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Mao Q, Zhang J, Yu L, Zhao Y, Luximon Y, Wang H. Effectiveness of sensor-based interventions in improving gait and balance performance in older adults: systematic review and meta-analysis of randomized controlled trials. J Neuroeng Rehabil 2024; 21:85. [PMID: 38807117 PMCID: PMC11131332 DOI: 10.1186/s12984-024-01375-0] [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: 12/18/2023] [Accepted: 05/10/2024] [Indexed: 05/30/2024] Open
Abstract
BACKGROUND Sensor-based interventions (SI) have been suggested as an alternative rehabilitation treatment to improve older adults' functional performance. However, the effectiveness of different sensor technologies in improving gait and balance remains unclear and requires further investigation. METHODS Ten databases (Academic Search Premier; Cumulative Index to Nursing and Allied Health Literature, Complete; Cochrane Central Register of Controlled Trials; MEDLINE; PubMed; Web of Science; OpenDissertations; Open grey; ProQuest; and Grey literature report) were searched for relevant articles published up to December 20, 2022. Conventional functional assessments, including the Timed Up and Go (TUG) test, normal gait speed, Berg Balance Scale (BBS), 6-Minute Walk Test (6MWT), and Falling Efficacy Scale-International (FES-I), were used as the evaluation outcomes reflecting gait and balance performance. We first meta-analyzed the effectiveness of SI, which included optical sensors (OPTS), perception sensors (PCPS), and wearable sensors (WS), compared with control groups, which included non-treatment intervention (NTI) and traditional physical exercise intervention (TPEI). We further conducted sub-group analysis to compare the effectiveness of SI (OPTS, PCPS, and WS) with TPEI groups and compared each SI subtype with control (NTI and TPEI) and TPEI groups. RESULTS We scanned 6255 articles and performed meta-analyses of 58 selected trials (sample size = 2713). The results showed that SI groups were significantly more effective than control or TPEI groups (p < 0.000) in improving gait and balance performance. The subgroup meta-analyses between OPTS groups and TPEI groups revealed clear statistically significant differences in effectiveness for TUG test (mean difference (MD) = - 0.681 s; p < 0.000), normal gait speed (MD = 4.244 cm/s; p < 0.000), BBS (MD = 2.325; p = 0.001), 6MWT (MD = 25.166 m; p < 0.000), and FES-I scores (MD = - 2.036; p = 0.036). PCPS groups also presented statistically significant differences with TPEI groups in gait and balance assessments for normal gait speed (MD = 4.382 cm/s; p = 0.034), BBS (MD = 1.874; p < 0.000), 6MWT (MD = 21.904 m; p < 0.000), and FES-I scores (MD = - 1.161; p < 0.000), except for the TUG test (MD = - 0.226 s; p = 0.106). There were no statistically significant differences in TUG test (MD = - 1.255 s; p = 0.101) or normal gait speed (MD = 6.682 cm/s; p = 0.109) between WS groups and control groups. CONCLUSIONS SI with biofeedback has a positive effect on gait and balance improvement among a mixed population of older adults. Specifically, OPTS and PCPS groups were statistically better than TPEI groups at improving gait and balance performance, whereas only the group comparison in BBS and 6MWT can reach the minimal clinically important difference. Moreover, WS groups showed no statistically or clinically significant positive effect on gait and balance improvement compared with control groups. More studies are recommended to verify the effectiveness of specific SI. Research registration PROSPERO platform: CRD42022362817. Registered on 7/10/2022.
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Affiliation(s)
- Qian Mao
- School of Design, The Hong Kong Polytechnic University, Hong Kong, China
| | - Jiaxin Zhang
- School of System Design and Intelligent Manufacturing, Southern University of Science and Technology, Shenzhen, China
| | - Lisha Yu
- School of Data Science, Lingnan University, Hong Kong, China
| | - Yang Zhao
- School of Public Health (Shenzhen), Sun Yat-Sen University, Shenzhen, China
| | - Yan Luximon
- School of Design, The Hong Kong Polytechnic University, Hong Kong, China
| | - Hailiang Wang
- School of Design, The Hong Kong Polytechnic University, Hong Kong, China.
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Deng N, Soh KG, Abdullah BB, Tan H, Huang D. Active video games for improving health-related physical fitness in older adults: a systematic review and meta-analysis. Front Public Health 2024; 12:1345244. [PMID: 38694976 PMCID: PMC11061467 DOI: 10.3389/fpubh.2024.1345244] [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: 11/27/2023] [Accepted: 04/03/2024] [Indexed: 05/04/2024] Open
Abstract
Background The global population is experiencing a rapid rise in the quantity and percentage of older people. In an effort to enhance physical activity among older adults, active video games (AVGs) are being suggested as a compelling alternative and are currently under scrutiny to evaluate their efficacy in promoting the health of older people. Objective This review aims to synthesize current studies and formulate conclusions regarding the impact of AVGs on the health-related physical fitness of older adults. Methods Seven databases (PubMed, Web of Science, SCOPUS, SPORTDiscus, EMBASE, MEDLINE, and CINAHL) were searched from inception to January 21, 2024. Eligible studies included randomized controlled trials examining the effect of AVGs compared to control conditions on health-related physical fitness outcomes in older adults. The methodological quality of the included trials was assessed using the PEDro scale, and the certainty of evidence was evaluated using the GRADE approach. A random-effects model was used to calculate effect sizes (ES; Hedge's g) between experimental and control groups. Results The analysis included 24 trials with a total of 1428 older adults (all ≥ 60 years old). Compared to controls, AVGs produced significant increases in muscular strength (moderate ES = 0.64-0.68, p < 0.05) and cardiorespiratory fitness (moderate ES = 0.79, p < 0.001). However, no significant effects were found for body composition (trivial ES = 0.12-0.14; p > 0.05) and flexibility (trivial ES = 0.08; p = 0.677). The beneficial effects of AVGs were greater after a duration of ≥ 12 vs. < 12 weeks (cardiorespiratory fitness; ES = 1.04 vs. 0.29, p = 0.028) and following ≥ 60 minutes vs. < 60 minutes of session duration (muscular strength; ES = 1.20-1.24 vs. 0.27-0.42, p < 0.05). Conclusion AVGs appear to be an effective tool for enhancing muscular strength and cardiorespiratory fitness in older adults, although their impact on improving body composition and flexibility seems limited. Optimal improvement in cardiorespiratory fitness is associated with a longer duration of AVGs (≥ 12 weeks). Moreover, a session duration of ≥ 60 minutes may provide greater benefits for the muscular strength of older adults. Systematic review registration https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=482568, identifier CRD42023482568.
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Affiliation(s)
- Nuannuan Deng
- Department of Sports Studies, Faculty of Educational Studies, Universiti Putra Malaysia, Serdang, Selangor, Malaysia
| | - Kim Geok Soh
- Department of Sports Studies, Faculty of Educational Studies, Universiti Putra Malaysia, Serdang, Selangor, Malaysia
| | - Borhannudin Bin Abdullah
- Department of Sports Studies, Faculty of Educational Studies, Universiti Putra Malaysia, Serdang, Selangor, Malaysia
| | - Hermione Tan
- School of Computer Information Sciences, University of the Cumberlands, Williamsburg, KY, United States
| | - Dandan Huang
- College of Physical Education, Chongqing University, Chongqing, China
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Jiang Y, Ramasawmy P, Antal A. Uncorking the limitation-improving dual tasking using transcranial electrical stimulation and task training in the elderly: a systematic review. Front Aging Neurosci 2024; 16:1267307. [PMID: 38650865 PMCID: PMC11033383 DOI: 10.3389/fnagi.2024.1267307] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Accepted: 03/22/2024] [Indexed: 04/25/2024] Open
Abstract
Introduction With aging, dual task (DT) ability declines and is more cognitively demanding than single tasks. Rapidly declining DT performance is regarded as a predictor of neurodegenerative disease. Task training and non-invasive transcranial electrical stimulation (tES) are methods applied to optimize the DT ability of the elderly. Methods A systematic search was carried out in the PUBMED, TDCS (transcranial direct current stimulation) databases, as well as Web of Science, and a qualitative analysis was conducted in 56 included studies. Aiming to summarize the results of studies that implemented tES, task training, or the combination for improving DT ability and related performance changes in healthy elderly and geriatric patients. For different approaches, the training procedures, parameters, as well as outcomes were discussed. Results Task training, particularly cognitive-motor DT training, has more notable effects on improving DT performance in the elderly when compared to the neuromodulation method. Discussion Anodal transcranial direct current stimulation (tDCS) over the left dorsolateral prefrontal cortex (L-DLPFC), or its combination with task training could be promising tools. However, additional evidence is required from aged healthy people and patients, as well as further exploration of electrode montage.
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Affiliation(s)
- Yong Jiang
- Department of Neurology, University Medical Center, Georg August University of Göttingen, Göttingen, Germany
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Lee K, Yi J, Lee SH. Effects of community-based fall prevention interventions for older adults using information and communication technology: A systematic review and meta-analysis. Health Informatics J 2024; 30:14604582241259324. [PMID: 38825745 DOI: 10.1177/14604582241259324] [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] [Indexed: 06/04/2024]
Abstract
Objectives: This systematic review and meta-analysis aimed to investigate the effect of fall prevention interventions using information and communication technology (ICT). Methods: A comprehensive search across four databases was performed. The inclusion criteria were fall prevention interventions including telehealth, computerized balance training, exergaming, mobile application education, virtual reality exercise, and cognitive-behavioral training for community-dwelling adults aged ≥60 years. Results: Thirty-four studies were selected. Telehealth, smart home systems, and exergames reduced the risk of falls (RR = 0.63, 95% CI [0.54, 0.75]). Telehealth and exergame improved balance (MD = 3.30, 95% CI [1.91, 4.68]; MD = 4.40, 95% CI [3.09, 5.71]). Telehealth improved physical function (SMD = 0.69, 95% CI [0.23, 1.16]). Overall, ICT fall interventions improved fall efficacy but not cognitive function. For quality of life (QOL), mixed results were found depending on the assessment tools. Conclusion: Future investigations on telehealth, smart home systems, or exergames are needed to motivate older adults to exercise and prevent falls.
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Affiliation(s)
- Kayoung Lee
- College of Nursing, Gachon University, Incheon, Korea
| | - Jungeun Yi
- College of Nursing, The Catholic University of Korea, Seoul, Korea
| | - Seon-Heui Lee
- College of Nursing, Gachon University, Incheon, Korea
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Yoong SQ, Wu VX, Jiang Y. Experiences of older adults participating in dance exergames: A systematic review and meta-synthesis. Int J Nurs Stud 2024; 152:104696. [PMID: 38301305 DOI: 10.1016/j.ijnurstu.2024.104696] [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: 08/22/2023] [Revised: 12/27/2023] [Accepted: 01/10/2024] [Indexed: 02/03/2024]
Abstract
BACKGROUND Interventions to encourage adequate physical activity amongst older adults have had limited long-term success. Dancing and exergames, two beneficial and enjoyable physical activities for older adults, may make regular exercise more interesting and effective. Dance exergames are physical exercises that integrate sensory, cognitive, psychological, and physical functions by requiring users to interact with game scenarios through deliberate body motions and receive real-time feedback. They provide an inherently enjoyable gaming and workout experience, which may boost exercise adherence. However, little is known about older adults' experiences with dance exergames. OBJECTIVE To synthesise the qualitative experiences of older adults participating in dance exergames. DESIGN Systematic review and meta-synthesis. METHODS Dance exergame studies (peer-reviewed and grey literature) involving older adults in any setting published in English from inception to 17 August 2023 were included. Qualitative or mixed-method studies must use immersive or non-immersive virtual-reality platforms. PubMed, Scopus, CINAHL, The Cochrane Library, ProQuest Dissertations & Theses Global, Google Scholar, and reference lists of relevant studies and reviews were searched for eligible studies. The search strategy for Scopus was: (TITLE-ABS-KEY (danc*) AND TITLE-ABS-KEY (exergames OR exergame OR video AND games OR virtual AND reality) AND TITLE-ABS-KEY (older AND adults OR elderly OR seniors OR geriatrics)). Thematic synthesis by Thomas and Harden was used for meta-synthesis. RESULTS Eleven studies (n = 200 older adults) were included. Three themes and 14 subthemes were synthesised: 1) Dance exergames as dual-task training for physical, cognitive, and psychological well-being, 2) Concerns on usability issues, and 3) Possible enhancements of dance exergames. Older adults recognised that dance exergames could improve their physical, cognitive, and psychological well-being. Existing dance exergame systems had several usability issues. For example, some older adults were unfamiliar with using new technology and had trouble in navigating the game systems. The older adults also provided various suggestions for adaptation to their age group, such as ensuring a variety of dances, difficulty levels suited for older adults' cultural backgrounds, and physical and cognitive capabilities. CONCLUSIONS Dance exergames may be an attractive way to encourage older adults to exercise, but appropriate modifications are needed. When designing/selecting dance exergames for older persons, researchers, healthcare professionals, and senior care centres should consider using exergames that have simple designs, varied dances that are locally adapted, and appeal to a large proportion of older adults. REGISTRATION PROSPERO CRD42023395709.
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Affiliation(s)
- Si Qi Yoong
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
| | - Vivien Xi Wu
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
| | - Ying Jiang
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
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Leitão L, Campos Y, Louro H, Figueira ACC, Figueiredo T, Pereira A, Conceição A, Marinho DA, Neiva HP. Detraining and Retraining Effects from a Multicomponent Training Program on the Functional Capacity and Health Profile of Physically Active Prehypertensive Older Women. Healthcare (Basel) 2024; 12:271. [PMID: 38275551 PMCID: PMC10815818 DOI: 10.3390/healthcare12020271] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2023] [Revised: 01/12/2024] [Accepted: 01/19/2024] [Indexed: 01/27/2024] Open
Abstract
BACKGROUND Resuming a physical exercise program after a period of cessation is common in older women. Monitoring the responses during this detraining (DT) and retraining (RT) may allow us to analyze how the body reacts to an increase and a reduction in physical inactivity. Therefore, we conducted a follow-up training, DT, and RT in prehypertensive older women to analyze the response to these periods. METHODS Twenty-three prehypertensive older women (EG; 68.3 ± 2.8 years; 1.61 ± 0.44 m) performed 36 weeks of the multicomponent training program (MTP) followed by twelve weeks of DT plus eight weeks of RT. Fifteen prehypertensive older women (CG; 66.3 ± 3.2 years; 1.59 ± 0.37 m) maintained their normal routine. Functional capacity (FC), lipid, and hemodynamic profile were assessed before, during 24 and 36 weeks of the MTP, after 4 and 12 weeks of DT, and after 8 weeks of RT. RESULTS After 24 weeks of the MTP, only SBP did not improve. Four weeks of DT did not affect lower body strength (30-CS), TC, or GL. Eight weeks of RT improved BP (SBP: -2.52%; ES: 0.36; p < 0.00; DBP: -1.45%; ES: 0.44; p < 0.02), handgrip strength (3.77%; ES: 0.51; p < 0.00), and 30-CS (3.17%; ES: 0.38; p < 0.04) compared with 36 weeks of the MTP. CONCLUSIONS Eight weeks of RT allowed patients to recover the benefits lost with detraining, which after only four weeks affected them negatively, and the systematic practice of exercise contributed to greater regulation of BP since 24 weeks of the MTP proved not to be enough to promote positive effects of SBP.
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Affiliation(s)
- Luís Leitão
- Sciences and Technology Department, Superior School of Education of Polytechnic Institute of Setubal, 2910-761 Setúbal, Portugal; (A.C.C.F.); (T.F.); (A.P.)
- Life Quality Research Centre, 2040-413 Rio Maior, Portugal
- Department of Sport Sciences, University of Beira Interior, 6201-001 Covilhã, Portugal; (D.A.M.); (H.P.N.)
| | - Yuri Campos
- Post Graduate Program in Physical Education, Federal University of Juiz de Fora, Juiz de Fora 36036-900, Brazil;
- Study Group and Research in Neuromuscular Responses, Federal University of Lavras, Lavras 37200-900, Brazil
| | - Hugo Louro
- Department of Sport Sciences, Sport Sciences School of Rio Maior, Polytechnic Institute of Santarém, 2040-413 Santarém, Portugal; (H.L.); (A.C.)
- Research Center in Sports Sciences, Health Sciences and Human Development (CIDESD), 6201-001 Covilhã, Portugal
| | - Ana Cristina Corrêa Figueira
- Sciences and Technology Department, Superior School of Education of Polytechnic Institute of Setubal, 2910-761 Setúbal, Portugal; (A.C.C.F.); (T.F.); (A.P.)
- Life Quality Research Centre, 2040-413 Rio Maior, Portugal
| | - Teresa Figueiredo
- Sciences and Technology Department, Superior School of Education of Polytechnic Institute of Setubal, 2910-761 Setúbal, Portugal; (A.C.C.F.); (T.F.); (A.P.)
- Life Quality Research Centre, 2040-413 Rio Maior, Portugal
| | - Ana Pereira
- Sciences and Technology Department, Superior School of Education of Polytechnic Institute of Setubal, 2910-761 Setúbal, Portugal; (A.C.C.F.); (T.F.); (A.P.)
- Life Quality Research Centre, 2040-413 Rio Maior, Portugal
| | - Ana Conceição
- Department of Sport Sciences, Sport Sciences School of Rio Maior, Polytechnic Institute of Santarém, 2040-413 Santarém, Portugal; (H.L.); (A.C.)
- Research Center in Sports Sciences, Health Sciences and Human Development (CIDESD), 6201-001 Covilhã, Portugal
| | - Daniel A. Marinho
- Department of Sport Sciences, University of Beira Interior, 6201-001 Covilhã, Portugal; (D.A.M.); (H.P.N.)
- Research Center in Sports Sciences, Health Sciences and Human Development (CIDESD), 6201-001 Covilhã, Portugal
| | - Henrique P. Neiva
- Department of Sport Sciences, University of Beira Interior, 6201-001 Covilhã, Portugal; (D.A.M.); (H.P.N.)
- Research Center in Sports Sciences, Health Sciences and Human Development (CIDESD), 6201-001 Covilhã, Portugal
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Kim H, Kim G, Kim Y, Ha J. The Effects of ICT-Based Interventions on Physical Mobility of Older Adults: A Systematic Literature Review and Meta-Analysis. Int J Clin Pract 2023; 2023:5779711. [PMID: 38020536 PMCID: PMC10656205 DOI: 10.1155/2023/5779711] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Revised: 09/06/2023] [Accepted: 10/19/2023] [Indexed: 12/01/2023] Open
Abstract
Systematic literature review and meta-analysis were conducted to integrate and analyze intervention studies dealing with the effects of information and communications technology- (ICT-) based interventions on the physical mobility of older adults in the community. The PubMed/MEDLINE, Embase, CINAHL, and Cochrane CENTRAL databases were searched for studies published from January 2000 to December 2022. We used the Risk of Bias 2 (RoB 2) tool to evaluate the quality of the randomized controlled studies in the systematic review. The meta-analysis was performed using a random-effects model. The model was used to calculate the standardized mean difference (SMD) and 95% confidence interval (CI) for both effect measures. I2 tests were used to measure the presence of heterogeneity. Thirty-seven randomized controlled trials were included (2,419 intervention participants), of which 23 were included in the meta-analysis. ICT interventions significantly improved Timed Up and Go (TUG) as a marker of physical mobility variable in older adults (SMD = -0.33, 95% CI: -0.57 to -0.10, p=0.005, I2 = 74.7%). A sensitivity analysis was performed on subgroups, and interventions were found to be effective in improving TUG in the exergame group (SMD = -0.40, 95% CI: -0.72 to -0.08, p < 0.001, I2 = 75.0%) and in the exergame with virtual reality (VR) group (SMD = -0.33, 95% CI: -1.01 to 0.35, p < 0.001, I2 = 91.0%) but both groups showed high heterogeneity. A meta-analysis was also performed on Short Physical Performance Battery (SPPB) but statistically significant results were not found (SMD = -0.19, 95% CI: -0.61 to 0.23, p=0.375, I2 = 87.7%). For the Berg Balance Scale (BBS), the post-intervention scores were significantly better than baseline (SMD = 1.52, 95% CI: 0.48 to 2.57, p=0.004, I2 = 93.5%). However, the number of studies included in the meta-analysis was small and heterogeneity was high, so follow-up studies are needed. This study confirmed that exergames, telecommunication, e-health, information applications, and robots were used as effective ICT-based interventions for improving the physical mobility of older adults. It is necessary to develop and apply more diverse ICT-based interventions that will prevent impairments of mobility and encourage older adults to live more independently, with a higher quality of life, based on extensive research on ICT-based interventions.
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Affiliation(s)
- Hyori Kim
- College of Nursing, Seoul National University, Seoul 03080, Republic of Korea
| | - Gahye Kim
- College of Nursing, Seoul National University, Seoul 03080, Republic of Korea
| | - Yeonghun Kim
- Robotics Lab, Hyundai Motor Company, Uiwang 16082, Republic of Korea
| | - Jiyeon Ha
- College of Nursing, Research Institute of Nursing Science, Ajou University, Suwon 16499, Republic of Korea
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Chen YL, Tseng CH, Lin HT, Wu PY, Chao HC. Dual-task multicomponent exercise-cognitive intervention improved cognitive function and functional fitness in older adults. Aging Clin Exp Res 2023; 35:1855-1863. [PMID: 37418224 DOI: 10.1007/s40520-023-02481-0] [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: 04/25/2023] [Accepted: 06/13/2023] [Indexed: 07/08/2023]
Abstract
BACKGROUND Maintaining cognitive and physical function is essential to healthy aging. AIM This study aims to investigate the effect of an exercise-cognitive dual-task program in Chinese language on cognitive function and functional fitness in older adults. METHODS Seventy adults aged 60-84 years were conveniently assigned to one of the three groups: exercise-cognitive dual-task (EC) group (n = 28), exercise group (n = 22), and control group (n = 20). The EC group received a 90-min class including multicomponent exercise-cognitive dual-task twice a week. The exercise group received a 90-min class including multicomponent exercise twice a week. The control group maintained their regular level of physical activity and general lifestyle. Cognitive functions and functional fitness were measured before and after the 12-week intervention. RESULTS The participants in the EC and exercise group significantly improved scores in Taiwanese Frontal Assessment Battery, the Chang Gung University Orthographical Fluency Test, and the Mini-Mental State Examination; however, those in the control group did not. The participants in the EC and exercise group showed significant increases in almost all functional fitness tests. The participants in the EC group showed significantly higher improvements in Chang Gung University Orthographical Fluency Test score and aerobic endurance than the exercise group and in Chang Gung University Orthographical Fluency Test score and lower body strength than the control group. In addition, the changes in Taiwanese Frontal Assessment Battery and Mini-Mental State Examination scores were significantly correlated with the changes in functional fitness. CONCLUSION The dual-task intervention resulted in greater improvements in verbal fluency, endurance, and muscular strength than exercise alone and control.
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Affiliation(s)
- Yi-Ling Chen
- Department of Sports Medicine, China Medical University, Taichung, Taiwan
| | - Chien-Hsing Tseng
- Department of Recreation and Sport Management, Shu-Te University, 82445, Kaohsiung City, Taiwan
| | - Hsin-Tzu Lin
- Office of University Social Responsibility, Chung Yuan Christian University, Taoyuan City, Taiwan
| | - Pin-Yu Wu
- Department of Adult and Continuing Education, National Chung-Cheng University, Chiayi, Taiwan
| | - Hsueh-Chin Chao
- Physical Education Office, National Kaohsiung University of Science and Technology, 415 Jiangong Rd., Sanmin Dist., Kaohsiung, 807618, Taiwan.
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Kim Y, Park C, Yoon B, You J(SH. Bolstering Cognitive and Locomotor Function in Post-Stroke Dementia Using Human-Robotic Interactive Gait Training. J Clin Med 2023; 12:5661. [PMID: 37685727 PMCID: PMC10488393 DOI: 10.3390/jcm12175661] [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: 06/20/2023] [Revised: 07/25/2023] [Accepted: 08/29/2023] [Indexed: 09/10/2023] Open
Abstract
Studies have reported inconclusive results regarding the effectiveness and clinical indications of the exclusive use of human-robotic interactive gait training (HIT) in patients with post-stroke dementia (PSD). This study aimed to compare the effects of human-robotic interactive gait training (HIT) and conventional physiotherapy (CPT) on cognitive and sensorimotor functions, trunk balance and coordination, dynamic and static balance, and activities related to daily living performance in patients with PSD. Forty-eight patients with PSD who received 60-minute therapy sessions three times per week for 6 weeks were assigned to either the CPT (n = 25) or HIT (n = 23) group. The clinical outcomes included the scores of the mini-mental state examination (MMSE), Fugl-Meyer assessment (FMA), trunk impairment scale (TIS), Berg balance scale (BBS), and modified Barthel index (MBI). Friedman tests were conducted at p < 0.05. The Friedman tests showed that HIT had superior effects to CPT in relation to MMSE, FMA, and TIS (p < 0.05), but not in relation to BBS and MBI (p > 0.05). Our results provide promising clinical evidence that HIT significantly improves cognitive and sensorimotor recovery functions, as well as trunk balance and coordination, in patients with PSD who cannot concurrently perform dual cognitive-locomotor tasks.
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Affiliation(s)
| | | | | | - Joshua (Sung) H. You
- Sports Movement Artificial Robotics Technology (SMART) Institute, Department of Physical Therapy, Yonsei University, Wonju 26943, Republic of Korea; (Y.K.); (C.P.); (B.Y.)
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Shin S, Wuensche B. What type of exercises should older adults engage in to improve fall efficacy and physical fitness related to falling? J Exerc Rehabil 2023; 19:198-207. [PMID: 37662531 PMCID: PMC10468295 DOI: 10.12965/jer.2346276.138] [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: 06/14/2023] [Accepted: 07/18/2023] [Indexed: 09/05/2023] Open
Abstract
This study aimed to examine the effects of exercise interventions developed over the past 10 years to prevent falls among older adults. Cochrane, PubMed, and Embase databases were systematically searched on November 3, 2022, using the following keywords: "elderly" or "aged" and "fall prevention exercise" and "randomized controlled trial." A total of 918 articles were retrieved, and finally, 18 studies were included in the meta-analysis. main conclusions were as follows: fall prevention exercises showed moderately positive effects on balance, gait, mobility, physical function, lower limb power, and strength, but low effects on proprioception, vision, and reaction speed. The effect sizes were highest when the intervention period was 1-24 weeks, time was 31-60 min, and frequency was thrice per week. Place of intervention (home, community, laboratory) and age (>75 years, <75 years) showed similarly moderate effect sizes. A combined program that includes balance, co-ordination, and resistance exercises is appropriate to improve fall-related fitness and fall efficacy in community-dwelling older individuals.
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Affiliation(s)
- Sohee Shin
- School of Exercise and Sport Science, University of Ulsan, Ulsan,
Korea
| | - Burkhard Wuensche
- Department of Computer Science, University of Auckland, Auckland,
New Zealand
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Bartolomé Martín I, Esteve Arríen A, Neira Álvarez M, Cristofori G, Cedeno-Veloz BA, Esbrí Víctor M, Pérez Pena B, González Ramírez A, Caballero-Mora MÁ. Specialized Care Resources for Diagnosis and Management of Patients Who Have Suffered Falls: Results of a National Survey in Geriatric Units. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:5975. [PMID: 37297579 PMCID: PMC10252905 DOI: 10.3390/ijerph20115975] [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: 04/02/2023] [Revised: 05/16/2023] [Accepted: 05/23/2023] [Indexed: 06/12/2023]
Abstract
INTRODUCTION Clinical guidelines recommend comprehensive multifactorial assessment and intervention to prevent falls and fractures in older populations. METHODS A descriptive study was conducted by the Falls Study Group of the Spanish Geriatric Medicine Society (SEMEG) to outline which types of healthcare-specific resources were assigned for fall assessment in Spanish geriatric departments. A self-reported seven-item questionnaire was delivered from February 2019 to February 2020. Where geriatric medicine departments were not available, we tried to contact geriatricians working in those areas. RESULTS Information was obtained regarding 91 participant centers from 15 autonomous communities, 35.1% being from Catalonia and 20.8% from Madrid. A total of 21.6% reported a multidisciplinary falls unit, half of them in geriatric day hospitals. Half of them reported fall assessment as part of a general geriatric assessment in general geriatric outpatient clinics (49.5%) and, in 74.7% of cases, the assessment was based on functional tests. A total of 18.7% reported the use of biomechanical tools, such as posturography, gait-rides or accelerometers, for gait and balance analysis, and 5.5% used dual X-ray absorptiometry. A total of 34% reported research activity focused on falls or related areas. Regarding intervention strategies, 59% reported in-hospital exercise programs focused on gait and balance improvement and 79% were aware of community programs or the pathways to refer patients to these resources. CONCLUSIONS This study provides a necessary starting point for a future deep analysis. Although this study was carried out in Spain, it highlights the need to improve public health in the field of fall prevention, as well as the need, when implementing public health measures, to verify that these measures are implemented homogeneously throughout the territory. Therefore, although this analysis was at the local level, it could be useful for other countries to reproduce the model.
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Affiliation(s)
| | | | - Marta Neira Álvarez
- Geriatrician Department, Hospital Universitario Infanta Leonor, Universidad Complutense, 28031 Madrid, Spain;
| | - Giovanna Cristofori
- Geriatrician Department, Hospital Universitario Central de la Cruz Roja, 28003 Madrid, Spain;
| | | | - Mariano Esbrí Víctor
- Geriatrician Department, Hospital Perpetuo Socorro Albacete, 02006 Albacete, Spain;
| | - Bárbara Pérez Pena
- Geriatrician Department, Hospital Universitario Marqués de Valdecilla Santander, 39008 Santander, Spain;
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Swinnen N, de Bruin ED, Guimarães V, Dumoulin C, De Jong J, Akkerman R, Vandenbulcke M, Stubbs B, Vancampfort D. The feasibility of a stepping exergame prototype for older adults with major neurocognitive disorder residing in a long-term care facility: a mixed methods pilot study. Disabil Rehabil 2023:1-15. [PMID: 36824039 DOI: 10.1080/09638288.2023.2182916] [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: 06/08/2022] [Revised: 02/13/2023] [Accepted: 02/16/2023] [Indexed: 02/25/2023]
Abstract
PURPOSE To explore the feasibility of an exergame prototype in residential individuals with major neurocognitive disorder (MNCD). MATERIALS AND METHODS Participants were randomly assigned to a 12-week stepping exergame training or traditional exercise (active control group). Semi-structured interviews were conducted after six and 12 weeks of exergaming. Qualitative data were thematically analysed using NVivo 12. The Short Physical Performance Battery, one minute sit-to-stand test, Mini-Mental State Examination (MMSE), Neuropsychiatric Inventory, Cornell Scale for Depression in Dementia, and Dementia Quality of Life were assessed at baseline and post intervention using a Quade's ANCOVA. RESULTS Seven older adults with MNCD in the exergame and 11 in the active control group completed the study [mean age = 83.2 ± 6.5 years; 94.4% female; SPPB score = 7.3 ± 2.4]. Results indicated that the VITAAL exergame prototype was experienced as enjoyable and beneficial. The post-MMSE score was higher (η2=.02, p = 0.01, F = 8.1) following exergaming versus traditional exercise. CONCLUSIONS The findings suggest that the exergame prototype is accepted by individuals with MNCD residing in a long-term care facility when they are able to participate and under the condition that they are extensively guided. The preliminary efficacy results revealed higher post-MMSE scores after exergaming versus traditional exercise. Future trials should confirm or refute these findings. TRIAL REGISTRATION The trial was registered in ClinicalTrials.gov (Identifier: NCT04436315)Implications for rehabilitationThe VITAAL exergame prototype is accepted by individuals with MNCD residing in a long-term care facility who are able to participate.Supervision of exergaming by health professionals is essential for successful implementation.The VITAAL exergame prototype might maintain cognitive levels in major neurocognitive disorder longer than walking combined with standardised squatting and stepping exercises.
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Affiliation(s)
- Nathalie Swinnen
- Department of Rehabilitation Sciences, KU Leuven, Leuven, Belgium
| | - Eling D de Bruin
- Department of Health Sciences and Technology, Institute of Human Movement Sciences and Sport, ETH Zurich, Zurich, Switzerland
- Division of Physiotherapy, Department of Neurobiology, Care Sciences and Society, Karolinska Institute, Stockholm, Sweden
| | - Vânia Guimarães
- Fraunhofer Portugal Research Center for Assistive Information and Communication Solutions, Porto, Portugal
| | - Chantal Dumoulin
- Faculty of Medicine, University of Montreal, Québec, Canada
- Montreal Geriatric University Institute, Québec, Canada
| | | | | | - Mathieu Vandenbulcke
- Department of Neurosciences, KU Leuven, Leuven, Belgium
- University Psychiatric Centre KU Leuven, Leuven-Kortenberg, Belgium
| | - Brendon Stubbs
- South London and Maudsley NHS Foundation Trust, London, UK
- Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King's College London, London, UK
| | - Davy Vancampfort
- Department of Rehabilitation Sciences, KU Leuven, Leuven, Belgium
- University Psychiatric Centre KU Leuven, Leuven-Kortenberg, Belgium
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Jofré-Saldía E, Villalobos-Gorigoitía Á, Cofré-Bolados C, Ferrari G, Gea-García GM. Multicomponent Training in Progressive Phases Improves Functional Capacity, Physical Capacity, Quality of Life, and Exercise Motivation in Community-Dwelling Older Adults: A Randomized Clinical Trial. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:2755. [PMID: 36768119 PMCID: PMC9916387 DOI: 10.3390/ijerph20032755] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Revised: 01/31/2023] [Accepted: 02/01/2023] [Indexed: 06/18/2023]
Abstract
OBJECTIVE To evaluate the effect of a multicomponent progressive training program (MPTP) on functionality, quality of life (QoL) and motivation to exercise (EM) in a group of older adults (OA) of a community. METHODS A total of 55 participants of 69.42 ± 6.01 years of age were randomized into two groups; experimental (EG:35) and control (CG:20), and subjected to 27 weeks of MPTP. Functionality (pre/post-intervention) was assessed using the Short Physical Performance Battery (SPPB), Time Up and Go (TUG), Walking While Talking Test (WWT), Manual Dynamometry (MD), Forced Expiratory Volume in the first second (FEV1), Sit and Reach (SR), Back Scratch (BS), and walk for 2 min (2 mST). QoL was assessed using the SF-36 questionnaire and EM using the BREQ-3. The Kolmogorov-Smirnov and Levene tests were applied. A two-way repeated measures ANOVA was applied. A significance level of p < 0.05 was accepted for all comparisons. RESULTS The EG compared to the CG improved in SPPB (ΔEG/CG: 29.67%/p < 0.001), TUG (ΔEG/CG: 35.70%/p < 0.05), WWT (ΔEG/CG: 42.93%/p < 0.001), MD (ΔEG/CG: 20.40%/p < 0.05), FEV1 (ΔEG/CG: 21.37%/p < 0.05), BS (ΔEG/CG: 80.34%/p < 0.05), 2 mST (ΔEG/CG: 33.02%/p < 0.05), SF-36 (ΔEG/CG: 13.85%/p < 0.001), and Intrinsic Regulation (ΔEG/CG: 27.97%/p < 0.001); Identified by regulation (ΔEG/CG: 9.29%/p < 0.05). CONCLUSION An MPTP improves functionality, QoL and EM, and is a safe and effective method for community OAs.
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Affiliation(s)
- Emilio Jofré-Saldía
- Instituto de Ciencias de la Salud, Universidad de O’Higgins, Rancagua 2841935, Chile
- Facultad de Educación y Ciencias Sociales, Instituto del Deporte y Bienestar, Universidad Andres Bello, Santiago 7550000, Chile
| | | | - Cristián Cofré-Bolados
- School of Physical Activity, Sport and Health Sciences, University of Santiago de Chile, Santiago 9170022, Chile
| | - Gerson Ferrari
- School of Physical Activity, Sport and Health Sciences, University of Santiago de Chile, Santiago 9170022, Chile
- Faculty of Health Sciences, Universidad Autónoma de Chile, Providencia 7500912, Chile
| | - Gemma María Gea-García
- Faculty of Sport, Catholic University of Murcia, 30107 Murcia, Spain
- Health, Physical Activity, Fitness and Motor Control Performance Research Group (GISAFFCOM), Catholic University of Murcia, 30107 Murcia, Spain
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Ma C, Li M, Li R, Wu C. The effect of rhythmic movement on physical and cognitive functions among cognitively healthy older adults: A systematic review and meta-analysis. Arch Gerontol Geriatr 2023; 104:104837. [PMID: 36257163 DOI: 10.1016/j.archger.2022.104837] [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: 06/20/2022] [Revised: 10/05/2022] [Accepted: 10/10/2022] [Indexed: 11/05/2022]
Abstract
OBJECTIVE To explore the effects of rhythmic movement interventions on the physical and cognitive functions among cognitively healthy older adults. METHODS We searched PubMed, Web of Science, Cochrane Library, EMBASE, CNKI, CBM, Wanfang Data, and VIP databases from inception to March 30, 2022. The inclusion criteria were: ① randomized controlled trials (RCTs); ② older adults (aged ≥ 60 years) without cognitive impairments or neurological or neurodegenerative diseases; ③ intervention: rhythmic movement (rhythmic exercise or physical activities performed to music); ④ outcomes: physical or cognitive function. Overall, 44 RCTs across 20 countries (n = 2752 participants) were included. RESULTS An association was found between rhythmic movement and improved physical function (mobility, cardiopulmonary endurance, muscle strength, flexibility, and balance), global cognitive function, and quality of life (QOL). The physical function outcomes suggested additional significant benefits when using control groups with no exercise than when using control groups with exercise. No significant improvement was found in executive function. CONCLUSION Regular rhythmic movement likely improves physical function, global cognitive function, and QOL in healthy older adults. The effect of rhythmic movement on the physical function in older adults is similar to that of routine exercise. Further studies on cognitive function of healthy older adults using larger samples of populations with more balanced sex ratios with long-term follow-up are particularly encouraged.
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Affiliation(s)
- Chifen Ma
- School of Nursing, Peking University, Health Science Center, Room 510, 38 Xueyuan Road, Haidian District, Beijing 100191, China; College of Health Services and Management, Xuzhou Kindergarten Teachers College, Xuzhou, China
| | - Mengyuan Li
- School of Nursing, Peking University, Health Science Center, Room 510, 38 Xueyuan Road, Haidian District, Beijing 100191, China
| | - Ruyue Li
- School of Nursing, Peking University, Health Science Center, Room 510, 38 Xueyuan Road, Haidian District, Beijing 100191, China
| | - Chao Wu
- School of Nursing, Peking University, Health Science Center, Room 510, 38 Xueyuan Road, Haidian District, Beijing 100191, China.
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Borghi-Silva A, da Luz Goulart C, Silva R, Oliveira M, Back G, Arena R, Faghy M. Proposing an #EASIER cardiopulmonary rehabilitation protocol for coronavirus disease 2019 survivors. HEART AND MIND 2023. [DOI: 10.4103/hm.hm_28_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/14/2023] Open
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Zukowski LA, Shaikh FD, Haggard AV, Hamel RN. Acute effects of virtual reality treadmill training on gait and cognition in older adults: A randomized controlled trial. PLoS One 2022; 17:e0276989. [PMID: 36322594 PMCID: PMC9629584 DOI: 10.1371/journal.pone.0276989] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Accepted: 10/17/2022] [Indexed: 12/28/2022] Open
Abstract
INTRODUCTION Everyday walking often involves walking with divided attention (i.e., dual-tasking). Exercise interventions for older adults should mimic these simultaneous physical and cognitive demands. This proof-of-concept study had a two-fold purpose: 1) identify acute cognitive and gait benefits of a single session of virtual reality treadmill training (VRTT), relative to conventional treadmill training (CTT), and 2) identify differences between those who reduced dual-task costs (i.e., responders) on gait or cognition and those who did not, after the session. METHODS Sixty older adults were randomized to complete a single 30-minute session of VRTT (n = 30, 71.2±6.5 years, 22 females) or CTT (n = 30, 72.0±7.7 years, 21 females). Pre- and post-exercise session, participants performed single-task walking, single-task cognitive, and dual-task walking trials while gait and cognition were recorded. Gait variables were gait speed and gait speed variability. Cognition variables were response reaction time, response accuracy, and cognitive throughput. Dual-task effects (DTE) on gait and cognition variables were also calculated. RESULTS Post-exercise, there were no group differences (all p>0.05). During single- and dual-task trials, both groups walked faster (single-task: F(1, 58) = 9.560, p = 0.003; dual-task: F(1, 58) = 19.228, p<0.001), responded more quickly (single-task: F(1, 58) = 5.054, p = 0.028; dual-task: F(1, 58) = 8.543, p = 0.005), and reduced cognitive throughput (single-task: F(1, 58) = 6.425, p = 0.014; dual-task: F(1, 58) = 28.152, p<0.001). Both groups also exhibited reduced DTE on gait speed (F(1, 58) = 8.066, p = 0.006), response accuracy (F(1, 58) = 4.123, p = 0.047), and cognitive throughput (F(1, 58) = 6.807, p = 0.012). Gait responders and non-responders did not differ (all p>0.05), but cognitive responders completed fewer years of education (t(58) = 2.114, p = 0.039) and better information processing speed (t(58) = -2.265, p = 0.027) than cognitive non-responders. CONCLUSIONS The results indicate that both VRTT and CTT may acutely improve gait and cognition. Therefore, older adults will likely benefit from participating in either type of exercise. The study also provides evidence that baseline cognition can impact training effects on DTE on cognition.
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Affiliation(s)
- Lisa A. Zukowski
- Department of Physical Therapy, High Point University, High Point, North Carolina, United States of America
- * E-mail:
| | - Faisal D. Shaikh
- Department of Physical Therapy, High Point University, High Point, North Carolina, United States of America
| | - Alexa V. Haggard
- Department of Physical Therapy, High Point University, High Point, North Carolina, United States of America
| | - Renee N. Hamel
- Department of Physical Therapy, High Point University, High Point, North Carolina, United States of America
- School of Physiotherapy, University of Otago, Dunedin, New Zealand
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da Silva DJF, Torres JL, Ericeira LP, Jardim NYV, da Costa VO, Carvalho JPR, Corrêa PGR, Bento-Torres J, Picanço-Diniz CW, Bento-Torres NVO. Pilates and Cognitive Stimulation in Dual Task an Intervention Protocol to Improve Functional Abilities and Minimize the Rate of Age-Related Cognitive Decline in Postmenopausal Women. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:13333. [PMID: 36293914 PMCID: PMC9603464 DOI: 10.3390/ijerph192013333] [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: 09/08/2022] [Revised: 09/30/2022] [Accepted: 10/08/2022] [Indexed: 06/16/2023]
Abstract
UNLABELLED It is already known the effectiveness of Pilates training on cognitive and functional abilities. It is also known that dual-task exercise and cognitive stimuli improve cognition and functional capacity. However, no previous report combined cognitive stimuli and Pilates in dual task and measured its effects on the cognitive and physical performances of postmenopausal women. OBJECTIVE To apply an interventional dual-task (PILATES-COG) protocol and to evaluate its influence on memory, language, and functional physical performances on healthy, community-dwelling postmenopausal older women. METHODS 47 women with amenorrhea for at least 12 months participated in this study. Those allocated on the PILATES-COG group underwent a 12-week, twice a week regimen of 50 min sessions of simultaneous mat Pilates exercise program and cognitive tasks. Cognitive and physical functional performance were assessed. Two-way mixed ANOVA was used for data analysis, and Bonferroni post hoc tests were used for within- and between-group comparisons. RESULTS The PILATES-COG group showed significant improvement after the intervention in semantic verbal fluency (p < 0.001; ηρ² = 0.268), phonological verbal fluency (p < 0.019; ηρ² = 0.143), immediate memory (p < 0.001; ηρ² = 0.258), evocation memory (p < 0.001 ηρ² = 0.282), lower-limb muscle strength (p < 0.001; ηρ² = 0.447), balance (p < 0.001; ηρ² = 0.398), and dual-ask cost (p < 0.05; ηρ² = 0.111) assessments on healthy, community-dwelling postmenopausal older women. CONCLUSION This is the first report of a feasible and effective approach using Pilates and cognitive stimulation in dual task for the reduction of age-related cognitive decline and the improvement of physical functional performance in healthy postmenopausal women.
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Affiliation(s)
- Daniel José Fontel da Silva
- Graduate Program in Human Movement Sciences, Federal University of Pará, Belém 66075-110, Brazil
- Neurodegeneration and Infection Research Laboratory, Institute of Biological Science, João de Barros Barreto University Hospital, Federal University of Pará, Belém 66073-005, Brazil
| | - Juliana Lima Torres
- Neurodegeneration and Infection Research Laboratory, Institute of Biological Science, João de Barros Barreto University Hospital, Federal University of Pará, Belém 66073-005, Brazil
| | - Luiza Pimentel Ericeira
- Neurodegeneration and Infection Research Laboratory, Institute of Biological Science, João de Barros Barreto University Hospital, Federal University of Pará, Belém 66073-005, Brazil
| | - Naina Yuki Vieira Jardim
- Neurodegeneration and Infection Research Laboratory, Institute of Biological Science, João de Barros Barreto University Hospital, Federal University of Pará, Belém 66073-005, Brazil
| | - Victor Oliveira da Costa
- Neurodegeneration and Infection Research Laboratory, Institute of Biological Science, João de Barros Barreto University Hospital, Federal University of Pará, Belém 66073-005, Brazil
| | - Josilayne Patrícia Ramos Carvalho
- Graduate Program in Human Movement Sciences, Federal University of Pará, Belém 66075-110, Brazil
- Neurodegeneration and Infection Research Laboratory, Institute of Biological Science, João de Barros Barreto University Hospital, Federal University of Pará, Belém 66073-005, Brazil
| | - Paola Geaninne Reis Corrêa
- Neurodegeneration and Infection Research Laboratory, Institute of Biological Science, João de Barros Barreto University Hospital, Federal University of Pará, Belém 66073-005, Brazil
| | - João Bento-Torres
- Graduate Program in Human Movement Sciences, Federal University of Pará, Belém 66075-110, Brazil
- Neurodegeneration and Infection Research Laboratory, Institute of Biological Science, João de Barros Barreto University Hospital, Federal University of Pará, Belém 66073-005, Brazil
| | - Cristovam Wanderley Picanço-Diniz
- Neurodegeneration and Infection Research Laboratory, Institute of Biological Science, João de Barros Barreto University Hospital, Federal University of Pará, Belém 66073-005, Brazil
| | - Natáli Valim Oliver Bento-Torres
- Graduate Program in Human Movement Sciences, Federal University of Pará, Belém 66075-110, Brazil
- Neurodegeneration and Infection Research Laboratory, Institute of Biological Science, João de Barros Barreto University Hospital, Federal University of Pará, Belém 66073-005, Brazil
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Olyaei G, Khanmohammadi R, Talebian S, Hadian MR, Bagheri H, Najafi M. The effect of exergaming on cognition and brain activity in older adults: A motor- related cortical potential study. Physiol Behav 2022; 255:113941. [PMID: 35963295 DOI: 10.1016/j.physbeh.2022.113941] [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: 09/18/2021] [Revised: 07/05/2022] [Accepted: 08/04/2022] [Indexed: 11/24/2022]
Abstract
Exergames have positive effects on various cognitive domains. However, to the best of our knowledge, not only have few studies investigated the exergame-induced brain changes, but also in most of them, preparatory brain activity has not been considered. Preparatory brain activity is a particularly relevant aspect for investigating the interaction between cognitive and sensorimotor functions in the brain. Accordingly, the aim of this study was to investigate the effects of an exergame protocol versus traditional motor-cognitive dual-task training on the cognition and proactive components of movement-related cortical potential. A total of 52 older adults were randomly assigned to the intervention (exergame training) and the control group (motor-cognitive dual-task training). The outcome measurements were neurophysiological data (i.e., the amplitude of the late contingent negative variation [CNV], and alpha/beta event-related desynchronization [ERD]), and neuropsychological data (rate-correct score [RCS] in go/no go task and trail-making test [TMT]). The results revealed that both groups had a decreased late CNV, and alpha/ beta ERD in post-training compared to pre-training in Cz and C3 channels. Moreover, both groups had an increased RCS and a decreased TMT-A in post-training compared to pre-training. However, for TMT-B, the results indicated a significant interaction in favor of the exergame group. These findings indicate that in older adults, both interventions may result in increasing inhibitory control, information processing speed, and preparatory brain activity. However, for cognitive flexibility, exergame has an additional effect relative to the control group.
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Affiliation(s)
- Gholamreza Olyaei
- Physical Therapy Department, Tehran University of Medical Sciences, Tehran, Iran
| | - Roya Khanmohammadi
- Physical Therapy Department, Tehran University of Medical Sciences, Tehran, Iran.
| | - Saeed Talebian
- Physical Therapy Department, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Reza Hadian
- Physical Therapy Department, Tehran University of Medical Sciences, Tehran, Iran
| | - Hossein Bagheri
- Physical Therapy Department, Tehran University of Medical Sciences, Tehran, Iran
| | - Marzieyh Najafi
- Physical Therapy Department, Tehran University of Medical Sciences, Tehran, Iran
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Wender CL, Sandroff BM, Krch D. Rationale and methodology for examining the acute effects of aerobic exercise combined with varying degrees of virtual reality immersion on cognition in persons with TBI. Contemp Clin Trials Commun 2022; 29:100963. [PMID: 35865279 PMCID: PMC9294260 DOI: 10.1016/j.conctc.2022.100963] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Revised: 06/26/2022] [Accepted: 06/29/2022] [Indexed: 11/19/2022] Open
Abstract
Persons with Traumatic Brain Injury (TBI) commonly present with long-term cognitive deficits in executive function, processing speed, attention, and learning and memory. While specific cognitive rehabilitation techniques have shown significant success for deficits in individual domains, aerobic exercise training represents a promising approach for an efficient and general treatment modality that might improve many cognitive domains concurrently. Existing studies in TBI report equivocal results, however, and are hampered by methodological concerns, including small sample sizes, uncontrolled single-group designs, and the use of suboptimal exercise modalities for eliciting cognitive improvements in this population. One particularly promising modality involves the application of environmental enrichment via virtual reality (VR) during aerobic exercise in persons with TBI, but this has yet to be investigated. One approach for systematically developing an optimal aerobic exercise intervention for persons with TBI involves the examination of single bouts of aerobic exercise (i.e., acute aerobic exercise) on cognition. Acute exercise research is a necessary first step for informing the development of high-quality exercise training interventions that are more likely to induce meaningful beneficial effects. To date, such an acute exercise paradigm has yet to be conducted in persons with TBI. To that end, we propose an acute exercise study that will investigate the acute effects of aerobic exercise with incremental degrees of environmental enrichment (VR) relative to a control comparison condition on executive function (divided attention and working memory) and processing speed in 24 people with TBI.
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Affiliation(s)
- Carly L.A. Wender
- Center for Traumatic Brain Injury Research, Kessler Foundation, East Hanover, NJ, USA
- Department of Physical Medicine and Rehabilitation, Rutgers-NJ Medical School, Newark, NJ, USA
- Corresponding author. Kessler Foundation, 120 Eagle Rock Ave, Suite 100, East Hanover, NJ, 07936, USA.
| | - Brian M. Sandroff
- Center for Neuropsychology & Neuroscience Research, Kessler Foundation, West Orange, NJ, USA
- Department of Physical Medicine and Rehabilitation, Rutgers-NJ Medical School, Newark, NJ, USA
| | - Denise Krch
- Center for Traumatic Brain Injury Research, Kessler Foundation, East Hanover, NJ, USA
- Department of Physical Medicine and Rehabilitation, Rutgers-NJ Medical School, Newark, NJ, USA
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Rondão CADM, Mota MPG, Esteves D. Development of a Combined Exercise and Cognitive Stimulation Intervention for People with Mild Cognitive Impairment-Designing the MEMO_MOVE PROGRAM. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:10221. [PMID: 36011852 PMCID: PMC9408716 DOI: 10.3390/ijerph191610221] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/05/2022] [Revised: 08/13/2022] [Accepted: 08/14/2022] [Indexed: 06/15/2023]
Abstract
UNLABELLED Dementia patients are at high risk for the decline of both physical and cognitive capacities, resulting in an increased risk of the loss of autonomy. Exercise is regarded as a non-pharmacological therapy for dementia, considering the potential benefits of preventing cognitive decline and improving physical fitness. In this paper, we aim to describe the different design stages for an exercise program combined with cognitive stimulation for a population with mild cognitive impairment, i.e., the MEMO_MOVE program. METHODS The intervention design followed the Medical Research Council's guidelines for complex interventions and was structured according to the six steps in quality intervention development (6SQuID). The intervention was described considering the Template for Intervention Description and Replication (TIDieR). In order to establish the intervention characteristics, a literature review was conducted to collate and analyze previous work, which provided a summary the type of exercise that should be implemented among this population. RESULTS The MEMO_MOVE program was structured and described, regarding (i) inclusion of a cognitive stimulation component; (ii) the kind of cognitive stimulation; and (iii) the type of exercise, duration, frequency, intensity, and program length. CONCLUSIONS A systematic step-by-step process design was followed to create a specific intervention to promote physical fitness and cognitive stimulation in individuals with mild dementia.
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Affiliation(s)
| | - Maria Paula Gonçalves Mota
- Research Center in Sports Sciences, Health Sciences and Human Development (CIDESD), 5001-801 Vila Real, Portugal
- Department of Sports, University of Trás os Montes e Alto Douro, 5000-801 Vila Real, Portugal
| | - Dulce Esteves
- Department of Sports, University of Beira Interior, 6201-001 Covilhã, Portugal
- Research Center in Sports Sciences, Health Sciences and Human Development (CIDESD), 5001-801 Vila Real, Portugal
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Hu M, Hu H, Shao Z, Gao Y, Zeng X, Shu X, Huang J, Shen S, Wu IXY, Xiao LD, Feng H. Effectiveness and acceptability of non-pharmacological interventions in people with mild cognitive impairment: Overview of systematic reviews and network meta-analysis. J Affect Disord 2022; 311:383-390. [PMID: 35597472 DOI: 10.1016/j.jad.2022.05.043] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/05/2022] [Revised: 04/30/2022] [Accepted: 05/06/2022] [Indexed: 11/26/2022]
Abstract
BACKGROUND To explore effectiveness and acceptability of non-pharmacological interventions in mild cognitive impairment (MCI). METHODS Overview of systematic reviews and network meta-analysis were conducted. Systematic reviews (SRs) were searched via seven databases from June 2015 to June 2020. Randomized controlled trials (RCTs) were retrieved. The Methodological quality was assessed by AMSTAR 2 and RoB 2. Outcomes were effectiveness and acceptability measured by standardized mean differences (SMDs) and odd ratios (ORs) with 95% confidence interval (CI). Pairwise meta-analysis was first conducted, followed by network meta-analysis. RESULTS A total of 22 SRs and 42 RCTs with 4401 participants were included. The methodological quality of included SRs and RCTs were moderate. There were four interventions, with three types of physical activity (aerobic, muscle-strengthening, and mind-body), three types of cognitive (rehearsal-based, compensatory, and mixed), multicomponent (physical and cognitive component), and nutrition intervention. No significant inconsistency was identified. Regarding intervention effectiveness, muscle-strengthening (SMDs 0.87, 95% CI 0.31-1.43; rank 1), mind-body (0.76, 0.38-1.14; rank 2) and aerobic (0.34, 0.13-0.50; rank 3) were significantly better than the control group and there was no significant difference among these types of intervention . Cognitive intervention of rehearsal-based (1.33, 0.30-2.35; rank 1) and mixed (0.55, 0.00-1.11; rank 2) were significantly better than the control group and there was no significant difference among these types of intervention. Multicomponent intervention (0.32, 0.02-0.62) were significantly better than the control group but not better than the single component group. Regarding acceptability, there was no significant difference among types of intervention. CONCLUSION Physical activity, cognitive, and multicomponent intervention could be provided regardless of their types and acceptability due to their effectiveness on improved cognitive function for people with MCI.
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Affiliation(s)
- Mingyue Hu
- Xiangya Nursing School, Central South University, Changsha, China
| | - Hengyu Hu
- Xiangya Nursing School, Central South University, Changsha, China
| | - Zhanfang Shao
- Xiangya School of Public Health, Central South University, Changsha, China
| | - Yinyan Gao
- Xiangya Nursing School, Central South University, Changsha, China
| | - Xianmei Zeng
- Xiangya Nursing School, Central South University, Changsha, China
| | - Xinhui Shu
- Kaifeng Central Hospital, Kaifeng, China
| | - Jundan Huang
- Xiangya Nursing School, Central South University, Changsha, China
| | | | - Irene X Y Wu
- Xiangya School of Public Health, Central South University, Changsha, China.
| | - Lily Dongxia Xiao
- College of Nursing and Health Sciences, Flinders University, Adelaide, SA, Australia.
| | - Hui Feng
- Xiangya Nursing School, Central South University, Changsha, China; Oceanwide Health Management Institute, Central South University, Changsha, China; National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China.
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22
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Buyle M, Jung Y, Pavlou M, Gonzalez SC, Bamiou DE. The role of motivation factors in exergame interventions for fall prevention in older adults: A systematic review and meta-analysis. Front Neurol 2022; 13:903673. [PMID: 35989930 PMCID: PMC9388774 DOI: 10.3389/fneur.2022.903673] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2022] [Accepted: 07/11/2022] [Indexed: 11/27/2022] Open
Abstract
Balance disorders and falls are common in the elderly population. Regular balance exercises are an evidence-based physical intervention to prevent falls in older adults, while patient motivation and adherence are important factors for intervention outcome. Exergames are a relatively new, alternative intervention for physical rehabilitation as they improve balance and strength in older adults. The aims of this systematic review and meta-analysis were to assess the (1) effect of motivation factors as per the Capability, Opportunity and Motivation model of Behavior change (COM-B) on the effectiveness of exergame interventions in healthy older adults, (2) effectiveness of exergames to improve balance in older healthy adults and, (3) impact of exergames on cognitive outcomes. Results show that motivation and capability components influence the general outcome of the exergame training. Motivational factors should thus be considered when setting-up an exergame intervention. Furthermore, exergame intervention appears to be a promising training method in comparison to traditional exercise training. However, exergame training in itself might not be sufficient to improve fall risk and cognitive performance.
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Affiliation(s)
- Margot Buyle
- Psychological Sciences Research Institute and Institute of NeuroScience, Université Catholique de Louvain, Louvain-la-Neuve, Belgium
- *Correspondence: Margot Buyle
| | - Yujin Jung
- Audiology Department, Guy's and St Thomas' National Health Service Foundation Trust, London, United Kingdom
| | - Marousa Pavlou
- Faculty of Life Sciences and Medicine, Centre for Human and Applied Physiological Sciences, King's College London, London, United Kingdom
| | - Sergi Costafreda Gonzalez
- Division of Psychiatry, Faculty of Brain Sciences, University College London, London, United Kingdom
| | - Doris-Eva Bamiou
- University College London Ear Institute, Faculty of Brain Sciences, University College London, London, United Kingdom
- Biomedical Research Centre, National Institute for Health Research, London, United Kingdom
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23
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Rezola-Pardo C, Irazusta J, Mugica-Errazquin I, Gamio I, Sarquis-Adamson Y, Gil SM, Ugartemendia M, Montero-Odasso M, Rodriguez-Larrad A. Effects of multicomponent and dual-task exercise on falls in nursing homes: The AgeingOn Dual-Task study. Maturitas 2022; 164:15-22. [PMID: 35763894 DOI: 10.1016/j.maturitas.2022.06.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2021] [Revised: 04/28/2022] [Accepted: 06/14/2022] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To compare the effects of a multicomponent exercise program and a dual-task exercise program on the number of falls (fall rate) and number of fallers (fall incidence) and on parameters associated with fall risk in older adults living in long-term nursing homes (LTNH). STUDY DESIGN This is a secondary analysis of a single-blind randomized controlled trial involving 85 older adults in nine LTNHs (Gipuzkoa, Spain). Participants allocated to the multicomponent group underwent a twice-a-week 3-month individualized and progressive resistance and balance program. The dual-task group performed simultaneous cognitive training with the same multicomponent exercises. MAIN OUTCOMES Fall rate and incidence were analyzed using Poisson regression (adjusting for cognitive function and previous fall rate) and Kaplan-Meier analysis, respectively. Handgrip asymmetry, single- and dual-task TUG velocity and cost were assessed using two-way ANOVA for repeated measures and paired Student's t-tests. RESULTS The dual-task group showed a 3.8 times greater risk of falling than the multicomponent group during the intervention, and a 2.59 times greater risk during the 12-month follow-up. There were no between-group differences in fall incidence. There were between-group differences in handgrip strength asymmetry in favor of the multicomponent group. While only the multicomponent group improved on the TUG test, the dual-task group improved on dual-task cost. CONCLUSIONS Compared with the dual-task program, the multicomponent exercise program showed more benefits in reducing falls and in parameters associated with fall risk in LTNH residents. Future studies are warranted to confirm our results and continue to explore physical and cognitive interventions to prevent falls in LTNHs. Australian New Zealand Clinical Trials Registry ACTRN12618000536268.
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Affiliation(s)
- Chloe Rezola-Pardo
- Department of Physiology, Faculty of Medicine and Nursing, University of the Basque Country (UPV/EHU), Leioa, Bizkaia, Spain.
| | - Jon Irazusta
- Department of Physiology, Faculty of Medicine and Nursing, University of the Basque Country (UPV/EHU), Leioa, Bizkaia, Spain; BioCruces Health Research Institute, Barakaldo, Bizkaia, Spain
| | - Itxaso Mugica-Errazquin
- Department of Nursing II, Faculty of Medicine and Nursing, University of the Basque Country (UPV/EHU), Donostia, Gipuzkoa, Spain
| | - Ines Gamio
- Matia Bermingham, Matia Fundazioa, Donostia, Gipuzkoa, Spain
| | - Yanina Sarquis-Adamson
- Gait and Brain Lab, Parkwood Institute and Lawson Health Research Institute, University of Western Ontario, London, Ontario, Canada
| | - Susana María Gil
- Department of Physiology, Faculty of Medicine and Nursing, University of the Basque Country (UPV/EHU), Leioa, Bizkaia, Spain
| | - Maider Ugartemendia
- Department of Nursing II, Faculty of Medicine and Nursing, University of the Basque Country (UPV/EHU), Donostia, Gipuzkoa, Spain
| | - Manuel Montero-Odasso
- Gait and Brain Lab, Parkwood Institute and Lawson Health Research Institute, University of Western Ontario, London, Ontario, Canada; Division of Geriatric Medicine, Department of Medicine, Schulich School of Medicine and Dentistry, University of Western Ontario, London, Ontario, Canada; Department of Epidemiology and Biostatistics, University of Western Ontario, London, Ontario, Canada
| | - Ana Rodriguez-Larrad
- Department of Physiology, Faculty of Medicine and Nursing, University of the Basque Country (UPV/EHU), Leioa, Bizkaia, Spain; BioCruces Health Research Institute, Barakaldo, Bizkaia, Spain
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24
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Teraz K, Šlosar L, Paravlić AH, de Bruin ED, Marusic U. Impact of Motor-Cognitive Interventions on Selected Gait and Balance Outcomes in Older Adults: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Front Psychol 2022; 13:837710. [PMID: 35783735 PMCID: PMC9245546 DOI: 10.3389/fpsyg.2022.837710] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2021] [Accepted: 04/25/2022] [Indexed: 12/02/2022] Open
Abstract
Background Efficient performance of most daily activities requires intact and simultaneous execution of motor and cognitive tasks. To mitigate age-related functional decline, various combinations of motor and cognitive training have shown promising results. The aim of this systematic review and meta-analysis of randomized controlled trials (RCTs) was to evaluate the efficacy of different types of motor-cognitive training interventions (e.g., sequential and simultaneous) on selected functional outcomes in healthy older adults. Methods Six online academic databases were used to retrieve eligible RCTs up to April 2021, following PRISMA guidelines and PICO criteria. A random-effects model was used for all meta-analyses conducted on selected functional outcomes: single- and dual-task gait speed, the Timed Up and Go Test (TUG), and Berg Balance Scale (BBS) score. Effect size (ES) was calculated as Hedges' g and interpreted as: trivial: <0.20, small: 0.20–0.60, moderate: 0.61–1.20, large: 1.21–2.00, very large: 2.01–4.00 or extremely large >4.00. Results From 2,546 retrieved records, 91 RCTs were included for meta-analysis (n = 3,745 participants; 64.7–86.9 years). The motor-cognitive interventions included differed according to the type of training (e.g., sequential, simultaneous with additional cognitive task or exergame training. The results showed that motor-cognitive interventions can improve gait speed under single-task conditions (small ES = 0.34, P = 0.003). The effect of the intervention was moderated by the type of control group (Q = 6.203, P = 0.013): passive (moderate ES = 0.941, P = 0.001) vs. active controls (trivial ES = 0.153, P = 0.180). No significant effect was found for dual-task walking outcomes (P = 0.063). Motor-cognitive intervention had a positive effect on TUG (small ES = 0.42, P < 0.001), where the effect of intervention was moderated by control group [passive (moderate ES = 0.73, P = 0.001) vs. active (small ES = 0.20, P = 0.020)], but not by the type of training (P = 0.064). Finally, BBS scores were positively affected by motor-cognitive interventions (small ES = 0.59, P < 0.001) with however no significant differences between type of control group (P = 0.529) or intervention modality (P = 0.585). Conclusions This study provides evidence for the effectiveness of various types of motor-cognitive interventions on performance-based measures of functional mobility in healthy older adults. With respect to significant effects, gait speed under single-task condition was improved by motor-cognitive interventions, but the evidence shows that this type of intervention is not necessarily more beneficial than motor training alone. On the other hand, motor-cognitive interventions are better at improving multicomponent tasks of dynamic balance and mobility function, as measured by the TUG. Because of substantial heterogeneity and the current limited availability of different types of interventions, the conclusions should be interpreted with caution.
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Affiliation(s)
- Kaja Teraz
- Institute for Kinesiology Research, Science and Research Centre Koper, Koper, Slovenia
- Faculty of Sport, University of Ljubljana, Ljubljana, Slovenia
| | - Luka Šlosar
- Institute for Kinesiology Research, Science and Research Centre Koper, Koper, Slovenia
| | - Armin H. Paravlić
- Institute for Kinesiology Research, Science and Research Centre Koper, Koper, Slovenia
- Faculty of Sport, University of Ljubljana, Ljubljana, Slovenia
- Faculty of Sports Studies, Masaryk University, Brno, Czechia
| | - Eling D. de Bruin
- Institute of Human Movement Sciences and Sport, Department of Health Sciences and Technology, ETH Zurich, Zurich, Switzerland
- Division of Physiotherapy, Department of Neurobiology, Care Sciences and Society, Karolinska Institute, Stockholm, Sweden
- *Correspondence: Eling D. de Bruin
| | - Uros Marusic
- Institute for Kinesiology Research, Science and Research Centre Koper, Koper, Slovenia
- Department of Health Sciences, Alma Mater Europaea – ECM, Maribor, Slovenia
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25
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Hai L, Hou HY, Zhou C, Li HJ. The Effect of Exergame Training on Physical Functioning of Healthy Older Adults: A Meta-Analysis. Games Health J 2022; 11:207-224. [PMID: 35653720 DOI: 10.1089/g4h.2021.0173] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Exergames have attracted increasing attention from both the public and researchers. Although previous systematic reviews provided evidence that exergame training is beneficial for improving balance or mobility in older adults, multidimensional physical function measurements, including balance, upper body strength, lower body strength, aerobic endurance, and gait, might help us achieve more robust and reliable results. This meta-analysis aims to quantify the effects of exergame training on overall and specific physical function in healthy older adults. We systematically searched exergame training studies published between January 1985 and June 2021. Forty-eight studies were included in the present meta-analysis, with a total of 1099 participants included in the training group and 1098 participants in the control group. Random-effects meta-analyses found that older adults obtained a small benefit in overall physical function performance (g = 0.43, 95% confidence interval [CI] = 0.33 to 0.53), moderate benefits in balance (g = 0.59, 95% CI = 0.46 to 0.71), upper body strength (g = 0.65, 95% CI = 0.20 to 1.10), lower body strength (g = 0.51, 95% CI = 0.37 to 0.65), and aerobic endurance (g = 0.65, 95% CI = 0.44 to 0.86), a small benefit in gait (g = 0.33, 95% CI = 0.08 to 0.59), and negligible effects on upper body flexibility (g = 0.13, 95% CI = -0.06 to 0.32) and lower body flexibility (g = 0.10, 95% CI = -0.45 to 0.67) from exergame training. The mini-mental state examination score was positively associated with the overall training efficacy (β = 0.08, P = 0.01), while body mass index and the sample size in the training group were negatively associated with the overall training efficacy (β = -0.01, P < 0.01; β = -0.004, P < 0.01). The current meta-analytic findings revealed that exergame training produced general benefits for overall physical function and different effects on specific physical function domains in older adults.
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Affiliation(s)
- Lagan Hai
- CAS Key Laboratory of Behavioral Science, Institute of Psychology, Beijing, China.,Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Hai-Yan Hou
- CAS Key Laboratory of Behavioral Science, Institute of Psychology, Beijing, China.,Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Chen Zhou
- CAS Key Laboratory of Behavioral Science, Institute of Psychology, Beijing, China.,Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Hui-Jie Li
- CAS Key Laboratory of Behavioral Science, Institute of Psychology, Beijing, China.,Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
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26
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Foot-ankle therapeutic exercise program can improve gait speed in people with diabetic neuropathy: a randomized controlled trial. Sci Rep 2022; 12:7561. [PMID: 35534614 PMCID: PMC9082985 DOI: 10.1038/s41598-022-11745-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2021] [Accepted: 04/29/2022] [Indexed: 11/08/2022] Open
Abstract
This study sought to determine whether a foot–ankle therapeutic exercise program can improve daily physical activity (i.e. number of steps) and fast and self-selected gait speed in people with diabetic peripheral neuropathy (DPN). In this single-blind randomized controlled trial and intention-to-treat analysis, 78 volunteers with DPN were allocated into a control group, which received usual care, and an intervention group (IG), which received usual care plus a 12-week foot–ankle exercise program. The adherence at 12 weeks rate in the IG was 92.3% (36 participants) and the dropout was 5.1% in the control group (2 participants). The number of steps and self-selected gait speed did not change significantly in either group (p > 0.05), although a 1,365-step difference between groups were observed at 1-year followup. The 12-week foot–ankle therapeutic exercises improved significantly fast-gait speed (primary outcome) (p = 0.020), ankle range of motion (p = 0.048), and vibration perception (secondary outcomes) (p = 0.030), compared with usual-care at 12 weeks. At 24 weeks, the IG showed better quality of life than controls (p = 0.048). At 1-year, fast-gait speed and vibration perception remained higher in the IG versus controls. Overall, the program may be a complementary treatment strategy for improving musculoskeletal and functional deficits related to DPN. Trial registration ClinicalTrials.gov NCT02790931 (06/06/2016).
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27
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Torre MM, Temprado JJ. A Review of Combined Training Studies in Older Adults According to a New Categorization of Conventional Interventions. Front Aging Neurosci 2022; 13:808539. [PMID: 35177975 PMCID: PMC8844451 DOI: 10.3389/fnagi.2021.808539] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2021] [Accepted: 12/29/2021] [Indexed: 11/21/2022] Open
Abstract
Physical and cognitive training are effective to attenuate age-related declines of brain and cognition. Accordingly, interest in interventions that combine physical, motor, and cognitive exercises has recently grown. In the present review, we aimed to determine whether and under which conditions combined training could be more effective than separated cognitive and physical training, thanks to a structured framework build around seven interacting constructs (stimuli, settings, targets, markers, outcomes, moderators, and mechanisms), which collectively afford a global picture of the determining factors of combined training. We concluded that the general principles underlying the effectiveness of combined training were still difficult identify, due to the heterogeneity of the available studies. However, our analysis also suggested that, when they are well-designed and well-conducted, combined training interventions are more effective than separated physical and cognitive training to improve brain and cognition in older adults. Also, we identified still not answered questions, which could be addressed in futures studies. Finally, we showed that the new categorization of combined training could be also applied to review the literature on training with exergames.
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Affiliation(s)
- Marta Maria Torre
- Institut des Sciences du Mouvement, ISM UMR 7287, CNRS, Aix Marseille Université, Marseille, France
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28
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Suleiman-Martos N, García-Lara R, Albendín-García L, Romero-Béjar JL, Cañadas-De La Fuente GA, Monsalve-Reyes C, Gomez-Urquiza JL. Effects of active video games on physical function in independent community-dwelling older adults: A systematic review and meta-analysis. J Adv Nurs 2021; 78:1228-1244. [PMID: 34935178 DOI: 10.1111/jan.15138] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2021] [Revised: 08/25/2021] [Accepted: 12/09/2021] [Indexed: 02/02/2023]
Abstract
AIM To analyse the effects of active video games on physical function in independent community-dwelling older adults. DESIGN Systematic review and meta-analysis of randomized controlled trials. DATA SOURCES The CINAHL, LILACS, Medline, Proquest and Scopus databases were consulted, with no restriction by year of publication. REVIEW METHODS Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed. The meta-analysis was performed using RevMan software. RESULTS The analysis included 22 randomized controlled trials with a total of 1208 participants (all ≥55 years old). In our meta-analyses, the effects produced by playing the active video games (mean differences) were statistically significant for the variables Gait speed and Timed up-and-go. The differences between the control and experimental groups were not significant in the following tests: 6-minute walk, 30-second chair stand, balance (measured with the Berg Balance Scale), cadence, grip strength, knee extension strength, 8-Foot Up-and-Go or velocity. CONCLUSIONS Physical exercise from participation in active video games has beneficial effects on two clinical parameters (Gait speed and Timed up-and-go) in independent community-dwelling older adults. However, the effects on other parameters do not differ from those obtained with conventional exercise training. Therefore, the clinical significance of these benefits is limited. IMPACT Older adults usually perform little physical activity. In consequence, researchers have increasingly considered alternatives to traditional forms of exercise. One such is that provided by active video games, which can be a source of stimulation, encouraging adherence and motivation in exercise programmes. Our review shows that active video games can improve gait speed and mobility, but in other respects obtain no differences from conventional exercises. Further tailored randomized clinical trials should be undertaken with diverse populations of older adults to evaluate different physical function variables to determine the most appropriate training approach and its optimal design and duration.
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Affiliation(s)
| | - Rubén García-Lara
- Granada-Northeast Health Management Area, Andalusian Health Service, Granada, Spain
| | - Luis Albendín-García
- Granada-Metropolitano Health District, Andalusian Health Service, Granada, Spain
| | - José L Romero-Béjar
- Statistics and Operational Research Department, University of Granada, Granada, Spain
| | | | - Carolina Monsalve-Reyes
- Social Sciences Department, Catholic University of La Santísima Concepción, Concepción, Chile
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Thalmann M, Ringli L, Adcock M, Swinnen N, de Jong J, Dumoulin C, Guimarães V, de Bruin ED. Usability Study of a Multicomponent Exergame Training for Older Adults with Mobility Limitations. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182413422. [PMID: 34949028 PMCID: PMC8705921 DOI: 10.3390/ijerph182413422] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/27/2021] [Revised: 12/08/2021] [Accepted: 12/14/2021] [Indexed: 11/28/2022]
Abstract
The global population aged 60 years and over rises due to increasing life expectancy. More older adults suffer from “geriatric giants”. Mobility limitations, including immobility and instability, are usually accompanied by physical and cognitive decline, and can be further associated with gait changes. Improvements in physical and cognitive functions can be achieved with virtual reality exergame environments. This study investigated the usability of the newly developed VITAAL exergame in mobility-impaired older adults aged 60 years and older. Usability was evaluated with a mixed-methods approach including a usability protocol, the System Usability Scale, and a guideline-based interview. Thirteen participants (9 female, 80.5 ± 4.9 years, range: 71–89) tested the exergame and completed the measurement. The System Usability Scale was rated in a marginal acceptability range (58.3 ± 16.5, range: 30–85). The usability protocol and the guideline-based interview revealed general positive usability. The VITAAL exergame prototype received positive feedback and can be considered usable by older adults with mobility limitations. However, minor improvements to the system in terms of design, instructions, and technical aspects should be taken into account. The results warrant testing of the feasibility of the adapted multicomponent VITAAL exergame, and its effects on physical and cognitive functions, in comparison with conventional training, should be studied.
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Affiliation(s)
- Melanie Thalmann
- Department of Health Sciences and Technology, Institute of Human Movement Science and Sport, ETH Zürich, 8093 Zurich, Switzerland; (M.T.); (L.R.); (M.A.)
| | - Lisa Ringli
- Department of Health Sciences and Technology, Institute of Human Movement Science and Sport, ETH Zürich, 8093 Zurich, Switzerland; (M.T.); (L.R.); (M.A.)
| | - Manuela Adcock
- Department of Health Sciences and Technology, Institute of Human Movement Science and Sport, ETH Zürich, 8093 Zurich, Switzerland; (M.T.); (L.R.); (M.A.)
| | - Nathalie Swinnen
- Department of Rehabilitation Sciences, KU Leuven, 3001 Leuven, Belgium;
- University Psychiatric Centre, KU Leuven, 3070 Kortenberg, Belgium
| | | | - Chantal Dumoulin
- School of Rehabilitation, Faculty of Medicine, Université de Montréal, Montreal, QC H3T 1J4, Canada;
| | | | - Eling D. de Bruin
- Department of Health Sciences and Technology, Institute of Human Movement Science and Sport, ETH Zürich, 8093 Zurich, Switzerland; (M.T.); (L.R.); (M.A.)
- Division of Physiotherapy, Department of Neurobiology, Care Sciences and Society, Karolinska Institute, 171 77 Stockholm, Sweden
- Department of Health, OST—Eastern Swiss University of Applied Sciences, 9001 St. Gallen, Switzerland
- Correspondence: ; Tel.: +41-44-632-40-18
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30
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Turunen KM, Tirkkonen A, Savikangas T, Hänninen T, Alen M, Fielding RA, Kivipelto M, Stigsdotter Neely A, Törmäkangas T, Sipilä S. Effects of Physical and Cognitive Training on Falls and Concern about Falling in Older Adults: Results from a Randomized Controlled Trial. J Gerontol A Biol Sci Med Sci 2021; 77:1430-1437. [PMID: 34910809 PMCID: PMC9255687 DOI: 10.1093/gerona/glab375] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Indexed: 12/01/2022] Open
Abstract
Background The aim of this study is to investigate whether combined cognitive and physical training provides additional benefits to fall prevention when compared with physical training (PT) alone in older adults. Methods This is a prespecified secondary analysis of a single-blind, randomized controlled trial involving community-dwelling men and women aged 70–85 years who did not meet the physical activity guidelines. The participants were randomized into combined physical and cognitive training (PTCT, n = 155) and PT (n = 159) groups. PT included supervised and home-based physical exercises following the physical activity recommendations. PTCT included PT and computer-based cognitive training. The outcome was the rate of falls over the 12-month intervention (PTCT, n = 151 and PT, n = 155) and 12-month postintervention follow-up (PTCT, n = 143 and PT, n = 148). Falls were ascertained from monthly diaries. Exploratory outcomes included the rate of injurious falls, faller/recurrent faller/fall-related fracture status, and concern about falling. Results Estimated incidence rates of falls per person-year were 0.8 (95% confidence interval [CI] 0.7–1.1) in the PTCT and 1.1 (95% CI 0.9–1.3) in the PT during the intervention and 0.8 (95% CI 0.7–1.0) versus 1.0 (95% CI 0.8–1.1), respectively, during the postintervention follow-up. There was no significant difference in the rate of falls during the intervention (incidence rate ratio [IRR] = 0.78; 95% CI 0.56–1.10, p = .152) or in the follow-up (IRR = 0.83; 95% CI 0.59–1.15, p = .263). No significant between-group differences were observed in any exploratory outcomes. Conclusion A yearlong PTCT intervention did not result in a significantly lower rate of falls or concern about falling than PT alone in older community-dwelling adults. Clinical Trial Registration ISRCTN52388040
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Affiliation(s)
- Katri M Turunen
- Gerontology Research Center and Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland.,Seinäjoki University of Applied Sciences, School of Health Care and Social Work, Seinäjoki, Finland
| | - Anna Tirkkonen
- Gerontology Research Center and Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | - Tiina Savikangas
- Gerontology Research Center and Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | - Tuomo Hänninen
- NeuroCenter, Neurology, Kuopio University Hospital, Kuopio, Finland
| | - Markku Alen
- Department of Medical Rehabilitation, Oulu University Hospital, Oulu, Finland
| | - Roger A Fielding
- Nutrition, Exercise Physiology, and Sarcopenia Laboratory, Jean Mayer USDA Human Nutrition Research Center on Aging, Tufts University, Boston, Massachusetts, USA
| | - Miia Kivipelto
- Public Health Promotion Unit, Finnish Institute for Health and Welfare, Helsinki, Finland, Helsinki, Finland.,Division of Clinical Geriatrics, Center for Alzheimer Research, NVS, Karolinska Institutet, Stockholm, Sweden.,Institute of Clinical Medicine/Neurology, University of Eastern Finland, Kuopio, Finland.,Neuroepidemiology and Ageing Research Unit, School of Public Health, Imperial College London, London, United Kingdom
| | - Anna Stigsdotter Neely
- Department of Social and Psychological Studies, Karlstad University, Karlstad, Sweden.,Department of Psychology, Umeå University, Umeå, Sweden
| | - Timo Törmäkangas
- Gerontology Research Center and Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | - Sarianna Sipilä
- Gerontology Research Center and Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
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Chen Y, Zhang Y, Guo Z, Bao D, Zhou J. Comparison between the effects of exergame intervention and traditional physical training on improving balance and fall prevention in healthy older adults: a systematic review and meta-analysis. J Neuroeng Rehabil 2021; 18:164. [PMID: 34819097 PMCID: PMC8611920 DOI: 10.1186/s12984-021-00917-0] [Citation(s) in RCA: 31] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2021] [Accepted: 07/27/2021] [Indexed: 12/19/2022] Open
Abstract
OBJECTIVE Physical training (PT, e.g., Tai Chi and strength training) has been demonstrated to improve balance control and prevent falls. Recently, exergame intervention (EI) has emerged to prevent falls by enhancing both physical and cognitive functions in older adults. Therefore, we aim to quantitatively assess and compare the effects of PT and EI on the performance of balance control and fall prevention in healthy older adults via meta-analysis. METHODS A search strategy based on the PICOS principle was used to find the publication in the databases of PubMed, EMBASE, Web of Science, Cochrane Library, and MEDLINE. The quality and risk of bias in the studies were independently assessed by two researchers. RESULTS Twenty studies consisting of 845 participants were included. Results suggested that as compared to PT, EI induced greater improvement in postural control (sway path length, SMD = - 0.66, 95% CI - 0.91 to - 0.41, P < 0.001, I2 = 0%; sway speed, SMD = - 0.49, 95% CI - 0.71 to - 0.27, P < 0.001, I2 = 42%) and dynamic balance (SMD = - 0.19, 95% CI - 0.35 to - 0.03, P = 0.02, I2 = 0%) in healthy older adults. The EI with 90-119 min/week for more than 8-week significantly reduced falls. Subgroup analyses revealed that exergames, which were designed by the two principles of repeatedly performing diversified tasks and gradually increase the difficulty of the task, induced significant effects in improving balance control and falls prevention respectively (P = 0.03, P = 0.009). In addition, intervention that combines EI and PT induced significant improvement in postural control (P = 0.003). CONCLUSION The exergame intervention, especially the combination of EI and PT, is a promising strategy to improve balance control and reduce falls in healthy older adults. Future studies with rigorous design, larger sample size, and follow-up assessments are needed to further assess the effectiveness of diverse exergame interventions in fall prevention and to quantify the "dose-effect" relationship, as well as the carry-over effect of such intervention, which will ultimately help optimize the rehabilitative strategies to improve balance control and prevent falls.
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Affiliation(s)
- Yan Chen
- Sports Coaching College, Beijing Sport University, Beijing, China
| | - Yuan Zhang
- Human Development and Family Sciences, University of Connecticut, Storrs, CT, USA
| | - Zhenxiang Guo
- Sports Coaching College, Beijing Sport University, Beijing, China
| | - Dapeng Bao
- China Institute of Sport and Health Science, Beijing Sport University, Beijing, China.
| | - Junhong Zhou
- Hebrew SeniorLife Hinda and Arthur Marcus Institute for Aging Research, Harvard Medical School, Boston, MA, USA
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Swinnen N, de Bruin ED, Dumoulin C, Thalmann M, Guimarães V, De Jong J, Vandenbulcke M, Vancampfort D. The VITAAL Stepping Exergame Prototype for Older Adults With Major Neurocognitive Disorder: A Usability Study. Front Aging Neurosci 2021; 13:701319. [PMID: 34803650 PMCID: PMC8600328 DOI: 10.3389/fnagi.2021.701319] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2021] [Accepted: 09/28/2021] [Indexed: 11/13/2022] Open
Abstract
Purpose: This study investigates the usability of a stepping exergame in older adults with major neurocognitive disorder (MNCD) residing in a long-term care facility. Materials and Methods: A mixed methods study was conducted. Participants played exergames for 30 min on one try-out session. During the exergames, the think aloud method was used, and field notes were taken by the facilitator. Following the exergames, participants completed the System Usability Scale (SUS) and a semi-structured in-depth interview about usability including their personal experiences. Audio files were transcribed and a thematic content analysis of the think aloud data, field notes and interviews were performed using NVivo 12. Results: Twenty-two participants with MNCD were included [mean age = 84.3 ± 5.5 (70–95) years; 81.8% women; Short Physical Performance Battery score = 7.5 ± 3.2 (1–12), Montreal Cognitive Assessment score = 11.9 ± 4.4 (2–19)]. System usability was rated “ok to good” with a mean SUS score of 57.8 (SD = 12.3) with scores ranging from 37.5 to 90.0. Five main themes emerged from the thematic content analysis: (1) perceived user friendliness and acceptability of the exergames; (2) interactional experience; (3) motivational factors; (4) training modalities; and (5) risks. There were no adverse events nor dropouts. Conclusion: Participants evaluated the usability of the exergames positively. The results indicate that the stepping exergame is usable in older adults with MNCD.
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Affiliation(s)
- Nathalie Swinnen
- Department of Rehabilitation Sciences, KU Leuven, Leuven, Belgium
| | - Eling D de Bruin
- Department of Health Sciences and Technology, Institute of Human Movement Sciences and Sport, ETH Zürich, Zurich, Switzerland.,Division of Physiotherapy, Department of Neurobiology, Care Sciences and Society, Karolinska Institute, Stockholm, Sweden
| | - Chantal Dumoulin
- Faculty of Medicine, University of Montreal, Montreal, QC, Canada.,Montreal University Geriatrics Institute, Montreal, QC, Canada
| | - Melanie Thalmann
- Department of Health Sciences and Technology, Institute of Human Movement Sciences and Sport, ETH Zürich, Zurich, Switzerland
| | - Vânia Guimarães
- Fraunhofer Portugal Research Center for Assistive Information and Communication Solutions, Porto, Portugal
| | | | - Mathieu Vandenbulcke
- University Psychiatric Centre, KU Leuven, Leuven, Belgium.,Department of Neurosciences, KU Leuven, Leuven, Belgium
| | - Davy Vancampfort
- Department of Rehabilitation Sciences, KU Leuven, Leuven, Belgium.,University Psychiatric Centre, KU Leuven, Leuven, Belgium
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Nørgaard JE, Jorgensen MG, Ryg J, Andreasen J, Danielsen MB, Steiner DK, Andersen S. Effects of gait adaptability training on falls and fall-related fractures in older adults: a systematic review and meta-analysis. Age Ageing 2021; 50:1914-1924. [PMID: 34120163 DOI: 10.1093/ageing/afab105] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2021] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVE falls among older adults are common and can have devastating consequences. A novel task-specific exercise modality, gait adaptability training (GAT), has shown promising preventive effects. This systematic review and meta-analysis synthesise the evidence regarding GATs effect on falls and fall-related fractures in community-dwelling older adults. METHODS electronic databases (PubMed, EMBASE, CINAHL, CENTRAL) were systematically searched from inception to 18 June 2020. Additional sources include searches of trial registrations, manual screening of reference lists and requests to experts. We included randomised controlled trials (RCTs) evaluating the effect of GAT on falls with at least 6-month follow-up among community-dwelling people aged 60+ years. Two reviewers independently screened studies against eligibility criteria, extracted relevant information and appraised studies for bias. Random-effects meta-analytic models were employed to pool effect estimates. RESULTS eleven studies with 1,131 participants were included. A meta-analysis in which an outlier study was excluded showed that GAT reduces fall rates by 42% (incidence rate ratio 0.58, 95% confidence interval [CI] 0.39-0.81, I2 = 0.00%; moderate certainty; seven RCTs). Moreover, proportion with fall-related fractures and proportion of fallers was reduced by 81% (risk ratio [RR] 0.19, 95% CI 0.06-0.56, I2 = 0.00%; very low certainty; two RCTs) and 43% (RR 0.57, 95% CI 0.4-to 0.8, I2 = 47.08%; low certainty; 11 RCTs), respectively. CONCLUSIONS our results show that GAT significantly reduces the number of falls and prevents fall-related fractures in older community dwellers. GAT is a promising and feasible exercise modality; however, studies of high quality should be conducted to support a robust conclusion. PROTOCOL REGISTRATION PROSPERO; CRD42020191051.
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Affiliation(s)
- Jens Eg Nørgaard
- Department of Geriatric Medicine, Aalborg University Hospital, DK-9000 Aalborg, Denmark
- Department of Clinical Medicine, Aalborg University, DK-9000 Aalborg, Denmark
| | | | - Jesper Ryg
- Department of Geriatric Medicine, Odense University Hospital, DK-5000 Odense, Denmark
- Department of Clinical Research, University of Southern Denmark, DK-5000 Odense, Denmark
| | - Jane Andreasen
- Department of Occupational Therapy and Physiotherapy, Aalborg University Hospital, DK-9000 Aalborg, Denmark
- Public Health and Epidemiology Group, Department of Health, Science and Technology, Aalborg University, DK-9000 Aalborg, Denmark
| | - Mathias Brix Danielsen
- Department of Geriatric Medicine, Aalborg University Hospital, DK-9000 Aalborg, Denmark
- Department of Clinical Medicine, Aalborg University, DK-9000 Aalborg, Denmark
| | | | - Stig Andersen
- Department of Geriatric Medicine, Aalborg University Hospital, DK-9000 Aalborg, Denmark
- Department of Clinical Medicine, Aalborg University, DK-9000 Aalborg, Denmark
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Rosado H, Bravo J, Raimundo A, Carvalho J, Marmeleira J, Pereira C. Effects of two 24-week multimodal exercise programs on reaction time, mobility, and dual-task performance in community-dwelling older adults at risk of falling: a randomized controlled trial. BMC Public Health 2021; 21:408. [PMID: 34758759 PMCID: PMC8582089 DOI: 10.1186/s12889-021-10448-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2021] [Accepted: 02/15/2021] [Indexed: 11/11/2022] Open
Abstract
BACKGROUND Falls in older adults are considered a major public health problem. Declines in cognitive and physical functions, as measured by parameters including reaction time, mobility, and dual-task performance, have been reported to be important risk factors for falls. The aim of this study was to investigate the effects of two multimodal programs on reaction time, mobility, and dual-task performance in community-dwelling older adults at risk of falling. METHODS In this randomized controlled trial, fifty-one participants (75.4 ± 5.6 years) were allocated into two experimental groups (EGs) (with sessions 3 times per week for 24 weeks), and a control group: EG1 was enrolled in a psychomotor intervention program, EG2 was enrolled in a combined exercise program (psychomotor intervention program + whole-body vibration program), and the control group maintained their usual daily activities. The participants were assessed at baseline, after the intervention, and after a 12-week no-intervention follow-up period. RESULTS The comparisons revealed significant improvements in mobility and dual-task performance after the intervention in EG1, while there were improvements in reaction time, mobility, and dual-task performance in EG2 (p ≤ 0.05). The size of the interventions' clinical effect was medium in EG1 and ranged from medium to large in EG2. The comparisons also showed a reduction in the fall rate in both EGs (EG1: -44.2%; EG2: - 63.0%, p ≤ 0.05) from baseline to post-intervention. The interventions' effects on reaction time, mobility, and dual-task performance were no longer evident after the 12-week no-intervention follow-up period. CONCLUSIONS The results suggest that multimodal psychomotor programs were well tolerated by community-dwelling older adults and were effective for fall prevention, as well as for the prevention of cognitive and physical functional decline, particularly if the programs are combined with whole-body vibration exercise. The discontinuation of these programs could lead to the fast reversal of the positive outcomes achieved. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT03446352. Date of registration: February 07, 2018.
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Affiliation(s)
- Hugo Rosado
- Departamento de Desporto e Saúde, Escola de Ciências e Tecnologia, Universidade de Évora, Largo dos Colegiais 2, Évora, Portugal.
- Comprehensive Health Research Center (CHRC), Universidade de Évora, Largo dos Colegiais 2, Évora, Portugal.
| | - Jorge Bravo
- Departamento de Desporto e Saúde, Escola de Ciências e Tecnologia, Universidade de Évora, Largo dos Colegiais 2, Évora, Portugal
- Comprehensive Health Research Center (CHRC), Universidade de Évora, Largo dos Colegiais 2, Évora, Portugal
| | - Armando Raimundo
- Departamento de Desporto e Saúde, Escola de Ciências e Tecnologia, Universidade de Évora, Largo dos Colegiais 2, Évora, Portugal
- Comprehensive Health Research Center (CHRC), Universidade de Évora, Largo dos Colegiais 2, Évora, Portugal
| | - Joana Carvalho
- Faculdade de Desporto, Universidade do Porto, Praça de Gomes Teixeira, Porto, Portugal
- CIAFEL - Research Centre in Physical Activity, Health and Leisure, Universidade do Porto, Praça de Gomes Teixeira, Porto, Portugal
| | - José Marmeleira
- Departamento de Desporto e Saúde, Escola de Ciências e Tecnologia, Universidade de Évora, Largo dos Colegiais 2, Évora, Portugal
- Comprehensive Health Research Center (CHRC), Universidade de Évora, Largo dos Colegiais 2, Évora, Portugal
| | - Catarina Pereira
- Departamento de Desporto e Saúde, Escola de Ciências e Tecnologia, Universidade de Évora, Largo dos Colegiais 2, Évora, Portugal
- Comprehensive Health Research Center (CHRC), Universidade de Évora, Largo dos Colegiais 2, Évora, Portugal
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Monteagudo P, Cordellat A, Roldán A, Gómez-Cabrera MC, Pesce C, Blasco-Lafarga C. Exploring Potential Benefits of Accumulated Multicomponent-Training in Non-Active Older Adults: From Physical Fitness to Mental Health. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:9645. [PMID: 34574570 PMCID: PMC8469847 DOI: 10.3390/ijerph18189645] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/08/2021] [Revised: 09/08/2021] [Accepted: 09/09/2021] [Indexed: 11/16/2022]
Abstract
The present study aimed to analyze the impact of a multicomponent training (MCT) program in a group of non-active older adults, comparing two different dose distributions. Twenty-four individuals, assigned to two groups, completed 15 weeks of MCT (2 days/week). The continuous group (CMCT; n = 14, 9 females; 71.07 ± 5.09 years) trained for 60 min/session in the morning. The accumulated group (AMCT; n = 10, 5 females; 72.70 ± 3.59 years) performed the same exercises, volume, and intensity, but the training was distributed twice per day (30 min in the morning; 30 more in the afternoon). Bonferroni post hoc comparisons revealed significant (p < 0.001) and similar large improvements in both groups in lower limb strength (five times sit-to-stand test: CMCT, 12.55 ± 2.83 vs. 9.44 ± 1.72 s; AMCT, 10.37 ± 2.35 vs. 7.46 ± 1.75 s). In addition, there were large gains in preferred walking speed and instrumental daily life activities, which were higher for CMCT and AMCT, respectively (in this order: 1.00 ± 0.18 vs. 1.44 ± 0.26 m/s and 1.09 ± 0.80 vs. 1.58 ± 0.18 m/s; 33.07 ± 2.88 vs. 36.57 ± 1.65 points and 32.80 ± 1.93 vs. 36.80 ± 0.92 points); improvements in cardiorespiratory fitness, now moderate for CMCT (474.14 ± 93.60 vs. 529.64 ± 82.76 m) and large for AMCT (515.10 ± 20.24 vs. 589.60 ± 40.38 m); and medium and similar enhancements in agility in both groups (TUG test: CMCT: 7.49 ± 1.11 vs. 6.77 ± 1.16 s; AMCT: 6.84 ± 1.01 vs. 6.18 ± 0.62 s). None of the protocols had an impact on the executive function, whereas health-related quality of life showed a trend to significance in the whole sample only (EQindex overall sample, p = 0.062; d = 0.48 CMCT; d = 0.34 AMCT). Regardless of the type of dose distribution, starting multicomponent training improves physical function in non-active older adults, but does not improve cognitive function at mid-term. Because both forms of MCT showed similar compliance, slightly positive differences in accumulated strategies may indicate some benefits related to breaking afternoon sedentary behaviors, which deserves further research in longer and larger interventions. The mixed nature of MCT suggests accumulative group interventions may be a promising approach to address sedentary aging.
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Affiliation(s)
- Pablo Monteagudo
- Sport Performance and Physical Fitness Research Group (UIRFIDE), University of Valencia, 46010 Valencia, Spain; (A.C.); (A.R.)
- Department of Education and Specific Didactics, Jaume I University, 12071 Castellon, Spain
| | - Ana Cordellat
- Sport Performance and Physical Fitness Research Group (UIRFIDE), University of Valencia, 46010 Valencia, Spain; (A.C.); (A.R.)
- Physical Education and Sports Department, University of Valencia, 46010 Valencia, Spain
| | - Ainoa Roldán
- Sport Performance and Physical Fitness Research Group (UIRFIDE), University of Valencia, 46010 Valencia, Spain; (A.C.); (A.R.)
- Physical Education and Sports Department, University of Valencia, 46010 Valencia, Spain
| | - Mari Carmen Gómez-Cabrera
- Freshage Research Group, Department of Physiology, Faculty of Medicine, University of Valencia, CIBERFES, Fundación Investigación Hospital Clínico Universitario/INCLIVA, 46010 Valencia, Spain;
| | - Caterina Pesce
- Department of Movement, Human and Health Sciences, Foro Italico University, 00135 Rome, Italy;
| | - Cristina Blasco-Lafarga
- Sport Performance and Physical Fitness Research Group (UIRFIDE), University of Valencia, 46010 Valencia, Spain; (A.C.); (A.R.)
- Physical Education and Sports Department, University of Valencia, 46010 Valencia, Spain
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Lapierre N, Um Din N, Igout M, Chevrier J, Belmin J. Effects of a Rehabilitation Program Using a Patient-Personalized Exergame on Fear of Falling and Risk of Falls in Vulnerable Older Adults: Protocol for a Randomized Controlled Group Study. JMIR Res Protoc 2021; 10:e24665. [PMID: 34435968 PMCID: PMC8430847 DOI: 10.2196/24665] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2020] [Revised: 12/16/2020] [Accepted: 03/05/2021] [Indexed: 01/16/2023] Open
Abstract
BACKGROUND Older adults often experience physical, sensory, and cognitive decline. Therefore, they have a high risk of falls, which leads to severe health and psychological consequences and can induce fear of falling. Rehabilitation programs using exergames to prevent falls are being increasingly studied. Medimoov is a movement-based patient-personalized exergame for rehabilitation in older adults. A preliminary study showed that its use may influence functional ability and motivation. Most existing studies that evaluate the use of exergames do not involve an appropriate control group and do not focus on patient-personalized exergames. OBJECTIVE This study aims to evaluate the effects of Medimoov on risk of falls and fear of falling in older adults compared with standard psychomotor rehabilitation. METHODS This is a serial, comparative, randomized controlled group study. Both groups (n=25 in each) will receive psychomotor rehabilitation care. However, the methods of delivery will be different; one group will be exposed to the Medimoov exergame platform, and the other only to traditional means of psychomotor rehabilitation. The selection criteria will be (1) age of 65 years or older, (2) ability to answer a questionnaire, (3) ability to stand in a bipedal position for at least 1 minute, (4) score of 13 or greater on the Short Fall Efficacy Scale, and (5) stable medical condition. An evaluation will be made prior to starting the intervention, after 4 weeks of intervention, and at the end of the intervention (after 8 weeks), and it will focus on (1) risk of falls, (2) fear of falling, and (3) cognitive evaluations. Physical activity outside the session will also be assessed by actimetry. The outcome assessment will be performed according to intention-to-treat analysis. RESULTS The protocol (2019-11-22) has been approved by the Comité de Protection des Personnes Nord-Ouest I-Université de Rouen (2019-A00395-52), which is part of the French national ethical committee. The study received funding in February 2020. As of October 2020 (submission date), and due to the context of the COVID-19 pandemic, a total of 10 participants out of 50 had been enrolled in the study. The projected date for the end of the data collection is December 2021. Data analyses have not been started yet, and publication of the results is expected for Spring 2022. CONCLUSIONS The effects of psychomotor rehabilitation using the Medimoov exergame platform on the risk and fear of falls will be evaluated. This pilot study will be the basis for larger trials. TRIAL REGISTRATION ClinicalTrials.gov NCT04134988; https://clinicaltrials.gov/ct2/show/NCT04134988. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/24665.
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Affiliation(s)
- Nolwenn Lapierre
- Hôpital Charles Foix, Assistance Publique-Hôpitaux de Paris, AP-HP.Sorbonne Université, Ivry-Sur-Seine, France.,Centre de Recherches Interdisciplinaires, Université Paris Descartes, Paris, France
| | - Nathavy Um Din
- Hôpital Charles Foix, Assistance Publique-Hôpitaux de Paris, AP-HP.Sorbonne Université, Ivry-Sur-Seine, France
| | - Manuella Igout
- Hôpital Charles Foix, Assistance Publique-Hôpitaux de Paris, AP-HP.Sorbonne Université, Ivry-Sur-Seine, France
| | - Joël Chevrier
- Centre de Recherches Interdisciplinaires, Université Paris Descartes, Paris, France
| | - Joël Belmin
- Hôpital Charles Foix, Assistance Publique-Hôpitaux de Paris, AP-HP.Sorbonne Université, Ivry-Sur-Seine, France.,Faculté de Médecine Sorbonne, Sorbonne Université, Paris, France
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Virtual Reality Rehabilitation and Exergames—Physical and Psychological Impact on Fall Prevention among the Elderly—A Literature Review. APPLIED SCIENCES-BASEL 2021. [DOI: 10.3390/app11094098] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
The present review is aimed at the effectiveness of virtual reality (VR) and exergames in the prevention of falls among the elderly. Falls become a significant problem in the aging population and lead to psychological, social, and physical impairment. Prevention of falls is crucial to the well-being of the elderly population and is one of the challenges of contemporary rehabilitation. Recently, in view of the threat of the SARS-CoV-2 pandemic, contactless methods of rehabilitation, including telerehabilitation, appear as valuable rehabilitation tools. This review is based on the PRISMA guidelines and was carried out in five databases: PubMed, Medline, Web of Science, Scopus, and PEDro. Twenty-one randomized controlled trials, focused on the application of VR and exergames in the prevention of falls, were included. This review suggests that VR training in rehabilitation appears to be a promising complement to traditional techniques of physiotherapy to improve specific physical outcomes. VR and exergames could be considered as a complement of standard physiotherapy and its possible continuation at home for elderly. However, further high-quality studies, with carefully designed protocols and proper blinding, are needed.
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Gaspar AGM, Lapão LV. eHealth for Addressing Balance Disorders in the Elderly: Systematic Review. J Med Internet Res 2021; 23:e22215. [PMID: 33908890 PMCID: PMC8116987 DOI: 10.2196/22215] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2020] [Revised: 01/10/2021] [Accepted: 02/25/2021] [Indexed: 02/06/2023] Open
Abstract
Background The population is aging on a global scale, triggering vulnerability for chronic multimorbidity, balance disorders, and falls. Falls with injuries are the main cause of accidental death in the elderly population, representing a relevant public health problem. Balance disorder is a major risk factor for falling and represents one of the most frequent reasons for health care demand. The use of information and communication technologies to support distance healthcare (eHealth) represents an opportunity to improve the access and quality of health care services for the elderly. In recent years, several studies have addressed the potential of eHealth devices to assess the balance and risk of falling of elderly people. Remote rehabilitation has also been explored. However, the clinical applicability of these digital solutions for elderly people with balance disorders remains to be studied. Objective The aim of this review was to guide the clinical applicability of eHealth devices in providing the screening, assessment, and treatment of elderly people with balance disorders, but without neurological disease. Methods A systematic review was performed in accordance with the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analysis) statement. Data were obtained through searching the PubMed, Google Scholar, Embase, and SciELO databases. Only randomized controlled trials (RCTs) or quasiexperimental studies (QESs) published between January 2015 and December 2019 were included. The quality of the evidence to respond to the research question was assessed using Joanna Briggs Institute (JBI) Critical Appraisal for RCTs and the JBI Critical Appraisal Checklist for QESs. RCTs were assessed using the Cochrane risk of bias tool. We provide a narrative synthesis of the main outcomes from the included studies. Results Among 1030 unduplicated articles retrieved, 21 articles were included in this review. Twelve studies explored different technology devices to obtain data about balance and risk of falling. Nine studies focused on different types of balance exercise training. A wide range of clinical tests, functional scales, classifications of faller participants, sensor-based tasks, intervention protocols, and follow-up times were used. Only one study described the clinical conditions of the participants. Instrumental tests of the inner ear were neither used as the gold-standard test nor performed in pre and postrehabilitation assessments. Conclusions eHealth has potential for providing additional health care to elderly people with balance disorder and risk of falling. In the included literature, the heterogeneity of populations under study, methodologies, eHealth devices, and time of follow-up did not allow for clear comparison to guide proper clinical applicability. This suggests that more rigorous studies are needed.
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Affiliation(s)
- Andréa G Martins Gaspar
- Hospital Beatriz Ângelo, Lisbon, Portugal.,Global Health and Tropical Medicine, Instituto de Higiene e Medicina Tropical, Universidade NOVA de Lisboa, Lisbon, Portugal
| | - Luís Velez Lapão
- Global Health and Tropical Medicine, Instituto de Higiene e Medicina Tropical, Universidade NOVA de Lisboa, Lisbon, Portugal
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Goulart CDL, Silva RN, Oliveira MR, Guizilini S, Rocco IS, Mendez VMF, Bonjorno JC, Caruso FR, Arena R, Borghi-Silva A. Lifestyle and rehabilitation during the COVID-19 pandemic: guidance for health professionals and support for exercise and rehabilitation programs. Expert Rev Anti Infect Ther 2021; 19:1385-1396. [PMID: 33852807 DOI: 10.1080/14787210.2021.1917994] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Introduction: The coronavirus disease-2019 (COVID-19) is a highly contagious respiratory viral disease for both the general population and healthcare professionals caring for infected patients. Of particular concern is the potential for significant respiratory, cardiovascular, physical, and psychological dysfunctions.Areas covered: In this context, the current review will focus on the following areas: 1) staying physically active during the COVID-19 pandemic; 2) highlighting the importance of understanding COVID-19 mechanisms; 3) preventing infections for healthcare workers by using personal protective equipment; 4) highlighting importance of respiratory care and physical therapy during hospitalization in patients with COVID-19; and 5) facilitating referral to a rehabilitation program in patients recovering from COVID-19.Expert opinion: We recommend daily physical exercise, outdoors or at home, as physical exercise increases the synthesis of anti-inflammatory cytokines; Patients with COVID-19 may develop severe acute respiratory syndrome, hypoxemia, diffuse alveolar damage, ACE2 reduction in the cardiovascular system and muscle weakness acquired through a prolonged hospital stay; The role of the physiotherapist in the hospital environment is of fundamental importance-early mobilization is highly recommended in severe cases of COVID-19.
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Affiliation(s)
- Cássia Da Luz Goulart
- Cardiopulmonary Physiotherapy Laboratory, Physiotherapy Department, Universidade Federal De Sao Carlos, Sao Carlos, SP, Brazil
| | - Rebeca Nunes Silva
- Cardiopulmonary Physiotherapy Laboratory, Physiotherapy Department, Universidade Federal De Sao Carlos, Sao Carlos, SP, Brazil
| | - Murilo Rezende Oliveira
- Cardiopulmonary Physiotherapy Laboratory, Physiotherapy Department, Universidade Federal De Sao Carlos, Sao Carlos, SP, Brazil
| | - Solange Guizilini
- Department of the Human Movement Sciences, Universidade Federal De São Paulo - UNIFESP, Santos, SP, Brazil
| | - Isadora Salvador Rocco
- Department of the Human Movement Sciences, Universidade Federal De São Paulo - UNIFESP, Santos, SP, Brazil
| | | | - José Carlos Bonjorno
- Department of Medicine, Universidade Federal De Sao Carlos, Sao Carlos, SP, Brazil
| | - Flavia Rossi Caruso
- Cardiopulmonary Physiotherapy Laboratory, Physiotherapy Department, Universidade Federal De Sao Carlos, Sao Carlos, SP, Brazil
| | - Ross Arena
- Department of Physical Therapy, College of Applied Health Sciences, University of Illinois at Chicago, Chicago, IL., USA.,Healthy Living for Pandemic Event Protection (HL - PIVOT) Network, Chicago, IL, USA
| | - Audrey Borghi-Silva
- Cardiopulmonary Physiotherapy Laboratory, Physiotherapy Department, Universidade Federal De Sao Carlos, Sao Carlos, SP, Brazil.,Healthy Living for Pandemic Event Protection (HL - PIVOT) Network, Chicago, IL, USA
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Sipilä S, Tirkkonen A, Savikangas T, Hänninen T, Laukkanen P, Alen M, Fielding RA, Kivipelto M, Kulmala J, Rantanen T, Sihvonen SE, Sillanpää E, Stigsdotter Neely A, Törmäkangas T. Effects of physical and cognitive training on gait speed and cognition in older adults: A randomized controlled trial. Scand J Med Sci Sports 2021; 31:1518-1533. [PMID: 33772877 DOI: 10.1111/sms.13960] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2020] [Revised: 02/12/2021] [Accepted: 03/23/2021] [Indexed: 01/14/2023]
Abstract
Gait speed is a measure of health and functioning. Physical and cognitive determinants of gait are amenable to interventions, but best practices remain unclear. We investigated the effects of a 12-month physical and cognitive training (PTCT) on gait speed, dual-task cost in gait speed, and executive functions (EFs) compared with physical training (PT) (ISRCTN52388040). Community-dwelling older adults, who did not meet physical activity recommendations, were recruited (n = 314). PT included supervised walking/balance (once weekly) and resistance/balance training (once weekly), home exercises (2-3 times weekly), and moderate aerobic activity 150 min/week in bouts of >10 min. PTCT included the PT and computer training (CT) on EFs 15-20 min, 3-4 times weekly. The primary outcome was gait speed. Secondary outcomes were 6-min walking distance, dual-task cost in gait speed, and EF (Stroop and Trail Making B-A). The trial was completed by 93% of the participants (age 74.5 [SD3.8] years; 60% women). Mean adherence to supervised sessions was 59%-72% in PT and 62%-77% in PTCT. Home exercises and CT were performed on average 1.9 times/week. Weekly minutes spent in aerobic activities were 188 (median 169) in PT and 207 (median 180) in PTCT. No significant interactions were observed for gait speed (PTCT-PT, 0.02; 95%CI -0.03, 0.08), walking distance (-3.8; -16.9, 9.3) or dual-task cost (-0.22; -1.74, 1.30). Stroop improvement was greater after PTCT than PT (-6.9; -13.0, -0.8). Complementing physical training with EFs training is not essential for promotion of gait speed. For EF's, complementing physical training with targeted cognitive training provides additional benefit.
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Affiliation(s)
- Sarianna Sipilä
- Gerontology Research Center and Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | - Anna Tirkkonen
- Gerontology Research Center and Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | - Tiina Savikangas
- Gerontology Research Center and Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | - Tuomo Hänninen
- NeuroCenter, Neurology, Kuopio University Hospital, Kuopio, Finland
| | - Pia Laukkanen
- Gerontology Research Center and Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | - Markku Alen
- Department of Medical Rehabilitation, Oulu University Hospital, Oulu, Finland
| | - Roger A Fielding
- Nutrition, Exercise Physiology, and Sarcopenia Laboratory, Jean Mayer USDA Human Nutrition Research Center on Aging, Tufts University, Boston, MA, USA
| | - Miia Kivipelto
- Population Health Unit, Finnish Institute for Health and Welfare, Helsinki, Finland.,Division of Clinical Geriatrics, Center for Alzheimer Research, NVS, Karolinska Institutet, Stockholm, Sweden.,Institute of Clinical Medicine/Neurology, University of Eastern Finland, Kuopio, Finland.,Neuroepidemiology and Ageing Research Unit, School of Public Health, Imperial College London, London, UK
| | - Jenni Kulmala
- Population Health Unit, Finnish Institute for Health and Welfare, Helsinki, Finland.,Division of Clinical Geriatrics, Center for Alzheimer Research, NVS, Karolinska Institutet, Stockholm, Sweden.,Faculty of Social Sciences (Health Sciences) and Gerontology Research Centre (GEREC), Tampere University, Tampere, Finland
| | - Taina Rantanen
- Gerontology Research Center and Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | - Sanna E Sihvonen
- School of Health and Social Studies, Jyväskylä University of Applied Sciences, Jyväskylä, Finland
| | - Elina Sillanpää
- Gerontology Research Center and Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | - Anna Stigsdotter Neely
- Department of Social and Psychological Studies, Karlstad University, Karlstad, Sweden.,Engineering Psychology, Luleå University of Technology, Luleå, Sweden
| | - Timo Törmäkangas
- Gerontology Research Center and Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
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Bischoff LL, Cordes T, Meixner C, Schoene D, Voelcker-Rehage C, Wollesen B. Can cognitive-motor training improve physical functioning and psychosocial wellbeing in nursing home residents? A randomized controlled feasibility study as part of the PROCARE project. Aging Clin Exp Res 2021; 33:943-956. [PMID: 32537707 DOI: 10.1007/s40520-020-01615-y] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2020] [Accepted: 05/28/2020] [Indexed: 01/06/2023]
Abstract
BACKGROUND A multi-component training program holds promises for the elderly, but still has to be tested on its feasibility and effect in nursing homes. AIMS The aim of this study was (1) to design a multi-component training program which improves physical functioning and psychosocial wellbeing and (2) to evaluate the feasibility of this intervention in nursing home residents. METHODS This study is a two-arm, stratified-randomized controlled feasibility trail. Twenty-four nursing home residents (aged 83.7 ± 6.4, 21 women) were divided into an intervention and a waiting-list control group. The intervention group completed a multi-component training (including dual-task, dynamic balance, endurance and strength exercises) for 16 weeks (twice per week for 45-60 min). Primary outcomes were lower extremity functionality (SPPB), gait performance (GAITRite), health-related quality of life (SF-12) as well as life satisfaction (SWLS). RESULTS Life satisfaction (SWLS) and physical functioning (SPPB) increased in the intervention group after training whereas the control group showed a decrease. Gait parameters could only be analyzed for n = 5 participants of the intervention group and n = 2 of the control group and showed no time differences for the intervention group. The mean number of participants was 12.5 ± 1.9 per session (attendance ranged between 66% and 90%). CONCLUSION A multi-component training seems (1) to lead to clinically relevant improvements in physical functioning as well as in psychosocial wellbeing and (2) to be feasible and well accepted in nursing home residents. Nevertheless, the complexity and progression of the program as well as the testing protocol have to be adapted. Further research should test the effectiveness of this adapted program in a larger sample size.
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Affiliation(s)
- Laura L Bischoff
- Institute of Human Movement Science, University of Hamburg, Mollerstraße 10, 20148, Hamburg, Germany.
| | - Thomas Cordes
- Institute of Human Movement Science, University of Hamburg, Mollerstraße 10, 20148, Hamburg, Germany
| | - Charlotte Meixner
- Institute of Human Movement Science, University of Hamburg, Mollerstraße 10, 20148, Hamburg, Germany
| | - Daniel Schoene
- Institute of Medical Physics, Friedrich-Alexander University, Erlangen-Nuernberg, Germany
- Department of Geriatric Rehabilitation, Robert-Bosch Hospital, Stuttgart, Germany
| | | | - Bettina Wollesen
- Institute of Human Movement Science, University of Hamburg, Mollerstraße 10, 20148, Hamburg, Germany
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Belmonte Darraz S, González-Roldán AM, de María Arrebola J, Montoro-Aguilar CI. [Physical exercise impact on variables related to emotional and functional well-being in older adults]. Rev Esp Geriatr Gerontol 2021; 56:136-143. [PMID: 33775433 DOI: 10.1016/j.regg.2021.01.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Revised: 01/07/2021] [Accepted: 01/11/2021] [Indexed: 12/16/2022]
Abstract
BACKGROUND AND AIM The benefits of the physical exercise in aging, and specially in frailty, have been associated with reduced risk of mortality, chronic disease, and cognitive and functional impairments. Multi-component training, which combines strength, endurance, balance, and gait training, represents the most beneficial kind of physical exercise in older adults. METHODS Given the effectiveness of the multi-component training, a physical exercise program «Actívate» (based on the methodology Vivifrail), with the focus on «active aging», was conducted in the present study. Forty-nine older adults over 60 years participated in this program. RESULTS The physical exercise intervention led to a reduction in diastolic blood pressure, pain threshold and sleep disturbances (e. g. hypersomnia) (t ≥ 2.72, p < 0.01), as well as an increase of walking speed (t = 7.84, p ≤ 0.001). Further, quality of life factors (GENCAT scale), like emotional well-being, personal development, physical well-being, self-determination, and social inclusion, were greater after intervention (t ≥ -2.06, p < 0.05). CONCLUSIONS These findings underline the benefits of multi-component training in functionality of older adults, and further, provide relevant aspects about the modulation of pain perception, sleep disturbances, social factors and physical and emotional well-being. Physical exercise programs such as «Actívate» should be promoted, in order to encourage healthy lifestyle habits, in the older adults' population.
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Affiliation(s)
- Saliha Belmonte Darraz
- Instituto de Investigación en Ciencias de la Salud (IUNICS) e Instituto de Investigación en Salud de las Islas Baleares (IdISBa), Universidad de las Islas Baleares (UIB), Palma, España; Área de Sanidad del Ayuntamiento de Palma de Mallorca, Palma, España
| | - Ana María González-Roldán
- Instituto de Investigación en Ciencias de la Salud (IUNICS) e Instituto de Investigación en Salud de las Islas Baleares (IdISBa), Universidad de las Islas Baleares (UIB), Palma, España
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Furtado GE, Letieri RV, Silva-Caldo A, Trombeta JCS, Monteiro C, Rodrigues RN, Vieira-Pedrosa A, Barros MP, Cavaglieri CR, Hogervorst E, Teixeira AM, Ferreira JP. Combined Chair-Based Exercises Improve Functional Fitness, Mental Well-Being, Salivary Steroid Balance, and Anti-microbial Activity in Pre-frail Older Women. Front Psychol 2021; 12:564490. [PMID: 33841224 PMCID: PMC8026892 DOI: 10.3389/fpsyg.2021.564490] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2020] [Accepted: 02/09/2021] [Indexed: 11/13/2022] Open
Abstract
Introduction Regular exercise has long been shown to positively impact the immune system responsiveness and improve mental well-being (MWB). However, the putative links between biomarkers of mental health and immune efficiency in exercising subjects have been scarcely investigated. The aim of this study was to verify the effect of a 14-week combined chair-based exercise program (CEP) on salivary steroid hormones and anti-microbial proteins, functional fitness, and MWB indexes in pre-frail older women. Methods The participant women (82.8 4.6 years old; n = 32) were randomly divided into the exercising group (CEP, n = 17) and the non-exercising control group (CG, n = 15). The pre/post assessment included: (1) salivary anti-microbial proteins lysozyme; (Lys) and immunoglobulin-A (IgA); (2) salivary steroid hormones of testosterone (TT) and cortisol (COR); (3) functional fitness (gait speed, hand grip strength, and static balance); (4) MWB questionnaires (happiness, depression state, satisfaction with life, and stress). Results Significant differences with large Cohen's (d) effect sizes were found on increased salivary TT (p < 0.05; d = 0.60) after exercise intervention. The results revealed a decrease in IgA levels after CEP (p < 0.01, d = 0.30). The increase in subjective happiness levels (p < 0.05, d = 0.30) and decrease of stress perception (p < 0.01, d = 2.60) and depressive state (p < 0.05, d = 0.30) were found after intervention in the CEP group. Robust statistical differences in gait speed (p < 0.05; d = 0.60) and balance tests (p < 0.05; d = 0.80) were also found in the CEP group. In control, COR increased moderately (p < 0.05; d = 0.65) while no changes were found for the other indicators. Correlation analyses showed inter-dependence between pre-post variations of MWB, biochemical indexes, and fitness function (e.g., COR inverse correlation with hand grip strength and balance tests). Conclusion The CEP program was able to improve functional-fitness performance, decrease feelings of stress, and increase happiness. The CEP also induced clinically relevant hormonal and immune responses, which suggests that chair exercises that combine muscular strength, balance, and gait speed training are promising interventions to improve physical and mental health of older pre-frail adults.
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Affiliation(s)
- Guilherme Eustáquio Furtado
- Research Unit in Sport and Physical Activity-CIDAF (UID/PTD/04213/2020), Faculty of Sport Sciences and Physical Education (FCDEF-UC), University of Coimbra, Coimbra, Portugal.,Health Sciences Research Unit: Nursing (UICISA:E), Nursing School of Coimbra (ESEnfC), Coimbra, Portugal
| | - Rubens Vinícius Letieri
- Rehabilitation Sciences Program, Federal University of Alfenas (UNIFAL), Alfenas, Brazil.,Multidisciplinary Research Nucleus in Physical Education (NIMEF), Physical Education Department, Federal University of Tocantins (UFT), Tocantinópolis, Brazil
| | - Adriana Silva-Caldo
- Research Unit in Sport and Physical Activity-CIDAF (UID/PTD/04213/2020), Faculty of Sport Sciences and Physical Education (FCDEF-UC), University of Coimbra, Coimbra, Portugal
| | - Joice C S Trombeta
- Exercise Physiology Laboratory (FISEX), Faculty of Physical Education, University of Campinas (UNICAMP), Campinas, Brazil
| | - Clara Monteiro
- Cardiopulmonary Physiotherapy Laboratory, Federal University of São Carlos (UFscar), São Carlos, Brazil
| | - Rafael Nogueira Rodrigues
- Research Unit in Sport and Physical Activity-CIDAF (UID/PTD/04213/2020), Faculty of Sport Sciences and Physical Education (FCDEF-UC), University of Coimbra, Coimbra, Portugal
| | - Ana Vieira-Pedrosa
- Research Unit in Sport and Physical Activity-CIDAF (UID/PTD/04213/2020), Faculty of Sport Sciences and Physical Education (FCDEF-UC), University of Coimbra, Coimbra, Portugal
| | - Marcelo Paes Barros
- Institute of Physical Activity Sciences and Sports (ICAFE), Interdisciplinary Program in Health Sciences, Cruzeiro do Sul University, São Paulo, Brazil
| | - Cláudia Regina Cavaglieri
- Exercise Physiology Laboratory (FISEX), Faculty of Physical Education, University of Campinas (UNICAMP), Campinas, Brazil.,Graduate Program in Gerontology, Faculty of Medical Sciences, University of Campinas (UNICAMP), Campinas, Brazil
| | - Eef Hogervorst
- Applied Cognitive Research NCSEM, Loughborough University, Loughborough, United Kingdom
| | - Ana Maria Teixeira
- Research Unit in Sport and Physical Activity-CIDAF (UID/PTD/04213/2020), Faculty of Sport Sciences and Physical Education (FCDEF-UC), University of Coimbra, Coimbra, Portugal
| | - José Pedro Ferreira
- Research Unit in Sport and Physical Activity-CIDAF (UID/PTD/04213/2020), Faculty of Sport Sciences and Physical Education (FCDEF-UC), University of Coimbra, Coimbra, Portugal
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Gavelin HM, Dong C, Minkov R, Bahar-Fuchs A, Ellis KA, Lautenschlager NT, Mellow ML, Wade AT, Smith AE, Finke C, Krohn S, Lampit A. Combined physical and cognitive training for older adults with and without cognitive impairment: A systematic review and network meta-analysis of randomized controlled trials. Ageing Res Rev 2021; 66:101232. [PMID: 33249177 DOI: 10.1016/j.arr.2020.101232] [Citation(s) in RCA: 132] [Impact Index Per Article: 44.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2020] [Revised: 11/16/2020] [Accepted: 11/20/2020] [Indexed: 02/06/2023]
Abstract
Combining physical exercise with cognitive training is a popular intervention in dementia prevention trials and guidelines. However, it remains unclear what combination strategies are most beneficial for cognitive and physical outcomes. We aimed to compare the efficacy of the three main types of combination strategies (simultaneous, sequential or exergaming) to either intervention alone or control in older adults. Randomized controlled trials of combined cognitive and physical training were included in multivariate and network meta-analyses. In cognitively healthy older adults and mild cognitive impairment, the effect of any combined intervention relative to control was small and statistically significant for overall cognitive (k = 41, Hedges' g = 0.22, 95 % CI 0.14 to 0.30) and physical function (k = 32, g = 0.25, 95 % CI 0.13 to 0.37). Simultaneous training was the most efficacious approach for cognition, followed by sequential combinations and cognitive training alone, and significantly better than physical exercise. For physical outcomes, simultaneous and sequential training showed comparable efficacy as exercise alone and significantly exceeded all other control conditions. Exergaming ranked low for both outcomes. Our findings suggest that simultaneously and sequentially combined interventions are efficacious for promoting cognitive alongside physical health in older adults, and therefore should be preferred over implementation of single-domain training.
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Jardim NYV, Bento-Torres NVO, Costa VO, Carvalho JPR, Pontes HTS, Tomás AM, Sosthenes MCK, Erickson KI, Bento-Torres J, Diniz CWP. Dual-Task Exercise to Improve Cognition and Functional Capacity of Healthy Older Adults. Front Aging Neurosci 2021; 13:589299. [PMID: 33679369 PMCID: PMC7928356 DOI: 10.3389/fnagi.2021.589299] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2020] [Accepted: 01/20/2021] [Indexed: 12/04/2022] Open
Abstract
Background It has been suggested that physical inactivity and lack of stimulating cognitive activity are the two most significant modifiable risk factors to impair cognitive function. Although many studies that investigated the cognitive effects of physical exercise and cognitive stimuli in dual-task conditions showed improved cognitive performance, others have not confirmed these findings. The main aim of the present work is to analyze the effects of a dual-task multimodal physical exercise training, at moderate intensity, and cognitive stimulation on cognitive and physical function in healthy older adults. Methods This clinical trial was registered on the Brazilian Registry of Clinical Trials (RBR-9zrx3d). Here we tested the effects of a dual-task multimodal physical exercise training, at moderate intensity, on cognitive and physical function and quality of life in community dwelling older adults. The training protocol included 24 group sessions, 2/week, per 75 min. Cognition was assessed using CANTAB automated neuropsychological tests and Functional Capacity to Exercise tests. Performance was compared from baseline to post intervention and to a non-exercise control group using Mixed Linear Model for repeated measures. Results Control (CG) and dual-task (DTEx) groups progressed differentially over time on performance of episodic memory, sustained visual attention, functional mobility, cardiorespiratory fitness, lower limbs strength resistance, agility, quality of life and dual-task performance with significant improved DTEx performance. Control group did not show any significant changes on these tests except for showing a reduction in dual-task performance. Conclusion We suggest that the dual-task combination of multisensory cognitive stimulation and multimodal moderate physical exercise training, twice a week, may be adopted as an effective program to reduce progression of age-related cognitive decline and improve physical fitness and quality of life on healthy older adults. Clinical Trial Registration Brazilian Registry of Clinical Trials: https://ensaiosclinicos.gov.br/rg/RBR-9zrx3d -UTN code: U1111-1233-6349.
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Affiliation(s)
- Naina Yuki Vieira Jardim
- Neurodegeneration and Infection Research Laboratory, Institute of Biological Science/João de Barros Barreto University Hospital, Federal University of Pará, Belém, Brazil
| | - Natáli Valim Oliver Bento-Torres
- Neurodegeneration and Infection Research Laboratory, Institute of Biological Science/João de Barros Barreto University Hospital, Federal University of Pará, Belém, Brazil.,Physical Therapy and Occupational Therapy Program, Federal University of Pará, Belém, Brazil
| | - Victor Oliveira Costa
- Neurodegeneration and Infection Research Laboratory, Institute of Biological Science/João de Barros Barreto University Hospital, Federal University of Pará, Belém, Brazil
| | - Josilayne Patricia Ramos Carvalho
- Neurodegeneration and Infection Research Laboratory, Institute of Biological Science/João de Barros Barreto University Hospital, Federal University of Pará, Belém, Brazil.,Physical Therapy and Occupational Therapy Program, Federal University of Pará, Belém, Brazil
| | - Helen Tatiane Santos Pontes
- Neurodegeneration and Infection Research Laboratory, Institute of Biological Science/João de Barros Barreto University Hospital, Federal University of Pará, Belém, Brazil
| | - Alessandra Mendonça Tomás
- Neurodegeneration and Infection Research Laboratory, Institute of Biological Science/João de Barros Barreto University Hospital, Federal University of Pará, Belém, Brazil
| | - Marcia Consentino Kronka Sosthenes
- Neurodegeneration and Infection Research Laboratory, Institute of Biological Science/João de Barros Barreto University Hospital, Federal University of Pará, Belém, Brazil
| | - Kirk I Erickson
- Department of Psychology, University of Pittsburgh, Pittsburgh, PA, United States
| | - João Bento-Torres
- Neurodegeneration and Infection Research Laboratory, Institute of Biological Science/João de Barros Barreto University Hospital, Federal University of Pará, Belém, Brazil.,Physical Therapy and Occupational Therapy Program, Federal University of Pará, Belém, Brazil
| | - Cristovam Wanderley Picanço Diniz
- Neurodegeneration and Infection Research Laboratory, Institute of Biological Science/João de Barros Barreto University Hospital, Federal University of Pará, Belém, Brazil
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Broscheid KC, Behrendt T, Hamacher D, Böker S, Gagelmann T, Schmidt C, Caspari C, Meiler K, Napiontek A, Franke J, Schega L. Effect of a Multimodal Movement Intervention in Patients With Neurogenic Claudication Based on Lumbar Spinal Stenosis and/or Degenerative Spondylolisthesis-A Pilot Study. Front Med (Lausanne) 2020; 7:540070. [PMID: 33364242 PMCID: PMC7753178 DOI: 10.3389/fmed.2020.540070] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2020] [Accepted: 10/14/2020] [Indexed: 11/22/2022] Open
Abstract
Chronic low-back pain is a major individual, social, and economic burden. The impairment ranges from deterioration of gait, limited mobility, to psychosocial distress. Due to this complexity, the demand for multimodal treatments is huge. Our purpose is to compare the effects of a multimodal movement intervention (MI) (coordinative–cognitive exercises and dancing program) with standard physical therapy (PT) on gait, physical function, and quality of life in patients with lumbar spinal stenosis (LSS). The study design is based on a 6-week intervention with a two (group: MI/PT) by two (measurement time points: pre-/post-test) parallel group design with random assignment. Twenty-four subjects (18 female/6 male, 70.8 ± 10.6 years old) diagnosed with LSS were included and randomly allocated to the MI or PT group. The primary outcomes are minimum toe clearance (MTC) and double step length (DSL) variability and the Timed “Up & Go” test (TUG). Secondary outcomes are the Brief Pain Inventory, the short Fall Efficacy Scale–International (sFES-I), and the Oswestry Disability Index. Nine subjects for each group could be analyzed. The MTC variability revealed a significant between-group difference in the posttest (p = 0.008) showing a lower MTC variability for the MI compared to the PT group. The MI group displayed an improved TUG (p = 0.031) and a reduced sFES-I (p = 0.044). The decreased MTC variability and fear of falling as well as the improved functional mobility may contribute to a reduced risk of falling. For the subsequent study, further kinematic and cognitive parameters should be analyzed, and the number of participants has to be increased. Clinical Trial Registration: German Clinical Trial Register (ID: DRKS00021026/URL: https://www.drks.de/drks_web/navigate.do?navigationId=trial.HTML&TRIAL_ID=DRKS00021026).
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Affiliation(s)
- Kim-Charline Broscheid
- Department Human Science, Sport Science, Institute III, Otto von Guericke University Magdeburg, Magdeburg, Germany
| | - Tom Behrendt
- Department Human Science, Sport Science, Institute III, Otto von Guericke University Magdeburg, Magdeburg, Germany
| | - Dennis Hamacher
- Department Human Science, Sport Science, Institute III, Otto von Guericke University Magdeburg, Magdeburg, Germany
| | - Svantje Böker
- Department Human Science, Sport Science, Institute III, Otto von Guericke University Magdeburg, Magdeburg, Germany
| | - Tabea Gagelmann
- Department Human Science, Sport Science, Institute III, Otto von Guericke University Magdeburg, Magdeburg, Germany
| | - Christian Schmidt
- Department of Orthopaedic Surgery, Klinikum Magdeburg, Magdeburg, Germany
| | - Christina Caspari
- Department of Orthopaedic Surgery, Klinikum Magdeburg, Magdeburg, Germany
| | - Katharina Meiler
- Department of Orthopaedic Surgery, Klinikum Magdeburg, Magdeburg, Germany
| | - Andre Napiontek
- Association for Health, Exercise and Sport, Magdeburg, Germany
| | - Jörg Franke
- Department of Orthopaedic Surgery, Klinikum Magdeburg, Magdeburg, Germany
| | - Lutz Schega
- Department Human Science, Sport Science, Institute III, Otto von Guericke University Magdeburg, Magdeburg, Germany
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Additional Functional Performance Gains After 24-Week Unstable Strength Training With Cognitive Training in Community-Dwelling Healthy Older Adults: A Randomized Trial. J Aging Phys Act 2020; 29:412-422. [PMID: 33271505 DOI: 10.1123/japa.2020-0050] [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: 02/12/2020] [Revised: 08/05/2020] [Accepted: 08/06/2020] [Indexed: 11/18/2022]
Abstract
The authors investigated the effects of unstable strength training (UST) without or with cognitive training (C+UST) on functional performance in community-dwelling older adults. A total of 50 participants were randomly assigned (1:1) to either 24 weeks of thrice-weekly UST (n = 25) or C+UST (n = 25). All participants performed moderate-intensity strength exercises using unstable surfaces, and C+UST participants simultaneously received cognitive training in addition to UST. Primary outcomes included measures of functional performance: single- and dual-task timed up and go tests. Secondary outcomes included dynamic balance, mobility, handgrip strength, flexibility, quality of life, and concern about falling. The authors observed similar improvements on functional performance through the interventions. The C+UST group experienced additional gains at completion (single-task timed up and go: -0.90 s, 95% confidence interval [-2.38, -0.03]; dual-task timed up and go: -4.80 s, 95% confidence interval [-8.65, -0.95]) compared with the UST group. Moreover, significant differences were observed in mobility (sitting-rising test: -1.34, 95% confidence interval [-2.00, -0.20]) at 24 weeks. Both exercise modes improved single-task functional performance, while adding cognitive-training-optimized dual-task functional performance gains.
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Xu W, Liang HN, Baghaei N, Wu Berberich B, Yue Y. Health Benefits of Digital Videogames for the Aging Population: A Systematic Review. Games Health J 2020; 9:389-404. [DOI: 10.1089/g4h.2019.0130] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Affiliation(s)
- Wenge Xu
- Department of Computer Science and Software Engineering, Xi'an Jiaotong-Liverpool University, Suzhou, China
| | - Hai-Ning Liang
- Department of Computer Science and Software Engineering, Xi'an Jiaotong-Liverpool University, Suzhou, China
| | - Nilufar Baghaei
- Department of Information Technology, Otago Polytechnic Auckland International Campus, Auckland, New Zealand
- School of Natural and Computational Sciences, Massey University Auckland, Auckland, New Zealand
| | - Bing Wu Berberich
- International Business School Suzhou, Xi'an Jiaotong-Liverpool University, Suzhou, China
| | - Yong Yue
- Department of Computer Science and Software Engineering, Xi'an Jiaotong-Liverpool University, Suzhou, China
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Chan JKY, Klainin-Yobas P, Chi Y, Gan JKE, Chow G, Wu XV. The effectiveness of e-interventions on fall, neuromuscular functions and quality of life in community-dwelling older adults: A systematic review and meta-analysis. Int J Nurs Stud 2020; 113:103784. [PMID: 33120138 DOI: 10.1016/j.ijnurstu.2020.103784] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2020] [Revised: 08/20/2020] [Accepted: 09/27/2020] [Indexed: 01/01/2023]
Abstract
BACKGROUND Falls in older adults result in serious, life-limiting consequences. An increasing number of fall prevention interventions have used technology to reduce the number of falls in community-dwelling adults. Various types of e-interventions are being tested in clinical trials and in the community. These include telehealth, exergames, cognitive games, socialized training, smart home systems and non-conventional balance training. Currently, no systematic review and meta-analysis has assessed the overall effectiveness of e-interventions and compared the effectiveness of the different types. OBJECTIVES The aim of this review was to synthesize best available evidence concerning the effectiveness of e-interventions on fall, neuromuscular functions and quality of life in community-dwelling older adults. METHODS A rigorous three-step search was conducted in nine online databases for published and unpublished randomized controlled trials studying e-interventions. Studies were screened and assessed for individual and overall risk of bias by two independent reviewers. Six fall-related outcomes were evaluated in the meta-analysis: fall risk, balance, lower extremity strength, fall efficacy, cognitive function and health-related quality of life. Subgroup and sensitivity analysis were conducted during meta-analysis. RESULTS Thirty-one studies fit the eligibility criteria and had an overall 74.7% low risk of bias. A total of 4,877 older adults from 17 countries were included in narrative synthesis and meta-analysis. Telehealth combined with exercise programmes and smart home systems were able to reduce fall risk significantly (risk ratio=0.79, 95% CI [0.72, 0.86]). E-interventions also significantly improved balance and fall efficacy (standardized mean difference=0.28, 95% CI [0.04, 0.53]). However, lower extremity strength, cognitive function and health-related quality of life did not show significant improvements. CONCLUSION Telehealth combined with exercise and smart home systems demonstrated the best evidence of effectiveness in reduction of falls in community-dwelling older adults. Future research should focus on forecasting falls using smart home technology and Artificial Intelligence, and testing promising e-interventions on larger samples to improve the strength of evidence of fall prevention by e-interventions.
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Affiliation(s)
| | - Piyanee Klainin-Yobas
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Level 2, Clinical Research Centre, Block MD 11,10 Medical Drive, Singapore, 117597.
| | - Yuchen Chi
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Level 2, Clinical Research Centre, Block MD 11,10 Medical Drive, Singapore, 117597.
| | | | - Gigi Chow
- Khoo Teck Puat Hospital, 90 Yishun Central, Singapore, 768828.
| | - Xi Vivien Wu
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Level 2, Clinical Research Centre, Block MD 11,10 Medical Drive, Singapore, 117597.
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Hauer K, Litz E, Günther-Lange M, Ball C, de Bruin ED, Werner C. Effectiveness and sustainability of a motor-cognitive stepping exergame training on stepping performance in older adults: a randomized controlled trial. Eur Rev Aging Phys Act 2020; 17:17. [PMID: 33005256 PMCID: PMC7525984 DOI: 10.1186/s11556-020-00248-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Accepted: 09/11/2020] [Indexed: 02/07/2023] Open
Abstract
Background Training effects reported for stepping exergames on stepping performances in older adults often based on not comprehensively validated outcomes measures, and follow-up data on their sustainability are lacking. The aim of this study is to evaluate the effectiveness and sustainability of a motor-cognitive stepping exergame training on the stepping performance in older adults. Methods Fifty-eight older adults (78.3 ± 6.5 years) participated in the randomized controlled trial with a 10-week intervention and 10-week follow-up period. The intervention group (IG: n = 29) took part in a once-weekly exercise program including strength and balance exercises supplemented with an additional stepping exergame training. The control group (CG: n = 29) only performed the strength and balance exercises. Outcome measures included stepping reaction times (SRTs) and games scores for individual stepping exergame levels and for the overall exergame performance, as measured by an assessment strategy previously validated in older adults. Results SRTs and/or games scores for 7 out of 10 levels and the overall exergame performance significantly improved in the IG compared to the CG during the intervention (p ≤ 0.001–0.039, ηp2 = 0.090–0.445). Training gains were sustained for 2 levels and for the overall exergame performance (p = 0.017–0.033, ηp2 = 0.127–0.193). Conclusion The study demonstrates that the additional stepping exergame training effectively and sustainably improves the performance in complex motor-cognitive stepping exergame tasks in older adults, which can be relevant for preventing falls. Future research is needed to evaluate the effectiveness of such training on reducing the number of falls. Trial registration ISRCTN registry, ISRCTN14855620, 06/06/2019 (retrospectively registered).
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Affiliation(s)
- Klaus Hauer
- AGAPLESION Bethanien Hospital, Geriatric Center of Heidelberg University, Heidelberg, Germany
| | - Elena Litz
- AGAPLESION Bethanien Hospital, Geriatric Center of Heidelberg University, Heidelberg, Germany
| | - Michaela Günther-Lange
- AGAPLESION Bethanien Hospital, Geriatric Center of Heidelberg University, Heidelberg, Germany
| | - Caroline Ball
- AGAPLESION Bethanien Hospital, Geriatric Center of Heidelberg University, Heidelberg, Germany
| | - Eling D de Bruin
- Institute of Human Movement Sciences and Sport, Department of Health Sciences and Technology, ETH Zürich, HCP H 25.1, Leopold-Ruzicka-Weg 4, 8093 Zurich, Switzerland.,Division of Physiotherapy, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Huddinge, Sweden
| | - Christian Werner
- AGAPLESION Bethanien Hospital, Geriatric Center of Heidelberg University, Heidelberg, Germany.,Center of Geriatric Medicine, Heidelberg University, Heidelberg, Germany
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