]), which seemed to be greater for combined physical and cognitive interventions. However, the meta-analyses did not show any effects regarding specific cognitive functions. CONCLUSION Our analyses support that MNPI could improve the global cognition in older adults with MCI. However, more studies are needed to analyze the potential benefits of MNPI on older adults with MCI.
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Affiliation(s)
- Isabel Gómez-Soria
- Department of Physiatry and Nursing, Faculty of Health Sciences, Universidad de Zaragoza, Zaragoza, Spain; Institute of Health Research of Aragón (IIS Aragón), Zaragoza, Spain.
| | - Jorge Marin-Puyalto
- Department of Physiatry and Nursing, Faculty of Health and Sport Sciences, Universidad de Zaragoza, C/Pedro Cerbuna, 12, Zaragoza 50009, Spain; Growth, Exercise, Nutrition and Development (GENUD) Research Group, Universidad de Zaragoza, Zaragoza, Spain; Instituto Agroalimentario de Arag ́on (IA2), Zaragoza, Spain.
| | - Patricia Peralta-Marrupe
- Department of Physiatry and Nursing, Faculty of Health Sciences, Universidad de Zaragoza, Zaragoza, Spain.
| | - Eva Latorre
- Department of Biochemistry and Molecular and Cell Biology, Faculty of Sciences, Universidad de Zaragoza, Zaragoza, Spain; Institute of Health Research of Aragón (IIS Aragón), Zaragoza, Spain.
| | - Estela Calatayud
- Department of Physiatry and Nursing, Faculty of Health Sciences, Universidad de Zaragoza, Zaragoza, Spain; Institute of Health Research of Aragón (IIS Aragón), Zaragoza, Spain.
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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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Keawtep P, Wichayanrat W, Boripuntakul S, Chattipakorn SC, Sungkarat S. Cognitive Benefits of Physical Exercise, Physical-Cognitive Training, and Technology-Based Intervention in Obese Individuals with and without Postmenopausal Condition: A Narrative Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph192013364. [PMID: 36293943 PMCID: PMC9603710 DOI: 10.3390/ijerph192013364] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/04/2022] [Revised: 10/09/2022] [Accepted: 10/12/2022] [Indexed: 06/14/2023]
Abstract
Obesity and estrogen deprivation have been identified as significant risk factors for cognitive impairment. Thus, postmenopausal conditions when paired with obesity may amplify the risks of developing dementia. Physical exercise has been recommended as a primary treatment for preventing obesity-related comorbidities and alleviating menopausal symptoms. This narrative review aimed to summarize the effects of exercise on cognition in obese individuals with and without menopausal condition, along with potential physiological mechanisms linking these interventions to cognitive improvement. Research evidence has demonstrated that exercise benefits not only physical but also cognitive and brain health. Among various types of exercise, recent studies have suggested that combined physical-cognitive exercise may exert larger gains in cognitive benefits than physical or cognitive exercise alone. Despite the scarcity of studies investigating the effects of physical and combined physical-cognitive exercise in obese individuals, especially those with menopausal condition, existing evidence has shown promising findings. Applying these exercises through technology-based interventions may be a viable approach to increase accessibility and adherence to the intervention. More evidence from randomized clinical trials with large samples and rigorous methodology is required. Further, investigations of biochemical and physiological outcomes along with behavioral changes will provide insight into underlying mechanisms linking these interventions to cognitive improvement.
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Affiliation(s)
- Puntarik Keawtep
- Department of Physical Therapy, Faculty of Associated Medical Sciences, Chiang Mai University, Chiang Mai 50200, Thailand
| | - Wanachaporn Wichayanrat
- Department of Physical Therapy, Faculty of Associated Medical Sciences, Chiang Mai University, Chiang Mai 50200, Thailand
| | - Sirinun Boripuntakul
- Department of Physical Therapy, Faculty of Associated Medical Sciences, Chiang Mai University, Chiang Mai 50200, Thailand
- Research Group of Modern Management and Information Technology, College of Arts, Media and Technology, Chiang Mai University, Chiang Mai 50200, Thailand
| | - Siriporn C. Chattipakorn
- Neurophysiology Unit, Cardiac Electrophysiology Research and Training Center, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand
- Department of Oral Biology and Diagnostic Sciences, Faculty of Dentistry, Chiang Mai University, Chiang Mai 50200, Thailand
| | - Somporn Sungkarat
- Department of Physical Therapy, Faculty of Associated Medical Sciences, Chiang Mai University, Chiang Mai 50200, Thailand
- Research Group of Modern Management and Information Technology, College of Arts, Media and Technology, Chiang Mai University, Chiang Mai 50200, Thailand
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Van Laethem D, Van de Steen F, Kos D, Naeyaert M, Van Schuerbeek P, D’Haeseleer M, D’Hooghe MB, Van Schependom J, Nagels G. Cognitive-motor telerehabilitation in multiple sclerosis (CoMoTeMS): study protocol for a randomised controlled trial. Trials 2022; 23:778. [PMID: 36104820 PMCID: PMC9473474 DOI: 10.1186/s13063-022-06697-9] [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: 07/05/2022] [Accepted: 08/27/2022] [Indexed: 11/30/2022] Open
Abstract
Background The management of cognitive impairment is an important goal in the treatment of multiple sclerosis (MS). While cognitive rehabilitation has been proven to be effective in improving cognitive performance in MS, research in the elderly indicates a higher effectiveness of combined cognitive-motor rehabilitation. Here, we present the protocol of a randomised controlled clinical trial to assess whether a combined cognitive-motor telerehabilitation programme is more effective in improving working memory than only cognitive or motor training. Methods/design The CoMoTeMS-trial is a two-centre, randomised, controlled and blinded clinical trial. A total of 90 patients with MS will receive 12 weeks of either a combined cognitive-motor telerehabilitation programme or only cognitive or motor training. The primary outcome is a change in the digit span backwards. Secondary outcomes are other cognitive changes (Brief International Cognitive Assessment for Multiple Sclerosis and Backward Corsi), Expanded Disability Status Scale (EDSS), 6-Min Walk Test, 25-Foot Walk Test, 9-Hole Peg Test, anxiety and depression, fatigue, quality of life, cognitive and physical activity level, electroencephalography and magnetic resonance imaging of the brain. Discussion We hypothesise that the improvement in digit span backwards after 12 weeks of treatment will be significantly higher in the group treated with the combined cognitive-motor telerehabilitation programme, compared to the groups receiving only cognitive and only motor training. Trial registration ClinicalTrials.gov NCT05355389. Registered on 2 May 2022. Supplementary Information The online version contains supplementary material available at 10.1186/s13063-022-06697-9.
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Integrated cognitive and physical fitness training enhances attention abilities in older adults. NPJ AGING 2022; 8:12. [PMID: 36042247 PMCID: PMC9427998 DOI: 10.1038/s41514-022-00093-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Accepted: 07/20/2022] [Indexed: 11/25/2022]
Abstract
Preserving attention abilities is of great concern to older adults who are motivated to maintain their quality of life. Both cognitive and physical fitness interventions have been utilized in intervention studies to assess maintenance and enhancement of attention abilities in seniors, and a coupling of these approaches is a compelling strategy to buttress both cognitive and physical health in a time- and resource-effective manner. With this perspective, we created a closed-loop, motion-capture video game (Body-Brain Trainer: BBT) that adapts a player’s cognitive and physical demands in an integrated approach, thus creating a personalized and cohesive experience across both domains. Older adults who engaged in two months of BBT improved on both physical fitness (measures of blood pressure and balance) and attention (behavioral and neural metrics of attention on a continuous performance task) outcome measures beyond that of an expectancy matched, active, placebo control group, with maintenance of improved attention performance evidenced 1 year later. Following training, the BBT group’s improvement on the attention outcome measure exceeded performance levels attained by an untrained group of 20-year olds, and showed age-equilibration of a neural signature of attention shown to decline with age: midline frontal theta power. These findings highlight the potential benefits of an integrated, cognitive-physical, closed-loop training platform as a powerful tool for both cognitive and physical enhancement in older adults.
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Rondão CADM, Mota MPG, Esteves D. Development of a Combined Exercise and Cognitive Stimulation Intervention for People with Mild Cognitive Impairment-Designing the MEMO_MOVE PROGRAM. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:10221. [PMID: 36011852 PMCID: PMC9408716 DOI: 10.3390/ijerph191610221] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/05/2022] [Revised: 08/13/2022] [Accepted: 08/14/2022] [Indexed: 06/15/2023]
Abstract
UNLABELLED Dementia patients are at high risk for the decline of both physical and cognitive capacities, resulting in an increased risk of the loss of autonomy. Exercise is regarded as a non-pharmacological therapy for dementia, considering the potential benefits of preventing cognitive decline and improving physical fitness. In this paper, we aim to describe the different design stages for an exercise program combined with cognitive stimulation for a population with mild cognitive impairment, i.e., the MEMO_MOVE program. METHODS The intervention design followed the Medical Research Council's guidelines for complex interventions and was structured according to the six steps in quality intervention development (6SQuID). The intervention was described considering the Template for Intervention Description and Replication (TIDieR). In order to establish the intervention characteristics, a literature review was conducted to collate and analyze previous work, which provided a summary the type of exercise that should be implemented among this population. RESULTS The MEMO_MOVE program was structured and described, regarding (i) inclusion of a cognitive stimulation component; (ii) the kind of cognitive stimulation; and (iii) the type of exercise, duration, frequency, intensity, and program length. CONCLUSIONS A systematic step-by-step process design was followed to create a specific intervention to promote physical fitness and cognitive stimulation in individuals with mild dementia.
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Affiliation(s)
| | - Maria Paula Gonçalves Mota
- Research Center in Sports Sciences, Health Sciences and Human Development (CIDESD), 5001-801 Vila Real, Portugal
- Department of Sports, University of Trás os Montes e Alto Douro, 5000-801 Vila Real, Portugal
| | - Dulce Esteves
- Department of Sports, University of Beira Interior, 6201-001 Covilhã, Portugal
- Research Center in Sports Sciences, Health Sciences and Human Development (CIDESD), 5001-801 Vila Real, Portugal
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Abstract
Alzheimer’s disease (AD) is the most common major neurocognitive disorder of ageing. Although largely ignored until about a decade ago, accumulating evidence suggests that deteriorating brain energy metabolism plays a key role in the development and/or progression of AD-associated cognitive decline. Brain glucose hypometabolism is a well-established biomarker in AD but was mostly assumed to be a consequence of neuronal dysfunction and death. However, its presence in cognitively asymptomatic populations at higher risk of AD strongly suggests that it is actually a pre-symptomatic component in the development of AD. The question then arises as to whether progressive AD-related cognitive decline could be prevented or slowed down by correcting or bypassing this progressive ‘brain energy gap’. In this review, we provide an overview of research on brain glucose and ketone metabolism in AD and its prodromal condition – mild cognitive impairment (MCI) – to provide a clearer basis for proposing keto-therapeutics as a strategy for brain energy rescue in AD. We also discuss studies using ketogenic interventions and their impact on plasma ketone levels, brain energetics and cognitive performance in MCI and AD. Given that exercise has several overlapping metabolic effects with ketones, we propose that in combination these two approaches might be synergistic for brain health during ageing. As cause-and-effect relationships between the different hallmarks of AD are emerging, further research efforts should focus on optimising the efficacy, acceptability and accessibility of keto-therapeutics in AD and populations at risk of AD.
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Buyle M, Jung Y, Pavlou M, Gonzalez SC, Bamiou DE. The role of motivation factors in exergame interventions for fall prevention in older adults: A systematic review and meta-analysis. Front Neurol 2022; 13:903673. [PMID: 35989930 PMCID: PMC9388774 DOI: 10.3389/fneur.2022.903673] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2022] [Accepted: 07/11/2022] [Indexed: 11/27/2022] Open
Abstract
Balance disorders and falls are common in the elderly population. Regular balance exercises are an evidence-based physical intervention to prevent falls in older adults, while patient motivation and adherence are important factors for intervention outcome. Exergames are a relatively new, alternative intervention for physical rehabilitation as they improve balance and strength in older adults. The aims of this systematic review and meta-analysis were to assess the (1) effect of motivation factors as per the Capability, Opportunity and Motivation model of Behavior change (COM-B) on the effectiveness of exergame interventions in healthy older adults, (2) effectiveness of exergames to improve balance in older healthy adults and, (3) impact of exergames on cognitive outcomes. Results show that motivation and capability components influence the general outcome of the exergame training. Motivational factors should thus be considered when setting-up an exergame intervention. Furthermore, exergame intervention appears to be a promising training method in comparison to traditional exercise training. However, exergame training in itself might not be sufficient to improve fall risk and cognitive performance.
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Affiliation(s)
- Margot Buyle
- Psychological Sciences Research Institute and Institute of NeuroScience, Université Catholique de Louvain, Louvain-la-Neuve, Belgium
- *Correspondence: Margot Buyle
| | - Yujin Jung
- Audiology Department, Guy's and St Thomas' National Health Service Foundation Trust, London, United Kingdom
| | - Marousa Pavlou
- Faculty of Life Sciences and Medicine, Centre for Human and Applied Physiological Sciences, King's College London, London, United Kingdom
| | - Sergi Costafreda Gonzalez
- Division of Psychiatry, Faculty of Brain Sciences, University College London, London, United Kingdom
| | - Doris-Eva Bamiou
- University College London Ear Institute, Faculty of Brain Sciences, University College London, London, United Kingdom
- Biomedical Research Centre, National Institute for Health Research, London, United Kingdom
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Li F, Wang L, Qin Y, Liu G. Combined Tai Chi and cognitive interventions for older adults with or without cognitive impairment: A meta-analysis and systematic review. Complement Ther Med 2022; 67:102833. [PMID: 35439549 DOI: 10.1016/j.ctim.2022.102833] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2021] [Revised: 04/14/2022] [Accepted: 04/15/2022] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND AND PURPOSE Evidence from the field of cognitive interventions indicates that nonpharmaceutical interventions seem more promising in enhancing cognition. The number of clinical trials that examine the cognitive benefits of combined physical exercise with cognitive intervention on older adults has recently increased. Tai Chi (TC) has been recommended as an effective and safe exercise for older adults aged 60 and over. However, there is a lack of conclusion about whether combined TC with cognitive interventions can show more benefits than a single intervention for older adults. Thus, this review aimed to evaluate the effects of combined TC and cognitive interventions on older adults. METHODS PubMed, Embase, PsycINFO, and Web of Science were searched for English peer-reviewed papers from inception until November 12, 2021. Data were extracted by two independent reviewers. RESULTS A total of 1524 records were generated and nine studies were included. The pooled results showed that combined TC and cognitive interventions showed significantly large gains on memory [standardised mean difference (SMD) = 0.87, 95% confidence interval (CI): (0.01, 1.74), P 0.05], moderate gains on cognition [SMD = 0.74, 95% CI:(0.19, 1.29), P 0.05], and small size effects on balance. No statistically significant difference was found in executive function, depression, risk of falls, or well-being. CONCLUSION Combined TC and cognitive interventions have positive effects on improving cognition and balance in older adults, but their superiority over the single intervention, as well as their additional effects on the physical and psychological function, are required further investigation.
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Affiliation(s)
- Fei Li
- School of Nursing, Guangxi Medical University, Nanning, Guangxi, China.
| | - Li Wang
- Nursing Department, Second Nanning People's Hospital, Nanning, Guangxi, China
| | - Yan Qin
- The First People's Hospital of Nanning, Nanning, Guangxi, China
| | - Guiying Liu
- School of Nursing, Guangxi Medical University, Nanning, Guangxi, China
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Kimura D, Hosokawa T, Ujikawa T, Ito T. Effects of different exercise intensities on prefrontal activity during a dual task. Sci Rep 2022; 12:13008. [PMID: 35906385 PMCID: PMC9338235 DOI: 10.1038/s41598-022-17172-5] [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: 02/15/2022] [Accepted: 07/21/2022] [Indexed: 11/17/2022] Open
Abstract
The effects of physical exercise on cognitive tasks have been investigated. However, it is unclear how different exercise intensities affect the neural activity. In this study, we investigated the neural activity in the prefrontal cortex (PFC) by varying the exercise intensity while participants performed a dual task (DT). Twenty healthy young adults performed serial subtraction while driving a cycle ergometer. Exercise intensity was set to one of three levels: low, moderate, or high intensity. We did not find any significant change in PFC activity during DT under either the control (no exercise) or low-intensity conditions. In contrast, we observed a significant increase in PFC activity during DT under moderate- and high-intensity conditions. In addition, we observed complex hemodynamics after DT. PFC activity decreased from baseline after DT under the control condition, while it increased under the low-intensity condition. PFC activity remained higher than the baseline level after DT under the moderate-intensity condition but returned to baseline under the high-intensity condition. The results suggest that moderate-intensity exercise with a cognitive load effectively increases PFC activity, and low-intensity exercise may increase PFC activity when combined with a cognitive load.
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Affiliation(s)
- Daisuke Kimura
- Graduate School of Health Science and Technology, Kawasaki University of Medical Welfare, 288 Matsushima, Kurashiki, Okayama, 701-0193, Japan. .,Department of Physical Therapy, Faculty of Rehabilitation, Kawasaki University of Medical Welfare, 288 Matsushima, Kurashiki, Okayama, 701-0193, Japan.
| | - Takayuki Hosokawa
- Department of Orthoptics, Faculty of Rehabilitation, Kawasaki University of Medical Welfare, Kurashiki, Japan
| | - Takuya Ujikawa
- Department of Physical Therapy, Faculty of Rehabilitation, Kawasaki University of Medical Welfare, 288 Matsushima, Kurashiki, Okayama, 701-0193, Japan
| | - Tomotaka Ito
- Graduate School of Health Science and Technology, Kawasaki University of Medical Welfare, 288 Matsushima, Kurashiki, Okayama, 701-0193, Japan.,Department of Physical Therapy, Faculty of Rehabilitation, Kawasaki University of Medical Welfare, 288 Matsushima, Kurashiki, Okayama, 701-0193, Japan
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A Literature Review of High-Tech Physiotherapy Interventions in the Elderly with Neurological Disorders. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19159233. [PMID: 35954587 PMCID: PMC9368072 DOI: 10.3390/ijerph19159233] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/27/2022] [Revised: 07/22/2022] [Accepted: 07/27/2022] [Indexed: 11/28/2022]
Abstract
Neurological physiotherapy adopts a problem-based approach for each patient as determined by a thorough evaluation of the patient’s physical and mental well-being. Τhis work aims to provide a literature review of physical therapy interventions in the elderly with neurological diseases (NDs) and discuss physiotherapy procedures and methods that utilize cutting-edge technologies for which clinical studies are available. Hence, the review focuses on acute NDs (stroke), deteriorating NDs (Parkinson’s disease), and age-related cognitive impairment. The most used physiotherapy procedures on which clinical data are available are balance and gait training (robot-assisted or not), occupational therapy, classical physiotherapy, walking and treadmill training, and upper limb robot-assisted therapy. Respectively, the most often-used equipment are types of treadmills, robotic-assisted equipment (Lokomat® and Gait Trainer GT1), and portable walkway systems (GAITRite®), along with state-of-the-art technologies of virtual reality, virtual assistants, and smartphones. The findings of this work summarize the core standard tools and procedures, but more importantly, provide a glimpse of the new era in physiotherapy with the utilization of innovative equipment tools for advanced patient monitoring and empowerment.
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Pellegrini-Laplagne M, Dupuy O, Sosner P, Bosquet L. Effect of simultaneous exercise and cognitive training on executive functions, baroreflex sensitivity, and pre-frontal cortex oxygenation in healthy older adults: a pilot study. GeroScience 2022; 45:119-140. [PMID: 35881301 PMCID: PMC9315336 DOI: 10.1007/s11357-022-00595-3] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2021] [Accepted: 05/20/2022] [Indexed: 02/02/2023] Open
Abstract
Aging is characterized by cognitive decline affecting daily functioning. To manage this socio-economic challenge, several non-pharmacological methods such as physical, cognitive, and combined training are proposed. Although there is an important interest in this subject, the literature is still heterogeneous. The superiority of simultaneous training compared to passive control and physical training alone seems clear but very few studies compared simultaneous training to cognitive training alone. The aim of this pilot study was to investigate the effect of simultaneous exercise and cognitive training on several cognitive domains in healthy older adults, in comparison with either training alone. Thirty-five healthy older adults were randomized into one of three experimental groups: exercise training, cognitive training, and simultaneous exercise and cognitive training. The protocol involved two 30-min sessions per week for 24 weeks. Cognitive performance in several domains, pre-frontal cortex oxygenation, and baroreflex sensitivity were assessed before and after the intervention. All groups improved executive performance, including flexibility or working memory. We found a group by time interaction for inhibition cost (F(2,28) = 6.44; p < 0.01) and baroreflex sensitivity during controlled breathing (F(2,25) = 4.22; p = 0.01), the magnitude of improvement of each variable being associated (r = -0.39; p = 0.03). We also found a decrease in left and right pre-frontal cortex oxygenation in all groups during the trail making test B. A simultaneous exercise and cognitive training are more efficient than either training alone to improve executive function and baroreflex sensitivity. The results of this study may have important clinical repercussions by allowing to optimize the interventions designed to maintain the physical and cognitive health of older adults.
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Affiliation(s)
- Manon Pellegrini-Laplagne
- grid.11166.310000 0001 2160 6368Laboratoire MOVE (EA6314), Faculté des sciences du sport, Université de Poitiers, 8 allée Jean Monnet – TSA 31113 – 96073 Poitiers cedex 9, Poitiers, France
| | - Olivier Dupuy
- Laboratoire MOVE (EA6314), Faculté des sciences du sport, Université de Poitiers, 8 allée Jean Monnet - TSA 31113 - 96073 Poitiers cedex 9, Poitiers, France. .,School of Kinesiology and Physical Activity Sciences (EKSAP), Faculty of Medicine, University of Montreal, Montreal, Canada.
| | - Phillipe Sosner
- grid.11166.310000 0001 2160 6368Laboratoire MOVE (EA6314), Faculté des sciences du sport, Université de Poitiers, 8 allée Jean Monnet – TSA 31113 – 96073 Poitiers cedex 9, Poitiers, France ,Mon Stade, Paris, France
| | - Laurent Bosquet
- grid.11166.310000 0001 2160 6368Laboratoire MOVE (EA6314), Faculté des sciences du sport, Université de Poitiers, 8 allée Jean Monnet – TSA 31113 – 96073 Poitiers cedex 9, Poitiers, France ,grid.14848.310000 0001 2292 3357School of Kinesiology and Physical Activity Sciences (EKSAP), Faculty of Medicine, University of Montreal, Montreal, Canada
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Bruni F, Borghesi F, Mancuso V, Riva G, Stramba-Badiale M, Pedroli E, Cipresso P. Cognition Meets Gait: Where and How Mind and Body Weave Each Other in a Computational Psychometrics Approach in Aging. Front Aging Neurosci 2022; 14:909029. [PMID: 35875804 PMCID: PMC9304933 DOI: 10.3389/fnagi.2022.909029] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Accepted: 06/16/2022] [Indexed: 11/26/2022] Open
Abstract
Aging may be associated with conditions characterized by motor and cognitive alterations, which could have a detrimental impact on daily life. Although motors and cognitive aspects have always been treated as separate entities, recent literature highlights their relationship, stressing a strong association between locomotion and executive functions. Thus, designing interventions targeting the risks deriving from both components’ impairments is crucial: the dual-task represents a starting point. Although its role in targeting and decreasing difficulties in aging is well known, most interventions are focused on a single domain, proposing a vertical model in which patients emerge only for a single aspect per time during assessment and rehabilitation. In this perspective, we propose a view of the individual as a whole between mind and body, suggesting a multicomponent and multidomain approach that could integrate different domains at the same time retracing lifelike situations. Virtual Reality, thanks to the possibility to develop daily environments with engaging challenges for patients, as well as to manage different devices to collect multiple data, provides the optimal scenario in which the integration could occur. Artificial Intelligence, otherwise, offers the best methodologies to integrate a great amount of various data to create a predictive model and identify appropriate and individualized interventions. Based on these assumptions the present perspective aims to propose the development of a new approach to an integrated, multimethod, multidimensional training in order to enhance cognition and physical aspects based on behavioral data, incorporating consolidated technologies in an innovative approach to neurology.
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Affiliation(s)
| | - Francesca Borghesi
- Applied Technology for Neuropsychology Lab, IRCCS Istituto Auxologico Italiano, Milan, Italy
| | | | - Giuseppe Riva
- Applied Technology for Neuropsychology Lab, IRCCS Istituto Auxologico Italiano, Milan, Italy
- Human Technology Lab, Catholic University of the Sacred Heart, Milan, Italy
| | - Marco Stramba-Badiale
- Department of Geriatrics and Cardiovascular Medicine, IRCCS Istituto Auxologico Italiano, Milan, Italy
| | - Elisa Pedroli
- Faculty of Psychology, eCampus University, Novedrate, Italy
- Applied Technology for Neuropsychology Lab, IRCCS Istituto Auxologico Italiano, Milan, Italy
| | - Pietro Cipresso
- Applied Technology for Neuropsychology Lab, IRCCS Istituto Auxologico Italiano, Milan, Italy
- Department of Psychology, University of Turin, Turin, Italy
- *Correspondence: Pietro Cipresso,
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Conceptual Design of an Extended Reality Exercise Game for the Elderly. APPLIED SCIENCES-BASEL 2022. [DOI: 10.3390/app12136436] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Facing the increasingly serious ageing problem, IT technology is being applied more and more to alleviate the increasing health demands of the elderly. Virtual reality (VR) games, in particular, have been shown to benefit the physical and mental health of the elderly. However, almost all consumer-level VR games address the general user, not considering the characteristics of the elderly, such as their particular needs regarding cognitive aspects and safety. In addition, the existing VR rowing games’ research typically focuses on athlete training or is based on a rowing machine. Extending on previous research, this paper proposes a conceptual design of a VR rowing game, VRrowing to provide a home exercise game for the elderly which benefits both physical and mental health. This research first analysed the relevant literature and existing VR exercise games for the elderly to find characteristics and their particular needs. Then, following design principles (in exercise games, human–computer interaction, and user interfaces (UIs)) for the elderly, this study proposed a conceptual design of VRrowing through the MDA framework (standing for mechanics, dynamics, and aesthetics). The results cover the system architecture, activities and tasks, patterns and roles, mechanics and structures, and UI examples. Based on comprehensive consideration of the results from relevant research and fostering strengths and circumventing weaknesses, VRrowing was designed as a sports game, aimed at the elderly according to their characteristics and needs, which fills the void of home VR rowing games for seniors’ exercise. This research has reference value for scientific research or development personnel in VR game applications and evaluations, especially for such games targeting the elderly.
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