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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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Richardson DP, Foxe JJ, Freedman EG. Reduced Proactive and Reactive Cognitive Flexibility in Older Adults Underlies Performance Costs During Dual-Task Walking: A Mobile Brain/Body Imaging (MoBI) Study. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2024:2024.01.27.577090. [PMID: 38328169 PMCID: PMC10849668 DOI: 10.1101/2024.01.27.577090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/09/2024]
Abstract
Age-related reductions in cognitive flexibility may limit modulation of control processes during systematic increases to cognitive-motor demands, exacerbating dual-task costs. In this study, behavioral and neurophysiologic changes to proactive and reactive control during progressive cognitive-motor demands were compared across older and younger adults to explore the basis for age-differences in cognitive-motor interference (CMI). 19 younger (19 - 29 years old, mean age = 22.84 +/- 2.75 years, 6 male, 13 female) and 18 older (60 - 77 years old, mean age = 67.89 +/- 4.60 years, 9 male, 9 female) healthy adults completed cued task-switching while alternating between sitting and walking on a treadmill. Gait kinematics, task performance measures, and brain activity were recorded using electroencephalography (EEG) based Mobile Brain/Body Imaging (MoBI). Response accuracy on easier trial types improved in younger, but not older adults when they walked while performing the cognitive task. As difficulty increased, walking provoked accuracy costs in older, but not younger adults. Both groups registered faster responses and reduced gait variability during dual-task walking. Older adults exhibited lower amplitude modulations of proactive and reactive neural activity as cognitive-motor demands systematically increased, which may reflect reduced flexibility for progressive preparatory and reactive adjustments over behavioral control.
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Affiliation(s)
- David P. Richardson
- The Frederick J. and Marion A. Schindler Cognitive Neurophysiology Laboratory, The Del Monte Institute for Neuroscience, Department of Neuroscience, University of Rochester School of Medicine and Dentistry Rochester, New York, USA
| | - John J. Foxe
- The Frederick J. and Marion A. Schindler Cognitive Neurophysiology Laboratory, The Del Monte Institute for Neuroscience, Department of Neuroscience, University of Rochester School of Medicine and Dentistry Rochester, New York, USA
| | - Edward G. Freedman
- The Frederick J. and Marion A. Schindler Cognitive Neurophysiology Laboratory, The Del Monte Institute for Neuroscience, Department of Neuroscience, University of Rochester School of Medicine and Dentistry Rochester, New York, USA
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Kong L, Zhang Z, Bao J, Zhu X, Tan Y, Xia X, Zhang Q, Hao Y. Influences of cognitive load on center of pressure trajectory of young male adults with excess weight during gait initiation. Front Bioeng Biotechnol 2024; 11:1297068. [PMID: 38249798 PMCID: PMC10796550 DOI: 10.3389/fbioe.2023.1297068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Accepted: 12/11/2023] [Indexed: 01/23/2024] Open
Abstract
Introduction: Falls and fall-related injuries in young male adults with excess weight are closely related to an increased cognitive load. Previous research mainly focuses on analyzing the postural control status of these populations performing cognitive tasks while stabilized walking progress but overlooked a specific period of walking known as gait initiation (GI). It is yet unknown the influences of cognitive load on this population's postural control status during GI. Objective: This study aimed to determine the influences of cognitive load on the center of pressure (CoP) trajectory of young male adults with excess weight during GI. Design: A controlled laboratory study. Methods: Thirty-six male undergraduate students were recruited and divided into normal-weight, overweight, and obese groups based on their body mass index (BMI). Participants' CoP parameters during GI under single and dual-task conditions were collected by two force platforms. A mixed ANOVA was utilized to detect significant differences. Results: Compared with the normal-weight group, the obese group showed significant changes in the duration and CoP parameters during sub-phases of GI, mainly reflecting prolonged duration, increased CoP path length, higher mediolateral CoP displacement amplitude, and decreased velocity of anteroposterior CoP displacement. During GI with 1-back task, significantly increased mediolateral CoP displacement amplitude occurred in the obese group. During GI with 2-back task, the obese group had increased CoP path length, higher mediolateral CoP displacement amplitude, as well as a decreased velocity of CoP displacement. Conclusion: Based on the changes in CoP parameters during GI with cognitive tasks, young male adults with excess weight, mainly obese ones, have compromised postural stability. During GI with a difficult cognitive task, obese young male adults are more susceptible to deterioration in their lateral postural balance. These findings indicate that the increased cognitive load could exacerbate obese young male adults' postural control difficulty during GI under dual-task conditions, putting them at a higher risk of experiencing incidents of falls. Based on these findings, we offer suggestions for therapists to intervene with these young male adults to ensure their safety of GI.
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Affiliation(s)
- Lingyu Kong
- School of Physical Education, Soochow University, Suzhou, China
| | - Zhiqi Zhang
- School of Physical Education, Soochow University, Suzhou, China
| | - Jiawei Bao
- School of Mathematical Sciences, Soochow University, Suzhou, China
| | - Xinrui Zhu
- Rehabilitation Medicine Department, Xuzhou Rehabilitation Hospital, Xuzhou, China
| | - Yong Tan
- School of Physical Education, Soochow University, Suzhou, China
| | - Xihao Xia
- Wuxi 9th People’s Hospital Affiliated to Soochow University, Wuxi, China
| | - Qiuxia Zhang
- School of Physical Education, Soochow University, Suzhou, China
| | - Yuefeng Hao
- Orthopedics and Sports Medicine Center, The Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou, China
- Gusu School, Nanjing Medical University, Suzhou, China
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Downey R, Gagné N, Mohanathas N, Campos JL, Pichora-Fuller KM, Bherer L, Lussier M, Phillips NA, Wittich W, St-Onge N, Gagné JP, Li K. At-home computerized executive-function training to improve cognition and mobility in normal-hearing adults and older hearing aid users: a multi-centre, single-blinded randomized controlled trial. BMC Neurol 2023; 23:378. [PMID: 37864139 PMCID: PMC10588173 DOI: 10.1186/s12883-023-03405-1] [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: 09/07/2023] [Accepted: 09/26/2023] [Indexed: 10/22/2023] Open
Abstract
BACKGROUND Hearing loss predicts cognitive decline and falls risk. It has been argued that degraded hearing makes listening effortful, causing competition for higher-level cognitive resources needed for secondary cognitive or motor tasks. Therefore, executive function training has the potential to improve cognitive performance, in turn improving mobility, especially when older adults with hearing loss are engaged in effortful listening. Moreover, research using mobile neuroimaging and ecologically valid measures of cognition and mobility in this population is limited. The objective of this research is to examine the effect of at-home cognitive training on dual-task performance using laboratory and simulated real-world conditions in normal-hearing adults and older hearing aid users. We hypothesize that executive function training will lead to greater improvements in cognitive-motor dual-task performance compared to a wait-list control group. We also hypothesize that executive function training will lead to the largest dual-task improvements in older hearing aid users, followed by normal-hearing older adults, and then middle-aged adults. METHODS A multi-site (Concordia University and KITE-Toronto Rehabilitation Institute, University Health Network) single-blinded randomized controlled trial will be conducted whereby participants are randomized to either 12 weeks of at-home computerized executive function training or a wait-list control. Participants will consist of normal-hearing middle-aged adults (45-60 years old) and older adults (65-80 years old), as well as older hearing aid users (65-80 years old, ≥ 6 months hearing aid experience). Separate samples will undergo the same training protocol and the same pre- and post-evaluations of cognition, hearing, and mobility across sites. The primary dual-task outcome measures will involve either static balance (KITE site) or treadmill walking (Concordia site) with a secondary auditory-cognitive task. Dual-task performance will be assessed in an immersive virtual reality environment in KITE's StreetLab and brain activity will be measured using functional near infrared spectroscopy at Concordia's PERFORM Centre. DISCUSSION This research will establish the efficacy of an at-home cognitive training program on complex auditory and motor functioning under laboratory and simulated real-world conditions. This will contribute to rehabilitation strategies in order to mitigate or prevent physical and cognitive decline in older adults with hearing loss. TRIAL REGISTRATION Identifier: NCT05418998. https://clinicaltrials.gov/ct2/show/NCT05418998.
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Affiliation(s)
- Rachel Downey
- Department of Psychology, Concordia University, Montréal, Québec, Canada.
- PERFORM Centre, Concordia University, Montréal, Québec, Canada.
| | - Nathan Gagné
- Department of Psychology, Concordia University, Montréal, Québec, Canada
| | - Niroshica Mohanathas
- Department of Psychology, University of Toronto, Toronto, ON, Canada
- KITE-Toronto Rehabilitation Institute, University Health Network, Toronto, ON, Canada
| | - Jennifer L Campos
- Department of Psychology, University of Toronto, Toronto, ON, Canada
- KITE-Toronto Rehabilitation Institute, University Health Network, Toronto, ON, Canada
| | | | - Louis Bherer
- Département de Médecine, Université de Montréal, Montréal, Québec, Canada
- Centre de Recherche de L'Institut de Cardiologie de Montréal, Montréal, Québec, Canada
- Centre de Recherche de L'Institut Universitaire de Gériatrie de Montréal, Montréal, Québec, Canada
| | - Maxime Lussier
- Département de Médecine, Université de Montréal, Montréal, Québec, Canada
- Centre de Recherche de L'Institut de Cardiologie de Montréal, Montréal, Québec, Canada
| | - Natalie A Phillips
- Department of Psychology, Concordia University, Montréal, Québec, Canada
- PERFORM Centre, Concordia University, Montréal, Québec, Canada
| | - Walter Wittich
- École d'optométrie, Université de Montréal, Montréal, Québec, Canada
| | - Nancy St-Onge
- PERFORM Centre, Concordia University, Montréal, Québec, Canada
- Department of Health, Kinesiology and Applied Physiology, Concordia University, Montreal, QC, Canada
| | - Jean-Pierre Gagné
- École d'orthophonie Et d'audiologie, Université de Montréal, Montréal, Québec, Canada
| | - Karen Li
- Department of Psychology, Concordia University, Montréal, Québec, Canada
- PERFORM Centre, Concordia University, Montréal, Québec, Canada
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Lapanan K, Kantha P, Nantachai G, Hemrungrojn S, Maes M. The prefrontal cortex hemodynamic responses to dual-task paradigms in older adults: A systematic review and meta-analysis. Heliyon 2023; 9:e17812. [PMID: 37519646 PMCID: PMC10372207 DOI: 10.1016/j.heliyon.2023.e17812] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2023] [Revised: 05/16/2023] [Accepted: 06/28/2023] [Indexed: 08/01/2023] Open
Abstract
Background Functional near-infrared spectroscopy (fNIRS) is a method to measure cerebral hemodynamics. Determining the changes in prefrontal cortex (PFC) hemodynamics during dual-task paradigms is essential in explaining alterations in physical activities, especially in older adults. Aims To systematically review and meta-analyze the effects of dual-task paradigms on PFC hemodynamics in older adults. Methods The search was conducted in PubMed, Scopus, and Web of Science from inception until March 2023 to identify studies on the effects of dual-task paradigms on PFC hemodynamics. The meta-analysis included variables of cerebral hemodynamics, such as oxygenated hemoglobin (HbO2) and deoxygenated hemoglobin (HbR). The heterogeneity of the included studies was determined using the I2 statistic. Additionally, subgroup analysis was conducted to compare the effects of different types of cognitive tasks. Results A total of 37 studies were included in the systematic review, 25 studies comprising 2224 older adults were included in the meta-analysis. Our findings showed that inhibitory control and working memory tasks significantly increased HbO2 in the PFC by 0.53 (p < 0.01, 95% CI = 0.37 to 0.70) and 0.13 (p < 0.01, 95% CI = 0.08 to 0.18) μmol/L, respectively. Overall, HbO2 was significantly increased during dual-task paradigms by 0.36 μmol/L (P < 0.01, 95% CI = 0.27 to 0.45). Moreover, dual-task paradigms also decreased HbR in the PFC by 0.04 (P < 0.01, 95% CI = -0.07 to -0.01). Specifically, HbR decreased by 0.08 during inhibitory control tasks (p < 0.01, 95% CI = -0.13 to -0.02), but did not change during working memory tasks. Conclusion Cognitive tasks related to inhibitory control required greater cognitive demands, indicating higher pfc activation during dual-task paradigms in older adults. for clinical implications, the increase in pfc oxygenated hemoglobin and decrease in pfc deoxygenated hemoglobin may help explain why older adults are more likely to fall during daily activities.
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Affiliation(s)
- Kulvara Lapanan
- Department of Psychiatry, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
- Cognitive Fitness and Biopsychiatry Technology Research Unit, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Phunsuk Kantha
- School and Graduate Institute of Physical Therapy, College of Medicine, National Taiwan University, Taipei, Taiwan
- Faculty of Physical Therapy, Mahidol University, Nakhon Pathom, Thailand
| | - Gallayaporn Nantachai
- Department of Psychiatry, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
- Somdet Phra Sangharaj Nyanasamvara Geriatric Hospital, Department of Medical Services, Ministry of Public Health, Chon Buri Province, Thailand
| | - Solaphat Hemrungrojn
- Department of Psychiatry, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
- Cognitive Fitness and Biopsychiatry Technology Research Unit, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Michael Maes
- Department of Psychiatry, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
- Cognitive Fitness and Biopsychiatry Technology Research Unit, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
- Cognitive Impairment and Dementia Research Unit, Department of Psychiatry, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
- Deakin University, IMPACT - the Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Barwon Health, Geelong, Australia
- Department of Psychiatry, Medical University of Plovdiv, Plovdiv, Bulgaria
- Mental Health Center, University of Electronic Science and Technology of China, Chengdu 611731, China
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6
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Anguera JA, Rowe MA, Volponi JJ, Elkurdi M, Jurigova B, Simon AJ, Anguera-Singla R, Gallen CL, Gazzaley A, Marco EJ. Enhancing attention in children using an integrated cognitive-physical videogame: A pilot study. NPJ Digit Med 2023; 6:65. [PMID: 37046040 PMCID: PMC10097690 DOI: 10.1038/s41746-023-00812-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Accepted: 03/27/2023] [Indexed: 04/14/2023] Open
Abstract
Inattention can negatively impact several aspects of a child's life, including at home and school. Cognitive and physical interventions are two promising non-pharmaceutical approaches used to enhance attention abilities, with combined approaches often being marketed to teachers, therapists, and parents typically without research validation. Here, we assessed the feasibility of incorporating an integrated, cognitive-physical, closed-loop video game (body-brain trainer or 'BBT') as an after-school program, and also evaluated if there were attention benefits following its use. Twenty-two children (7-12 years of age) with a range of attention abilities were recruited to participate in this proof of concept, single-arm, longitudinal study (24 sessions over 8 weeks, ~30 min/day). We interrogated attention abilities through a parent survey of their child's behaviors, in addition to objective performance-based and neural measures of attention. Here we observed 95% compliance as well as, significant improvements on the parent-based reports of inattention and on cognitive tests and neural measures of attention that were comparable in scale to previous work. Exploratory measures of other cognitive control abilities and physical fitness also showed similar improvement, with exploratory evaluation of retained benefits on the primary attention-related outcomes being present 1-year later. Lastly, there was no correlation between the baseline parent-rated inattention score and the improvement on the primary task-based measures of attention, suggesting that intervention-based benefits were not solely attained by those who stood the most to gain. These pilot findings warrant future research to replicate and extend these findings.
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Affiliation(s)
- J A Anguera
- Neuroscape Center, Department of Neurology, University of California, San Francisco, USA.
- Department of Psychiatry, University of California, San Francisco, USA.
| | - M A Rowe
- Department of Neurodevelopmental Medicine, Cortica Healthcare, San Rafael, USA
| | - J J Volponi
- Neuroscape Center, Department of Neurology, University of California, San Francisco, USA
- Department of Psychiatry, University of California, San Francisco, USA
| | - M Elkurdi
- Department of Neurodevelopmental Medicine, Cortica Healthcare, San Rafael, USA
| | - B Jurigova
- Department of Psychiatry, University of California, San Francisco, USA
| | - A J Simon
- Neuroscape Center, Department of Neurology, University of California, San Francisco, USA
- Department of Psychiatry, University of California, San Francisco, USA
| | - R Anguera-Singla
- Neuroscape Center, Department of Neurology, University of California, San Francisco, USA
- Department of Psychiatry, University of California, San Francisco, USA
| | - C L Gallen
- Neuroscape Center, Department of Neurology, University of California, San Francisco, USA
| | - A Gazzaley
- Neuroscape Center, Department of Neurology, University of California, San Francisco, USA
- Department of Psychiatry, University of California, San Francisco, USA
| | - E J Marco
- Department of Neurodevelopmental Medicine, Cortica Healthcare, San Rafael, USA
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Gallou-Guyot M, Mandigout S, Marie R, Robin L, Daviet JC, Perrochon A. Feasibility and potential cognitive impact of a cognitive-motor dual-task training program using a custom exergame in older adults: A pilot study. Front Aging Neurosci 2023; 15:1046676. [PMID: 36819724 PMCID: PMC9932982 DOI: 10.3389/fnagi.2023.1046676] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Accepted: 01/09/2023] [Indexed: 02/05/2023] Open
Abstract
Introduction Dual-task training may be relevant and efficient in the context of active aging. An issue in training programs lies in enhancing the adherence of participants. This can potentially be improved using games as support. We designed and developed a custom interactive exergame in this way. The objective of this pilot study was to explore the potential use of this exergame and the feasibility of our intervention, including the level of safety and adherence. The result's trends on cognitive and motor capacities, as well as on the level of motivation for physical activity, fear of falling, and quality of life of participants, were also explored. Methods Older adults aged 65 years or older were recruited and realized 30 min of supervised training in groups of 4, 2-3 times a week for 12 weeks. Exercises consisted of incorporated cognitive and motor dual tasks, with an increased difficulty over the weeks. Our program's safety, engagement, attendance, and completion levels were evaluated. Participants' postural control in single-task and dual-task conditions, as well as their performances in mental inhibition, flexibility, working memory, mobility, and postural control, and their levels of motivation for physical activity, fear of falling, and quality of life were also assessed. We realized a per protocol statistical analysis with a p-value set at 0.05. Results Thirty-nine participants (aged 84.6 ± 8.5 years) were recruited. No adverse events, and 89% adherence, 88% attendance, and 87% completion rates were observed. A potentially significant effect of our exergame on working memory in single-task conditions and on the cognitive aspect of dual-task conditions was also observed. We observed no differences in other parameters. Discussion Our exergame seemed feasible and safe and was enjoyed by participants, mainly due to the gamification of our training program. Moreover, our exergame may be efficient for cognitive training in older adults, as well as for the maintenance of motor functions, motivation for physical activity, fear of falling, and quality of life levels. This constitutes the first step for our solution with interesting results that need to be further studied.
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Affiliation(s)
- Matthieu Gallou-Guyot
- Laboratoire HAVAE (UR20217), Université de Limoges, Limoges, France,*Correspondence: Matthieu Gallou-Guyot,
| | | | - Romain Marie
- Institut d’Ingénierie Informatique de Limoges, Limoges, France,3iL Ingénieurs, Limoges, France
| | - Louise Robin
- Laboratoire HAVAE (UR20217), Université de Limoges, Limoges, France,Center for Interdisciplinary Research in Rehabilitation and Social Integration (CIRRIS), Québec City, QC, Canada
| | - Jean-Christophe Daviet
- Laboratoire HAVAE (UR20217), Université de Limoges, Limoges, France,Pôle Neurosciences Tête et Cou, Service de Médecine Physique et de Réadaptation, Hôpital Jean Rebeyrol, CHU Limoges, Limoges, France
| | - Anaick Perrochon
- Laboratoire HAVAE (UR20217), Université de Limoges, Limoges, France
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Khan MJ, Kannan P, Wong TWL, Fong KNK, Winser SJ. A Systematic Review Exploring the Theories Underlying the Improvement of Balance and Reduction in Falls Following Dual-Task Training among Older Adults. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:16890. [PMID: 36554771 PMCID: PMC9778940 DOI: 10.3390/ijerph192416890] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Revised: 12/07/2022] [Accepted: 12/08/2022] [Indexed: 06/17/2023]
Abstract
BACKGROUND Balance impairment causes frequent falls in older adults, and preventing falls remains challenging. Dual-task (DT) training reduces falls by improving balance, but the precise theory is not fully understood. This review aims to explore the theories underlying the effectiveness of DT in improving balance and reducing falls in older adults. METHODS Eleven electronic databases were searched from database inception to June 2022. Two reviewers independently performed study screening and data extraction. The risk of bias (RoB) in the included studies was assessed using the Cochrane Collaboration RoB 2 tool. RESULTS The searches yielded 1478 citations, of which 30 studies met the inclusion criteria and were included in the review. Twenty-two of the 30 included studies utilized the motor-cognitive type of DT for training, while six used motor-motor and two utilized cognitive-cognitive DT. The included studies reported 20 different theories to explain the effectiveness of DT for improving balance and reducing falls in older adults. The predominant theory identified in the included studies was attention theory (n = 14). Overall, 26 studies reported improved balance and five studies found a reduction in fall incidence following DT training. Balance and falls improved significantly in 15 motor-cognitive DT intervention studies. CONCLUSION Attention shifting between two tasks is reported to occur following DT training. Motor-cognitive DT training improves balance and reduces fall incidence in older adults by shifting attention based on the difficulty and priority of a task from the motor to the cognitive task.
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Downey R, Bherer L, Pothier K, Vrinceanu T, Intzandt B, Berryman N, Lussier M, Vincent T, Karelis AD, Nigam A, Vu TTM, Bosquet L, Li KZH. Multiple routes to help you roam: A comparison of training interventions to improve cognitive-motor dual-tasking in healthy older adults. Front Aging Neurosci 2022; 14:710958. [PMID: 36408116 PMCID: PMC9670126 DOI: 10.3389/fnagi.2022.710958] [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: 05/17/2021] [Accepted: 10/07/2022] [Indexed: 11/06/2022] Open
Abstract
Cognitive-motor dual-tasking is a complex activity that predicts falls risk and cognitive impairment in older adults. Cognitive and physical training can both lead to improvements in dual-tasking; however, less is known about what mechanisms underlie these changes. To investigate this, 33 healthy older adults were randomized to one of three training arms: Executive function (EF; n = 10), Aerobic Exercise (AE; n = 10), Gross Motor Abilities (GMA; n = 13) over 12 weeks (1 h, 3×/week). Single and dual-task performance (gait speed, m/s; cognitive accuracy, %) was evaluated before and after training, using the 2-back as concurrent cognitive load. Training arms were designed to improve cognitive and motor functioning, through different mechanisms (i.e., executive functioning – EF, cardiorespiratory fitness – CRF, and energy cost of walking – ECW). Compared to baseline, we observed few changes in dual-task gait speed following training (small effect). However, dual-task cognitive accuracy improved significantly, becoming facilitated by walking (large effect). There were no differences in the magnitude of improvements across training arms. We also found that older adults with lower cognitive ability (i.e., MoCA score < 26; n = 14) improved more on the dual-task cognitive accuracy following training, compared to older adults with higher cognitive ability (i.e., MoCA ≥26; n = 18). Taken together, the results suggest that regardless of the type of intervention, training appears to strengthen cognitive efficiency during dual-tasking, particularly for older adults with lower baseline cognitive status. These gains appear to occur via different mechanisms depending on the form of intervention. Implications of this research are paramount, as we demonstrate multiple routes for improving cognitive-motor dual-tasking in older adults, which may help reduce risk of cognitive impairment.
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Affiliation(s)
- Rachel Downey
- Department of Psychology, Concordia University, Montréal, QC, Canada
- PERFORM Centre, Concordia University, Montréal, QC, Canada
- *Correspondence: Rachel Downey, ; Karen Z. H. Li
| | - Louis Bherer
- PERFORM Centre, Concordia University, Montréal, QC, Canada
- Département de Médecine, Université de Montréal, Montréal, QC, Canada
- Centre de recherche de l’Institut de cardiologie de Montréal, Montréal, QC, Canada
- Centre de recherche de l’Institut universitaire de gériatrie de Montréal, Montréal, QC, Canada
| | - Kristell Pothier
- PERFORM Centre, Concordia University, Montréal, QC, Canada
- Centre de recherche de l’Institut universitaire de gériatrie de Montréal, Montréal, QC, Canada
- Psychologie des Ages de la Vie et Adaptation, University of Tours, Tours, France
| | - Tudor Vrinceanu
- PERFORM Centre, Concordia University, Montréal, QC, Canada
- Département de Médecine, Université de Montréal, Montréal, QC, Canada
- Centre de recherche de l’Institut de cardiologie de Montréal, Montréal, QC, Canada
- Centre de recherche de l’Institut universitaire de gériatrie de Montréal, Montréal, QC, Canada
| | - Brittany Intzandt
- PERFORM Centre, Concordia University, Montréal, QC, Canada
- Centre de recherche de l’Institut de cardiologie de Montréal, Montréal, QC, Canada
- Centre de recherche de l’Institut universitaire de gériatrie de Montréal, Montréal, QC, Canada
| | - Nicolas Berryman
- Centre de recherche de l’Institut universitaire de gériatrie de Montréal, Montréal, QC, Canada
- Département des sciences de l’activité physique, Université du Québec à Montréal, Montréal, QC, Canada
| | - Maxime Lussier
- Département de Médecine, Université de Montréal, Montréal, QC, Canada
- Centre de recherche de l’Institut universitaire de gériatrie de Montréal, Montréal, QC, Canada
| | - Thomas Vincent
- PERFORM Centre, Concordia University, Montréal, QC, Canada
- Département de Médecine, Université de Montréal, Montréal, QC, Canada
- Centre de recherche de l’Institut de cardiologie de Montréal, Montréal, QC, Canada
- Centre de recherche de l’Institut universitaire de gériatrie de Montréal, Montréal, QC, Canada
| | - Antony D. Karelis
- Département des sciences de l’activité physique, Université du Québec à Montréal, Montréal, QC, Canada
| | - Anil Nigam
- Département de Médecine, Université de Montréal, Montréal, QC, Canada
- Centre de recherche de l’Institut de cardiologie de Montréal, Montréal, QC, Canada
| | | | - Laurent Bosquet
- Faculté des sciences du sport, Université de Poitiers, Poitiers, France
| | - Karen Z. H. Li
- Department of Psychology, Concordia University, Montréal, QC, Canada
- PERFORM Centre, Concordia University, Montréal, QC, Canada
- *Correspondence: Rachel Downey, ; Karen Z. H. Li
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Mack M, Stojan R, Bock O, Voelcker-Rehage C. Cognitive-motor multitasking in older adults: a randomized controlled study on the effects of individual differences on training success. BMC Geriatr 2022; 22:581. [PMID: 35840893 PMCID: PMC9284902 DOI: 10.1186/s12877-022-03201-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Accepted: 06/09/2022] [Indexed: 11/15/2022] Open
Abstract
Background Multitasking is an essential part of our everyday life, but performance declines typically in older age. Many studies have investigated the beneficial effects of cognitive, motor and combined cognitive-motor training on multitasking performance in older adults. Previous work, however, has not regarded interindividual differences in cognitive functioning and motor fitness that may affect training benefits. The current study aims to identify whether different training programs may have differential effects on multitasking performance depending on the initial level of cognitive functioning and motor fitness. Methods We conduct a 12-week single-blinded randomized controlled trial. A total of N = 150 healthy older adults are assigned to either a single cognitive, a single motor, or a simultaneous cognitive-motor training. Participants are trained twice per week for 45 min. A comprehensive test battery assesses cognitive functions, motor and cardiovascular fitness, and realistic multitasking during walking and driving in two virtual environments. We evaluate how multitasking performance is related not only to the training program, but also to participants’ initial levels of cognitive functioning and motor fitness. Discussion We expect that multitasking performance in participants with lower initial competence in either one or both domains (cognitive functioning, motor fitness) benefits more from single-task training (cognitive training and/or motor training). In contrast, multitasking performance in participants with higher competence in both domains should benefit more from multitask training (simultaneous cognitive-motor training). The results may help to identify whether tailored training is favorable over standardized one-size-fits all training approaches to improve multitasking in older adults. In addition, our findings will advance the understanding of factors that influence training effects on multitasking. Trial registration DRKS (German Clinical Trials Register), DRKS00022407. Registered 26/08/2020 - Retrospectively registered at https://www.drks.de/drks_web/setLocale_EN.do
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Affiliation(s)
- Melanie Mack
- Department of Neuromotor Behavior and Exercise, Institute of Sport and Exercise Sciences, University of Münster, Wilhelm-Schickard-Straße 8, 48149, Muenster, Germany
| | - Robert Stojan
- Department of Neuromotor Behavior and Exercise, Institute of Sport and Exercise Sciences, University of Münster, Wilhelm-Schickard-Straße 8, 48149, Muenster, Germany.,Institute of Human Movement Science and Health, Chemnitz University of Technology, Thueringer Weg 11, 09126, Chemnitz, Germany
| | - Otmar Bock
- Institute of Human Movement Science and Health, Chemnitz University of Technology, Thueringer Weg 11, 09126, Chemnitz, Germany.,Institute of Exercise Training and Sport Informatics, German Sport University, Am Sportpark Muengersdorf 6, 50927, Cologne, Germany
| | - Claudia Voelcker-Rehage
- Department of Neuromotor Behavior and Exercise, Institute of Sport and Exercise Sciences, University of Münster, Wilhelm-Schickard-Straße 8, 48149, Muenster, Germany. .,Institute of Human Movement Science and Health, Chemnitz University of Technology, Thueringer Weg 11, 09126, Chemnitz, Germany.
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11
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Rosado H, Bravo J, Raimundo A, Carvalho J, Almeida G, Pereira C. Can two multimodal psychomotor exercise programs improve attention, affordance perception, and balance in community dwellings at risk of falling? A randomized controlled trial. BMC Public Health 2022; 21:2336. [PMID: 35818044 PMCID: PMC9275017 DOI: 10.1186/s12889-022-13725-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Accepted: 07/01/2022] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Falls are associated with cognitive and physical function deterioration. Attention decline, inaccurate affordance perception, and balance impairment are considered to be risk factors for falls. Furthermore, few studies have reported psychomotor intervention as a fall prevention program. This study aimed to investigate the effects of two multimodal programs on attention, perceptual and stepping-forward boundaries, and balance in community-dwelling older adults at risk of falling. METHODS Fifty-one community-dwelling older adults were recruited to participate in a 24-week randomized controlled trial. Participants (75.4 ± 5.6 years) were randomly assigned to one of three groups: the 1) multimodal psychomotor program [EG1], 2) combined program (multimodal psychomotor program + whole-body vibration program) [EG2], and 3) control group. Participants were assessed at baseline, at post-intervention, and after a 12-week no-intervention follow-up period. RESULTS The within-group comparisons showed significant improvements in attention and balance in EG1 and EG2 after the intervention (p < 0.05). The magnitudes of the treatment effects were similar in both EGs, ranging from medium to large. Decreases in the fall rate were also observed in EG1 (- 44.2%) and EG2 (- 63.0%) (p < 0.05). During the follow-up period, these improvements in attention were maintained, while those in balance were reversed in both EGs. No significant differences between groups were found. CONCLUSIONS These study results suggest that both multimodal exercise programs were effective for fall prevention and were well tolerated by the participants. Specifically, EG1 and EG2 showed identical improvements in attention, and EG2 presented a slightly larger enhancement in balance and a larger decrease in the fall rate. Our findings demonstrate the benefits of maintaining the psychomotor intervention program by itself or in combination with the whole-body vibration program to prevent cognitive and physical function deterioration. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT03446352 . Date of registration: February 26, 2018.
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Affiliation(s)
- Hugo Rosado
- Departamento de Desporto e Saúde, Escola de Saúde e Desenvolvimento Humano, Universidade de Évora, Largo dos Colegiais 2, Évora, Portugal.
- Comprehensive Health Research Centre (CHRC), Universidade de Évora, Évora, Portugal.
| | - Jorge Bravo
- Departamento de Desporto e Saúde, Escola de Saúde e Desenvolvimento Humano, Universidade de Évora, Largo dos Colegiais 2, Évora, Portugal
- Comprehensive Health Research Centre (CHRC), Universidade de Évora, Évora, Portugal
| | - Armando Raimundo
- Departamento de Desporto e Saúde, Escola de Saúde e Desenvolvimento Humano, Universidade de Évora, Largo dos Colegiais 2, Évora, Portugal
- Comprehensive Health Research Centre (CHRC), Universidade de Évora, Évora, Portugal
| | - Joana Carvalho
- Faculdade de Desporto, Universidade do Porto, Porto, Portugal
- CIAFEL - Research Centre in Physical Activity, Health and Leisure, Porto, Portugal
| | - Gabriela Almeida
- Departamento de Desporto e Saúde, Escola de Saúde e Desenvolvimento Humano, Universidade de Évora, Largo dos Colegiais 2, Évora, Portugal
- Comprehensive Health Research Centre (CHRC), Universidade de Évora, Évora, Portugal
| | - Catarina Pereira
- Departamento de Desporto e Saúde, Escola de Saúde e Desenvolvimento Humano, Universidade de Évora, Largo dos Colegiais 2, Évora, Portugal
- Comprehensive Health Research Centre (CHRC), Universidade de Évora, Évora, Portugal
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12
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Makmee P, Wongupparaj P. Virtual Reality-based Cognitive Intervention for Enhancing Executive Functions in Community-dwelling Older Adults. INTERVENCION PSICOSOCIAL 2022; 31:133-144. [PMID: 37361011 PMCID: PMC10268555 DOI: 10.5093/pi2022a10] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/04/2022] [Accepted: 04/22/2022] [Indexed: 06/28/2023]
Abstract
With the rapid growth of the older population globally, it is anticipated that age-related cognitive decline in the prodromal phase and more severe pathological decline will increase. Moreover, currently, no effective treatment options for the disease exist. Thus, early and timely prevention actions are promising and prior strategies to preserve cognitive functions by preventing symptomatology from increasing the age-related deterioration of the functions in healthy older adults. This study aims to develop the virtual reality-based cognitive intervention for enhancing executive functions (EFs) and examine the EFs after training with the virtual reality-based cognitive intervention in community-dwelling older adults. Following inclusion/exclusion criteria, 60 community-dwelling older adults aged 60-69 years were involved in the study and randomly divided into passive control and experimental groups. Eight 60 min virtual reality-based cognitive intervention sessions were held twice a week and lasted for 1 month. The EFs (i.e., inhibition, updating, and shifting) of the participants were assessed by using standardized computerized tasks, i.e., Go/NoGo, forward and backward digit span, and Berg's card sorting tasks. Additionally, a repeated-measure ANCOVA and effect sizes were applied to investigate the effects of the developed intervention. The virtual reality-based intervention significantly improved the EFs of older adults in the experimental group. Specifically, the magnitudes of enhancement were observed for inhibitory as indexed by the response time, F(1) = 6.95, p < .05, ηp2 = .11, updating as represented by the memory span, F(1) = 12.09, p < .01, ηp2 = .18, and the response time, F(1) = 4.46, p = .04, ηp2 = .07, and shifting abilities as indexed by the percentage of correct responses, F(1) = 5.30, p = .03, ηp2 = .09, respectively. The results indicated that the simultaneous combined cognitive-motor control as embedded in the virtual-based intervention is safe and effective in enhancing EFs in older adults without cognitive impairment. Nevertheless, further studies are required to investigate the benefits of these enhancements to motor functions and emotional aspects relating to daily living and the well-being of older populations in communities.
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Affiliation(s)
- Pattrawadee Makmee
- Burapha UniversityCollege of Research Methodology and Cognitive ScienceCognitive Science and Innovation Research UnitThailandCognitive Science and Innovation Research Unit, College of Research Methodology and Cognitive Science, Burapha University, Thailand
| | - Peera Wongupparaj
- Burapha UniversityCollege of Research Methodology and Cognitive ScienceCognitive Science and Innovation Research UnitThailandCognitive Science and Innovation Research Unit, College of Research Methodology and Cognitive Science, Burapha University, Thailand
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Teraz K, Šlosar L, Paravlić AH, de Bruin ED, Marusic U. Impact of Motor-Cognitive Interventions on Selected Gait and Balance Outcomes in Older Adults: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Front Psychol 2022; 13:837710. [PMID: 35783735 PMCID: PMC9245546 DOI: 10.3389/fpsyg.2022.837710] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2021] [Accepted: 04/25/2022] [Indexed: 12/02/2022] Open
Abstract
Background Efficient performance of most daily activities requires intact and simultaneous execution of motor and cognitive tasks. To mitigate age-related functional decline, various combinations of motor and cognitive training have shown promising results. The aim of this systematic review and meta-analysis of randomized controlled trials (RCTs) was to evaluate the efficacy of different types of motor-cognitive training interventions (e.g., sequential and simultaneous) on selected functional outcomes in healthy older adults. Methods Six online academic databases were used to retrieve eligible RCTs up to April 2021, following PRISMA guidelines and PICO criteria. A random-effects model was used for all meta-analyses conducted on selected functional outcomes: single- and dual-task gait speed, the Timed Up and Go Test (TUG), and Berg Balance Scale (BBS) score. Effect size (ES) was calculated as Hedges' g and interpreted as: trivial: <0.20, small: 0.20–0.60, moderate: 0.61–1.20, large: 1.21–2.00, very large: 2.01–4.00 or extremely large >4.00. Results From 2,546 retrieved records, 91 RCTs were included for meta-analysis (n = 3,745 participants; 64.7–86.9 years). The motor-cognitive interventions included differed according to the type of training (e.g., sequential, simultaneous with additional cognitive task or exergame training. The results showed that motor-cognitive interventions can improve gait speed under single-task conditions (small ES = 0.34, P = 0.003). The effect of the intervention was moderated by the type of control group (Q = 6.203, P = 0.013): passive (moderate ES = 0.941, P = 0.001) vs. active controls (trivial ES = 0.153, P = 0.180). No significant effect was found for dual-task walking outcomes (P = 0.063). Motor-cognitive intervention had a positive effect on TUG (small ES = 0.42, P < 0.001), where the effect of intervention was moderated by control group [passive (moderate ES = 0.73, P = 0.001) vs. active (small ES = 0.20, P = 0.020)], but not by the type of training (P = 0.064). Finally, BBS scores were positively affected by motor-cognitive interventions (small ES = 0.59, P < 0.001) with however no significant differences between type of control group (P = 0.529) or intervention modality (P = 0.585). Conclusions This study provides evidence for the effectiveness of various types of motor-cognitive interventions on performance-based measures of functional mobility in healthy older adults. With respect to significant effects, gait speed under single-task condition was improved by motor-cognitive interventions, but the evidence shows that this type of intervention is not necessarily more beneficial than motor training alone. On the other hand, motor-cognitive interventions are better at improving multicomponent tasks of dynamic balance and mobility function, as measured by the TUG. Because of substantial heterogeneity and the current limited availability of different types of interventions, the conclusions should be interpreted with caution.
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Affiliation(s)
- Kaja Teraz
- Institute for Kinesiology Research, Science and Research Centre Koper, Koper, Slovenia
- Faculty of Sport, University of Ljubljana, Ljubljana, Slovenia
| | - Luka Šlosar
- Institute for Kinesiology Research, Science and Research Centre Koper, Koper, Slovenia
| | - Armin H. Paravlić
- Institute for Kinesiology Research, Science and Research Centre Koper, Koper, Slovenia
- Faculty of Sport, University of Ljubljana, Ljubljana, Slovenia
- Faculty of Sports Studies, Masaryk University, Brno, Czechia
| | - Eling D. de Bruin
- Institute of Human Movement Sciences and Sport, Department of Health Sciences and Technology, ETH Zurich, Zurich, Switzerland
- Division of Physiotherapy, Department of Neurobiology, Care Sciences and Society, Karolinska Institute, Stockholm, Sweden
- *Correspondence: Eling D. de Bruin
| | - Uros Marusic
- Institute for Kinesiology Research, Science and Research Centre Koper, Koper, Slovenia
- Department of Health Sciences, Alma Mater Europaea – ECM, Maribor, Slovenia
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Dual-Task Balance Training for Motor Skill Development among Children with Intelligence Quotient Discrepancy. Rehabil Res Pract 2022; 2022:2822171. [PMID: 35075399 PMCID: PMC8783738 DOI: 10.1155/2022/2822171] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2021] [Revised: 12/27/2021] [Accepted: 12/29/2021] [Indexed: 11/18/2022] Open
Abstract
The motor skills of people with mental disabilities are reportedly reduced compared with those of their peers. Therefore, any task incorporating both motor and cognitive skills was hypothesized to provide better motor recovery. The aim of this study is to find the effect of dual-task balance training (DTBT) on motor skill development in children of 6–13 years with intelligence quotient discrepancy (IQD) (score: 50–79). Overall, 30 individuals with mental disabilities aged 6–13 years having an IQ score of 50–79 were included. The participants were randomly divided into two groups that received dual-task training and standard balance training, respectively. IQ was measured with the Wechsler Intelligence Scale for Children-Revised, motor proficiency with the Bruininks–Oseretsky test, reaction time with COGNIBOARD, and balance with Functional Reach Test scores. Intervention was provided twice a week for 12 consecutive weeks. Participants in both groups showed higher test scores in all tests after the training program. Both training programs positively affected the motor performance of the participants. The DTBT was more effective in improving balance performance than the standard balance training. DTBT is a better tool than conventional balance training for improving motor skills and balance in children of 6–13 years with IQD (score: 50–79).
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Bohlke K, Zhu X, Sparto PJ, Redfern MS, Rosano C, Sejdic E, Rosso AL. The Effect of a Verbal Cognitive Task on Postural Sway Does Not Persist When the Task Is Over. SENSORS (BASEL, SWITZERLAND) 2021; 21:8428. [PMID: 34960520 PMCID: PMC8704561 DOI: 10.3390/s21248428] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/05/2021] [Revised: 12/13/2021] [Accepted: 12/14/2021] [Indexed: 12/01/2022]
Abstract
Dual-task balance studies explore interference between balance and cognitive tasks. This study is a descriptive analysis of accelerometry balance metrics to determine if a verbal cognitive task influences postural control after the task ends. Fifty-two healthy older adults (75 ± 6 years old, 30 female) performed standing balance and cognitive dual-tasks. An accelerometer recorded movement from before, during, and after the task (reciting every other letter of the alphabet). Thirty-six balance metrics were calculated for each task condition. The effect of the cognitive task on postural control was determined by a generalized linear model. Twelve variables, including anterior-posterior centroid frequency, peak frequency and entropy rate, medial-later entropy rate and wavelet entropy, and bandwidth in all directions, exhibited significant differences between baseline and cognitive task periods, but not between baseline and post-task periods. These results indicate that the verbal cognitive task did alter balance, but did not bring about persistent effects after the task had ended. Traditional balance measurements, i.e., root mean square and normalized path length, notably lacked significance, highlighting the potential to use other accelerometer metrics for the early detection of balance problems. These novel insights into the temporal dynamics of dual-task balance support current dual-task paradigms to reduce fall risk in older adults.
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Affiliation(s)
- Kayla Bohlke
- Department of Bioengineering, Swanson School of Engineering, University of Pittsburgh, Pittsburgh, PA 15260, USA;
| | - Xiaonan Zhu
- Department of Epidemiology, School of Public Health, University of Pittsburgh, Pittsburgh, PA 15260, USA; (X.Z.); (C.R.); (A.L.R.)
| | - Patrick J. Sparto
- Department of Physical Therapy, School of Health and Rehabilitation Sciences, University of Pittsburgh, Pittsburgh, PA 15260, USA;
| | - Mark S. Redfern
- Department of Bioengineering, Swanson School of Engineering, University of Pittsburgh, Pittsburgh, PA 15260, USA;
| | - Caterina Rosano
- Department of Epidemiology, School of Public Health, University of Pittsburgh, Pittsburgh, PA 15260, USA; (X.Z.); (C.R.); (A.L.R.)
| | - Ervin Sejdic
- The Edward S. Rogers Department of Electrical and Computer Engineering, Faculty of Applied Science and Engineering, University of Toronto, Toronto, ON M5S 1A1, Canada;
- Research & Innovation Department, North York General Hospital, Toronto, ON M2K 1E1, Canada
| | - Andrea L. Rosso
- Department of Epidemiology, School of Public Health, University of Pittsburgh, Pittsburgh, PA 15260, USA; (X.Z.); (C.R.); (A.L.R.)
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Chu HY, Chan HS, Chen MF. Effects of Horticultural Activities on Attitudes toward Aging, Sense of Hope and Hand-Eye Coordination in Older Adults in Residential Care Facilities. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:6555. [PMID: 34207071 PMCID: PMC8296344 DOI: 10.3390/ijerph18126555] [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: 06/07/2021] [Accepted: 06/09/2021] [Indexed: 11/24/2022]
Abstract
This study investigated the effects of an 8-week horticultural activity intervention on attitudes toward aging, sense of hope, and hand-eye coordination in 88 older adults in residential care facilities. In the experimental group, the mean score for "attitudes toward aging" increased from 3.81 before the intervention to 4.74 points after the intervention (standard deviation SD = 0.24 and 0.27, respectively), and the control group dropped from 3.75 to 3.70 (standard deviations, respectively SD = 0.27 and 0.28). The mean score for "sense of hope" increased from 3.28 before the intervention to 3.81 points after the intervention (SD = 0.49 and 0.26, respectively). In contrast to the control group, the mean score gradually declined from 3.26 to 3.16 points (standard deviation SD = 0.54 and 0.48, respectively). In the test of hand-eye coordination, the time required to complete the cup stacking test significantly decreased from 33.56 to 25.38 s in the experimental group but did not significantly change in the control group. Generalized estimating equation analysis revealed a significant interaction between group and time (p < 0.001). The data trends revealed significant differences in outcomes between the experimental group and the control group. At 3 months after the end of the study, the effect size in the experimental group remained higher than that in the control group.
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Affiliation(s)
- Hui-Ying Chu
- Department of Living Services Industry, Tainan University of Technology, No. 529, Zhongzheng Rd., Yongkang District, Tainan City 71002, Taiwan
| | - Hui-Shan Chan
- Department of Applied Cosmetology, National Tainan Junior College of Nursing, 78 Sec. 2, Minzu Rd., Tainan City 70043, Taiwan;
| | - Mei-Fang Chen
- Department of Nursing, National Tainan Junior College of Nursing, 78 Sec. 2, Minzu Rd., Tainan City 70043, Taiwan;
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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: 117] [Impact Index Per Article: 39.0] [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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Sanchez-Lastra MA, Molina AJ, Martin V, Fernández-Villa T, Cancela JM, Ayan C. Is Stretching Exercise An Adequate Control Group in Clinical Trials Aimed at Improving Physical Fitness and Function of Older Adults? A Systematic Review and Meta-Analysis. J Aging Phys Act 2020; 28:889-910. [PMID: 32498038 DOI: 10.1123/japa.2019-0257] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2019] [Revised: 03/04/2020] [Accepted: 03/30/2020] [Indexed: 11/18/2022]
Abstract
This study aimed to determine if stretching exercise can be implemented as an adequate control therapy in exercise randomized controlled trials aimed at improving physical fitness and physical function in older adults. Five electronic databases were systematically searched for randomized controlled trials focused in the physical fitness and function of older adults using stretching exercise as control group. The methodological quality was assessed and a meta-analysis was carried out. Sixteen studies were included, 13 in the meta-analysis. The methodological quality ranged from fair to good. The meta-analysis only in the controls resulted in significant improvements in different functional parameters related to walking, balance, knee flexion strength, or global physical function. The interventions, compared with the controls, significantly improved balance and knee strength parameters. Stretching exercise as control therapy in older people can lead to beneficial effects and could influence the interpretation of the effect size in the intervention groups.
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19
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Tasvuran Horata E, Cetin SY, Erel S. Effects of individual progressive single- and dual-task training on gait and cognition among older healthy adults: a randomized-controlled comparison study. Eur Geriatr Med 2020; 12:363-370. [PMID: 33226605 DOI: 10.1007/s41999-020-00429-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2020] [Accepted: 11/04/2020] [Indexed: 01/03/2023]
Abstract
PURPOSE Dual-task training has beneficial effects on older individuals for gait and cognition. This study was aimed to make a comparison between the effects of individual progressive single- and dual-task training on gait and cognition among healthy older individuals. METHODS A total of 32 participants were divided randomly into two groups as the single-task group (n = 16, 64.6 ± 3.3 years, 7 males and 9 females) and dual-task group (n = 16, 65.6 ± 2.6 years, 8 males and 8 females). The 10-m walk test with the LEGSys device was used to assess spatio-temporal gait parameters. The cognitive parameters were evaluated using the Standardized Mini-Mental State Exam and Stroop Test. An individual progressive 60 min single- and dual-task training programs were applied twice per week for a period of 6 weeks. RESULTS There were significant differences for both gait and cognition variables in the dual-task training group (p < 0.05), according to the comparison of pre- and post-treatment results. In the single-task training group, there were significant differences only in gait parameters with single-task conditions (p < 0.05). The comparisons of the delta values between the groups indicated that the dual-task training group was better compared to the single-task training group in gait speed, cadence, and many cognitive variables (p < 0.05). CONCLUSION Individual progressive dual-task training is an effective and useful method that improves gait performance and cognitive skills among older individuals. TRIAL REGISTRATION NUMBER AND DATE NCT03777111, 12/13/2018.
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Affiliation(s)
- Emel Tasvuran Horata
- Department of Physiotherapy and Rehabilitation, Afyonkarahisar Health Sciences University, Zafer Health Campus, A Block, 2078 Street No: 3, Afyonkarahisar, Turkey.
| | - Sebahat Yaprak Cetin
- Department of Physiotherapy and Rehabilitation, Akdeniz University, Antalya, Turkey
| | - Suat Erel
- School of Physical Therapy and Rehabilitation, Pamukkale University, Denizli, Turkey
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Jahanbakhsh H, Sohrabi M, Saberi Kakhki A, Khodashenas E. The effect of task-specific balance training program in dual-task and single-task conditions on balance performance in children with developmental coordination disorder. ACTA GYMNICA 2020. [DOI: 10.5507/ag.2020.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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21
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Raichlen DA, Bharadwaj PK, Nguyen LA, Franchetti MK, Zigman EK, Solorio AR, Alexander GE. Effects of simultaneous cognitive and aerobic exercise training on dual-task walking performance in healthy older adults: results from a pilot randomized controlled trial. BMC Geriatr 2020; 20:83. [PMID: 32122325 PMCID: PMC7052975 DOI: 10.1186/s12877-020-1484-5] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2019] [Accepted: 02/20/2020] [Indexed: 12/02/2022] Open
Abstract
Background The ability to walk and perform cognitive tasks simultaneously is a key aspect of daily life. Performance declines in these dual-tasks may be associated with early signs of neurodegenerative disease and increased risk of falls. Thus, interventions to improve dual-task walking performance are of great interest for promoting healthy aging. Here, we present results of a pilot randomized controlled trial (RCT) to evaluate the effects of a simultaneous aerobic exercise and cognitive training intervention on dual-task walking performance in healthy older adults. Methods Community-dwelling, healthy older adults were recruited to participate in a 12-week RCT. Participants were randomized into one of four groups (n = 74): 1) cognitive training (COG), 2) aerobic exercise (EX), 3) combined aerobic exercise and cognitive training (EXCOG), and 4) video-watching control (CON). The COG and EXCOG groups both used a tablet-based cognitive training program that challenged aspects of executive cognitive function, memory, and processing speed. Performance on a dual-task walking test (DTWT; serial subtraction during two-minute walk) was assessed by researchers blinded to groupings before the intervention, and at 6 and 12 weeks. We included all participants randomized with baseline measurements in an intention to treat analysis using linear mixed effects models. Results We found a significant group by time interaction for cognitive performance on the DTWT (p = 0.039). Specifically, participants in the EXCOG, EX, and COG groups significantly improved on the cognitive aspect of the DTWT following the full 12-week intervention (p = 3.5e-7, p = 0.048, p = 0.048, respectively). The improvements in EXCOG were twice as large as in the other groups, and were significant at 6 weeks (p = 0.019). The CON group did not show a significant change in cognitive performance on the DTWT, and no group significantly altered dual-task gait measures following the intervention. Conclusions A simultaneous aerobic exercise and cognitive training intervention significantly improved cognitive performance during a DTWT in healthy older adults. Despite no change in DTWT gait measures, significant improvements in cognitive performance indicate that further investigation in a larger RCT is warranted. Trial registration Clinicaltrials.gov, NCT04120792, Retrospectively Registered 08 October 2019.
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Affiliation(s)
- David A Raichlen
- Human and Evolutionary Biology Section, Department of Biological Sciences, University of Southern California, 3616 Trousdale Parkway, Los Angeles, CA, 90089-0372, USA.
| | - Pradyumna K Bharadwaj
- Department of Psychology, University of Arizona, 1503 E. University, Tucson, AZ, 85721, USA.,Evelyn F. McKnight Brain Institute, University of Arizona, Tucson, AZ, USA
| | - Lauren A Nguyen
- Department of Psychology, University of Arizona, 1503 E. University, Tucson, AZ, 85721, USA.,Evelyn F. McKnight Brain Institute, University of Arizona, Tucson, AZ, USA
| | - Mary Kathryn Franchetti
- Department of Psychology, University of Arizona, 1503 E. University, Tucson, AZ, 85721, USA.,Evelyn F. McKnight Brain Institute, University of Arizona, Tucson, AZ, USA
| | - Erika K Zigman
- Department of Psychology, University of Arizona, 1503 E. University, Tucson, AZ, 85721, USA.,Evelyn F. McKnight Brain Institute, University of Arizona, Tucson, AZ, USA
| | - Abigail R Solorio
- Department of Psychology, University of Arizona, 1503 E. University, Tucson, AZ, 85721, USA.,Evelyn F. McKnight Brain Institute, University of Arizona, Tucson, AZ, USA
| | - Gene E Alexander
- Department of Psychology, University of Arizona, 1503 E. University, Tucson, AZ, 85721, USA. .,Evelyn F. McKnight Brain Institute, University of Arizona, Tucson, AZ, USA. .,Department of Psychiatry, University of Arizona, Tucson, AZ, USA. .,Neuroscience Graduate Interdisciplinary Program, University of Arizona, Tucson, AZ, USA. .,Physiological Sciences Graduate Interdisciplinary Program, University of Arizona, Tucson, AZ, USA. .,BIO5 Institute, University of Arizona, Tucson, AZ, USA. .,Arizona Alzheimer's Consortium, Phoenix, AZ, USA.
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22
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Norouzi E, Vaezmosavi M, Gerber M, Pühse U, Brand S. Dual-task training on cognition and resistance training improved both balance and working memory in older people. PHYSICIAN SPORTSMED 2019; 47:471-478. [PMID: 31155997 DOI: 10.1080/00913847.2019.1623996] [Citation(s) in RCA: 38] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Objectives: With increasing age, declines in executive functions and basic motor skills such as posture control, muscle strength, and balance performance have been observed. However, no intervention has focused on enhancing both executive functions and balance performance concomitantly. Accordingly, the aim of the present study is to investigate whether and to what extent two different dual-task interventions improved both working memory and balancing. Specifically, we examined whether either a motor-cognitive dual task training (mCdtt) or a motor-motor dual-task training (mMdtt) impacted more favorably on working memory and on balance performance among a sample of older adults.Methods: A total of 60 older males (mean age: 68.31 years; SD = 3.83) were randomly assigned either to the mCdtt, the mMdtt or to control condition. Balance performance and working memory performance were tested at baseline, four weeks later at study completion, and again 12 weeks later at follow-up.Results: Balance and working memory improved from baseline to post-intervention and to follow-up (significant Time effect), but more so in the mCdtt compared to the mMdtt condition (significant Time × Group interaction). Further, compared to the mMdtt condition, higher scores were observed in the mCdtt condition (significant Group effect).Conclusion: Dual-task interventions improved both balance performance and working memory, but more so if cognitive performance was specifically trained along with resistance training.
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Affiliation(s)
- Ebrahim Norouzi
- Department of Motor Behavior, Faculty of Sport Science, Urmia University, Urmia, Iran
| | | | - Markus Gerber
- Department of Sport, Exercise and Health, Division of Sport and Psychosocial Health, University of Basel, Basel, Switzerland
| | - Uwe Pühse
- Department of Sport, Exercise and Health, Division of Sport and Psychosocial Health, University of Basel, Basel, Switzerland
| | - Serge Brand
- Department of Sport, Exercise and Health, Division of Sport and Psychosocial Health, University of Basel, Basel, Switzerland.,Substance Abuse Prevention Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran.,Sleep Disorders Research Centre, Kermanshah University of Medical Sciences, Kermanshah, Iran.,Psychiatric Clinics (UPK), Centre for Affective, Stress and Sleep Disorders, University of Basel, Basel, Switzerland
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23
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Can physical and cognitive training based on episodic memory be combined in a new protocol for daily training? Aging Clin Exp Res 2019; 31:1615-1623. [PMID: 30569279 DOI: 10.1007/s40520-018-1107-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2018] [Accepted: 12/14/2018] [Indexed: 01/22/2023]
Abstract
BACKGROUND Cognitive training (CT) is defined as guided practice on a set of standard tasks designed to stimulate particular cognitive functions. Recent studies have shown that physical exercise is beneficial for cognitive activity in older adults and patients with degenerative diseases. AIMS The main objective of the present study is to create a new cognitive tool able to provide training for cognitive functions that take advantage of the physical activity involved in the execution of the task. A study concerning the application of a new CT tool for episodic memory is presented and divided in two parts. The first one aims at developing a new sensorized device, called SmartTapestry, for physical and cognitive training. The second part aims at understanding its technical viability and level of sensitivity in stimulating the same cognitive domain covered by the standardized tests, despite the introduction of the physical activity variable. METHODS The SmartTapestry device was tested with a total of 53 subjects, 29 healthy subjects and 24 subjects suffering from mild cognitive impairment. RESULTS AND DISCUSSIONS The results show a good correlation between the two approaches (p < 0.005), suggesting that SmartTapestry can stimulate the same cognitive functions of traditional cognitive tasks, with the addition of physical exercise. CONCLUSIONS The results of this study may be useful in designing ecological and combined cognitive-physical tools, which can be used daily at home, reducing the presence of clinical staff, to train at the same time the brain and the body so as to improve the cognitive treatments efficacy.
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24
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Fiorini L, Maselli M, Esposito R, Castro E, Mancioppi G, Cecchi F, Laschi C, Ottino S, Rossi C, Pinori F, Tocchini S, Sportiello MT, Dario P, Cavallo F. Foot Inertial Sensing for Combined Cognitive-Motor Exercise of the Sustained Attention Domain. IEEE Trans Biomed Eng 2019; 66:2413-2420. [DOI: 10.1109/tbme.2019.2906758] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
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25
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Chan PT, Chang WC, Chiu HL, Kao CC, Liu D, Chu H, Chou KR. Effect of interactive cognitive-motor training on eye-hand coordination and cognitive function in older adults. BMC Geriatr 2019; 19:27. [PMID: 30691404 PMCID: PMC6350349 DOI: 10.1186/s12877-019-1029-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2018] [Accepted: 01/07/2019] [Indexed: 02/06/2023] Open
Abstract
Background Poor eye–hand coordination is associated with the symptoms of the early stage of cognitive decline. However, previous research on the eye–hand coordination of older adults without cognitive impairment is scant. Therefore, this study examined the effects of interactive cognitive-motor training on the visual-motor integration, visual perception, and motor coordination sub-abilities of the eye–hand coordination and cognitive function in older adults. Methods A double-blind randomized controlled trial was conducted with older adults. Sixty-two older adults were randomly assigned to the experimental (interactive cognitive-motor training) or active control (passive information activity) group, and both groups received 30 min of training each week, three times a week for 8 weeks. The primary outcome was eye–hand coordination, which was further divided into the sub-abilities of visual–motor integration, visual perception, and motor coordination. The secondary outcome was cognitive function. The generalized estimating equation was used to examine differences in immediate posttest, 3-month posttest, and 6-month posttest results between the two groups. Additionally, the baseline effect sizes were compared with the effect sizes of the immediate posttest, 3-month posttest, and 6-month posttests for the experimental group. Results There were no statistically significant differences between the intervention and control groups. The only statistically significant difference between the groups was in the attention dimension of cognitive function (p = 0.04). The visual–motor integration results showed a small to moderate effect size for pre post comparisons. Conclusions The 24 sessions of interactive cognitive-motor training showed no difference to an active control intervention. In the future, this intervention could be further investigated to establish whether it can be superior to an active control group in other populations. Trial registration The study protocol has been published on Chinese Clinical Trial Registry (ChiCTR) (registry no.: ChiCTR-IOR-14005490). Electronic supplementary material The online version of this article (10.1186/s12877-019-1029-y) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Pi-Tuan Chan
- Department of Nursing, En Chu Kong Hospital, Taipei, Taiwan
| | - Wen-Chi Chang
- Department of Nursing, Taipei Veterans General Hospital Yuanshan branches, Yilan, Taiwan
| | - Huei-Ling Chiu
- School of Gerontology Health Management, College of Nursing, Taipei Medical University, Taipei, Taiwan
| | - Ching-Chiu Kao
- School of Nursing, College of Nursing, Taipei Medical University, No.250, Wu-Hsing Street, Taipei, 110, Taiwan, Republic of China.,Department of Nursing, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan
| | - Doresses Liu
- Department of Nursing, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan
| | - Hsin Chu
- Institute of Aerospace and Undersea Medicine, School of Medicine, National Defense Medical Center, Taipei, Taiwan.,Department of Neurology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Kuei-Ru Chou
- School of Nursing, College of Nursing, Taipei Medical University, No.250, Wu-Hsing Street, Taipei, 110, Taiwan, Republic of China. .,Psychiatric Research Center, Taipei Medical University Hospital, Taipei, Taiwan. .,Department of Nursing, Taipei Medical University-Shuang Ho Hospital, Taipei, Taiwan.
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Marusic U, Kavcic V, Pisot R, Goswami N. The Role of Enhanced Cognition to Counteract Detrimental Effects of Prolonged Bed Rest: Current Evidence and Perspectives. Front Physiol 2019; 9:1864. [PMID: 30728781 PMCID: PMC6351441 DOI: 10.3389/fphys.2018.01864] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2018] [Accepted: 12/11/2018] [Indexed: 12/29/2022] Open
Abstract
Prolonged periods of physical inactivity or bed rest can lead to a significant decline of functional and cognitive functions. Different kinds of countermeasures (e.g., centrifugation, nutritional, and aerobic interventions) have been developed to attempt to mitigate negative effects related to bed rest confinement. The aim of this report is to provide an overview of the current evidence related to the effectiveness of computerized cognitive training (CCT) intervention during a period of complete physical inactivity in older adults. CCT, using a virtual maze navigation task, appears to be effective and has long-lasting benefits (up to 1.5 years after the study). Moreover, enhanced cognition (executive control) reduces decline in the ability to perform complex motor-cognitive dual-tasks after prolonged period of bed rest. It has been demonstrated that CCT administration in older adults also prevents bed rest stress-related physiological changes [these groups showed minimal changes in vascular function and an unchanged level of brain-derived neurotrophic factor (BDNF)] while control subjects showed decreased peripheral vascularization and increased plasma level of the neurotrophin BDNF during a 14-day bed rest. In addition, the effects of CCT are evident also from the brain electrocortical findings: CCT group revealed a decreased power in lower delta and theta bands while significant increases in the same EEG spectral bands power were found in control subjects. If we consider an increase of power in delta band as a marker of cortical aging, then the lack of shift of EEG power to lower band indicates a preventive role of CCT on the cortical level during physiological deconditioning induced by 2-week bed rest immobilization. However, replication on a larger sample is required to confirm the observed findings. Applications derived from these findings could be appropriate for implementation of hospital treatment for bed ridden patients as well as for fall prevention programs.
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Affiliation(s)
- Uros Marusic
- Institute for Kinesiology Research, Science and Research Centre Koper, Koper, Slovenia.,Department of Health Sciences, Alma Mater Europaea - European Center Maribor, Maribor, Slovenia
| | - Voyko Kavcic
- Institute of Gerontology, Wayne State University, Detroit, MI, United States
| | - Rado Pisot
- Institute for Kinesiology Research, Science and Research Centre Koper, Koper, Slovenia
| | - Nandu Goswami
- Department of Health Sciences, Alma Mater Europaea - European Center Maribor, Maribor, Slovenia.,Head of Research Unit: "Gravitational Physiology, Aging and Medicine", Otto Loewi Research Center of Vascular Biology, Immunity and Inflammation, Medical University of Graz, Graz, Austria
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27
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Effects of aerobic fitness on cognitive performance as a function of dual-task demands in older adults. Exp Gerontol 2019; 118:99-105. [PMID: 30659955 DOI: 10.1016/j.exger.2019.01.013] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2018] [Revised: 12/27/2018] [Accepted: 01/11/2019] [Indexed: 12/31/2022]
Abstract
The objective of this study was to examine the effects of aerobic fitness on cognitive performance under varying dual-task demands in older adults. Thirty-four participants (mean ± SD age: 68.6 ± 10.1 years, 24 females) were included in this study. VO2 max was assessed with the Rockport 1-mile walk test (range = 6.68-45.57). Participants engaged in a cognitive task, the Modified Stroop Color Word Test (MSCWT) on a self-paced treadmill while simultaneously standing or walking. Performance on the Stroop Test was measured as interference of the accuracy score. Participants demonstrated over a 4-fold increase in SI when going from Incongruent to Switching MSCWT blocks across both standing and walking tasks. Furthermore, there was a significant interaction between the MSCWT block and VO2 max in Stroop interference, such that Switching Stroop interference demonstrated greater changes due to VO2 max, in comparison to Incongruent SI, even after controlling for age, gender, body mass index, and years of education as covariates in analyses. These results provide evidence of a relationship between aerobic fitness and cognition, suggesting that dual-task interference may provide a sensitive indicator of effects of an aerobic intervention program on the cognitive performance among older adults.
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28
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Intzandt B, Beck EN, Silveira CR. The effects of exercise on cognition and gait in Parkinson’s disease: A scoping review. Neurosci Biobehav Rev 2018; 95:136-169. [DOI: 10.1016/j.neubiorev.2018.09.018] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2018] [Revised: 09/23/2018] [Accepted: 09/24/2018] [Indexed: 10/28/2022]
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29
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Li KZH, Bherer L, Mirelman A, Maidan I, Hausdorff JM. Cognitive Involvement in Balance, Gait and Dual-Tasking in Aging: A Focused Review From a Neuroscience of Aging Perspective. Front Neurol 2018; 9:913. [PMID: 30425679 PMCID: PMC6219267 DOI: 10.3389/fneur.2018.00913] [Citation(s) in RCA: 126] [Impact Index Per Article: 21.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2018] [Accepted: 10/09/2018] [Indexed: 11/20/2022] Open
Abstract
A substantial corpus of evidence suggests that the cognitive involvement in postural control and gait increases with aging. A large portion of such studies were based on dual-task experimental designs, which typically use the simultaneous performance of a motor task (e.g., static or dynamic balancing, walking) and a continuous cognitive task (e.g., mental arithmetic, tone detection). This focused review takes a cognitive neuroscience of aging perspective in interpreting cognitive motor dual-task findings. Specifically, we consider the importance of identifying the neural circuits that are engaged by the cognitive task in relation to those that are engaged during motor task performance. Following the principle of neural overlap, dual-task interference should be greatest when the cognitive and motor tasks engage the same neural circuits. Moreover, the literature on brain aging in general, and models of dedifferentiation and compensation, in particular, suggest that in cognitive motor dual-task performance, the cognitive task engages different neural substrates in young as compared to older adults. Also considered is the concept of multisensory aging, and the degree to which the age-related decline of other systems (e.g., vision, hearing) contribute to cognitive load. Finally, we discuss recent work on focused cognitive training, exercise and multimodal training of older adults and their effects on postural and gait outcomes. In keeping with the principle of neural overlap, the available cognitive training research suggests that targeting processes such as dividing attention and inhibition lead to improved balance and gait in older adults. However, more studies are needed that include functional neuroimaging during actual, upright performance of gait and balance tasks, in order to directly test the principle of neural overlap, and to better optimize the design of intervention studies to improve gait and posture.
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Affiliation(s)
- Karen Z. H. Li
- Department of Psychology, Concordia University, Montreal, QC, Canada
- Centre for Research in Human Development, Concordia University, Montreal, QC, Canada
- PERFORM Centre, Concordia University, Montreal, QC, Canada
| | - Louis Bherer
- PERFORM Centre, Concordia University, Montreal, QC, Canada
- Department of Medicine, Université de Montréal, Montreal, QC, Canada
- Centre de Recherche de l'Institut Universitaire de Gériatrie de Montréal, Montreal, QC, Canada
- Research Center, Montreal Heart Institute, Montreal, QC, Canada
| | - Anat Mirelman
- Center for the Study of Movement, Cognition and Mobility, Neurological Institute, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
- Department of Neurology, Sackler Faculty of Medicine and Sagol School of Neuroscience, Tel Aviv University, Tel Aviv, Israel
| | - Inbal Maidan
- Center for the Study of Movement, Cognition and Mobility, Neurological Institute, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
- Department of Neurology, Sackler Faculty of Medicine and Sagol School of Neuroscience, Tel Aviv University, Tel Aviv, Israel
| | - Jeffrey M. Hausdorff
- Center for the Study of Movement, Cognition and Mobility, Neurological Institute, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
- Department of Physical Therapy, Sackler Faculty of Medicine and Sagol School of Neuroscience, Tel Aviv University, Tel Aviv, Israel
- Rush Alzheimer's Disease Center and Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, IL, United States
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30
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Dasgupta P, VanSwearingen J, Sejdic E. "You can tell by the way I use my walk." Predicting the presence of cognitive load with gait measurements. Biomed Eng Online 2018; 17:122. [PMID: 30208897 PMCID: PMC6134780 DOI: 10.1186/s12938-018-0555-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2018] [Accepted: 09/01/2018] [Indexed: 11/12/2022] Open
Abstract
Background There is considerable evidence that a person’s gait is affected by cognitive load. Research in this field has implications for understanding the relationship between motor control and neurological conditions in aging and clinical populations. Accordingly, this pilot study evaluates the cognitive load based on gait accelerometry measurements of the walking patterns of ten healthy individuals (18–35 years old). Methods Data points were collected using six triaxial accelerometer sensors and treadmill pressure reports. Stride and window extraction methods were used to process these data points and separate into statistical features. A binary classification was created by using logistic regression, support vector machine, random forest, and learning vector quantization to classify cognitive load vs. no cognitive load. Results Within and between subjects, a cognitive load was predicted with accuracy values ranged of 0.93–1 by all four models. Various feature selection methods demonstrated that only 2–20 variables could be used to achieve similar levels of accuracies. Conclusion Coupling sensors with machine learning algorithms to detect the most minute changes in gait patterns, most of which are too subtle to identify with the human eye, may have a remarkable impact on the potential to detect potential neuromotor illnesses and fall risks. In doing so, we can open a new window to human health and safety prevention.
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Affiliation(s)
- Pritika Dasgupta
- Department of Biomedical Informatics, School of Medicine, University of Pittsburgh, Pittsburgh, PA, USA
| | - Jessie VanSwearingen
- Department of Physical Therapy, School of Health and Rehabilitation Sciences, University of Pittsburgh, Pittsburgh, PA, USA
| | - Ervin Sejdic
- Department of Electrical and Computer Engineering, Swanson School of Engineering, University of Pittsburgh, Pittsburgh, PA, USA.
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Pothier K, Gagnon C, Fraser SA, Lussier M, Desjardins-Crépeau L, Berryman N, Kergoat MJ, Vu TTM, Li KZH, Bosquet L, Bherer L. A comparison of the impact of physical exercise, cognitive training and combined intervention on spontaneous walking speed in older adults. Aging Clin Exp Res 2018; 30:921-925. [PMID: 29235076 DOI: 10.1007/s40520-017-0878-5] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2017] [Accepted: 12/05/2017] [Indexed: 11/28/2022]
Abstract
BACKGROUND Spontaneous walking speed (SWS) is one of the most important indicators of health in older adults. Studies have shown benefits of physical trainings on SWS in older adults but the impact of cognitive training and multidomain interventions remains understudied. AIMS This original study aimed at comparing the impact of aerobic/resistance exercise, computerized cognitive training and the combination of both interventions compared with active control conditions on SWS in healthy older adults. METHODS Ninety community-dwelling older adults were randomly assigned to four different combinations composed of two active interventions: physical aerobic/resistance and cognitive dual-task trainings, and two active control conditions: stretching exercises and computer lessons. The four combinations were the following: (1) aerobic/resistance and cognitive dual task (n = 28), (2) aerobic/resistance and computer lessons (n = 21), (3) stretching exercises and cognitive dual task and (n = 23), (4) stretching exercises and computer lessons (n = 18). Training sessions were held three times/week for three months. SWS for 30 s was assessed before and after the intervention. RESULTS Repeated-measures ANOVA showed a main effect of time and a significant three-way interaction suggesting differential improvement in SWS according to training combinations. A clinical meaningful improvement in SWS was observed in groups 1-3 (0.08-0.14 m/s; effect sizes: small to moderate) but not in the active control group 4. DISCUSSION Results of this study suggest that aerobic/resistance exercise and computerized dual-task training are two non-pharmacological interventions by which SWS, a functional vital sign, can be clinically improved in older adults. CONCLUSION This original study pointed out different tools to prevent functional decline in older people.
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Affiliation(s)
- Kristell Pothier
- Centre de Recherche, Institut Universitaire de Gériatrie de Montréal, 4545 Chemin Queen-Mary, Montreal, QC, H3W 1W4, Canada.
- PERFORM Centre, Concordia University, Montreal, Canada.
| | - Christine Gagnon
- Centre de Recherche, Institut Universitaire de Gériatrie de Montréal, 4545 Chemin Queen-Mary, Montreal, QC, H3W 1W4, Canada
- Research Center, Montreal Heart Institute, Montreal, Canada
| | - Sarah A Fraser
- Interdisciplinary School of Health Sciences, University of Ottawa, Ottawa, Canada
| | - Maxime Lussier
- Centre de Recherche, Institut Universitaire de Gériatrie de Montréal, 4545 Chemin Queen-Mary, Montreal, QC, H3W 1W4, Canada
- Rehabilitation Science, Department of Medicine, University of Montréal, Montreal, Canada
| | - Laurence Desjardins-Crépeau
- Centre de Recherche, Institut Universitaire de Gériatrie de Montréal, 4545 Chemin Queen-Mary, Montreal, QC, H3W 1W4, Canada
- Research Center, Montreal Heart Institute, Montreal, Canada
| | - Nicolas Berryman
- Centre de Recherche, Institut Universitaire de Gériatrie de Montréal, 4545 Chemin Queen-Mary, Montreal, QC, H3W 1W4, Canada
- Department of Sports Studies, Bishop's University, Sherbrooke, Canada
| | - Marie-Jeanne Kergoat
- Centre de Recherche, Institut Universitaire de Gériatrie de Montréal, 4545 Chemin Queen-Mary, Montreal, QC, H3W 1W4, Canada
- Department of Medicine, University of Montréal, Montreal, Canada
| | - T T Minh Vu
- Department of Medicine, University of Montréal, Montreal, Canada
- Research Center, Centre hospitalier de l'Université de Montréal, Montreal, Canada
| | - Karen Z H Li
- PERFORM Centre, Concordia University, Montreal, Canada
- Department of Psychology, Concordia University, Montreal, Canada
| | - Laurent Bosquet
- Faculté des sciences du sport, Université de Poitiers, Poitiers, France
| | - Louis Bherer
- Centre de Recherche, Institut Universitaire de Gériatrie de Montréal, 4545 Chemin Queen-Mary, Montreal, QC, H3W 1W4, Canada
- PERFORM Centre, Concordia University, Montreal, Canada
- Research Center, Montreal Heart Institute, Montreal, Canada
- Department of Medicine, University of Montréal, Montreal, Canada
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32
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Paraskevoudi N, Balcı F, Vatakis A. "Walking" through the sensory, cognitive, and temporal degradations of healthy aging. Ann N Y Acad Sci 2018; 1426:72-92. [PMID: 29741265 DOI: 10.1111/nyas.13734] [Citation(s) in RCA: 48] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2017] [Revised: 03/17/2018] [Accepted: 03/22/2018] [Indexed: 02/03/2023]
Abstract
As we age, there is a wide range of changes in motor, sensory, cognitive, and temporal processing due to alterations in the functioning of the central nervous and musculoskeletal systems. Specifically, aging is associated with degradations in gait; altered processing of the individual sensory systems; modifications in executive control, memory, and attention; and changes in temporal processing. These age-related alterations are often inter-related and have been suggested to result from shared neural substrates. Additionally, the overlap between these brain areas and those controlling walking raises the possibility of facilitating performance in several tasks by introducing protocols that can efficiently target all four domains. Attempts to counteract these negative effects of normal aging have been focusing on research to prevent falls and/or enhance cognitive processes, while ignoring the potential multisensory benefits accompanying old age. Research shows that the aging brain tends to increasingly rely on multisensory integration to compensate for degradations in individual sensory systems and for altered neural functioning. This review covers the age-related changes in the above-mentioned domains and the potential to exploit the benefits associated with multisensory integration in aging so as to improve one's mobility and enhance sensory, cognitive, and temporal processing.
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Affiliation(s)
- Nadia Paraskevoudi
- Multisensory and Temporal Processing Lab (MultiTimeLab), Department of History and Philosophy of Science, National and Kapodistrian University of Athens, Athens, Greece
| | - Fuat Balcı
- Department of Psychology, Koç University, Istanbul, Turkey
| | - Argiro Vatakis
- Multisensory and Temporal Processing Lab (MultiTimeLab), Department of History and Philosophy of Science, National and Kapodistrian University of Athens, Athens, Greece
- Cognitive Systems Research Institute, Athens, Greece
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Einfluss von computerbasiertem kognitivem Training auf Mobilität bei gesunden Älteren. Z Gerontol Geriatr 2018; 51:184-192. [DOI: 10.1007/s00391-018-1369-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2017] [Revised: 12/14/2017] [Accepted: 01/05/2018] [Indexed: 11/25/2022]
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