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Triki A, Borji R, Laatar R, Sahli S, Rebai H. The effect of dual-task training on postural and cognitive performances in adolescents with down syndrome. RESEARCH IN DEVELOPMENTAL DISABILITIES 2024; 153:104827. [PMID: 39216176 DOI: 10.1016/j.ridd.2024.104827] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/04/2024] [Revised: 07/25/2024] [Accepted: 08/21/2024] [Indexed: 09/04/2024]
Abstract
BACKGROUND The dual task training (DTT) has been shown to improve postural and cognitive performances in many populations. Therefore, it seems of interest to explore the effect of such training modality in individuals with Down syndrome (DS) presenting both cognitive and postural deficits. AIMS This study explored the effect of a DTT compared to a single task training (STT) on postural and cognitive performances in adolescents with DS. METHODS AND PROCEDURES The center of pressure velocity (CoPVm) and the cognitive performance in the selective word recall test were recorded under single task (ST) and DT conditions before and after 8 weeks in the STT group (STTG), the DTTG and the control group (CG). OUTCOMES AND RESULTS Before training, CoPVm values increased and cognitive performances decreased (p < 0.001) during the DT compared to ST conditions in all groups. After training, CoPVm decreased (p < 0.001) in the DTTG and the STTG under the ST conditions. However, under DT conditions, these values decreased (p < 0.001) only in the DTTG. The cognitive performance increased (p < 0.001) only in the DTTG in both ST and DT conditions. CONCLUSION The DTT is strongly recommended to improve both postural and cognitive performances in individuals with DS notably in DT conditions.
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Affiliation(s)
- Amina Triki
- Laboratory 'Optimisation de la Performance Sportive, Centre National de Médecine et Sciences du Sport (CNMSS)', Tunis, Tunisia
| | - Rihab Borji
- Research Laboratory: Education, Motricité, Sport et Santé, EM2S, LR19JS01, High Institute of Sport and Physical Education of Sfax, University of Sfax, Sfax, Tunisia.
| | - Rabeb Laatar
- Research Laboratory: Education, Motricité, Sport et Santé, EM2S, LR19JS01, High Institute of Sport and Physical Education of Sfax, University of Sfax, Sfax, Tunisia
| | - Sonia Sahli
- Research Laboratory: Education, Motricité, Sport et Santé, EM2S, LR19JS01, High Institute of Sport and Physical Education of Sfax, University of Sfax, Sfax, Tunisia
| | - Haithem Rebai
- Laboratory 'Optimisation de la Performance Sportive, Centre National de Médecine et Sciences du Sport (CNMSS)', Tunis, Tunisia
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Miura H, Ono Y, Suzuki T, Ogihara Y, Imai Y, Watanabe A, Tokikuni Y, Sakuraba S, Sawamura D. Regional brain activity and neural network changes in cognitive-motor dual-task interference: A functional near-infrared spectroscopy study. Neuroimage 2024; 297:120714. [PMID: 38950665 DOI: 10.1016/j.neuroimage.2024.120714] [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: 01/05/2024] [Revised: 06/25/2024] [Accepted: 06/28/2024] [Indexed: 07/03/2024] Open
Abstract
Previous neuroimaging studies have reported dual-task interference (DTi) and deterioration of task performance in a cognitive-motor dual task (DT) compared to that in a single task (ST). Greater frontoparietal activity is a neural signature of DTi; nonetheless, the underlying mechanism of cortical network in DTi still remains unclear. This study aimed to investigate the regional brain activity and neural network changes during DTi induced by highly demanding cognitive-motor DT. Thirty-four right-handed healthy young adults performed the spiral-drawing task. They underwent a paced auditory serial addition test (PASAT) simultaneously or independently while their cortical activity was measured using functional near-infrared spectroscopy. Motor performance was determined using the balanced integration score (BIS), a balanced index of drawing speed and precision. The cognitive task of the PASAT was administered with two difficulty levels defined by 1 s (PASAT-1 s) and 2 s (PASAT-2 s) intervals, allowing for the serial addition of numbers. Cognitive performance was determined using the percentage of correct responses. These motor and cognitive performances were significantly reduced during DT, which combined a drawing and a cognitive task at either difficulty level, compared to those in the corresponding ST conditions. The DT conditions were also characterized by significantly increased activity in the right dorsolateral prefrontal cortex (DLPFC) compared to that in the ST conditions. Multivariate Granger causality (GC) analysis of cortical activity in the selected frontoparietal regions of interest further revealed selective top-down causal connectivity from the right DLPFC to the right inferior parietal cortex during DTs. Furthermore, changes in the frontoparietal GC connectivity strength between the PASAT-2 s DT and ST conditions significantly correlated negatively with changes in the percentage of correct responses. Therefore, DTi can occur even in cognitively proficient young adults, and the right DLPFC and frontoparietal network being crucial neural mechanisms underlying DTi. These findings provide new insights into DTi and its underlying neural mechanisms and have implications for the clinical utility of cognitive-motor DTs applied to clinical populations with cognitive decline, such as those with psychiatric and brain disorders.
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Affiliation(s)
- Hiroshi Miura
- Graduate School of Health Sciences, Hokkaido University, Sapporo, Japan; Department of Rehabilitation, Higashinaebo Hospital, Sapporo, Japan
| | - Yumie Ono
- Department of Electronics and Bioinformatics, School of Science and Technology, Meiji University, Kawasaki, Japan
| | - Tatsuya Suzuki
- Department of Electronics and Bioinformatics, School of Science and Technology, Meiji University, Kawasaki, Japan; Electrical Engineering Program, Graduate School of Science and Technology, Meiji University, Kawasaki, Japan
| | - Yuji Ogihara
- Department of Rehabilitation, Higashinaebo Hospital, Sapporo, Japan
| | - Yuna Imai
- Department of Rehabilitation, Higashinaebo Hospital, Sapporo, Japan
| | - Akihiro Watanabe
- Department of Rehabilitation Science, Faculty of Health Sciences, Hokkaido University, Sapporo, Hokkaido, 060-0812, Japan
| | - Yukina Tokikuni
- Department of Rehabilitation Science, Faculty of Health Sciences, Hokkaido University, Sapporo, Hokkaido, 060-0812, Japan
| | - Satoshi Sakuraba
- Department of Rehabilitation Sciences, Health Sciences University of Hokkaido, Tobetsu, Ishikari, Japan
| | - Daisuke Sawamura
- Department of Rehabilitation Science, Faculty of Health Sciences, Hokkaido University, Sapporo, Hokkaido, 060-0812, Japan.
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Pasten JG, Aguayo JC, Aburto J, Araya-Quintanilla F, Álvarez-Bustos A, Valenzuela-Fuenzalida JJ, Camp PG, Sepúlveda-Loyola W. Dual-Task Performance in Individuals With Chronic Obstructive Pulmonary Disease: A Systematic Review With Meta-Analysis. Pulm Med 2024; 2024:1230287. [PMID: 39157540 PMCID: PMC11330333 DOI: 10.1155/2024/1230287] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2024] [Revised: 06/07/2024] [Accepted: 07/16/2024] [Indexed: 08/20/2024] Open
Abstract
Background: Chronic obstructive pulmonary disease (COPD) is characterized by important extrapulmonary alterations that could affect the performance in dual task (DT) (motor and cognitive tasks executed simultaneously), which is defined as DT interference (DTI). Objective: To compare the performance of DT between individuals with COPD and healthy control subjects (HCSs). Methods: The literature search was conducted in seven databases (Medline, Scopus, Web of Science, PEDro, SciELO, LILACS, and Google Scholar) up to December 2023, including studies published in English, Spanish, or Portuguese. Studies with individuals diagnosed with COPD older than 60 years, who were evaluated with any DT assessment, and compared with HCS were included. The quality of the studies was evaluated using the risk of bias in nonrandomized studies of interventions (ROBINS-I). The meta-analysis was performed with JAMOVI software 5.4. The study protocol was registered on PROSPERO (CRD42023435212). Results: From a total of 128 articles, 5 observational studies were selected in this review, involving 252 individuals aged between 60 and 80 years, from France, Italy, Canada, Turkey, and Belgium. Notable DTI was observed in individuals with COPD compared to HCS (standard mean difference [SMD] = 0.91; 95% confidence interval (CI) 0.06-1.75, p = 0.04). Individuals with COPD had impaired gait speed, balance control, muscle strength, and cognitive interference during DT compared to HCS. DT assessment protocols included different combination of motor and cognitive tasks, using functional test, gait analysis, and muscle strength paired with countdown and verbal fluency tasks. Studies presented low (n = 2), moderate (n = 1), and serious (n = 2) overall risk of bias. Conclusion: Older adults diagnosed with COPD exhibited a significant DTI compared to HCSs, which is characterized by poorer physical and cognitive performance during DT execution. These findings highlight the importance of incorporating DT assessments into clinical practice for individuals with COPD.
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Affiliation(s)
- Joselyn González Pasten
- Facultad de Salud y Ciencias SocialesUniversidad de Las Américas, Santiago, Chile
- Grupo de Estudiantes de Iniciación Científica en Kinesiología (GICK)Universidad de Las Américas, Santiago, Chile
| | - Jennifer Campos Aguayo
- Facultad de Salud y Ciencias SocialesUniversidad de Las Américas, Santiago, Chile
- Grupo de Estudiantes de Iniciación Científica en Kinesiología (GICK)Universidad de Las Américas, Santiago, Chile
| | - Javiera Aburto
- Facultad de Salud y Ciencias SocialesUniversidad de Las Américas, Santiago, Chile
- Grupo de Estudiantes de Iniciación Científica en Kinesiología (GICK)Universidad de Las Américas, Santiago, Chile
| | - Felipe Araya-Quintanilla
- Escuela de KinesiologíaFacultad de Odontología y Ciencias de la RehabilitaciónUniversidad San Sebastián, Santiago, Chile
| | - Alejandro Álvarez-Bustos
- Biomedical Research Center Network for Frailty and Healthy Ageing (CIBERFES)Institute of Health Carlos III, Madrid, Spain
| | | | - Pat G. Camp
- Department of Physical TherapyUniversity of British Columbia, Vancouver, British Columbia, Canada
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Nishimoto R, Inokuchi H, Fujiwara S, Ogata T. Implicit learning provides advantage over explicit learning for gait-cognitive dual-task interference. Sci Rep 2024; 14:18336. [PMID: 39112521 PMCID: PMC11306735 DOI: 10.1038/s41598-024-68284-z] [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: 03/15/2024] [Accepted: 07/22/2024] [Indexed: 08/10/2024] Open
Abstract
Dual-task performance holds significant relevance in real-world scenarios. Implicit learning is a possible approach for improving dual-task performance. Analogy learning, utilizing a single metaphor to convey essential information about motor skills, has emerged as a practical method for fostering implicit learning. However, evidence supporting the effect of implicit learning on gait-cognitive dual-task performance is insufficient. This exploratory study aimed to examine the effects of implicit and explicit learning on dual-task performance in both gait and cognitive tasks. Tandem gait was employed on a treadmill to assess motor function, whereas serial seven subtraction tasks were used to gauge cognitive performance. Thirty healthy community-dwelling older individuals were randomly assigned to implicit or explicit learning groups. Each group learned the tandem gait task according to their individual learning styles. The implicit learning group showed a significant improvement in gait performance under the dual-task condition compared with the explicit learning group. Furthermore, the implicit learning group exhibited improved dual-task interference for both tasks. Our findings suggest that implicit learning may offer greater advantages than explicit learning in acquiring autonomous motor skills. Future research is needed to uncover the mechanisms underlying implicit learning and to harness its potential for gait-cognitive dual-task performance in clinical settings.
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Affiliation(s)
- Ryoki Nishimoto
- Department of Rehabilitation Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-Ku, Tokyo, 113-8655, Japan
- Department of Rehabilitation Medicine, Graduate School of Medicine, The University of Tokyo, Tokyo, 113-8655, Japan
| | - Haruhi Inokuchi
- Department of Rehabilitation Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-Ku, Tokyo, 113-8655, Japan
| | - Sayaka Fujiwara
- Department of Rehabilitation Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-Ku, Tokyo, 113-8655, Japan
| | - Toru Ogata
- Department of Rehabilitation Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-Ku, Tokyo, 113-8655, Japan.
- Department of Rehabilitation Medicine, Graduate School of Medicine, The University of Tokyo, Tokyo, 113-8655, Japan.
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Benn NL, Jervis-Rademeyer H, Souza WH, Pakosh M, Inness EL, Musselman KE. Balance Interventions to Improve Upright Balance Control and Balance Confidence in People With Motor-Incomplete Spinal Cord Injury or Disease: A Systematic Review and Meta-analysis. Arch Phys Med Rehabil 2024:S0003-9993(24)01162-6. [PMID: 39111646 DOI: 10.1016/j.apmr.2024.07.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2024] [Revised: 06/18/2024] [Accepted: 07/02/2024] [Indexed: 08/27/2024]
Abstract
OBJECTIVES To assist with clinical decision making, evidence syntheses are needed to demonstrate the efficacy of available interventions and examine the intervention components and dosage parameters. This systematic review and meta-analysis described the efficacy, components and dosage of interventions targeting upright balance control, balance confidence, and/or falls in adults with motor-incomplete spinal cord injury/disease (SCI/D). DATA SOURCES A search strategy following the population, intervention, control, outcome framework was developed. Six databases were searched: APA PsychInfo, Cumulative Index to Nursing and Allied Health Literature, Embase, Emcare Nursing, Web of Science CC, and Medline. STUDY SELECTION Title, abstract, and full-text screening were conducted by 2 researchers independently. Inclusion criteria included the following: (1) adults with chronic, motor-incomplete SCI/D; (2) physical intervention targeting upright postural control; and (3) clinical and/or biomechanical measures of upright balance control and/or balance confidence and/or documentation of falls. DATA EXTRACTION Participant characteristics, balance intervention details, adverse events, and study results were extracted. The Downs and Black Checklist was used to assess methodological quality. Meta-analyses on pre-post intervention outcomes and a meta-regression of dosage were completed. Grading of Recommendations, Assessment, Development, and Evaluations approach was used to evaluate the quality of the evidence. DATA SYNTHESIS The search returned 1664 unique studies; 26 were included. Methodological quality was moderate to good. Participants were 500 individuals with SCI/D, aged 18-74 years (males: females = 2.4:1). Minor adverse events were reported in 8 studies (eg, muscle soreness and fatigue). Walking interventions and upright balance training with visual feedback had clinically meaningful and significant pooled effects on improving standing balance control. Only walking interventions had a significant pooled effect on improving balance confidence. There were no significant findings on dosage response. Few studies evaluated the effects of balance interventions on the occurrence of falls. CONCLUSIONS Walking interventions and upright balance training with visual feedback had greater effects on upright balance control than conventional physiotherapy; however, the quality of the evidence was very low.
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Affiliation(s)
- Natasha L Benn
- Rehabilitation Sciences Institute, Temerty Faculty of Medicine, University of Toronto, Toronto, Canada; KITE Research Institute, Toronto Rehabilitation Institute-University Health Network, Toronto, Canada
| | | | - Wagner H Souza
- KITE Research Institute, Toronto Rehabilitation Institute-University Health Network, Toronto, Canada
| | - Maureen Pakosh
- KITE Research Institute, Toronto Rehabilitation Institute-University Health Network, Toronto, Canada
| | - Elizabeth L Inness
- Rehabilitation Sciences Institute, Temerty Faculty of Medicine, University of Toronto, Toronto, Canada; KITE Research Institute, Toronto Rehabilitation Institute-University Health Network, Toronto, Canada; Department of Physical Therapy, Temerty Faculty of Medicine, University of Toronto, Toronto, Canada
| | - Kristin E Musselman
- Rehabilitation Sciences Institute, Temerty Faculty of Medicine, University of Toronto, Toronto, Canada; KITE Research Institute, Toronto Rehabilitation Institute-University Health Network, Toronto, Canada; Department of Physical Therapy, Temerty Faculty of Medicine, University of Toronto, Toronto, Canada.
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6
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Orhan E, Batuk İT, Batuk MO. Balance Performance in Young Adults With Hearing Aids: How Can It Be Affected by the Visual Cognitive Task? JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2024; 67:2774-2781. [PMID: 39018264 DOI: 10.1044/2024_jslhr-23-00530] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/19/2024]
Abstract
OBJECTIVE The aim of this study was to investigate the effect of a visual cognitive additional task on balance performance in young adults with hearing aids (HAs). METHOD Twenty young adult HA users and 20 controls were recruited for the study. Participants were asked to stand on a force plate using computerized dynamic posturography and perform a Sensory Organization Test (SOT) as a balance task under single-task (ST) and dual-task (DT) conditions. The DT condition involved performing a visual cognitive task (Backward Digit Recall) while maintaining balance. Balance performance was measured using equilibrium scores under four different conditions. RESULTS The results showed that SOT scores of HA users decreased significantly in the DT compared to the ST (p of Condition 1: < .001; p of Condition 4: < .001; p of Condition 6: = .001). HA users' SOT scores in the DT condition were statistically significantly lower than controls (p of Condition 1: < .003; p of Condition 4: < .009; p of Condition 6: = .004). This suggests that the presence of a visual cognitive additional task has a negative impact on balance performance in young adults with HAs. CONCLUSIONS These findings highlight the importance of considering the impact of cognitive tasks on balance performance in young adults with HAs. Further studies should investigate the specific needs of hearing loss patients in multitasking conditions, including age, degree of hearing loss, and cognitive ability, to develop effective interventions to reduce the risk of falls.
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Affiliation(s)
- Emre Orhan
- Department of Audiology, Gazi University, Ankara, Turkey
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Carretti G, Spano F, Sgambati E, Manetti M, Marini M. Adapted Training to Boost Upper Body Sensorimotor Control and Daily Living Functionality in Visually Impaired Baseball Players. MEDICINA (KAUNAS, LITHUANIA) 2024; 60:1136. [PMID: 39064565 PMCID: PMC11279096 DOI: 10.3390/medicina60071136] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/13/2024] [Revised: 07/10/2024] [Accepted: 07/12/2024] [Indexed: 07/28/2024]
Abstract
Background and Objectives: Vision significantly contributes to postural control, balance, coordination, and body kinematics, thus deeply influencing everyday functionality. Sight-impaired subjects often show upper body anatomofunctional and kinetic chain alterations negatively impacting daily living efficiency and autonomy. The present study aimed to investigate and train, for the first time, upper body sensorimotor control in an Italian blind baseball team to boost global and segmental functionality while contemporarily prevent injuries. Materials and Methods: The whole team underwent a validated test battery using both quantitative traditional tools, such as goniometric active range of motion and muscular/functional tests, and an innovative biofeedback-based device, a Libra proprioceptive board. Consequently, a 6-week adapted training protocol was designed and leaded to improve sensorimotor control and, hence, counteract disability-related deficits and sport-specific overuse syndromes. Results: Statistically significant improvements were observed in all the investigated parameters. Noteworthy, an overall boost of global and segmental stability was detected through an orthostatic dynamic balance enhancement during the Y Balance test (p = 0.01) and trunk multiplanar control improvement on the Libra board (p = 0.01). Concurrently, the comparison of baseline vs. post-intervention outcomes revealed a consistent increase in upper body mobility (p < 0.05 for all the assessed districts), core recruitment (p = 0.01 for all the administered functional tests), and proprioceptive postural control (p = 0.01 for the Libra board validated test). Conclusions: Our findings suggest that a tailored sensorimotor training, conceived and led by an adapted physical activity kinesiologist, may effectively improve upper body functional prerequisites and global proprioceptive control, thus potentially promoting autonomy, quality of life, and physical activity/sport practice adherence in visually impaired individuals.
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Affiliation(s)
- Giuditta Carretti
- Department of Experimental and Clinical Medicine, Section of Anatomy and Histology, University of Florence, 50134 Florence, Italy; (G.C.); (F.S.); (M.M.)
| | - Francesca Spano
- Department of Experimental and Clinical Medicine, Section of Anatomy and Histology, University of Florence, 50134 Florence, Italy; (G.C.); (F.S.); (M.M.)
| | - Eleonora Sgambati
- Department of Biosciences and Territory, University of Molise, 86090 Pesche, Italy;
| | - Mirko Manetti
- Department of Experimental and Clinical Medicine, Section of Anatomy and Histology, University of Florence, 50134 Florence, Italy; (G.C.); (F.S.); (M.M.)
| | - Mirca Marini
- Department of Experimental and Clinical Medicine, Section of Anatomy and Histology, University of Florence, 50134 Florence, Italy; (G.C.); (F.S.); (M.M.)
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Qian Y, Schwartz A, Jung A, Zhang Y, Seitz U, Wilds G, Kim M, Kramer AF, Chukoskie L. The Influence of Separate and Combined Exercise and Foreign Language Acquisition on Learning and Cognition. Brain Sci 2024; 14:572. [PMID: 38928573 PMCID: PMC11201889 DOI: 10.3390/brainsci14060572] [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: 05/01/2024] [Revised: 05/23/2024] [Accepted: 05/29/2024] [Indexed: 06/28/2024] Open
Abstract
Aging contributes significantly to cognitive decline. Aerobic exercise (AE) has been shown to induce substantial neuroplasticity changes, enhancing cognitive and brain health. Likewise, recent research underscores the cognitive benefits of foreign language learning (FLL), indicating improvements in brain structure and function across age groups. However, the lack of a comprehensive paradigm integrating language learning with exercise limits research on combined effects in older adults. In order to address this gap, we devised a novel approach using a virtual world tourism scenario for auditory-based language learning combined with aerobic cycling. Our study examines the impact of simultaneous AE and FLL integration on cognitive and language learning outcomes compared to FLL alone. A total of 20 older adults were randomly assigned to AE + FLL and FLL-only groups. The results revealed significantly improved Spanish language learning outcomes in both combined and language learning-only groups. Additionally, significant cognitive function improvement was observed in the FLL group following short-term language learning.
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Affiliation(s)
- Yijun Qian
- Department of Physical Therapy, Movement and Rehabilitation Science, Bouvé College of Health Science, Northeastern University, 360 Huntington Ave, Boston, MA 02115, USA; (Y.Q.); (A.S.); (A.J.); (G.W.)
| | - Anna Schwartz
- Department of Physical Therapy, Movement and Rehabilitation Science, Bouvé College of Health Science, Northeastern University, 360 Huntington Ave, Boston, MA 02115, USA; (Y.Q.); (A.S.); (A.J.); (G.W.)
| | - Ara Jung
- Department of Physical Therapy, Movement and Rehabilitation Science, Bouvé College of Health Science, Northeastern University, 360 Huntington Ave, Boston, MA 02115, USA; (Y.Q.); (A.S.); (A.J.); (G.W.)
| | - Yichi Zhang
- College of Art, Media and Design, Northeastern University, 360 Huntington Ave, Boston, MA 02115, USA; (Y.Z.); (U.S.); (M.K.)
| | - Uri Seitz
- College of Art, Media and Design, Northeastern University, 360 Huntington Ave, Boston, MA 02115, USA; (Y.Z.); (U.S.); (M.K.)
| | - Gabrielle Wilds
- Department of Physical Therapy, Movement and Rehabilitation Science, Bouvé College of Health Science, Northeastern University, 360 Huntington Ave, Boston, MA 02115, USA; (Y.Q.); (A.S.); (A.J.); (G.W.)
| | - Miso Kim
- College of Art, Media and Design, Northeastern University, 360 Huntington Ave, Boston, MA 02115, USA; (Y.Z.); (U.S.); (M.K.)
| | - Arthur F. Kramer
- The Center for Cognitive and Brain Health, Northeastern University, 805 Columbus Ave, Boston, MA 02115, USA;
- Beckman Institute, University of Illinois, Urbana, IL 61801, USA
| | - Leanne Chukoskie
- Department of Physical Therapy, Movement and Rehabilitation Science, Bouvé College of Health Science, Northeastern University, 360 Huntington Ave, Boston, MA 02115, USA; (Y.Q.); (A.S.); (A.J.); (G.W.)
- College of Art, Media and Design, Northeastern University, 360 Huntington Ave, Boston, MA 02115, USA; (Y.Z.); (U.S.); (M.K.)
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9
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Saraiva M, Vilas-Boas JP, Castro MA. Postural Control and Muscle Activity during Dual-Task in Young Adults. Behav Sci (Basel) 2024; 14:403. [PMID: 38785895 PMCID: PMC11117846 DOI: 10.3390/bs14050403] [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: 03/22/2024] [Revised: 05/08/2024] [Accepted: 05/10/2024] [Indexed: 05/25/2024] Open
Abstract
In everyday life, we recurrently perform two tasks simultaneously, which is called dual-tasking. A common dual task is smartphone use while standing or walking. According to previous studies, this task can compromise postural stability. However, few studies have analyzed lower limb muscle activity during dual-tasking using smartphones. This study aimed to assess the postural sway and muscle activity during dual-tasking in young adults. Thirty-six healthy young adults (23.08 ± 3.92 years) participated in this study. They performed a single task (ST: keeping a quiet standing posture) and a dual task (DT: keeping the ST while simultaneously performing a cognitive task on their smartphone). Postural sway was assessed through the center of pressure (CoP) analysis using a force platform: total CoP displacement, CoP displacement in the anterior-posterior and medial-lateral directions, mean total velocity of the CoP, mean velocity of the CoP in the anterior-posterior and medial-lateral directions, and 95% confidence ellipse sway area. A surface electromyography system recorded the muscle activity of the lumbar spinal erector and five muscles of the lower limb (bilaterally). The results showed an increase in postural sway from the ST to the DT in all CoP variables (p < 0.05), and muscle activity in most muscles analyzed decreased from the ST to the DT (p < 0.05). In conclusion, our results reflect a decentralization of attention from motor performance once postural sway increased and muscle activity decreased in dual-task conditions.
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Affiliation(s)
- Marina Saraiva
- Dr. Lopes Dias Health School, Sector of Physiotherapy, Polytechnic Institute of Castelo Branco, 6000-767 Castelo Branco, Portugal
- RoboCorp Laboratory, i2A, Polytechnic Institute of Coimbra, 3046-854 Coimbra, Portugal;
- Centre for Mechanical Engineering, Materials and Processes, CEMMPRE, University of Coimbra, 3030-788 Coimbra, Portugal
| | - João Paulo Vilas-Boas
- Faculty of Sports and CIAFEL, University of Porto, 4200-450 Porto, Portugal;
- LABIOMEP-UP, Faculty of Sports and CIFI2D, The University of Porto, 4200-450 Porto, Portugal
| | - Maria António Castro
- RoboCorp Laboratory, i2A, Polytechnic Institute of Coimbra, 3046-854 Coimbra, Portugal;
- Centre for Mechanical Engineering, Materials and Processes, CEMMPRE, University of Coimbra, 3030-788 Coimbra, Portugal
- School of Health Sciences, Sector of Physiotherapy, ciTechCare, CDRSP, Polytechnic University of Leiria, 2411-901 Leiria, Portugal
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10
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Hars M, Fernandez N, Herrmann F, Rizzoli R, Ferrari S, Graf C, Vuilleumier P, Trombetti A. Effects of Dalcroze Eurhythmics Exercise Versus Multicomponent Exercise on Physical and Cognitive Function, and Falls in Older Adults: The EPHYCOS Randomized Controlled Trial. Adv Biol (Weinh) 2024:e2400089. [PMID: 38700122 DOI: 10.1002/adbi.202400089] [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: 02/18/2024] [Revised: 04/18/2024] [Indexed: 05/05/2024]
Abstract
Currently, robust evidence is lacking to support one exercise type over another in the prevention of physical and cognitive decline and falls among older adults, primarily because of the lack of comparative trials of proven interventions. Therefore, a 12-month randomized, single-blind, comparative effectiveness trial is conducted, in which 142 older adults at high risk for falls are randomized (1:1) to receive an evidence-based Dalcroze Eurhythmics (DE) exercise program (once weekly, group-based) or an evidence-based multicomponent (MULTI) exercise program incorporating balance, functional, and strength training activities (twice weekly, group- and home-based), for 12 months. The primary outcome is gait variability under dual-task at 12 months. At 12 months, the DE group has significant improvements compared with MULTI group on gait under both dual-task (adjusted β for stride variability: -2.3, 95%CI, -3.1 to -1.4; p < 0.001) and single-task, and on a variety of secondary physical and cognitive/executive function outcomes. The adjusted hazard ratio for falls is 0.58 (95%CI, 0.37 to 0.93) for the DE group compared with MULTI group. In conclusion, DE exercise is more effective than MULTI exercise in improving physical and cognitive function and reducing falls in older adults. The mechanisms underlying DE exercise-induced benefits remain to be fully elucidated.
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Affiliation(s)
- Mélany Hars
- Division of Bone Diseases, Department of Medicine, Geneva University Hospitals and Faculty of Medicine, Geneva, 1205, Switzerland
- Division of Geriatrics and Rehabilitation, Department of Rehabilitation and Geriatrics, Geneva University Hospitals and Faculty of Medicine, Geneva, 1226, Switzerland
| | - Natalia Fernandez
- Laboratory for Behavioral Neurology and Imaging of Cognition, Department of Neuroscience, Faculty of Medicine, University of Geneva, Geneva, 1205, Switzerland
| | - François Herrmann
- Division of Geriatrics and Rehabilitation, Department of Rehabilitation and Geriatrics, Geneva University Hospitals and Faculty of Medicine, Geneva, 1226, Switzerland
| | - René Rizzoli
- Division of Bone Diseases, Department of Medicine, Geneva University Hospitals and Faculty of Medicine, Geneva, 1205, Switzerland
| | - Serge Ferrari
- Division of Bone Diseases, Department of Medicine, Geneva University Hospitals and Faculty of Medicine, Geneva, 1205, Switzerland
| | - Christophe Graf
- Division of Geriatrics and Rehabilitation, Department of Rehabilitation and Geriatrics, Geneva University Hospitals and Faculty of Medicine, Geneva, 1226, Switzerland
| | - Patrik Vuilleumier
- Laboratory for Behavioral Neurology and Imaging of Cognition, Department of Neuroscience, Faculty of Medicine, University of Geneva, Geneva, 1205, Switzerland
| | - Andrea Trombetti
- Division of Bone Diseases, Department of Medicine, Geneva University Hospitals and Faculty of Medicine, Geneva, 1205, Switzerland
- Division of Geriatrics and Rehabilitation, Department of Rehabilitation and Geriatrics, Geneva University Hospitals and Faculty of Medicine, Geneva, 1226, Switzerland
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11
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Scarmagnan GS, Lino TB, Pimentel DE, Silva AVB, da Silva Ramos IM, Christofoletti G. Benefits of a Dual-Task Training on Motor and Cognitive Functions in Community-Dwelling Older Adults: A Controlled Clinical Trial. Am J Phys Med Rehabil 2024; 103:377-383. [PMID: 37903601 DOI: 10.1097/phm.0000000000002352] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2023]
Abstract
OBJECTIVE The aim of the study is to verify the effects of a 3-mo dual-task training on motor and cognitive functions in community-dwelling older adults. DESIGN In this prospective, single-blinded, controlled clinical trial, a total of 40 participants were allocated to either the experimental or the control (no-exercise) group. The intervention program consisted of a combination of motor and cognitive exercises conducted twice a week on nonconsecutive days. The main outcome measures were postural stability, mobility, fear of falling, and cognitive functions. Multiple analyses of variance were used to assess the impact of the dual-task training. Effect sizes (η 2 p) were reported. Significance was set at 5%. RESULTS Compared with the control group, participants who underwent the dual-task training showed positive outcomes in terms of postural stability (η 2 p = 0.298, P = 0.020), mobility (η 2 p = 0.285, P = 0.003), and cognitive functions (η 2 p = 0.536, P = 0.001). No significant differences were observed between the groups in terms of the fear of falling ( P = 0.566). CONCLUSIONS Three-month dual-task training was beneficial for postural control, mobility, and cognitive functions in community-dwelling older adults. Based on the present findings, healthcare professionals should consider incorporating dual-task training into clinical practice.
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Affiliation(s)
- Gabriella Simões Scarmagnan
- From the Faculty of Medicine, Universidade Federal de Mato Grosso do Sul, Campo Grande, Brazil (GSS, TBL, GC); and Institute of Health, Universidade Federal de Mato Grosso do Sul, Campo Grande, Brazil (DEP, AVBS, IMSR, GC)
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12
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Domingos J, Dean J, Fernandes JB, Família C, Fernandes S, Godinho C. Exploring barriers and educational needs in implementing dual-task training for Parkinson's disease: insights from professionals. Front Med (Lausanne) 2024; 11:1325978. [PMID: 38646555 PMCID: PMC11032016 DOI: 10.3389/fmed.2024.1325978] [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: 10/25/2023] [Accepted: 03/25/2024] [Indexed: 04/23/2024] Open
Abstract
Introduction There is growing evidence suggesting that dual-task training benefits people with Parkinson's disease (PD) on both physical and cognitive outcomes. However, there is no known data regarding professionals' educational needs and barriers to its implementation. This study aimed to explore the barriers and educational needs of healthcare and exercise professionals to integrate dual-task training into their practice with people with PD. Methods We conducted a study based on a web survey. Social media channels were used to recruit a convenience sample of exercise and healthcare professionals working with people with PD. Results Of the 185 eligible responses, the majority were physiotherapists (68.1%) followed by occupational therapists (10.8%). Most participants attended Parkinson specific training (88.6%) and employed the treatments set up in individual one on-one sessions (58.9%). We identified several barriers to dual-task training implementation, with lack of time (to prepare materials), staying creative and/ or accessing new ideas, unreliable tools for measuring gains, and insufficient expertise as the most referred by participants. The educational needs most referred included accessing examples of interventions in general, knowing what strategies to apply and their application for people with different symptoms. Discussion Our results highlight that professionals remain challenged to integrate dualtask training into PD clinical care mainly due to knowledge gaps, difficulties in accessing new ideas, and lack of time.
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Affiliation(s)
- Josefa Domingos
- Radboud University Medical Centre, Donders Institute for Brain, Cognition and Behaviour, Department of Neurology, Center of Expertise for Parkinson and Movement Disorders, Nijmegen, Netherlands
- Egas Moniz Center for Interdisciplinary Research (CiiEM), Egas Moniz School of Health & Science, Almada, Portugal
| | - John Dean
- Triad Health, Aurora, CO, United States
| | - Júlio Belo Fernandes
- Egas Moniz Center for Interdisciplinary Research (CiiEM), Egas Moniz School of Health & Science, Almada, Portugal
- Nurs* Lab, Almada, Portugal
| | - Carlos Família
- Egas Moniz Center for Interdisciplinary Research (CiiEM), Egas Moniz School of Health & Science, Almada, Portugal
- Molecular Pathology and Forensic Biochemistry Laboratory (MPFBL), Caparica, Portugal
| | - Sónia Fernandes
- Egas Moniz Center for Interdisciplinary Research (CiiEM), Egas Moniz School of Health & Science, Almada, Portugal
- Nurs* Lab, Almada, Portugal
| | - Catarina Godinho
- Egas Moniz Center for Interdisciplinary Research (CiiEM), Egas Moniz School of Health & Science, Almada, Portugal
- Nurs* Lab, Almada, Portugal
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13
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Uysal İ, Özden F, Tümtürk İ, İmerci A. The effectiveness of dual task exercise training on balance, mobility, physical performance, and quality of life in children with cerebral palsy: a single-blind randomized controlled trial. Ir J Med Sci 2024; 193:813-821. [PMID: 37777679 DOI: 10.1007/s11845-023-03530-3] [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: 09/04/2023] [Accepted: 09/12/2023] [Indexed: 10/02/2023]
Abstract
BACKGROUND Most activities of daily living require more than one activity, including motor-motor or motor-cognitive task. Few studies have investigated the effects of dual-task training in children with cerebral palsy (CP). AIMS This study was aimed at investigating the effectiveness of motor-cognitive dual-task exercise training in children with cerebral palsy (CP). METHODS A single-blind randomized controlled trial was conducted with thirty children with CP. Participants were randomized into dual group training group (DTG) and control group (CG). Children were evaluated before the intervention and after 12 weeks of treatment with Gross Motor Function Classification Scale (GMFCS), Pediatric Berg Balance Test (PBBS), Single Leg Stance Test (SLST), Timed Up and Go Test (TUG), 3 Meter Backwards Walk Test (3-MBWT), 6 Meter Walk Test (6-MWT), and General Children's Quality of Life Measure (KINDL). RESULTS DTG demonstrated significantly improved all KINDL scores (p < 0.01). In comparisons between groups adjusted analysis, results showed a better improvement of all KINDL scores in-favor-of DTG (p < 0.01). Significant improvements were found in all SLST scores and PBS in DTG (p < 0.01). Adjusted analysis results proved there was a significant improvement in all balance scores on behalf of DTG (p < 0.01). Significant improvement was observed in DTG for TUG, 3MBWT, and 6MWT scores (p = 0.001). An improvement in-favor-of DTG was found for all performance tests in the adjusted analysis (p < 0.001). CONCLUSION The results of this randomized controlled trial highlighted the advantage of dual-task training on balance, physical performance, and quality of life in children with CP.
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Affiliation(s)
- İsmail Uysal
- Fethiye Vocational School of Health Services, Department of Health Care Services, Muğla Sıtkı Koçman University, Muğla, Turkey.
| | - Fatih Özden
- Department of Health Care Services, Köyceğiz Vocational School of Health Services, Muğla Sıtkı Koçman University, Muğla, Turkey
| | - İsmet Tümtürk
- Department of Physiotherapy and Rehabilitation, Institute of Health Sciences, Süleyman Demirel University, Isparta, Turkey
| | - Ahmet İmerci
- Faculty of Medicine, Department of Orthopaedics and Traumatology, Muğla Sıtkı Koçman University, Muğla, Turkey
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Ager AL, Cools AM, Borms D, Roy JS. How does a motor or cognitive dual-task affect our sense of upper limb proprioception? PLoS One 2024; 19:e0299856. [PMID: 38507455 PMCID: PMC10954121 DOI: 10.1371/journal.pone.0299856] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2023] [Accepted: 02/15/2024] [Indexed: 03/22/2024] Open
Abstract
BACKGROUND Daily upper limb activities require multitasking and our division of attention. How we allocate our attention can be studied using dual-task interference (DTi). Given the vital role proprioception plays in movement planning and motor control, it is important to investigate how conscious upper limb proprioception is impacted by DTi through cognitive and motor interference. PURPOSE To examine how dual-task interference impacts conscious upper limb proprioception during active joint repositioning tasks (AJRT). METHODS Forty-two healthy participants, aged between 18 and 35, took part in this cross-sectional study. Participants completed two AJRT during three conditions: baseline (single task), dual-cognitive task (serial subtractions), and dual-motor task (non-dominant hand movements). The proprioceptive error (PE; difference between their estimation and targeted position) was measured using an AJRT of 75% and 90% of maximum internal rotation using the Biodex System IIITM and the Upper Limb Proprioception Reaching Test (PRO-Reach). To determine if PEs differed during dual-task interference, interference change scores from baseline were used with one sample t-tests and analyses of variance. RESULTS The overall mean PE with the Biodex was 4.1° ± 1.9 at baseline. Mean change scores from baseline reflect a mean improvement of 1.5° ± 1.0 (p < .001) during dual-cognitive task and of 1.5° ± 1.2 (p < .001) during dual-motor task. The overall mean PE with the PRO-Reach was 4.4cm ± 1.1 at baseline. Mean change scores from baseline reflect a mean worsening of 1.0cm ± 1.1 (p < .001) during dual-cognitive task and improvement of 0.8cm ± 0.6 (p < .001) during dual-motor task. Analysis of variance with the Biodex PEs revealed an interference effect (p < .001), with the cognitive condition causing greater PEs compared to the motor condition and a criterion position effect (p = .006), where 75% of maximum IR produced larger PEs during both interference conditions. An interference effect (p = .022) with the PRO-Reach PEs was found highlighting a difference between the cognitive and motor conditions, with decreased PEs during the contralateral motor task. CONCLUSION Interference tasks did impact proprioception. Cognitive interference produced mixed results, whereas improved proprioception was seen during motor interference. Individual task prioritization strategies are possible, where each person may choose their own attention strategy when faced with dual-task interference.
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Affiliation(s)
- Amanda L. Ager
- Center for Interdisciplinary Research in Rehabilitation and Social Integration (CIRRIS), Quebec City, Quebec, Canada
- Department of Rehabilitation Sciences and Physiotherapy, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | - Ann M. Cools
- Department of Rehabilitation Sciences and Physiotherapy, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | - Dorien Borms
- Department of Rehabilitation Sciences and Physiotherapy, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
- Department of Human Structure and Repair, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | - Jean-Sébastien Roy
- Center for Interdisciplinary Research in Rehabilitation and Social Integration (CIRRIS), Quebec City, Quebec, Canada
- School of Rehabilitation Sciences, Faculty of Medicine, Université Laval, Quebec City, Quebec, Canada
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15
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Chow GCC, Ha SCW. Positive skill transfer in balance and speed control from balance bike to pedal bike in adults: A multiphase intervention study. PLoS One 2024; 19:e0298142. [PMID: 38422110 PMCID: PMC10903920 DOI: 10.1371/journal.pone.0298142] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Accepted: 01/17/2024] [Indexed: 03/02/2024] Open
Abstract
BACKGROUND Learning to cycle can be challenging for adults who did not acquire the necessary skills during childhood. Balance bikes have been used to teach children how to cycle, but it was unclear whether this approach could also be effective for adults. PURPOSE To address this, a multi-phase intervention study was conducted to investigate whether healthy adults could be taught to cycle independently through the use of a balance bike. METHODS In Phase 1, a case-control observational study was conducted in which 13 cyclists and 8 non-cyclists completed balance bike tests. Based on the findings, an 8-session intervention pre- and post-test study was conducted in Phase 2, using an 8 × 20-minute balance bike training programme to improve cycling postural stability and control. Another 11 non-cyclists completed the novel programme. The time taken to complete the balance bike tests was compared before and after the program, while their cycling confidence was recorded in each session. To assess the effectiveness of the programme, participants were invited to cycle on a pedal bike to evaluate their ability to cycle independently. RESULTS The results in Phase 1 showed that cyclists performed better on the balance bike than non-cyclists, with Bayes factor analyses providing evidence of this difference, BF01 = 0.228 in the 15 m sprint test and BF01 = 0.138 in the two-turn curved sprint test. The novel training programme in Phase 2 demonstrated remarkable effectiveness in improving their balance bike riding performance, as evidenced by the Bayes factor for completion times in the repeated measures being BF01 < 0.001. All participants were able to cycle independently with confidence after the programme. CONCLUSIONS This study sheds light on the idea that it's never too late for adults to learn how to ride a bike. It provides evidence that healthy adults can learn to ride independently with the help of a balance bike, a tool that's commonly used for teaching children. The study identifies five key principles for effective balance bike training in adults, including focusing on riding speed, gliding to turn, building cycling confidence, engaging high motor skills, and using a dual-task approach. Our evidence-based training programme offers a safe, enjoyable, and effective way for adults to develop the skills and confidence they need to ride, even if they've never ridden before.
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Affiliation(s)
- Gary C. C. Chow
- Department of Health and Physical Education, The Education University of Hong Kong, Ting Kok, Hong Kong
| | - Sophia C. W. Ha
- Department of Health and Physical Education, The Education University of Hong Kong, Ting Kok, Hong Kong
- School of Health and Sports Science, Regent College London, London, United Kingdom
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Zhao P, Ma K, Ji Z, Jiang G. Effects of Task Interference on Kinematics and Dual-Task Cost of Running in Early Childhood. SENSORS (BASEL, SWITZERLAND) 2024; 24:1534. [PMID: 38475070 PMCID: PMC11154332 DOI: 10.3390/s24051534] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/06/2024] [Revised: 02/21/2024] [Accepted: 02/26/2024] [Indexed: 03/14/2024]
Abstract
Children aged 3-8 are in a critical period for motor development and postural control. Running is a basic motor skill that children need to master in early childhood. While running, children are prone to dangerous events such as falls. This study investigates the kinematic characteristics of running by children associated with different interference tasks, i.e., normalized running, cognitive dual-tasks, and obstacle crossing tasks, and provides a theoretical foundation for the interference mechanism of children's dynamic postural control and for screening of motor disorders. Two hundred children aged 3-8 were recruited. The BTS Bioengineering infrared motion capture system was used to collect spatiotemporal and kinematic running data under three tasks. Repeated measures of variance analysis were used to compare the effects of different interference tasks and ages on children's running signs. The main and interaction effect tests were compared by the Bonferroni method. The results and conclusions are as follows: (1) Running characteristics of early childhood are influenced by interference tasks and age. With interference tasks, the overall characteristics of running by children aged 3-8 showed an increasing trend in running cycle time and a decreasing trend in stride length, step length, cadence, and speed. (2) Both cognitive and obstacle crossing tasks had costs, and cognitive task costs were greater than obstacle crossing costs. Children adopted a "task first" running strategy with different interference tasks. When facing cognitive tasks, their overall joint motion decreased, and they reduced joint motions to promote task completion. When facing obstacle crossing tasks, because of the characteristics of the task itself, children increased joint motions to cope with interference. (3) In terms of age, the running characteristics showed a nonlinear development trend in various indicators, with a degree of recurrence and high variability in adjacent age groups. (4) The dual-task interference paradigm of "postural-cognition" can be used as a motor intervention tool to promote the development of basic motor skills in early childhood.
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Affiliation(s)
- Panchao Zhao
- Department of Physical Education, China University of Geosciences (Beijing), Beijing 100083, China;
- College of P.E. and Sports, Beijing Normal University, Beijing 100875, China; (Z.J.); (G.J.)
| | - Kai Ma
- Department of Physical Education, China University of Geosciences (Beijing), Beijing 100083, China;
| | - Zhongqiu Ji
- College of P.E. and Sports, Beijing Normal University, Beijing 100875, China; (Z.J.); (G.J.)
| | - Guiping Jiang
- College of P.E. and Sports, Beijing Normal University, Beijing 100875, China; (Z.J.); (G.J.)
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Tramontano M, Argento O, Orejel Bustos AS, DE Angelis S, Montemurro R, Bossa M, Belluscio V, Bergamini E, Vannozzi G, Nocentini U. Cognitive-motor dual-task training improves dynamic stability during straight and curved gait in patients with multiple sclerosis: a randomized controlled trial. Eur J Phys Rehabil Med 2024; 60:27-36. [PMID: 37997324 DOI: 10.23736/s1973-9087.23.08156-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2023]
Abstract
BACKGROUND Multiple Sclerosis (MS) is a chronic inflammatory, demyelinating, degenerative disease of the central nervous system and the second most frequent cause of permanent disability in young adults. One of the most common issues concerns the ability to perform postural and gait tasks while simultaneously completing a cognitive task (namely, dual-task DT). AIM Assessing cognitive-motor dual-task training effectiveness in patients with Multiple Sclerosis (PwMS) for dynamic gait quality when walking on straight, curved, and blindfolded paths. DESIGN Two-arm single-blind randomized controlled trial. Follow-up at 8 weeks. SETTING Neurorehabilitation Hospital. POPULATION A sample of 42 PwMS aged 28-71, with a score of 4.00±1.52 on the Expanded Disability Status Scale were recruited. METHODS Participants were randomized in conventional (CTg) neurorehabilitation and dual-task training (DTg) groups and received 12 sessions, 3 days/week/4 weeks. They were assessed at baseline (T0), after the treatment (T1), and 8 weeks after the end of the treatment (T2) through Mini-BESTest, Tinetti Performance Oriented Mobility Assessment, Modified Barthel Index, and a set of spatiotemporal parameters and gait quality indices related to stability, symmetry, and smoothness of gait extracted from initial measurement units (IMUs) data during the execution of the 10-meter Walk Test (10mWT), the Figure-of-8 Walk Test (Fo8WT) and the Fukuda Stepping Test (FST). RESULTS Thirty-one PwMS completed the trial at T2. Significant improvement within subjects was found in Mini-BESTest scores for DTg from T0 to T1. The IMU-based assessment indicated significant differences in stability (P<0.01) and smoothness (P<0.05) measures between CTg and DTg during 10mWT and Fo8WT. Substantial improvements (P<0.017) were also found in the inter-session comparison, primarily for DTg, particularly for stability, symmetry, and smoothness measures. CONCLUSIONS This study supports the effectiveness of DT in promoting dynamic motor abilities in PwMS. CLINICAL REHABILITATION IMPACT Cognitive-motor DT implemented into the neurorehabilitation conventional program could be a useful strategy for gait and balance rehabilitation.
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Affiliation(s)
- Marco Tramontano
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy -
- Unit of Occupational Medicine, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy -
| | - Ornella Argento
- Santa Lucia Foundation, Scientific Institute for Research and Health Care, Rome, Italy
| | - Amaranta S Orejel Bustos
- Santa Lucia Foundation, Scientific Institute for Research and Health Care, Rome, Italy
- Department of Movement, Human and Health Sciences, University of Rome "Foro Italico", Rome, Italy
| | - Sara DE Angelis
- Santa Lucia Foundation, Scientific Institute for Research and Health Care, Rome, Italy
| | - Rebecca Montemurro
- Santa Lucia Foundation, Scientific Institute for Research and Health Care, Rome, Italy
| | - Michela Bossa
- Santa Lucia Foundation, Scientific Institute for Research and Health Care, Rome, Italy
| | - Valeria Belluscio
- Santa Lucia Foundation, Scientific Institute for Research and Health Care, Rome, Italy
- Department of Movement, Human and Health Sciences, University of Rome "Foro Italico", Rome, Italy
| | - Elena Bergamini
- Santa Lucia Foundation, Scientific Institute for Research and Health Care, Rome, Italy
- Department of Movement, Human and Health Sciences, University of Rome "Foro Italico", Rome, Italy
| | - Giuseppe Vannozzi
- Santa Lucia Foundation, Scientific Institute for Research and Health Care, Rome, Italy
- Department of Movement, Human and Health Sciences, University of Rome "Foro Italico", Rome, Italy
| | - Ugo Nocentini
- Santa Lucia Foundation, Scientific Institute for Research and Health Care, Rome, Italy
- Department of Clinical Sciences and Translational Medicine, University of Rome Tor Vergata, Rome, Italy
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Salihu AT, Hill KD, Jaberzadeh S. Age and Type of Task-Based Impact of Mental Fatigue on Balance: Systematic Review and Meta-Analysis. J Mot Behav 2024; 56:373-391. [PMID: 38189442 DOI: 10.1080/00222895.2023.2299706] [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: 04/03/2023] [Accepted: 12/21/2023] [Indexed: 01/09/2024]
Abstract
The role of cognition in balance control suggests that mental fatigue may negatively affect balance. However, cognitive involvement in balance control varies with the type or difficulty of the balance task and age. Steady-state balance tasks, such as quiet standing, are well-learned tasks executed automatically through reflex activities controlled by the brainstem and spinal cord. In contrast, novel, and challenging balance tasks, such as proactively controlling balance while walking over rugged terrain or reacting to unexpected external perturbations, may require cognitive processing. Furthermore, individuals with preexisting balance impairments due to aging or pathology may rely on cognitive processes to control balance in most circumstances. This systematic review and meta-analysis investigated the effect of mental fatigue on different types of balance control tasks in young and older adults. A literature search was conducted in seven electronic databases and 12 studies met eligibility criteria. The results indicated that mental fatigue had a negative impact on both proactive (under increased cognitive load) and reactive balance in young adults. In older adults, mental fatigue affected steady-state and proactive balance. Therefore, mentally fatigued older individuals may be at increased risk of a loss of balance during steady-state balance task compared to their younger counterparts.
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Affiliation(s)
- Abubakar Tijjani Salihu
- Monash Neuromodulation Research Unit, Department of Physiotherapy, School of Primary and Allied Health Care, Faculty of Medicine, Nursing and Health Science, Monash University, Melbourne, Victoria, Australia
| | - Keith D Hill
- Rehabilitation, Ageing and Independent Living (RAIL) Research Centre, School of Primary and Allied Health Care, Monash University, Frankston, Victoria, Australia
| | - Shapour Jaberzadeh
- Monash Neuromodulation Research Unit, Department of Physiotherapy, School of Primary and Allied Health Care, Faculty of Medicine, Nursing and Health Science, Monash University, Melbourne, Victoria, Australia
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Ghai S, Ghai I. Floor-hugging Intervention: A Perspective on Floor Exposure and After-Fall Contingency Intervention. ADVANCES IN REHABILITATION SCIENCE AND PRACTICE 2024; 13:27536351241271548. [PMID: 39184216 PMCID: PMC11342326 DOI: 10.1177/27536351241271548] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 05/15/2024] [Accepted: 07/01/2024] [Indexed: 08/27/2024]
Abstract
The fear of falling is a pressing public health issue, yet current interventions often fall short in addressing it effectively. As a result, there is a need for innovative interventions that go beyond symptom relief to address the underlying causes. From this standpoint, we propose that limited exposure to floors and a lack of post-fall contingencies may contribute to the uncertainty that amplifies the fear of falling, particularly in fall prone populations. We explore the theoretical underpinnings of this hypothesis and propose a framework based on the Uncertainty and Anticipation model to elucidate potential connections. Building upon this, we introduce the Floor-hugging intervention-a two-part strategy designed to confront these challenges. Firstly, we propose gradual exposure to different floor scenarios through guided imagery to diminish fear by familiarizing individuals with such situations. Secondly, we advocate for the adoption of evidence-based ways to get up from the floor for developing after fall contingencies. We delve into the theoretical framework supporting our approach and its potential to reduce the fear of falling while improving physical, social, and psychological well-being. Additionally, we outline prospective outcome measures to comprehensively assess the impact of the intervention across biopsychosocial domains. This perspective aims to stimulate discussion on the potential role of floor exposure and post-fall strategies in reducing the fear of falling, while also advocating for innovative interventions to empower and protect fall-prone populations.
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Affiliation(s)
- Shashank Ghai
- Department of Political, Historical, Religious and Cultural Studies, Karlstad University, Karlstad, Sweden
- Centre for Societal Risk Research, Karlstad University, Karlstad, Sweden
| | - Ishan Ghai
- School of Life Sciences, Jacobs University Bremen, Bremen, Germany
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20
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Rieger MM, Papegaaij S, Steenbrink F, van Dieën JH, Pijnappels M. Effects of Perturbation-Based Treadmill Training on Balance Performance, Daily Life Gait, and Falls in Older Adults: REACT Randomized Controlled Trial. Phys Ther 2024; 104:pzad136. [PMID: 37805994 PMCID: PMC10802992 DOI: 10.1093/ptj/pzad136] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2023] [Revised: 06/01/2023] [Accepted: 08/04/2023] [Indexed: 10/10/2023]
Abstract
OBJECTIVE The aim of this study was to evaluate the effect of perturbation-based treadmill training on gait quality in daily life, a predictor of fall risk that was used as the primary outcome. An additional aim was to evaluate the effects on secondary outcomes, including balance, gait performance, self-efficacy, daily life physical activity, and falls. METHODS Seventy community-dwelling older adults (mean age = 74.73 [SD = 5.69] years; 46 women) at risk of falling were randomized and received 4 weeks of dual-task treadmill training, either with or without treadmill perturbations. Balance, gait performance, self-efficacy, and daily life trunk accelerometry at baseline, after intervention, and at a 6-month follow-up were assessed and compared within group over time and between groups for each time point, and their change rates between groups over time were also assessed. RESULTS Both groups improved in their balance, gait performance, and self-efficacy; the experimental group showed a significantly larger decrease in concern of falling and an increase in physical performance than the controls. These training effects did not translate into significant improvements in daily life gait quality or physical activity. However, the number of daily life falls and the percentage of fallers decreased significantly more in the experimental group. CONCLUSION A 4-week perturbation-based dual-task treadmill training program can improve self-efficacy, balance, and gait performance in a controlled setting and reduce daily life falls, although not through changes in quantity or quality of daily life gait. IMPACT Perturbation-based treadmill training is a safe and efficient way to train older adults' balance recovery and gait performance, increase self-efficacy, and prevent falls.
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Affiliation(s)
- Markus M Rieger
- Department of Human Movement Sciences, Amsterdam Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Motek Medical B.V., Houten, Amsterdam, The Netherlands
| | | | | | - Jaap H van Dieën
- Department of Human Movement Sciences, Amsterdam Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Mirjam Pijnappels
- Department of Human Movement Sciences, Amsterdam Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
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de Rond V, D'Cruz N, Hulzinga F, McCrum C, Verschueren S, de Xivry JJO, Nieuwboer A. Neural correlates of weight-shift training in older adults: a randomized controlled study. Sci Rep 2023; 13:19609. [PMID: 37949995 PMCID: PMC10638445 DOI: 10.1038/s41598-023-46645-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Accepted: 11/03/2023] [Indexed: 11/12/2023] Open
Abstract
Mediolateral weight-shifting is an important aspect of postural control. As it is currently unknown whether a short training session of mediolateral weight-shifting in a virtual reality (VR) environment can improve weight-shifting, we investigated this question and also probed the impact of practice on brain activity. Forty healthy older adults were randomly allocated to a training (EXP, n = 20, age = 70.80 (65-77), 9 females) or a control group (CTR, n = 20, age = 71.65 (65-82), 10 females). The EXP performed a 25-min weight-shift training in a VR-game, whereas the CTR rested for the same period. Weight-shifting speed in both single- (ST) and dual-task (DT) conditions was determined before, directly after, and 24 h after intervention. Functional Near-Infrared Spectroscopy (fNIRS) assessed the oxygenated hemoglobin (HbO2) levels in five cortical regions of interest. Weight-shifting in both ST and DT conditions improved in EXP but not in CTR, and these gains were retained after 24 h. Effects transferred to wider limits of stability post-training in EXP versus CTR. HbO2 levels in the left supplementary motor area were significantly increased directly after training in EXP during ST (change < SEM), and in the left somatosensory cortex during DT (change > SEM). We interpret these changes in the motor coordination and sensorimotor integration areas of the cortex as possibly learning-related.
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Affiliation(s)
- Veerle de Rond
- Neuromotor Rehabilitation Research Group, Department of Rehabilitation Sciences, KU Leuven, Leuven, Belgium
| | - Nicholas D'Cruz
- Neuromotor Rehabilitation Research Group, Department of Rehabilitation Sciences, KU Leuven, Leuven, Belgium
- Motor Control and Neuroplasticity Research Group, Department of Kinesiology, KU Leuven, Leuven, Belgium
| | - Femke Hulzinga
- Neuromotor Rehabilitation Research Group, Department of Rehabilitation Sciences, KU Leuven, Leuven, Belgium
| | - Christopher McCrum
- Neuromotor Rehabilitation Research Group, Department of Rehabilitation Sciences, KU Leuven, Leuven, Belgium
- Department of Nutrition and Movement Sciences, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University, Maastricht, The Netherlands
| | - Sabine Verschueren
- Research Group for Musculoskeletal Rehabilitation, Department of Kinesiology, KU Leuven, Leuven, Belgium
| | - Jean-Jacques Orban de Xivry
- Motor Control and Neuroplasticity Research Group, Department of Kinesiology, KU Leuven, Leuven, Belgium
- Leuven Brain Institute (LBI), Leuven, Belgium
| | - Alice Nieuwboer
- Neuromotor Rehabilitation Research Group, Department of Rehabilitation Sciences, KU Leuven, Leuven, Belgium.
- Leuven Brain Institute (LBI), Leuven, Belgium.
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22
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Bazzi H, Cacace AT. Altered gait parameters in distracted walking: a bio-evolutionary and prognostic health perspective on passive listening and active responding during cell phone use. Front Integr Neurosci 2023; 17:1135495. [PMID: 38027460 PMCID: PMC10668124 DOI: 10.3389/fnint.2023.1135495] [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: 12/31/2022] [Accepted: 08/21/2023] [Indexed: 12/01/2023] Open
Abstract
The underpinnings of bipedal gait are reviewed from an evolutionary biology and prognostic health perspective to better understand issues and concerns related to cell phone use during ambulation and under conditions of distraction and interference. We also consider gait-related health issues associated with the fear of or risk of falling and include prognostic dimensions associated with cognitive decline, dementia, and mortality. Data were acquired on 21 healthy young adults without hearing loss, vestibular, balance, otological or neurological dysfunction using a computerized walkway (GAITRite® Walkway System) combined with specialized software algorithms to extract gait parameters. Four experimental conditions and seven temporo-spatial gait parameters were studied: gait velocity, cadence, stride length, ambulatory time, single-support time, double-support time, and step count. Significant main effects were observed for ambulation time, velocity, stride velocity, and double-support time. The greatest impact of distraction and interference occurred during the texting condition, although other significant effects occurred when participants were verbally responding to queries and passively listening to a story. These experimental observations show that relatively simple distraction and interference tasks implemented through the auditory sensory modality can induce significant perturbations in gait while individuals were ambulating and using a cell phone. Herein, emphasis is placed on the use of quantifiable gait parameters in medical, psychological, and audiological examinations to serve as a foundation for identifying and potentially averting gait-related disturbances.
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Affiliation(s)
- Hassan Bazzi
- Department of Biological Sciences, Wayne State University, Detroit, MI, United States
| | - Anthony T. Cacace
- Department of Communication Sciences and Disorders, Wayne State University, Detroit, MI, United States
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23
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Sax van der Weyden MN, Kearney JW, Cortes N, Fernandes O, Martin JR. Common law enforcement load carriage systems have limited acute effects on postural stability and muscle activity. APPLIED ERGONOMICS 2023; 113:104091. [PMID: 37437354 DOI: 10.1016/j.apergo.2023.104091] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Revised: 07/01/2023] [Accepted: 07/06/2023] [Indexed: 07/14/2023]
Abstract
Law enforcement officers are inherently at a high risk of injury and the loads they must carry during their occupational duties further increase their injury risk. It is unknown how different methods of carrying a law enforcement officer's load influence factors related to injury risk. This study assessed the effects of common law enforcement load carriage systems on muscular activity and postural stability while standing. Twenty-four participants performed single and dual-task (i.e. concurrent performance of cognitive tasks) standing while wearing a duty belt, tactical vest, and no load. The postural stability and muscle activity were measured and effects of condition and task examined. Dual task standing decreased postural stability and increased muscular activity. The belt and vest (7.2 kg each) increased muscle activity compared to control for the right abdominals, low back, right thigh. The duty belt resulted in less muscle activity in the right abdominals but more muscle activity in the left multifidus compared to the control. The findings indicate that common law enforcement load carriage systems increase muscular activity but do not affect postural stability. However, the lack of differences between the duty belt and tactical vest did not provide clear support for one load carriage system versus the other.
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Affiliation(s)
- Megan N Sax van der Weyden
- Sports Medicine Assessment Research & Testing (SMART) Laboratory, VA, USA; School of Kinesiology, George Mason University, VA, USA.
| | - James W Kearney
- Sports Medicine Assessment Research & Testing (SMART) Laboratory, VA, USA; School of Kinesiology, George Mason University, VA, USA.
| | - Nelson Cortes
- School of Sport, Rehabilitation, and Exercise Sciences, University of Essex, Essex, England, UK; Department of Bioengineering. George Mason University, VA, USA.
| | - Orlando Fernandes
- School of Science and Technology, University of Évora, Évora, Portugal.
| | - Joel R Martin
- Sports Medicine Assessment Research & Testing (SMART) Laboratory, VA, USA; School of Kinesiology, George Mason University, VA, USA.
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24
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Selim FM, Elshafey MA, El-Ayadi MM, Albeltagi DM, Ali MS. Efficacy of dual-task training on stability and function in children with ataxia after medulloblastoma resection: A randomized controlled trial. Pediatr Blood Cancer 2023; 70:e30613. [PMID: 37561355 DOI: 10.1002/pbc.30613] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Revised: 07/25/2023] [Accepted: 07/27/2023] [Indexed: 08/11/2023]
Abstract
BACKGROUND/OBJECTIVE In children, medulloblastoma (MB) is the most prevalent posterior fossa tumor. The first line of treatment is maximal safe resection. Therefore, symptoms of ataxia are commonly seen. Training the brain on balance and cognitive tasks makes balance more automatic than without cognitive tasks. The goal was to assess the effectiveness of dual-task practice on balance after MB excision in children with ataxia. METHODS Thirty children with ataxia after MB resection at Children Cancer Hospital Egypt were randomized into two equal groups. Exercises for mobility, balance, and gait training were given to both groups. The research group underwent a specific dual-task program (balance and cognitive). The program ran 3 days per week for 8 weeks. Children were evaluated before and after the treatment regimen using the Scale of Assessment and Rating of Ataxia (SARA), the HUMAC Balance System, Pediatric Balance Scale, and Functional Independent Measurement. All children's legal guardians signed an ethical agreement. RESULTS A notable improvement in balance was found in the dual group in Pediatric Balance Scale (PBS) (p = .028) and stability test (p = .0001) in favor of the study group. No discernible difference was observed in the Functional Independent Measurement score among the two groups (p = .158), although there was a statistically significant increase in both groups after treatment. CONCLUSION Dual-task program is more effective than traditional physical therapy alone in improving balance in children with ataxia after MB resection.
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Affiliation(s)
- Fatma M Selim
- Department of Physical Therapy for Pediatrics, Faculty of Physical Therapy, Cairo University, Dokki, Egypt
| | - Mohamed A Elshafey
- Department of Physical Therapy for Pediatrics, Faculty of Physical Therapy, Cairo University, Dokki, Egypt
| | - Moatasem M El-Ayadi
- Pediatric Oncology Department, National Cancer Institute, Cairo University and Children Cancer Hospital Egypt (CCHE-57357), Dokki, Egypt
| | - Doaa M Albeltagi
- Clinical Research Center, Children Cancer Hospital Egypt (CCHE-57357), Cairo, Egypt
| | - Mostafa S Ali
- Department of Physical Therapy for Pediatrics, Faculty of Physical Therapy, Cairo University, Dokki, Egypt
- Department of Physical Therapy for Pediatrics, Faculty of Physical Therapy, 6th of October University, 6th of October City, Egypt
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25
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Divandari N, Bird ML, Vakili M, Jaberzadeh S. The Association Between Cognitive Domains and Postural Balance among Healthy Older Adults: A Systematic Review of Literature and Meta-Analysis. Curr Neurol Neurosci Rep 2023; 23:681-693. [PMID: 37856048 PMCID: PMC10673728 DOI: 10.1007/s11910-023-01305-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/12/2023] [Indexed: 10/20/2023]
Abstract
PURPOSE OF REVIEW This review aims to explore which cognitive domain is more closely associated with which type of balance (static or dynamic). RESENT FINDING Based on recent reviews, inhibitory control, a part of cognition, plays a crucial role in balance performance. Previous reviews report significant links between cognition, mobility, and physical function in older adults. However, evidence regarding the relationship between cognition and balance scores remains inconclusive. The strength of association between cognition and balance appears to be domain-specific and task-specific. Executive function exhibits the strongest correlation with balance, while episodic memory shows a small link with dynamic balance. Processing speed and global cognition demonstrate moderate correlations. Additionally, there is a slight association between cognitive domains and static balance. Further research is needed to elucidate the underlying mechanisms and develop targeted interventions for managing balance-related concerns that are domain-specific and task-specific.
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Affiliation(s)
- Nahid Divandari
- Monash Neuromodulation Research Unit, Department of Physiotherapy, School of Primary and Allied Health Care, Faculty of Medicine, Nursing and Health Science, Monash University, PO Box 527, Melbourne, Frankston, VIC, 3199, Australia.
| | - Marie-Louise Bird
- School of Health Sciences, University of Tasmania, Newnham Tasmania 7248, Launceston, Australia
| | - Mahdi Vakili
- Mowbray Medical Clinic, Invermay, TAS, Australia
| | - Shapour Jaberzadeh
- Monash Neuromodulation Research Unit, Department of Physiotherapy, School of Primary and Allied Health Care, Faculty of Medicine, Nursing and Health Science, Monash University, PO Box 527, Melbourne, Frankston, VIC, 3199, Australia
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26
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Nishimoto R, Fujiwara S, Kutoku Y, Ogata T, Mihara M. Effect of dual-task interaction combining postural and visual perturbations on cortical activity and postural control ability. Neuroimage 2023; 280:120352. [PMID: 37648121 DOI: 10.1016/j.neuroimage.2023.120352] [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: 01/30/2023] [Revised: 07/27/2023] [Accepted: 08/27/2023] [Indexed: 09/01/2023] Open
Abstract
Previous studies have suggested cortical involvement in postural control in humans by measuring cortical activities and conducting dual-task paradigms. In dual-task paradigms, task performance deteriorates and can be facilitated in specific dual-task settings. Theoretical frameworks explaining these dual-task interactions have been proposed and debated for decades. Therefore, we investigated postural control performance under different visual conditions using a virtual reality system, simultaneously measuring cortical activities with a functional near-infrared spectroscopy system. Twenty-four healthy participants were included in this study. Postural stability and cortical activities after perturbations were measured under several conditions consisting of postural and visual perturbations. The results showed that concurrent visual and postural perturbations could facilitate cortical activities in the supplementary motor area and superior parietal lobe. Additionally, visual distractors deteriorated postural control ability and cortical activation of the supplementary motor area. These findings supported the theoretical framework of the "Cross talk model", in which concurrent tasks using similar neural domains can facilitate these task performances. Furthermore, it indicated that the cortical resource capacity and domains activated for information processing should be considered in experiments involving dual-task paradigms and training.
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Affiliation(s)
- Ryoki Nishimoto
- Department of Neurology, Kawasaki Medical School, Okayama 701-0192, Japan; Department of Rehabilitation Medicine, The University of Tokyo Hospital, Tokyo 113-8655, Japan
| | - Sayaka Fujiwara
- Department of Rehabilitation Medicine, The University of Tokyo Hospital, Tokyo 113-8655, Japan
| | - Yumiko Kutoku
- Department of Neurology, Kawasaki Medical School, Okayama 701-0192, Japan
| | - Toru Ogata
- Department of Rehabilitation Medicine, Graduate School of Medicine, The University of Tokyo, Tokyo 113-8655, Japan; Department of Rehabilitation Medicine, The University of Tokyo Hospital, Tokyo 113-8655, Japan
| | - Masahito Mihara
- Department of Neurology, Kawasaki Medical School, Okayama 701-0192, Japan.
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27
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Wang L, Yu G, Chen Y. Effects of dual-task training on chronic ankle instability: a systematic review and meta-analysis. BMC Musculoskelet Disord 2023; 24:814. [PMID: 37833685 PMCID: PMC10571247 DOI: 10.1186/s12891-023-06944-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Accepted: 10/07/2023] [Indexed: 10/15/2023] Open
Abstract
BACKGROUND Dual-task training has been a popular intervention for individuals with balance impairments. However, the effects of dual-task training on chronic ankle instability (CAI) have not been comprehensively analyzed and reliable clinical evidence is scarce. The purpose of this systematic review and meta-analysis is to evaluate the effectiveness of dual-task training on postural stability and functional ability in individuals with CAI. METHODS PubMed, Web of Science, EBSCO, Cochrane Library, Physiotherapy Evidence Database (PEDro), and China National Knowledge Infrastructure (CNKI) were researched from inception to November 2022. This study was conducted by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Two reviewers assessed the studies for inclusion and extracted data. The Cochrane Risk of Bias list was used to assess the risk of bias in included studies. Mean differences (MD) with a 95% confidence interval (CI) were calculated with the RevMan 5.3 software. RESULTS A total of 7 randomized controlled trials with 192 CAI met the inclusion criteria. The meta-analysis results showed that compared with the control group, dual-task training significantly improved the Y-balance test (MD = 1.60, 95% CI: -0.00 to 3.21, P = 0.050) and reduced COP-area (MD = - 0.94, 95% CI: -1.62 to - 0.26, P = 0.007) in individuals with CAI. However, there is no significant difference between dual-task training and the control group on COP-velocity (MD = - 0.26, 95% CI: -0.70 to 0.17, P = 0.240), hop test (MD = - 0.20, 95% CI: -0.66 to 0.26, P = 0.386) and BESS (MD = - 1.24, 95% CI: -2.95 to 0.48, P = 0.157) in individuals with CAI. CONCLUSION This meta-analysis showed that dual-task training may be effective in improving static and dynamic postural stability. However, more high-quality randomized controlled trials are needed to verify the short and long-term effectiveness of dual-task training on CAI.
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Affiliation(s)
- Lu Wang
- Department of Rehabilitation, Beijing Tongren Hospital, Capital Medical University, 1 Dongjiaominxiang, Beijing, 100730, China
| | - Ge Yu
- Department of Rehabilitation, Beijing Tongren Hospital, Capital Medical University, 1 Dongjiaominxiang, Beijing, 100730, China
| | - Yaping Chen
- Department of Rehabilitation, Beijing Tongren Hospital, Capital Medical University, 1 Dongjiaominxiang, Beijing, 100730, China.
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28
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Pitts J, Kannan L, Bhatt T. Cognitive Task Domain Influences Cognitive-Motor Interference during Large-Magnitude Treadmill Stance Perturbations. SENSORS (BASEL, SWITZERLAND) 2023; 23:7746. [PMID: 37765803 PMCID: PMC10534402 DOI: 10.3390/s23187746] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/01/2023] [Revised: 09/02/2023] [Accepted: 09/02/2023] [Indexed: 09/29/2023]
Abstract
Reactive balance is postulated to be attentionally demanding, although it has been underexamined in dual-tasking (DT) conditions. Further, DT studies have mainly included only one cognitive task, leaving it unknown how different cognitive domains contribute to reactive balance. This study examined how DT affected reactive responses to large-magnitude perturbations and compared cognitive-motor interference (CMI) between cognitive tasks. A total of 20 young adults aged 18-35 (40% female; 25.6 ± 3.8 y) were exposed to treadmill support surface perturbations alone (single-task (ST)) and while completing four cognitive tasks: Target, Track, Auditory Clock Test (ACT), Letter Number Sequencing (LNS). Three perturbations were delivered over 30 s in each trial. Cognitive tasks were also performed while seated and standing (ST). Compared to ST, post-perturbation MOS was lower when performing Track, and cognitive performance was reduced on the Target task during DT (p < 0.05). There was a larger decline in overall (cognitive + motor) performance from ST for both of the visuomotor tasks compared to the ACT and LNS (p < 0.05). The highest CMI was observed for visuomotor tasks; real-life visuomotor tasks could increase fall risk during daily living, especially for individuals with difficulty attending to more than one task.
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Affiliation(s)
| | | | - Tanvi Bhatt
- Department of Physical Therapy, University of Illinois at Chicago, 1919 W Taylor St., Chicago, IL 60612, USA
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29
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Patel EJ, Hum M, Gardi A, Steenerson KK, Rizk HG, Sharon JD. VM-PATHI Correlates With Cognitive Function Improvement After Successful Treatment in Patients With Vestibular Migraine. Otol Neurotol 2023; 44:813-816. [PMID: 37525385 DOI: 10.1097/mao.0000000000003976] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/02/2023]
Abstract
OBJECTIVE To assess changes in cognitive function in vestibular migraine patients undergoing treatment. STUDY DESIGN Prospective cohort. SETTING Single-institution tertiary-care center. PATIENTS Thirty-four patients with vestibular migraine were included in the study. Average age at diagnosis was 47.9 years. A majority of patients (91.2%) were female. INTERVENTIONS Vestibular therapies included pharmacologic treatment (67.6%), mindfulness-based stress reduction (58.8%), vestibular physical therapy (20.6%), and lifestyle changes only (2.9%). MAIN OUTCOME MEASURES Pretreatment and posttreatment questionnaires were collected including the Cognitive Failures Questionnaire (CFQ), Vestibular Migraine Patient Assessment Tool and Handicap Inventory (VM-PATHI), and Dizziness Handicap Inventory. RESULTS Median time between pretreatment and posttreatment questionnaire was 4.4 months (range, 2.8-15.6. mo). CFQ scores decreased in subjects who responded to treatment, as defined by those with a positive change in VM-PATHI score (average decrease, 6.5; p = 0.03). CFQ scores did not improve in subjects who had no improvement in their vestibular condition, as defined by no change or an increase in VM-PATHI score (average increase, 2.0; p = 0.53). Univariate linear regression showed that VM-PATHI score change was highly predictive of CFQ change ( p < 0.01, r2 = 0.36). Multivariate regression demonstrated that the VM-PATHI ( p = 0.03) and not the Dizziness Handicap Inventory ( p = 0.10) predicted changes in CFQ score. CONCLUSIONS Self-reported cognitive dysfunction improves with successful treatment of vestibular migraine.
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Affiliation(s)
- Evan J Patel
- Department of Otolaryngology-Head and Neck Surgery, University of California San Francisco, San Francisco
| | - Maxwell Hum
- Department of Otolaryngology-Head and Neck Surgery, University of California San Francisco, San Francisco
| | - Adam Gardi
- Department of Otolaryngology-Head and Neck Surgery, University of California San Francisco, San Francisco
| | - Kristen K Steenerson
- Department of Neurology and Neurological Sciences, Stanford University School of Medicine, Palo Alto, California
| | - Habib G Rizk
- Department of Otolaryngology-Head and Neck Surgery, Medical University of South Carolina, Charleston, South Carolina
| | - Jeffrey D Sharon
- Department of Otolaryngology-Head and Neck Surgery, University of California San Francisco, San Francisco
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Pantoja-Cardoso A, Aragão-Santos JC, Santos PDJ, Dos-Santos AC, Silva SR, Lima NBC, Vasconcelos ABS, Fortes LDS, Da Silva-Grigoletto ME. Functional Training and Dual-Task Training Improve the Executive Function of Older Women. Geriatrics (Basel) 2023; 8:83. [PMID: 37736883 PMCID: PMC10514855 DOI: 10.3390/geriatrics8050083] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Revised: 08/13/2023] [Accepted: 08/16/2023] [Indexed: 09/23/2023] Open
Abstract
Functional training (FT) is a type of multicomponent training with emphasis on activities of daily living that stimulate different physical capacities in only one session. Dual-task training (DTT) is a type of training that simultaneously applies cognitive and motor stimuli. We investigated the effects of sixteen weeks of FT and DTT and eight weeks of detraining on older women's inhibitory control, working memory, and cognitive flexibility. Sixty-two older women (66.9 ± 5.4 years; 27.7 ± 3.9 kg/m2) completed a 16-week intervention program comprising the FT (n = 31) and DTT (n = 31), and 43 returned after the detraining period. We used the Stroop Color Word Color test to evaluate inhibitory control, the Corsi Block Test to assess working memory, and the Trail Making Test to evaluate cognitive flexibility. Only DTT reduced the congruent response time between the pre-test and post-test (d= -0.64; p < 0.001), with no difference between the post-test and the detraining values (d = 1.13; p < 0.001). Both groups reduced the incongruent response time between the pre-test and post-test (FT: d = -0.61; p = 0.002; DTT: d= -0.59; p = 0.002) without a difference between groups. There were no significant differences in working memory and cognitive flexibility. Sixteen weeks of FT and DTT increased the inhibitory control of older women but not the working memory and cognitive flexibility, and these effects persisted after eight weeks of detraining.
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Affiliation(s)
- Alan Pantoja-Cardoso
- Postgraduate Program in Physical Education, Federal University of Sergipe, São Cristovao 49100-000, Brazil;
| | - Jose Carlos Aragão-Santos
- Postgraduate Program in Health Sciences, Federal University of Sergipe, São Cristovao 49100-000, Brazil; (J.C.A.-S.); (N.B.C.L.)
| | - Poliana de Jesus Santos
- Postgraduate Program in Physiological Science, Federal University of Sergipe, São Cristovao 49100-000, Brazil; (P.d.J.S.); (S.R.S.)
| | - Ana Carolina Dos-Santos
- Graduation in Physiotherapy, Federal University of Sergipe, São Cristovao 49100-000, Brazil;
| | - Salviano Resende Silva
- Postgraduate Program in Physiological Science, Federal University of Sergipe, São Cristovao 49100-000, Brazil; (P.d.J.S.); (S.R.S.)
| | - Newton Benites Carvalho Lima
- Postgraduate Program in Health Sciences, Federal University of Sergipe, São Cristovao 49100-000, Brazil; (J.C.A.-S.); (N.B.C.L.)
| | - Alan Bruno Silva Vasconcelos
- Postgraduate Program in Physiological Science, Federal University of Sergipe, São Cristovao 49100-000, Brazil; (P.d.J.S.); (S.R.S.)
| | - Leonardo de Sousa Fortes
- Associate Graduate Program in Physical Education, Federal University of Paraiba, João Pessoa 58051-900, Brazil;
| | - Marzo Edir Da Silva-Grigoletto
- Postgraduate Program in Physical Education, Federal University of Sergipe, São Cristovao 49100-000, Brazil;
- Postgraduate Program in Health Sciences, Federal University of Sergipe, São Cristovao 49100-000, Brazil; (J.C.A.-S.); (N.B.C.L.)
- Postgraduate Program in Physiological Science, Federal University of Sergipe, São Cristovao 49100-000, Brazil; (P.d.J.S.); (S.R.S.)
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31
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Salis C, Jarrar R, Murray LL. Language-Specific Dual-Task Effects After Stroke: A Systematic Review. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2023:1-26. [PMID: 37418751 DOI: 10.1044/2023_jslhr-23-00006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/09/2023]
Abstract
PURPOSE The dual-task paradigm has been frequently used to examine stroke-related deficits because it samples behavioral performance under conditions of distraction similar to functioning in real-life environments. This original systematic review synthesizes studies that examined dual-task effects involving spoken language production in adults affected by stroke, including transient ischemic attack (TIA) and poststroke aphasia. METHOD Five databases were searched (inception to March 2022) for eligible peer-reviewed articles. The 21 included studies reported a total of 561 stroke participants. Thirteen studies focused on single word production, for example, word fluency, and eight on discourse production, for example, storytelling. Most studies included participants who had suffered a major stroke. Six studies focused on aphasia, whereas no study focused on TIA. A meta-analysis was not appropriate because of the heterogeneity of outcome measures. RESULTS Some single word production studies found dual-task language effects whereas others did not. This finding was compounded by the lack of appropriate control participants. Most single word and discourse studies utilized motoric tasks in the dual-task condition. Our certainty (or confidence) assessment was based on a methodological appraisal of each study and information about reliability/fidelity. As 10 of the 21 studies included appropriate control groups and limited reliability/fidelity information, the certainty of the findings may be described as weak. CONCLUSIONS Language-specific dual-task costs were identified in single word studies, especially those that focused on aphasia as well as half of the nonaphasia studies. Unlike single word studies, nearly all studies of discourse showed dual-task decrements on at least some variables. SUPPLEMENTAL MATERIAL https://doi.org/10.23641/asha.23605311.
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Affiliation(s)
- Christos Salis
- Speech & Language Sciences, Newcastle University, Newcastle upon Tyne, United Kingdom
| | - Rawand Jarrar
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, United Kingdom
| | - Laura L Murray
- School of Communication Sciences and Disorders, Faculty of Health Sciences, Western University, London, Ontario, Canada
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32
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Sozzi S, Ghai S, Schieppati M. The 'Postural Rhythm' of the Ground Reaction Force during Upright Stance and Its Conversion to Body Sway-The Effect of Vision, Support Surface and Adaptation to Repeated Trials. Brain Sci 2023; 13:978. [PMID: 37508910 PMCID: PMC10377030 DOI: 10.3390/brainsci13070978] [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: 05/11/2023] [Revised: 06/12/2023] [Accepted: 06/18/2023] [Indexed: 07/30/2023] Open
Abstract
The ground reaction force (GRF) recorded by a platform when a person stands upright lies at the interface between the neural networks controlling stance and the body sway deduced from centre of pressure (CoP) displacement. It can be decomposed into vertical (VGRF) and horizontal (HGRF) vectors. Few studies have addressed the modulation of the GRFs by the sensory conditions and their relationship with body sway. We reconsidered the features of the GRFs oscillations in healthy young subjects (n = 24) standing for 90 s, with the aim of characterising the possible effects of vision, support surface and adaptation to repeated trials, and the correspondence between HGRF and CoP time-series. We compared the frequency spectra of these variables with eyes open or closed on solid support surface (EOS, ECS) and on foam (EOF, ECF). All stance trials were repeated in a sequence of eight. Conditions were randomised across different days. The oscillations of the VGRF, HGRF and CoP differed between each other, as per the dominant frequency of their spectra (around 4 Hz, 0.8 Hz and <0.4 Hz, respectively) featuring a low-pass filter effect from VGRF to HGRF to CoP. GRF frequencies hardly changed as a function of the experimental conditions, including adaptation. CoP frequencies diminished to <0.2 Hz when vision was available on hard support surface. Amplitudes of both GRFs and CoP oscillations decreased in the order ECF > EOF > ECS ≈ EOS. Adaptation had no effect except in ECF condition. Specific rhythms of the GRFs do not transfer to the CoP frequency, whereas the magnitude of the forces acting on the ground ultimately determines body sway. The discrepancies in the time-series of the HGRF and CoP oscillations confirm that the body's oscillation mode cannot be dictated by the inverted pendulum model in any experimental conditions. The findings emphasise the robustness of the VGRF "postural rhythm" and its correspondence with the cortical theta rhythm, shed new insight on current principles of balance control and on understanding of upright stance in healthy and elderly people as well as on injury prevention and rehabilitation.
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Affiliation(s)
| | - Shashank Ghai
- Department of Political, Historical, Religious and Cultural Studies, Karlstad University, 65188 Karlstad, Sweden
- Centre for Societal Risk Research, Karlstad University, 65188 Karlstad, Sweden
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Borji R, Fendri T, Kasmi S, Haddar E, Laatar R, Sahli S, Rebai H. Dual-Task Training Effects on the Cognitive-Motor Interference in Individuals with Intellectual Disability. J Mot Behav 2023; 55:341-353. [PMID: 37076126 DOI: 10.1080/00222895.2023.2201183] [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: 01/17/2023] [Revised: 03/16/2023] [Accepted: 04/04/2023] [Indexed: 04/21/2023]
Abstract
This study explored the effect of dual task (DT) training compared to single task (ST) training on postural and cognitive performances in DT conditions in individuals with intellectual disability (ID). Postural sways and cognitive performances were measured separately and simultaneously before and after 8 weeks in the ST training group (STTG), the DT training group (DTTG) and the control group (CG) that did not received any training. Before training, postural sways and cognitive performances were higher in the DT condition compared to ST one in all groups. After training, postural sways were higher in the DT condition compared to the ST only in the STTG and the CG. The cognitive performance increased after training only in the DTTG.
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Affiliation(s)
- Rihab Borji
- Research Laboratory: Education, Motricité, Sport et Santé, EM2S, LR19JS01, High Institute of Sport and Physical Education of Sfax, University of Sfax, Sfax, Tunisia
| | - Thoraya Fendri
- Research Laboratory: Education, Motricité, Sport et Santé, EM2S, LR19JS01, High Institute of Sport and Physical Education of Sfax, University of Sfax, Sfax, Tunisia
| | - Sofien Kasmi
- Tunisian Research Laboratory 'Sports Performance Optimization (LR09SEP01), National Center of Medicine and Science in Sports (CNMSS), Tunis, Tunisia
| | - Emna Haddar
- Research Laboratory: Education, Motricité, Sport et Santé, EM2S, LR19JS01, High Institute of Sport and Physical Education of Sfax, University of Sfax, Sfax, Tunisia
| | - Rabeb Laatar
- Research Laboratory: Education, Motricité, Sport et Santé, EM2S, LR19JS01, High Institute of Sport and Physical Education of Sfax, University of Sfax, Sfax, Tunisia
| | - Sonia Sahli
- Research Laboratory: Education, Motricité, Sport et Santé, EM2S, LR19JS01, High Institute of Sport and Physical Education of Sfax, University of Sfax, Sfax, Tunisia
| | - Haithem Rebai
- Tunisian Research Laboratory 'Sports Performance Optimization (LR09SEP01), National Center of Medicine and Science in Sports (CNMSS), Tunis, Tunisia
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Silva LWND, Moura VTGD, Leal IDS, Nascimento MDM, Trombini-Souza F. Is foot clearance influenced by different types of dual task in once-only faller community-dwelling older adults? Gait Posture 2023; 103:27-31. [PMID: 37084625 DOI: 10.1016/j.gaitpost.2023.04.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2022] [Revised: 04/01/2023] [Accepted: 04/14/2023] [Indexed: 04/23/2023]
Abstract
BACKGROUND Tripping is one of the main causes of falls in older adults and has an important association with minimum toe clearance (MTC). MTC variability while performing alternating (ADT) or concurrent (CDT) dual-task activities may be a useful gait parameter to differentiate once-only fallers from non-faller older adults. RESEARCH QUESTION Is the MTC variability influenced by ADT and CDT in once-only faller community-dwelling older adults? METHODS Twenty-two community-dwelling older adults with a self-report of up to one fall in the last 12 months were allocated to the fallers group and 38 to the non-fallers group. Gait data were collected by two foot-worn inertial sensors (Physilog® 5, GaitUp, Lausanne, Switzerland). MTC mean magnitude and variability, as well as the stride-to-stride variability, stride time and length, lower limb peak angular velocity, and foot forward linear speed at the MTC instant, were calculated across approximately 50 gait cycles for each participant and condition using the GaitUp Analyzer software (GaitUp, Lausanne, Switzerland). The statistical analyzes were performed in the Statistical Package for the Social Sciences (SPSS), v.22.0, using generalized mixed linear models, adopting an alpha of 5%. RESULTS AND SIGNIFICANCE No interaction effect was observed; however, faller participants reduced the MTC variability (standard deviation) [(mean difference, MD = -0.099 cm; confidence interval, 95%CI = -0.183 to -0.015)], regardless of the condition. CDT compared to a single task (only gait) reduced the mean magnitude of the foot forward linear speed (MD=-0.264 m/s; 95%CI=-0.462 to -0.067), peak angular velocity (MD = -25.205 degrees/s; 95%CI = -45.507 to -4.904), and gait speed (MD = -0.104 m/s; 95%CI = -0.179 to -0.029), regardless of the group. These results suggest that MTC variability, regardless of condition, may be a promising gait parameter to differentiate once-only faller community-dwelling older adults from non-fallers.
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Affiliation(s)
| | | | - Iara Dos Santos Leal
- Department of Physical Therapy, University of Pernambuco, Petrolina, PE, Brazil; Master's and Doctoral Programs in Rehabilitation and Functional Performance, University of Pernambuco, Petrolina, PE, Brazil
| | | | - Francis Trombini-Souza
- Department of Physical Therapy, University of Pernambuco, Petrolina, PE, Brazil; Master's and Doctoral Programs in Rehabilitation and Functional Performance, University of Pernambuco, Petrolina, PE, Brazil.
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Nascimento MDM, Maduro PA, Rios PMB, Nascimento LDS, Silva CN, Kliegel M, Ihle A. The Effects of 12-Week Dual-Task Physical-Cognitive Training on Gait, Balance, Lower Extremity Muscle Strength, and Cognition in Older Adult Women: A Randomized Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:ijerph20085498. [PMID: 37107780 PMCID: PMC10139030 DOI: 10.3390/ijerph20085498] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Revised: 04/04/2023] [Accepted: 04/11/2023] [Indexed: 05/11/2023]
Abstract
This study aims to investigate the effects of dual-task physical-cognitive the training on body balance (BB), gait performance (GP), lower limb muscle strength (LEMS), and cognitive performance (CP) in a group of cognitively normal older adult women (n = 44; 66.20 ± 4.05 years). Of these, 22 were randomly allocated to the dual-task training (DT) group, and 22 participated in the control group (CG). Assessments were performed at baseline, after 12 weeks of intervention, and at the end of 12 weeks of follow-up, using the following instruments: Timed Up & Go (TUG), Timed Up & Go manual (TUGm), Timed Up & Go cognitive (TUGc), Balance Test (TEC), sit-to-stand test (STS), and verbal fluency test (VF). After 12 weeks of DT training, participants showed a significant time × group interaction in all motor assessments (BB, GP, LEMS), as well as in three cognitive tests (VF-grouping, VF-exchange, VF-total). No time-group interaction effect was indicated for the VF-category test. At all evaluation times, CG members maintained constant physical and cognitive performance. We conclude that 12 weeks of physical-cognitive DT training was effective in promoting BB, GP, and LEMS, as well as CP in cognitively normal older adult women, with lasting effects up to 12 weeks after the intervention.
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Affiliation(s)
- Marcelo de Maio Nascimento
- Department of Physical Education, Federal University of Vale do São Francisco, Campus Petrolina 56304-917, Brazil
- Correspondence: ; Tel.: +55-(87)-21016856
| | - Paula Andreatta Maduro
- University Hospital of the Federal University of Vale do São Francisco, Campus Petrolina 56304-917, Brazil
| | - Pâmala Morais Bagano Rios
- Department of Psychology, Federal University of Vale do São Francisco, Campus Petrolina 56304-917, Brazil
| | - Lara dos Santos Nascimento
- Department of Physical Education, Federal University of Vale do São Francisco, Campus Petrolina 56304-917, Brazil
| | - Carolina Nascimento Silva
- Department of Psychology, Federal University of Vale do São Francisco, Campus Petrolina 56304-917, Brazil
| | - Matthias Kliegel
- Department of Psychology, University of Geneva, 1205 Geneva, Switzerland (A.I.)
- Center for the Interdisciplinary Study of Gerontology and Vulnerability, University of Geneva, 1205 Geneva, Switzerland
- Swiss National Centre of Competence in Research LIVES—Overcoming Vulnerability: Life Course Perspectives, 1015 Lausanne, Switzerland
| | - Andreas Ihle
- Department of Psychology, University of Geneva, 1205 Geneva, Switzerland (A.I.)
- Center for the Interdisciplinary Study of Gerontology and Vulnerability, University of Geneva, 1205 Geneva, Switzerland
- Swiss National Centre of Competence in Research LIVES—Overcoming Vulnerability: Life Course Perspectives, 1015 Lausanne, Switzerland
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Saraiva M, Castro MA, Vilas-Boas JP. Muscular and Prefrontal Cortex Activity during Dual-Task Performing in Young Adults. Eur J Investig Health Psychol Educ 2023; 13:736-747. [PMID: 37185908 PMCID: PMC10137896 DOI: 10.3390/ejihpe13040055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2023] [Revised: 03/24/2023] [Accepted: 03/29/2023] [Indexed: 04/03/2023] Open
Abstract
Postural control depends on attentional resources besides automatic processes. The dual-task paradigm is a possible approach to analyzing the interference and performance between motor and/or cognitive tasks. Various studies showed that, when individuals simultaneously perform two tasks, the postural stability can decline during a dual-task compared with a single-task due to the attentional resources required performing the tasks. However, little is known about the cortical and muscular activity pattern during dual-task performance. Therefore, this study aims to analyze the muscular and prefrontal activity under dual-task performance in healthy young adults. Thirty-four healthy young adults (mean age ± SD = 22.74 ± 3.74 years) were recruited to perform a postural task (standing posture) and a dual-task (maintaining standing posture while performing a cognitive task). Lower-limb muscle activity was bilaterally collected from five muscles using surface electromyography (sEMG), and the co-contraction index (CCI) was also calculated for selected muscle pairings. The oxy- and deoxyhemoglobin concentrations (prefrontal cortex activity) were recorded using functional near-infrared spectroscopy (fNIRS). Data were compared between single- and dual-task performance. Prefrontal activity increased (p < 0.05), and muscle activity decreased in most analyzed muscles (p < 0.05), from the single-task to cognitive dual-task performing. The co-contraction index patterns changed from single- to dual-task conditions in most selected muscle pairs (p < 0.05). We conclude that the cognitive task negatively interfered with motor performance once the muscle activity decreased and the prefrontal cortex activity increased under a dual-task, suggesting that young adults prioritized cognitive task performance, and they allocated more attentional resources to the cognitive task over the motor performance. Understanding the neuromotor changes can help adopt a better clinical practice to prevent injuries. However, future studies are recommended to assess and monitor muscular and cortical activity during the dual-task performance to provide additional information about the cortical and muscular activity patterns in postural control while performing a dual-task.
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Ghai S. Does Music Therapy Improve Gait after Traumatic Brain Injury and Spinal Cord Injury? A Mini Systematic Review and Meta-Analysis. Brain Sci 2023; 13:brainsci13030522. [PMID: 36979332 PMCID: PMC10046548 DOI: 10.3390/brainsci13030522] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Revised: 03/12/2023] [Accepted: 03/15/2023] [Indexed: 03/30/2023] Open
Abstract
There is a growing body of research examining the potential benefits of music therapy-based auditory stimulation (MT) for individuals with movement disorders in improving gait performance. However, there is limited knowledge about the effects of MT on gait outcomes in individuals with traumatic brain injury (TBI) or spinal cord injury (SCI). A previous review of MT's impact on gait in TBI had limitations, and there are no studies on its effects on gait in SCI. In this study, we conducted a meta-analysis to more thoroughly evaluate the impact of MT on gait outcomes in individuals with TBI and SCI. We systematically searched through eight databases and found six studies on MT in TBI and four on SCI. Our meta-analysis showed that MT has positive medium effect improvements on spatiotemporal aspects of gait in individuals with TBI (Hedge's g: 0.52) and SCI (0.53). These findings suggest that MT could be a practical intervention for enhancing different aspects of gait in these populations, although the limited number and "fair" quality of the studies included in the meta-analysis may affect the generalizability of the outcomes. Further research is needed to fully understand the mechanisms by which MT may influence gait and determine the optimal parameters for its use.
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Affiliation(s)
- Shashank Ghai
- Psychology of Learning and Instruction, Department of Psychology, School of Science, Technische Universität Dresden, 01069 Dresden, Germany
- Centre for Tactile Internet with Human-in-the-Loop (CeTI), Technische Universität Dresden, 01069 Dresden, Germany
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Tasseel-Ponche S, Roussel M, Toba MN, Sader T, Barbier V, Delafontaine A, Meynier J, Picard C, Constans JM, Schnitzler A, Godefroy O, Yelnik AP. Dual-task versus single-task gait rehabilitation after stroke: the protocol of the cognitive-motor synergy multicenter, randomized, controlled superiority trial (SYNCOMOT). Trials 2023; 24:172. [PMID: 36890548 PMCID: PMC9994785 DOI: 10.1186/s13063-023-07138-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Accepted: 02/07/2023] [Indexed: 03/10/2023] Open
Abstract
BACKGROUND Gait disorders and cognitive impairments are prime causes of disability and institutionalization after stroke. We hypothesized that relative to single-task gait rehabilitation (ST GR), cognitive-motor dual-task (DT) GR initiated at the subacute stage would be associated with greater improvements in ST and DT gait, balance, and cognitive performance, personal autonomy, disability, and quality of life in the short, medium and long terms after stroke. METHODS This multicenter (n=12), two-arm, parallel-group, randomized (1:1), controlled clinical study is a superiority trial. With p<0.05, a power of 80%, and an expected loss to follow-up rate of 10%, the inclusion of 300 patients will be required to evidence a 0.1-m.s-1 gain in gait speed. Trial will include adult patients (18-90 years) in the subacute phase (0 to 6 months after a hemispheric stroke) and who are able to walk for 10 m (with or without a technical aid). Registered physiotherapists will deliver a standardized GR program (30 min three times a week, for 4 weeks). The GR program will comprise various DTs (phasic, executive function, praxis, memory, and spatial cognition tasks during gait) in the DT (experimental) group and gait exercises only in the ST (control) group. The primary outcome measure is gait speed 6 months after inclusion. The secondary outcomes are post-stroke impairments (National Institutes of Health Stroke Scale and the motor part of the Fugl-Meyer Assessment of the lower extremity), gait speed (10-m walking test), mobility and dynamic balance (timed up-and-go test), ST and DT cognitive function (the French adaptation of the harmonization standards neuropsychological battery, and eight cognitive-motor DTs), personal autonomy (functional independence measure), restrictions in participation (structured interview and the modified Rankin score), and health-related quality of life (on a visual analog scale). These variables will be assessed immediately after the end of the protocol (probing the short-term effect), 1 month thereafter (the medium-term effect), and 5 months thereafter (the long-term effect). DISCUSSION The main study limitation is the open design. The trial will focus on a new GR program applicable at various stages after stroke and during neurological disease. TRIAL REGISTRATION NCT03009773 . Registered on January 4, 2017.
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Affiliation(s)
- Sophie Tasseel-Ponche
- Department of Physical Medicine and Rehabilitation, Amiens University Hospital, Amiens, France.
- Laboratory of Functional Neurosciences, UR UPJV 4559, Jules Verne University of Picardie, Amiens, France.
| | - Martine Roussel
- Laboratory of Functional Neurosciences, UR UPJV 4559, Jules Verne University of Picardie, Amiens, France
- Department of Neurology, Amiens University Hospital, Amiens, France
| | - Monica N Toba
- Laboratory of Functional Neurosciences, UR UPJV 4559, Jules Verne University of Picardie, Amiens, France
| | - Thibaud Sader
- Department of Physical Medicine and Rehabilitation, Amiens University Hospital, Amiens, France
| | - Vincent Barbier
- Department of Physical Medicine and Rehabilitation, Amiens University Hospital, Amiens, France
| | - Arnaud Delafontaine
- Department of Physical Medicine and Rehabilitation, Amiens University Hospital, Amiens, France
| | - Jonathan Meynier
- Clinical Research and Innovation Directorate, Amiens University Hospital, Amiens, France
| | - Carl Picard
- Clinical Research and Innovation Directorate, Amiens University Hospital, Amiens, France
| | | | - Alexis Schnitzler
- PRM Department, Hôpital Lariboisière-F.Widal AP-HP, Paris, France
- INSERM U1153 - CRESS EpiAgeing, Paris University, Hôtel-Dieu, Paris, France
| | - Olivier Godefroy
- Laboratory of Functional Neurosciences, UR UPJV 4559, Jules Verne University of Picardie, Amiens, France
- Department of Neurology, Amiens University Hospital, Amiens, France
| | - Alain Pierre Yelnik
- PRM Department, Hôpital Lariboisière-F.Widal AP-HP, Paris, France
- UMR 9010, Paris University, Centre Borelli, Paris, France
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Bruyneel AV, Reinmann A, Gafner SC, Sandoz JD, Duclos NC. Does texting while walking affect spatiotemporal gait parameters in healthy adults, older people, and persons with motor or cognitive disorders? A systematic review and meta-analysis. Gait Posture 2023; 100:284-301. [PMID: 36696854 DOI: 10.1016/j.gaitpost.2023.01.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Revised: 12/07/2022] [Accepted: 01/15/2023] [Indexed: 01/19/2023]
Abstract
BACKGROUND Smartphone use during postural-locomotor tasks is an everyday activity for individuals of all ages in diverse environmental situations and with various health conditions. Nevertheless, the use of smartphones during walking is responsible for many accidents. RESEARCH QUESTION This systematic review and meta-analysis examined spatiotemporal gait parameters during the dual-task situation "texting + gait" versus isolated gait task (single task) in adult persons (>18 years). METHODS Electronic database searches were performed in PubMed, Embase, CINHAL, and LISSA. Two examiners assessed the eligibility and quality of appraisal with the Downs and Black checklist. The standardized mean difference (SMD) with 95 % confidence intervals was calculated to compare single- and dual-task situations. The pooled estimates of the overall effect were computed using a random or fixed effects method, and forest plots were generated. RESULTS AND SIGNIFICANCE A total of 25 studies were included. All studies included healthy adults, with four studies including older persons and three including people with pathological conditions. The walking task was with (N = 4) and without (N = 21) obstacles and in laboratory (N = 21) or ecological conditions (N = 7). The quality scores were 6-8/16 for eight studies, 9-12/16 for seven studies, and more than 12/16 for three studies. During the "texting + gait" tasks, the meta-analysis highlighted a significant impairment of gait speed, step and stride length, cadence, and double and single support (p < 0.05). The spatiotemporal parameters of gait were systematically altered during the texting task regardless of the population and test conditions. However, the quality of the studies is moderate, and few studies have been conducted for people with motor deficiencies. The impact of texting on walking should be better considered to develop prevention actions.
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Affiliation(s)
- Anne-Violette Bruyneel
- Geneva School of Health Sciences, HES-SO University of Applied Sciences and Arts Western Switzerland, Switzerland.
| | - Aline Reinmann
- Geneva School of Health Sciences, HES-SO University of Applied Sciences and Arts Western Switzerland, Switzerland.
| | - Simone C Gafner
- School of Health Sciences, HES-SO Valais-Wallis, University of Applied Sciences and Arts Western Switzerland, Switzerland.
| | - Jean-David Sandoz
- Geneva School of Health Sciences, HES-SO University of Applied Sciences and Arts Western Switzerland, Switzerland.
| | - Noémie C Duclos
- Univ. Bordeaux, INSERM, BPH, U1219, Team ACTIVE, F-33000, Bordeaux, France; Univ.Bordeaux, Collège Sciences de la santé, Institut Universitaire des Sciences de la Réadaptation, F-33000, Bordeaux, France.
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Zhou J, Manor B, McCarten JR, Wade MG, Jor’dan AJ. The effects of cognitive impairment on the multi-scale dynamics of standing postural control during visual-search in older men. Front Aging Neurosci 2023; 15:1068316. [PMID: 36761178 PMCID: PMC9905142 DOI: 10.3389/fnagi.2023.1068316] [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: 10/12/2022] [Accepted: 01/10/2023] [Indexed: 01/26/2023] Open
Abstract
Background Cognitive impairment disrupts postural control, particularly when standing while performing an unrelated cognitive task (i.e., dual-tasking). The temporal dynamics of standing postural sway are "complex," and such complexity may reflect the capacity of the postural control system to adapt to task demands. We aimed to characterize the impact of cognitive impairment on such sway complexity in older adults. Methods Forty-nine older adult males (Alzheimer's disease (AD): n = 21; mild cognitive impairment (MCI): n = 13; cognitively-intact: n = 15) completed two 60-s standing trials in each of single-task and visual-search dual-task conditions. In the dual-task condition, participants were instructed to count the frequency of a designated letter in a block of letters projected on screen. The sway complexity of center-of-pressure fluctuations in anterior-posterior (AP) and medial-lateral (ML) direction was quantified using multiscale entropy. The dual-task cost to complexity was obtained by calculating the percent change of complexity from single- to dual-task condition. Results Repeated-measures ANOVAs revealed significant main effects of group (F > 4.8, p < 0.01) and condition (F = 7.7, p < 0.007) on both AP and ML sway complexity; and significant interaction between group and condition for ML sway complexity (F = 3.7, p = 0.03). The AD group had the lowest dual-task ML complexity, as well as greater dual-task cost to ML (p = 0.03) compared to the other two groups. Visual-search task accuracy was correlated with ML sway complexity in the dual-task condition (r = 0.42, p = 0.007), and the dual-task cost to ML sway complexity (r = 0.39, p = 0.01) across all participants. Conclusion AD-related cognitive impairment was associated with a greater relative reduction in postural sway complexity from single- to dual-tasking. Sway complexity appears to be sensitive to the impact of cognitive impairment on standing postural control.
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Affiliation(s)
- Junhong Zhou
- Hinda and Arthur Marcus Institute for Aging Research, Hebrew SeniorLife, Boston, MA, United States,*Correspondence: Junhong Zhou,
| | - Brad Manor
- Hinda and Arthur Marcus Institute for Aging Research, Hebrew SeniorLife, Boston, MA, United States,Harvard Medical School, Boston, MA, United States
| | - John Riley McCarten
- Geriatric Research Education and Clinical Center (GRECC), Veterans Affairs Health Care System, Minneapolis, MN, United States,School of Medicine, University of Minnesota, Minneapolis, MN, United States
| | - Michael G. Wade
- School of Kinesiology, University of Minnesota, Minneapolis, MN, United States
| | - Azizah J. Jor’dan
- Department of Exercise and Health Sciences, Manning College of Nursing and Health Sciences, University of Massachusetts Boston, Boston, MA, United States
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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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Pitts J, Bhatt T. Effects of mentally induced fatigue on balance control: a systematic review. Exp Brain Res 2023; 241:13-30. [PMID: 36329316 DOI: 10.1007/s00221-022-06464-x] [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: 05/03/2022] [Accepted: 09/07/2022] [Indexed: 11/06/2022]
Abstract
The relationship between cognitive demands and postural control is controversial. Mental fatigue paradigms investigate the attentional requirements of postural control by assessing balance after a prolonged cognitive task. However, a majority of mental fatigue research has focused on cognition and sports performance, leaving balance relatively underexamined. The purpose of this paper was to systematically review the existing literature on mental fatigue and balance control. We conducted a comprehensive search on PubMed and Web of Science databases for studies comparing balance performance pre- to post-mental fatigue or between a mental fatigue and control group. The literature search resulted in ten relevant studies including both volitional (n = 7) and reactive (n = 3) balance measures. Mental fatigue was induced by various cognitive tasks which were completed for 20-90 min prior to balance assessment. Mental fatigue affected both volitional and reactive balance, resulting in increased postural sway, decreased accuracy on volitional tasks, delayed responses to perturbations, and less effective balance recovery responses. These effects could have been mediated by the depletion of attentional resources or impaired sensorimotor perception which delayed appropriate balance-correcting responses. However, the current literature is limited by the number of studies and heterogeneous mental fatigue induction methods. Future studies are needed to confirm these postulations and examine the effects of mental fatigue on different populations and postural tasks. This line of research could be clinically relevant to improve safety in occupational settings where individuals complete extremely long durations of cognitive tasks and for the development of effective fall-assessment and fall-prevention paradigms.
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Affiliation(s)
- Jessica Pitts
- Department of Physical Therapy, University of Illinois at Chicago, 1919 W Taylor Street, Chicago, IL, 60612, USA
| | - Tanvi Bhatt
- Department of Physical Therapy, University of Illinois at Chicago, 1919 W Taylor Street, Chicago, IL, 60612, USA.
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iPhone Accelerometry Provides a Sensitive In-Home Assessment of Age-Related Changes in Standing Balance. J Aging Phys Act 2022; 31:489-496. [PMID: 36640781 DOI: 10.1123/japa.2022-0214] [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: 06/11/2022] [Revised: 08/23/2022] [Accepted: 09/23/2022] [Indexed: 12/25/2022]
Abstract
Remote health monitoring has become increasingly important, especially in aging populations. We aimed to identify tasks that are sensitive to age-related changes in balance during fully remote, at-home balance assessment. Participants were 12 healthy young adults (mean age = 26.08 years, range: 18-33) and 12 healthy older adults (mean age = 67.33 years, range: 60-75). Participants performed standing tasks monitored via video conference while their balance was quantified using a custom iPhone application measuring mediolateral center of mass acceleration. We included three stances (feet together, tandem, and single leg) with eyes open or closed, with or without a concurrent cognitive task. Older adults demonstrated significantly more variable center of mass accelerations in tandem (p = .04, ηp2=.25) and significantly higher (p < .01, ηp2=.45) and more variable (p < .01, ηp2=.44) center of mass accelerations in single leg compared with young adults. We also observed that as task challenge increased, balance dual-task cost diminished for older, but not young, adults.
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Effect of Dual-Task Training on Gait and Balance in Stroke Patients: An Updated Meta-analysis. Am J Phys Med Rehabil 2022; 101:1148-1155. [PMID: 35363622 DOI: 10.1097/phm.0000000000002016] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
OBJECTIVE The main purpose of this meta-analysis was to evaluate the effect of dual-task training on gait and balance improvement in stroke patients. DESIGN The PubMed, Embase, Cochrane Library, MEDLINE, CINAHL, CNKI, Wan Fang, and VIP databases were searched from inception to January 28, 2021, for randomized controlled trials investigating the effect of dual-task training on gait and balance intervention in stroke patients. RESULTS A total of 17 studies with 575 stroke patients that compared the efficacy and safety of dual-task training with those of conventional physical therapy or single-task training were included in this meta-analysis. The meta-analysis showed that the data were as follows under the dual-task training: step length (mean difference = 2.7, 95% confidence interval = 1.33 to 4.08, P = 0.0001); cadence (mean difference = 5.06, 95% confidence interval = 3.37 to 6.75, P < 0.00001); stride length (mean difference = 7.34, 95% confidence interval = 5.47 to 9.22, P < 0.00001); 10-meter walk test times (mean difference = -2.36, 95% confidence interval = -3.70 to -1.02), P = 0.0006); Berg Balance Scale (mean difference = 3.8, 95% confidence interval = 0.04 to 7.55, P = 0.05); Fugl-Meyer motor assessment of lower extremities (mean difference = 2.27, 95% confidence interval = -1.04 to 5.59, P = 0.18). CONCLUSIONS This meta-analysis showed that dual-task training can improve stroke patients' step length, cadence, stride length, and 10-meter walk test. However, possible advantages in improving balance function need further exploration.
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Auditory Stimulation Improves Gait and Posture in Cerebral Palsy: A Systematic Review with Between- and Within-Group Meta-Analysis. CHILDREN 2022; 9:children9111752. [DOI: 10.3390/children9111752] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Revised: 11/07/2022] [Accepted: 11/08/2022] [Indexed: 11/17/2022]
Abstract
The past decade has seen an increased interest in the implementation of auditory stimulation (AStim) for managing gait and postural deficits in people with cerebral palsy. Although existing reviews report beneficial effects of AStim on the spatiotemporal and kinematic parameters of gait, there are still numerous limitations that need to be addressed to correctly interpret these results. For instance, existing reviews have failed to characterize the effects of AStim by conducting separate between and within-group meta-analyses, these reviews have not evaluated the influence of AStim on postural outcomes, and nor have included several high-quality existing trials. In this study, we conducted between- and within-group meta-analyses to establish a state of evidence for the influence of AStim on gait and postural outcomes in people with cerebral palsy. We searched the literature according to PRISMA-P guidelines across 10 databases. Of 1414 records, 14 studies, including a total of 325 people with cerebral palsy, met the inclusion criterion. We report a significant enhancement in gait speed, stride length, cadence, and gross motor function (standing and walking) outcomes with AStim compared to conventional physiotherapy. The findings from this analysis reveal the beneficial influence of AStim on the spatiotemporal and kinematic parameters of gait and postural stability in people with cerebral palsy. Furthermore, we discuss the futurized implementation of smart wearables that can deliver person-centred AStim rehabilitation in people with cerebral palsy.
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Research progress in the application of motor-cognitive dual task training in rehabilitation of walking function in stroke patients. JOURNAL OF NEURORESTORATOLOGY 2022. [DOI: 10.1016/j.jnrt.2022.100028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
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Rizzato A, Marcolin G, Paoli A. Non-exercise activity thermogenesis in the workplace: The office is on fire. Front Public Health 2022; 10:1024856. [PMID: 36388282 PMCID: PMC9650196 DOI: 10.3389/fpubh.2022.1024856] [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: 08/22/2022] [Accepted: 10/05/2022] [Indexed: 01/28/2023] Open
Abstract
From the second half of the previous century, there has been a shift toward occupations largely composed of desk-based behaviors. This, inevitably, has led to a workload reduction and a consequent lower energy expenditure. On this point, small increments of the non-exercise activity thermogenesis (NEAT) could be the rationale to reach health benefits over a prolonged period. Different published researches suggest solutions to reverse sitting time and new alternative workstations have been thought to increase total physical activity. Therefore, the purpose of this narrative review is to summarize the current state of the research regarding the "NEAT approach" to weight-gain prevention in work environments. This review analyzes the main evidence regarding new alternative workstations such as standing, walking workstations, seated pedal, and gymnastic balls to replace a standard office chair.
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A Comprehensive Appraisal of Meta-Analyses of Exercise-Based Stroke Rehabilitation with Trial Sequential Analysis. Healthcare (Basel) 2022; 10:healthcare10101984. [PMID: 36292431 PMCID: PMC9602124 DOI: 10.3390/healthcare10101984] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2022] [Revised: 09/25/2022] [Accepted: 09/29/2022] [Indexed: 11/04/2022] Open
Abstract
Meta-analysis is a common technique used to synthesise the results of multiple studies through the combination of effect size estimates and testing statistics. Numerous meta-analyses have investigated the efficacy of exercise programmes for stroke rehabilitation. However, meta-analyses may also report false-positive results because of insufficient information or random errors. Trial sequential analysis (TSA) is an advanced technique for calculating the required information size (RIS) and more restrictive statistical significance levels for the precise assessment of any specific treatment. This study used TSA to examine whether published meta-analyses in the field of stroke rehabilitation reached the RIS and whether their overall effect sizes were sufficient. A comprehensive search of six electronic databases for articles published before May 2022 was conducted. The intervention methods were divided into four primary groups, namely aerobic or resistance exercise, machine-assisted exercise, task-oriented exercise, and theory-based exercise. The primary outcome measure was gait speed and the secondary outcome measure was balance function. The data were obtained either from the meta-analyses or as raw data from the original cited texts. All data analysis was performed in TSA software. In total, 38 articles with 46 analysable results were included in the TSA. Only 17 results (37.0%) reached the RIS. In conclusion, meta-analysis interpretation is challenging. Clinicians must consider the RIS of meta-analyses before applying the results in real-world situations. TSA can provide accurate evaluations of treatment effects, which is crucial to the development of evidence-based medicine.
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Reinmann A, Bruyneel AV, Gligorov J, Mesure S, Combescure C, Koessler T, Bodmer A. Influence of chemotherapy on postural control and quality of life in women with gynaecological cancer: a protocol of a prospective observational study. BMJ Open 2022; 12:e061664. [PMID: 36691184 PMCID: PMC9454005 DOI: 10.1136/bmjopen-2022-061664] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2022] [Accepted: 07/31/2022] [Indexed: 01/26/2023] Open
Abstract
INTRODUCTION Chemotherapy-induced peripheral neuropathy is a frequent side effect of some chemotherapies that can cause postural control disorders and has a serious impact on quality of life (QoL). An enhanced understanding of postural control dysfunction could help build a systematic and accurate assessment as well as specific exercises to limit the impact on QoL. This study aims to assess the influence of chemotherapy on postural control and the QoL for women with gynaecological cancer. METHODS AND ANALYSIS This prospective observational study will include 37 participants with cancer treated using neurotoxic chemotherapy. Their postural control in various conditions (rigid and foam surfaces, eyes open and closed, with and without tendon vibration, and dual tasks), limits of stability, QoL and modified Total Neuropathy Score will be assessed. A linear mixed model will compare postural control pre-chemotherapy and post-chemotherapy. ETHICS AND DISSEMINATION This study was approved by an ethical review board in Geneva (CCER-2020-01639). The study findings will be disseminated through conference presentations and publications in peer-reviewed journals. TRIAL REGISTRATION NUMBER NCT04692168.
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Affiliation(s)
- Aline Reinmann
- Geneva School of Health Sciences, HES-SO University of Applied Sciences and Arts Western Switzerland, Geneva, Switzerland
| | - Anne-Violette Bruyneel
- Geneva School of Health Sciences, HES-SO University of Applied Sciences and Arts Western Switzerland, Geneva, Switzerland
| | - Joseph Gligorov
- Department of Oncology, AP-HP. Sorbonne University, Paris, France
| | - Serge Mesure
- Institute of Movement Sciences, National Centre of Scientific Research, Aix-Marseille-University, Marseille, France
| | - Christophe Combescure
- CRC & Division of clinical epidemiology, Department of health and community medicine, University of Geneva & University Hospitals of Geneva, Geneva, Switzerland
| | - Thibaud Koessler
- Service of Oncology, Geneva University Hospitals, Geneva, Switzerland
- University of Geneva, Geneva, Switzerland
| | - Alexandre Bodmer
- Service of Oncology, Geneva University Hospitals, Geneva, Switzerland
- University of Geneva, Geneva, Switzerland
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Sangari M, Dehkordi PS, Shams A. Age and attentional focus instructions effects on postural and supra-postural tasks among older adults with mild cognitive impairments. Neurol Sci 2022; 43:6795-6801. [PMID: 36036296 DOI: 10.1007/s10072-022-06355-7] [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: 06/28/2022] [Accepted: 08/16/2022] [Indexed: 10/15/2022]
Abstract
OBJECTIVE The purpose of this study was to investigate the age and attentional focus instruction effects on the postural and supra-postural tasks among older adults with mild cognitive impairments. METHOD Forty healthy adults (mean age of 48.01 ± 5.45 years) and 40 older adults with mild cognitive impairments (mean age of 69.87 ± 4.28 years) were selected as participants. They were randomly divided into eight groups receiving internal and external attentional focus instructions for postural and supra-postural tasks. The postural status was evaluated by measuring the COP sway velocity with the Master Balance System. RESULTS The results showed that in both phases of acquisition and retention, the main effect of the attentional focus type was significant (P < 0.05). The group's postural control with external attentional instructions was better than the group's postural control with internal attentional instructions. Furthermore, the CI elderly gained benefit from the guidelines of attentional focus. Results showed that the task type was not significant in the acquisition phase. However, in the retention phase, the main effect of the attentional focus type was significant. The groups' postural function with the supra-postural task was better than the groups with the postural task. Furthermore, the older adults showed a better postural function in the supra-postural task than in the postural task. CONCLUSIONS Our results showed that the ability to allocate resources of attention may decrease with CI. These findings suggest that considering the effect of the supra-postural tasks' manipulation on postural control, it is possible to improve balance by designing training programs for directing supra-postural tasks. The findings of the present study can be a guide for educators and therapists. They can increase the balance of the patients by considering the dysfunction and the type of attentional guidelines to prevent them from falling and performing a dual task.
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Affiliation(s)
- Mandana Sangari
- Department of Physical Education, Chalous Branch, Islamic Azad University, Mazandaran, Iran
| | | | - Amir Shams
- Department of Motor Behavior, Sport Science Research Institute of Iran, Tehran, Iran
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