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Herold F, Theobald P, Gronwald T, Kaushal N, Zou L, de Bruin ED, Bherer L, Müller NG. The Best of Two Worlds to Promote Healthy Cognitive Aging: Definition and Classification Approach of Hybrid Physical Training Interventions. JMIR Aging 2024; 7:e56433. [PMID: 39083334 PMCID: PMC11325123 DOI: 10.2196/56433] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2024] [Revised: 04/29/2024] [Accepted: 05/06/2024] [Indexed: 08/02/2024] Open
Abstract
A healthy lifestyle can be an important prerequisite to prevent or at least delay the onset of dementia. However, the large number of physically inactive adults underscores the need for developing and evaluating intervention approaches aimed at improving adherence to a physically active lifestyle. In this regard, hybrid physical training, which usually combines center- and home-based physical exercise sessions and has proven successful in rehabilitative settings, could offer a promising approach to preserving cognitive health in the aging population. Despite its potential, research in this area is limited as hybrid physical training interventions have been underused in promoting healthy cognitive aging. Furthermore, the absence of a universally accepted definition or a classification framework for hybrid physical training interventions poses a challenge to future progress in this direction. To address this gap, this article informs the reader about hybrid physical training by providing a definition and classification approach of different types, discussing their specific advantages and disadvantages, and offering recommendations for future research. Specifically, we focus on applying digital technologies to deliver home-based exercises, as their use holds significant potential for reaching underserved and marginalized groups, such as older adults with mobility impairments living in rural areas.
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Affiliation(s)
- Fabian Herold
- Research Group Degenerative and Chronic Diseases, Movement, Faculty of Health Sciences Brandenburg, University of Potsdam, Potsdam, Germany
| | - Paula Theobald
- Research Group Degenerative and Chronic Diseases, Movement, Faculty of Health Sciences Brandenburg, University of Potsdam, Potsdam, Germany
| | - Thomas Gronwald
- Institute of Interdisciplinary Exercise Science and Sports Medicine, Hamburg, Germany
| | - Navin Kaushal
- Department of Health Sciences, School of Health & Human Sciences, Indiana University, Indianapolis, IN, United States
| | - Liye Zou
- Body-Brain-Mind Laboratory, Shenzhen University, Shenzhen, China
| | - Eling D de Bruin
- Department of Health Sciences and Technology, Institute of Human Movement Sciences and Sport, ETH Zürich, Zürich, Switzerland
- Department of Neurobiology, Care Sciences, and Society, Karolinska Institute, Stockholm, Sweden
- Department of Health, OST - Eastern Swiss University of Applied Sciences, St Gallen, Switzerland
| | - Louis Bherer
- Montreal Heart Institute, Montreal, QC, Canada
- Department of Medicine, Université de Montreal, Montreal, QC, Canada
- Centre de Recherche de l'Institut Universitaire de Geriatrie de Montreal, Montreal, QC, Canada
| | - Notger G Müller
- Research Group Degenerative and Chronic Diseases, Movement, Faculty of Health Sciences Brandenburg, University of Potsdam, Potsdam, Germany
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Maas SA, Göcking T, Stojan R, Voelcker-Rehage C, Kutz DF. Synchronization of Neurophysiological and Biomechanical Data in a Real-Time Virtual Gait Analysis System (GRAIL): A Proof-of-Principle Study. SENSORS (BASEL, SWITZERLAND) 2024; 24:3779. [PMID: 38931563 PMCID: PMC11207734 DOI: 10.3390/s24123779] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/15/2024] [Revised: 06/04/2024] [Accepted: 06/07/2024] [Indexed: 06/28/2024]
Abstract
The investigation of gait and its neuronal correlates under more ecologically valid conditions as well as real-time feedback visualization is becoming increasingly important in neuro-motor rehabilitation research. The Gait Real-time Analysis Interactive Lab (GRAIL) offers advanced opportunities for gait and gait-related research by creating more naturalistic yet controlled environments through immersive virtual reality. Investigating the neuronal aspects of gait requires parallel recording of brain activity, such as through mobile electroencephalography (EEG) and/or mobile functional near-infrared spectroscopy (fNIRS), which must be synchronized with the kinetic and /or kinematic data recorded while walking. This proof-of-concept study outlines the required setup by use of the lab streaming layer (LSL) ecosystem for real-time, simultaneous data collection of two independently operating multi-channel EEG and fNIRS measurement devices and gait kinetics. In this context, a customized approach using a photodiode to synchronize the systems is described. This study demonstrates the achievable temporal accuracy of synchronous data acquisition of neurophysiological and kinematic and kinetic data collection in the GRAIL. By using event-related cerebral hemodynamic activity and visually evoked potentials during a start-to-go task and a checkerboard test, we were able to confirm that our measurement system can replicate known physiological phenomena with latencies in the millisecond range and relate neurophysiological and kinetic data to each other with sufficient accuracy.
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Affiliation(s)
| | | | | | | | - Dieter F. Kutz
- Department of Neuromotor Behavior and Exercise, University of Münster, 48149 Münster, Germany; (S.A.M.); (T.G.); (R.S.); (C.V.-R.)
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Ramalho A, Paulo R, Duarte-Mendes P, Serrano J, Petrica J. Age Unplugged: A Brief Narrative Review on the Intersection of Digital Tools, Sedentary and Physical Activity Behaviors in Community-Dwelling Older Adults. Healthcare (Basel) 2024; 12:935. [PMID: 38727492 PMCID: PMC11083116 DOI: 10.3390/healthcare12090935] [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: 04/10/2024] [Revised: 04/28/2024] [Accepted: 04/30/2024] [Indexed: 05/13/2024] Open
Abstract
This brief narrative review assesses how digital technologies-such as wearables, mobile health apps, and various digital tools such as computers, game consoles, tablets, smartphones, and extended reality systems-can influence sedentary and physical activity behaviors among community-dwelling older adults. Each section highlights the central role of these technologies in promoting active aging through increased motivation, engagement and customized experiences. It underlines the critical importance of functionality, usability and adaptability of devices and confirms the effectiveness of digital interventions in increasing physical activity and reducing sedentary behavior. The sustainable impact of these technologies needs to be further investigated, with a focus on adapting digital health strategies to the specific needs of older people. The research advocates an interdisciplinary approach and points out that such collaborations are essential for the development of accessible, effective and ethical solutions. This perspective emphasizes the potential of digital tools to improve the health and well-being of the aging population and recommends their strategic integration into health promotion and policy making.
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Affiliation(s)
- André Ramalho
- Polytechnic Institute of Castelo Branco, 6000-266 Castelo Branco, Portugal; (R.P.); (P.D.-M.); (J.S.); (J.P.)
- SPRINT Sport Physical Activity and Health Research & Innovation Center, 2001-904 Santarém, Portugal
| | - Rui Paulo
- Polytechnic Institute of Castelo Branco, 6000-266 Castelo Branco, Portugal; (R.P.); (P.D.-M.); (J.S.); (J.P.)
- SPRINT Sport Physical Activity and Health Research & Innovation Center, 2001-904 Santarém, Portugal
| | - Pedro Duarte-Mendes
- Polytechnic Institute of Castelo Branco, 6000-266 Castelo Branco, Portugal; (R.P.); (P.D.-M.); (J.S.); (J.P.)
- SPRINT Sport Physical Activity and Health Research & Innovation Center, 2001-904 Santarém, Portugal
| | - João Serrano
- Polytechnic Institute of Castelo Branco, 6000-266 Castelo Branco, Portugal; (R.P.); (P.D.-M.); (J.S.); (J.P.)
- SPRINT Sport Physical Activity and Health Research & Innovation Center, 2001-904 Santarém, Portugal
| | - João Petrica
- Polytechnic Institute of Castelo Branco, 6000-266 Castelo Branco, Portugal; (R.P.); (P.D.-M.); (J.S.); (J.P.)
- SPRINT Sport Physical Activity and Health Research & Innovation Center, 2001-904 Santarém, Portugal
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Ramalho A, Duarte-Mendes P, Paulo R, Serrano J, Petrica J. Crossing the digital frontier: are older adults ready for virtual reality workouts? Front Public Health 2024; 12:1324004. [PMID: 38389949 PMCID: PMC10881650 DOI: 10.3389/fpubh.2024.1324004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2023] [Accepted: 01/24/2024] [Indexed: 02/24/2024] Open
Abstract
In the dynamic web of our digital age, virtual reality (VR) is crystallizing as a promising medium for promoting physical activity in older adults, overcoming age-old barriers. This perspective article explores the intricate synergy between VR and physical activity in older adults and highlights the many challenges of aging within a virtual environment. While VR heralds the potential for multisensory interaction and cognitive enhancement, a thorough assessment of its impact is paramount. The reach of VR goes beyond immediate applications and permeates the emotional and psychological realms of the human journey. Such an exploration requires a comprehensive perspective that goes beyond a purely technical assessment. The aim of this article is not to present clear-cut solutions, but to encourage reflection on the diverse impact of VR on our aging population. We argue for a future in which technology complements, rather than eclipses, the depth of human experience.
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Affiliation(s)
- André Ramalho
- Sport, Health & Exercise Research Unit (SHERU), Polytechnic Institute of Castelo Branco, Castelo Branco, Portugal
- Sport Physical Activity and Health Research & INnovation CenTer, SPRINT, Santarém, Portugal
| | - Pedro Duarte-Mendes
- Sport, Health & Exercise Research Unit (SHERU), Polytechnic Institute of Castelo Branco, Castelo Branco, Portugal
- Sport Physical Activity and Health Research & INnovation CenTer, SPRINT, Santarém, Portugal
| | - Rui Paulo
- Sport, Health & Exercise Research Unit (SHERU), Polytechnic Institute of Castelo Branco, Castelo Branco, Portugal
- Sport Physical Activity and Health Research & INnovation CenTer, SPRINT, Santarém, Portugal
| | - João Serrano
- Sport, Health & Exercise Research Unit (SHERU), Polytechnic Institute of Castelo Branco, Castelo Branco, Portugal
- Sport Physical Activity and Health Research & INnovation CenTer, SPRINT, Santarém, Portugal
| | - João Petrica
- Sport, Health & Exercise Research Unit (SHERU), Polytechnic Institute of Castelo Branco, Castelo Branco, Portugal
- Sport Physical Activity and Health Research & INnovation CenTer, SPRINT, Santarém, Portugal
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Paravlic A, Šlosar L, Abazovic E, Marusic U. Effects of digital-based interventions on muscular strength in adults: a systematic review, meta-analysis and meta-regression of randomized controlled trials with quality of evidence assessment. Ann Med 2023; 55:2230886. [PMID: 37452683 PMCID: PMC10901531 DOI: 10.1080/07853890.2023.2230886] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Revised: 06/01/2023] [Accepted: 06/24/2023] [Indexed: 07/18/2023] Open
Abstract
BACKGROUND In the last three decades, both medical and sports science professionals have recognized the considerable potential of digital-based interventions (DBI) to enhance the health-related outcomes of their practitioners. OBJECTIVES This study aimed to investigate the effectiveness and potential moderators of DBI on measures of muscular strength. METHODS Six databases (PubMed/MEDLINE, Web of Science, SportDiscus, Embase, Cochrane Register of Controlled Trials and Google Scholar) were searched for eligible studies up to June 2022. The GRADE, PEDRO, and TIDieR checklists were used to assess the quality of evidence, methodology, and completeness of intervention descriptions, respectively. RESULTS A total of 56 studies were included in the meta-analysis (n = 2346), and participants were classified as healthy (n = 918), stroke survivors (n = 572), diagnosed with other neurological disorders (n = 683), and frail (n = 173). The DBI showed a small effect (standardized mean difference [SMD] = 0.28, 95% CI 0.21 to 0.31; p < 0.001) on strength, regardless of the type of intervention, control group, or tested body part. More specifically, while splitting the studies into different subgroups, a meta-analysis of 19 studies (n = 918) showed a small effect (SMD = 0.38, 95% CI 0.12 to 0.63; p = 0.003) on strength in the asymptomatic population. Similarly, small but positive effects of DBI were observed for stroke survivors (SMD = 0.34, 95% CI 0.13 to 0.56; p = 0.002), patients diagnosed with other neurological disorders (SMD = 0.17, 95% CI 0.03 to 0.32; p = 0.021), and the frail population (SMD = 0.25, 95% CI 0.0 to 0.5; p = 0.051). Sub-group analysis and meta-regression revealed that neither variable modified the effects of the DBI on measures of strength. CONCLUSIONS Overall, DBI may serve as an effective method to improve measures of strength in adults, regardless of their health status as well as the type of digital device, the presence of human-computer interaction, and the age of participants. In addition, the DBI was found to be more effective than traditional training or rehabilitation methods.KEY MESSAGESDigital-based intervention (DBI) is effective in improving measures of muscular strength in adults regardless of participants' health statusDBIs were equally effective for strength improvements in lower and upper limbsAlthough, DBIs were found to be effective in improving muscular strength, most studies did not follow strength training guidelines when prescribing the interventions.
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Affiliation(s)
- Armin Paravlic
- Faculty of Sport, University of Ljubljana, Ljubljana, Slovenia
- Science and Research Centre Koper, Institute for Kinesiology Research, Koper, Slovenia
- Faculty of Sports Studies, Masaryk University, Brno, Czech Republic
| | - Luka Šlosar
- Science and Research Centre Koper, Institute for Kinesiology Research, Koper, Slovenia
- Department of Health Sciences, Alma Mater Europaea – ECM-, Maribor, Slovenia
| | - Ensar Abazovic
- Faculty of Sport and Physical Education, University of Sarajevo, Sarajevo, Bosnia and Herzegovina
| | - Uros Marusic
- Science and Research Centre Koper, Institute for Kinesiology Research, Koper, Slovenia
- Department of Health Sciences, Alma Mater Europaea – ECM-, Maribor, Slovenia
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Basharat A, Mehrabi S, Muñoz JE, Middleton LE, Cao S, Boger J, Barnett-Cowan M. Virtual reality as a tool to explore multisensory processing before and after engagement in physical activity. Front Aging Neurosci 2023; 15:1207651. [PMID: 38020766 PMCID: PMC10652573 DOI: 10.3389/fnagi.2023.1207651] [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: 04/17/2023] [Accepted: 10/02/2023] [Indexed: 12/01/2023] Open
Abstract
Introduction This pilot study employed a non-randomized control trial design to explore the impact of physical activity within a virtual reality (VR) environment on multisensory processing among community-dwelling older adults. Methods The investigation compared both chronic (over 6 weeks) and acute effects of VR-based physical activity to a reading control group. The evaluation metrics for multisensory processing included audiovisual response time (RT), simultaneity judgments (SJ), sound-induced flash illusion (SIFI), and temporal order judgments (TOJ). A total of 13 older adults were provided with VR headsets featuring custom-designed games, while another 14 older adults were assigned to a reading-based control group. Results Results indicated that acute engagement in physical activity led to higher accuracy in the SIFI task (experimental group: 85.6%; control group: 78.2%; p = 0.037). Additionally, both chronic and acute physical activity resulted in quicker response times (chronic: experimental group = 336.92; control group = 381.31; p = 0.012; acute: experimental group = 333.38; control group = 383.09; p = 0.006). Although the reading group showed a non-significant trend for greater improvement in mean RT, covariate analyses revealed that this discrepancy was due to the older age of the reading group. Discussion The findings suggest that immersive VR has potential utility for enhancing multisensory processing in older adults. However, future studies must rigorously control for participant variables like age and sex to ensure more accurate comparisons between experimental and control conditions.
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Affiliation(s)
- Aysha Basharat
- Department of Kinesiology and Health Sciences, Faculty of Health, University of Waterloo, Waterloo, ON, Canada
| | - Samira Mehrabi
- Department of Kinesiology and Health Sciences, Faculty of Health, University of Waterloo, Waterloo, ON, Canada
| | - John E. Muñoz
- Department of Systems Design Engineering, Faculty of Engineering, University of Waterloo, Waterloo, ON, Canada
| | | | - Shi Cao
- Department of Systems Design Engineering, Faculty of Engineering, University of Waterloo, Waterloo, ON, Canada
| | | | - Michael Barnett-Cowan
- Department of Kinesiology and Health Sciences, Faculty of Health, University of Waterloo, Waterloo, ON, Canada
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Šlosar L, Peskar M, Pišot R, Marusic U. Environmental enrichment through virtual reality as multisensory stimulation to mitigate the negative effects of prolonged bed rest. Front Aging Neurosci 2023; 15:1169683. [PMID: 37674784 PMCID: PMC10477372 DOI: 10.3389/fnagi.2023.1169683] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2023] [Accepted: 08/07/2023] [Indexed: 09/08/2023] Open
Abstract
Prolonged bed rest causes a multitude of deleterious physiological changes in the human body that require interventions even during immobilization to prevent or minimize these negative effects. In addition to other interventions such as physical and nutritional therapy, non-physical interventions such as cognitive training, motor imagery, and action observation have demonstrated efficacy in mitigating or improving not only cognitive but also motor outcomes in bedridden patients. Recent technological advances have opened new opportunities to implement such non-physical interventions in semi- or fully-immersive environments to enable the development of bed rest countermeasures. Extended Reality (XR), which covers augmented reality (AR), mixed reality (MR), and virtual reality (VR), can enhance the training process by further engaging the kinesthetic, visual, and auditory senses. XR-based enriched environments offer a promising research avenue to investigate the effects of multisensory stimulation on motor rehabilitation and to counteract dysfunctional brain mechanisms that occur during prolonged bed rest. This review discussed the use of enriched environment applications in bedridden patients as a promising tool to improve patient rehabilitation outcomes and suggested their integration into existing treatment protocols to improve patient care. Finally, the neurobiological mechanisms associated with the positive cognitive and motor effects of an enriched environment are highlighted.
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Affiliation(s)
- Luka Šlosar
- Science and Research Centre Koper, Institute for Kinesiology Research, Koper, Slovenia
- Alma Mater Europaea – ECM, Department of Health Sciences, Maribor, Slovenia
| | - Manca Peskar
- Science and Research Centre Koper, Institute for Kinesiology Research, Koper, Slovenia
- Biological Psychology and Neuroergonomics, Department of Psychology and Ergonomics, Faculty V: Mechanical Engineering and Transport Systems, Technische Universität Berlin, Berlin, Germany
| | - Rado Pišot
- Science and Research Centre Koper, Institute for Kinesiology Research, Koper, Slovenia
| | - Uros Marusic
- Science and Research Centre Koper, Institute for Kinesiology Research, Koper, Slovenia
- Alma Mater Europaea – ECM, Department of Health Sciences, Maribor, Slovenia
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Senathirajah Y, Solomonides A. Human Factors and Organizational Issues: Contributions from 2022. Yearb Med Inform 2023; 32:210-214. [PMID: 38147862 PMCID: PMC10751143 DOI: 10.1055/s-0043-1768750] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2023] Open
Abstract
OBJECTIVES To review publications in the field of Human Factors and Organisational Issues (HF&OI) in the year 2022 and to assess major contributions to the subject. METHOD A bibliographic search was conducted following refinement of standardized queries used in previous years. Sources used were PubMed, Web of Science, and referral via references from other papers. The search was carried out in January 2023, and (using the PubMed article type inclusion functionality) included clinical trials, meta-analyses, randomized controlled trials, reviews, case reports, classical articles, clinical studies, observational studies (including veterinary), comparative studies, and pragmatic clinical trials. RESULTS Among the 520 returned papers published in 2022 in the various areas of HF&OI, the full review process selected two best papers from among 10 finalists. As in previous years, topics showed development including increased use of Artificial Intelligence (AI) and digital health tools, advancement of methodological frameworks for implementation and evaluation as well as design, and trials of specific digital tools. CONCLUSIONS Recent literature in HF&OI continues to focus on both theoretical advances and practical deployment, with focus on areas of patient-facing digital health, methods for design and evaluation, and attention to implementation barriers.
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Brach M, de Bruin ED, Levin O, Hinrichs T, Zijlstra W, Netz Y. Evidence-based yet still challenging! Research on physical activity in old age. Eur Rev Aging Phys Act 2023; 20:7. [PMID: 36932320 PMCID: PMC10022149 DOI: 10.1186/s11556-023-00318-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2022] [Accepted: 03/13/2023] [Indexed: 03/19/2023] Open
Abstract
Preserving functional health and quality-of-life in old age is a major goal and global challenge in public health. The high rate of sedentary behavior that is characteristic of the older adult population exacerbates impairments of physiological and structural systems that are typically seen in the aging process. Achieving an understanding of the profound influence of physical activity on all aspects of health in old age is the driving force behind the emergence of "physical activity in old age" as a growing area of research. Accumulated evidence implies that being physically active and exercising is far superior to other optimal aging facilitators. Yet this area of research faces numerous constraints and obstacles. This commentary addresses some of these challenges, primarily the heterogeneity of the aging process, which induces both inter- and intra-individual differences among aged individuals, heterogeneity in assessment tools, unjustified inclusion/exclusion criteria and insufficient recruitment strategies, difficulties in implementing research results in real-world conditions, and rudimentary exploitation of innovative technology. We explain the importance of establishing a network of multidisciplinary scientists and stakeholders to propose consensus-based goals and scientifically evidenced wide-ranging plans for dealing with these challenges. In addition, we suggest work directions for this network.
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Affiliation(s)
- Michael Brach
- Institute of Sport and Exercise Sciences, University of Münster, Münster, Germany
| | - Eling D. de Bruin
- Department of Health, OST – Eastern Swiss University of Applied Sciences, St. Gallen, Switzerland
- Institute of Human Movement Sciences and Sport, Department of Health Sciences and Technology, ETH Zurich, Zurich, Switzerland
- Department of Neurobiology, Care Sciences and Society, Karolinska Institute, Stockholm, Sweden
| | - Oron Levin
- Movement Control and Neuroplasticity Research Group, Biomedical Sciences, KU Leuven, Louvain, Belgium
| | - Timo Hinrichs
- Division of Sports and Exercise Medicine, Department of Sport, Exercise and Health, University of Basel, Basel, Switzerland
| | - Wiebren Zijlstra
- Institute of Movement and Sport Gerontology, German Sport University Cologne, Cologne, Germany
| | - Yael Netz
- Levinsky-Wingate Academic Center, The Academic College at Wingate, Netanya, Israel
- Department of Health Promotion and Rehabilitation, Lithuanian Sports University, Kaunas, Lithuania
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