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Purcell J, Wiley R, Won J, Callow D, Weiss L, Alfini A, Wei Y, Carson Smith J. Increased neural differentiation after a single session of aerobic exercise in older adults. Neurobiol Aging 2023; 132:67-84. [PMID: 37742442 DOI: 10.1016/j.neurobiolaging.2023.08.008] [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: 12/22/2022] [Revised: 08/19/2023] [Accepted: 08/24/2023] [Indexed: 09/26/2023]
Abstract
Aging is associated with decreased cognitive function. One theory posits that this decline is in part due to multiple neural systems becoming dedifferentiated in older adults. Exercise is known to improve cognition in older adults, even after only a single session. We hypothesized that one mechanism of improvement is a redifferentiation of neural systems. We used a within-participant, cross-over design involving 2 sessions: either 30 minutes of aerobic exercise or 30 minutes of seated rest (n = 32; ages 55-81 years). Both functional Magnetic Resonance Imaging (fMRI) and Stroop performance were acquired soon after exercise and rest. We quantified neural differentiation via general heterogeneity regression. There were 3 prominent findings following the exercise. First, participants were better at reducing Stroop interference. Second, while there was greater neural differentiation within the hippocampal formation and cerebellum, there was lower neural differentiation within frontal cortices. Third, this greater neural differentiation in the cerebellum and temporal lobe was more pronounced in the older ages. These data suggest that exercise can induce greater neural differentiation in healthy aging.
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Affiliation(s)
- Jeremy Purcell
- Department of Kinesiology, University of Maryland, College Park, MD, USA; Maryland Neuroimaging Center, University of Maryland, College Park, MD, USA.
| | - Robert Wiley
- Department of Psychology, University of North Carolina at Greensboro, Greensboro, NC, USA
| | - Junyeon Won
- Department of Kinesiology, University of Maryland, College Park, MD, USA; Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Dallas, Dallas, TX, USA
| | - Daniel Callow
- Department of Kinesiology, University of Maryland, College Park, MD, USA; Program in Neuroscience and Cognitive Science, University of Maryland, College Park, MD, USA
| | - Lauren Weiss
- Department of Kinesiology, University of Maryland, College Park, MD, USA; Program in Neuroscience and Cognitive Science, University of Maryland, College Park, MD, USA
| | - Alfonso Alfini
- National Center on Sleep Disorders Research, Division of Lung Diseases, National Heart, Lung, and Blood Institute, Bethesda, MD, USA
| | - Yi Wei
- Maryland Neuroimaging Center, University of Maryland, College Park, MD, USA
| | - J Carson Smith
- Department of Kinesiology, University of Maryland, College Park, MD, USA; Program in Neuroscience and Cognitive Science, University of Maryland, College Park, MD, USA.
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Jespersen L, Maes KM, Ardenkjær-Skinnerup N, Roig M, Bjørndal JR, Beck MM, Lundbye-Jensen J. Acute exercise performed before and after motor practice enhances the positive effects on motor memory consolidation. Neurobiol Learn Mem 2023; 205:107830. [PMID: 37741613 DOI: 10.1016/j.nlm.2023.107830] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Revised: 08/27/2023] [Accepted: 09/17/2023] [Indexed: 09/25/2023]
Abstract
Performing a single bout of exercise can enhance motor learning and long-term retention of motor skills. Parameters such as the intensity and when the exercise bout is performed in relation to skill practice (i.e., timing) likely influence the effectiveness. However, it is still not fully understood how exercise should be administered to maximize its effects and how exercise interacts with distinct components of skill learning. Here, we expand this knowledge by investigating the potential synergistic effects of performing acute exercise both prior to and following motor practice. Sixty-four, able-bodied, young adult male participants practiced a sequential visuomotor accuracy tracking (SVAT) task requiring rapid and accurate force modulation and high levels of precision control using intrinsic hand muscles. The task also contained a repeated pattern of targets that allowed sequence-specific skill improvements. Sequential and non-sequential motor performance was assessed at baseline, immediately after motor practice, and again seven days later. One group performed moderate-intensity exercise before practice (PREMO), a second group performed high-intensity exercise after practice (POSTHI), a third group exercised both before and after practice (PREMO + POSTHI), and a fourth group did not exercise during these periods (CON). Regardless of the exercise condition, acute exercise improved long-term retention of the skill by countering performance decay between experimental sessions (i.e., a 7-day interval). Furthermore, exercising both before and after motor practice led to the greatest improvements in skilled performance over time. We found that the effects of exercise were not specific to the practiced sequence. Namely, the effects of exercise generalized across sequential and non-sequential target positions and orders. This suggests that acute exercise works through mechanisms that promote general aspects of motor memory (e.g., lasting improvements in fast and accurate motor execution). The results demonstrate that various exercise protocols can promote the stabilization and long-term retention of motor skills. This effect can be enhanced when exercise is performed both before and after practice.
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Affiliation(s)
- Lasse Jespersen
- Movement & Neuroscience, Department of Nutrition, Exercise & Sports, University of Copenhagen, Nørre Allé 51, DK2200 Copenhagen, Denmark.
| | - Katrine Matlok Maes
- Movement & Neuroscience, Department of Nutrition, Exercise & Sports, University of Copenhagen, Nørre Allé 51, DK2200 Copenhagen, Denmark
| | - Nicoline Ardenkjær-Skinnerup
- Movement & Neuroscience, Department of Nutrition, Exercise & Sports, University of Copenhagen, Nørre Allé 51, DK2200 Copenhagen, Denmark
| | - Marc Roig
- Memory and Motor Rehabilitation Laboratory, Feil and Oberfeld Research Centre, Jewish Rehabilitation Hospital, Montreal Center for Interdisciplinary Research in Rehabilitation, Laval, Quebec, Canada; School of Physical and Occupational Therapy, Faculty of Medicine, McGill University, Montreal, Quebec, Canada
| | - Jonas Rud Bjørndal
- Movement & Neuroscience, Department of Nutrition, Exercise & Sports, University of Copenhagen, Nørre Allé 51, DK2200 Copenhagen, Denmark
| | - Mikkel Malling Beck
- Movement & Neuroscience, Department of Nutrition, Exercise & Sports, University of Copenhagen, Nørre Allé 51, DK2200 Copenhagen, Denmark; Danish Research Centre for Magnetic Resonance, Centre for Functional and Diagnostic Imaging and Research, Copenhagen University Hospital Amager and Hvidovre, Kettegård Allé 30, 2650 Hvidovre, Denmark
| | - Jesper Lundbye-Jensen
- Movement & Neuroscience, Department of Nutrition, Exercise & Sports, University of Copenhagen, Nørre Allé 51, DK2200 Copenhagen, Denmark
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Maeneja R, Silva CR, Ferreira IS, Abreu AM. Aerobic physical exercise versus dual-task cognitive walking in cognitive rehabilitation of people with stroke: a randomized clinical trial. Front Psychol 2023; 14:1258262. [PMID: 37901076 PMCID: PMC10611528 DOI: 10.3389/fpsyg.2023.1258262] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2023] [Accepted: 09/26/2023] [Indexed: 10/31/2023] Open
Abstract
Introduction Stroke is a neurological deficit caused by an acute focal injury to the central nervous system due to vascular injury that can result in loss of neurological function, lasting brain damage, long-term disability and, in some cases, death. The literature reports that aerobic physical exercise, as well as dual-task cognitive walking, are used for the cognitive recovery of people with stroke. We aimed to assess whether aerobic physical exercise influences post-stroke cognitive recovery, namely performance on selective and sustained attention. We tested the hypothesis that post-stroke aerobic physical exercise leads to more significant gains than post-stroke dual-task cognitive walking. Methods We used a Randomized Clinical Trial, single-blind, parallel group, to verify the existence of differences between two groups. A total of 34 patients with subacute to chronic stroke were divided into two groups to train three times a week for 12 weeks: the aerobic physical exercise (PE) group engaged in 20 min on a treadmill, 20 min on a stationary bicycle and 5 min on a desk bike pedal exerciser per session; the dual-task (DT) gait exercise group walked for 45 min while simultaneously performing cognitive tasks per session. All participants were assessed on cognitive functioning with the Mini-Mental State Examination (MMSE) and d2 Test of Attention before acute interventions and post interventions. We have also applied a Visual Analog Scale to monitor the participants' perceived difficulty, pre-, post-acute, and post-chronic interventions. Participants also responded to a Borg Scale of perceived exertion following the acute and the final session of chronic training. Results A mixed model ANOVA revealed a significant interaction effect with a large effect size for most of the cognitive variables under study. The variables associated with the d2 Test of Attention showed significant differences between the groups, mainly from T0 to T2. Also for MMSE, an ANOVA revealed a significant interaction effect with significant improvements from T0 to T2. Our results strongly suggest that aerobic physical exercise is more beneficial than dual-task cognitive-gait exercise since in the PE group, cognitive attention scores increase, and cognitive impairment and perception of exertion decrease, compared to the DT group. Conclusion These findings support that PE provides more significant benefits for patients post-stroke when compared to DT.
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Affiliation(s)
- Reinaldo Maeneja
- Institute of Health Sciences, Universidade Católica Portuguesa, Lisbon, Portugal
- Faculdade de Ciências da Saúde e Desporto, Universidade Save, Maxixe, Mozambique
| | - Cláudia R. Silva
- Institute of Health Sciences, Universidade Católica Portuguesa, Lisbon, Portugal
- Escola Superior de Saúde de Alcoitão, Alcabideche, Portugal
| | - Inês S. Ferreira
- Faculty of Health Sciences, Universidade Europeia, Lisbon, Portugal
- Center for Research in Neuropsychology and Cognitive and Behavioral Intervention (CINEICC), Faculdade de Psicologia e de Ciências da Educação (FPCE), Universidade de Coimbra, Coimbra, Portugal
- Psychological Assessment and Psychometrics Laboratory (PsyAssessmentLab), Faculdade de Psicologia e de Ciências da Educação (FPCE), Universidade de Coimbra, Coimbra, Portugal
| | - Ana Maria Abreu
- Institute of Health Sciences, Universidade Católica Portuguesa, Lisbon, Portugal
- Center for Interdisciplinary Research in Health, Universidade Católica Portuguesa, Lisbon, Portugal
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Iring-Sanchez S, Tosto J, Favre M, Kim S, Falvo M, Serrador JM. The consideration of post-exercise impact on SCAT3 scores in athletes immediately following a head injury. Brain Inj 2023; 37:643-654. [PMID: 36961103 PMCID: PMC11025343 DOI: 10.1080/02699052.2023.2184868] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2022] [Revised: 01/09/2023] [Accepted: 01/23/2023] [Indexed: 03/25/2023]
Abstract
METHODS Symptoms were assessed immediately following completion of a rugby match (median 60 minutes). Players removed from the match for assessment due to a head hit were classified as head injured. Controls completed match without head hit. RESULTS 209 players (67 female; 33 ± 13 years) participated with 80 experiencing a head injury. Symptom severity was significantly greater in head injured (26.2 ± 17.6) compared with controls (8.9 ± 11.5, P < 0.001). 21% of control players reporting >16 symptom severity, misclassifying them as suspected concussion. There were no significant sex differences. Factor analysis produced four symptom clusters of which Headache was most discriminatory between the head injured (median = 1.7) and controls (median = 0.0). CONCLUSION These findings demonstrate that exercise and contact during a game affect symptom assessment, increasing the likelihood of misclassifying players with suspected concussion. Factor characterization of symptoms associated with head injury using an exercised comparison group provides more useful discrimination. These results highlight the necessity for objective measures to diagnose concussions outside of symptom self-report.
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Affiliation(s)
- Stephanie Iring-Sanchez
- Pharmacology, Physiology & Neuroscience, Rutgers Biomedical Health Sciences, Newark, NJ, USA
- Biomedical Engineering, New Jersey Institute of Technology, Newark, NJ USA
| | - Jenna Tosto
- RUSK Rehabilitation, New York University Grossman School of Medicine, New York, NY USA
| | - Michelle Favre
- Pharmacology, Physiology & Neuroscience, Rutgers Biomedical Health Sciences, Newark, NJ, USA
| | - Sinae Kim
- Department of Biostatistics and Epidemiology, Rutgers School of Public Health, Piscataway, NJ USA
| | - Michael Falvo
- Pharmacology, Physiology & Neuroscience, Rutgers Biomedical Health Sciences, Newark, NJ, USA
- War Related Illness and Injury Study Center, Department of Veterans Affairs, NJ Healthcare System, East Orange, NJ, USA
| | - Jorge M. Serrador
- Pharmacology, Physiology & Neuroscience, Rutgers Biomedical Health Sciences, Newark, NJ, USA
- MARCS Institute for Brain, Behaviour & Development, Western Sydney University, Sydney, Australia
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Rogers CJ, Ayuso J, Hackney ME, Penza C. Alzheimer Disease and Related Cognitive Impairment in Older Adults: A Narrative Review of Screening, Prevention, and Management for Manual Therapy Providers. J Chiropr Med 2023; 22:148-156. [PMID: 37346234 PMCID: PMC10280085 DOI: 10.1016/j.jcm.2023.03.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Revised: 09/16/2022] [Accepted: 03/08/2023] [Indexed: 06/23/2023] Open
Abstract
Objective The aim of this narrative review was to review literature relevant to manual therapists about cognitive impairment, together with screening, potential treatment, and prevention modalities. Methods A literature search of AMED (Allied and Complementary Medicine Database), CINAHL (Cumulative Index of Nursing and Allied Health Literature), PubMed, and MEDLINE was conducted with the search terms "cognitive decline," "cognitive impairment," "screening," and "prevention." We reviewed current screening practices, including functional exams, imaging, and laboratory testing. We reviewed current potential preventive measures and treatments being implemented in practice. Results We selected 49 resources for this narrative summary. The Montreal Cognitive Assessment and Mini-Mental State Exam are recommended screening tools. Imaging and laboratory testing are not recommended in screening for cognitive decline. Promotion of healthy, active living through physical and mental activities may assist with prevention of cognitive decline. Conclusion Cognitive decline affects a large proportion of the US population. Recognizing signs and symptoms of this condition starts with individuals, caretakers, family members, and health care providers. Health care providers should utilize the most appropriate screening tools to assess the presence of cognitive conditions.
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Affiliation(s)
- Casey J. Rogers
- Veteran's Health Administration Birmingham/Atlanta Geriatric Research Education and Clinical Center (GRECC), Birmingham, Alabama
| | - Jaime Ayuso
- Northwestern Health Sciences University, Bloomington, Minnesota
| | - Madeleine E. Hackney
- Veteran's Health Administration Birmingham/Atlanta Geriatric Research Education and Clinical Center (GRECC), Birmingham, Alabama
- Division of Geriatrics and Gerontology, Department of Medicine, Emory University School of Medicine, Atlanta, Georgia
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Anzeneder S, Zehnder C, Martin-Niedecken AL, Schmidt M, Benzing V. Acute exercise and children's cognitive functioning: What is the optimal dose of cognitive challenge? PSYCHOLOGY OF SPORT AND EXERCISE 2023; 66:102404. [PMID: 37665845 DOI: 10.1016/j.psychsport.2023.102404] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Revised: 11/26/2022] [Accepted: 02/08/2023] [Indexed: 09/06/2023]
Abstract
Acute bouts of exercise have the potential to benefit children's cognition. Inconsistent evidence on the role of qualitative exercise task characteristics calls for further investigation of the cognitive challenge level in exercise. Thus, the study aim was to investigate which "dose" of cognitive challenge in acute exercise benefits children's cognition, also exploring the moderating role of individual characteristics. In a within-subject experimental design, 103 children (Mage = 11.1, SD = 0.9, 48% female) participated weekly in one of three 15-min exergames followed by an Attention Network task. Exergame sessions were designed to keep physical intensity constant (65% HRmax) and to have different cognitive challenge levels (low, mid, high; adapted to the ongoing individual performance). ANOVAs performed on variables that reflect the individual functioning of attention networks revealed a significant effect of cognitive challenge on executive control efficiency (reaction time performances; p = .014, ƞ2p = .08), with better performances after the high-challenge condition compared to lower ones (ps < .015), whereas alerting and orienting were unaffected by cognitive challenge (ps > .05). ANOVAs performed on variables that reflect the interactive functioning of attention networks revealed that biological sex moderated cognitive challenge effects. For males only, the cognitive challenge level influenced the interactive functioning of executive control and orienting networks (p = .004; ƞ2p = .07). Results suggest that an individualized and adaptive cognitively high-challenging bout of exercise is more beneficial to children's executive control than less challenging ones. For males, the cognitive challenge in an acute bout seems beneficial to maintain executive control efficiency also when spatial attention resources cannot be validly allocated in advance. Results are interpreted referring to the cognitive stimulation hypothesis and arousal theory.
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Affiliation(s)
- Sofia Anzeneder
- Institute of Sport Science, University of Bern, Bern, Switzerland.
| | - Cäcilia Zehnder
- Institute of Sport Science, University of Bern, Bern, Switzerland
| | | | - Mirko Schmidt
- Institute of Sport Science, University of Bern, Bern, Switzerland
| | - Valentin Benzing
- Institute of Sport Science, University of Bern, Bern, Switzerland
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Pechstein AE, Gollie JM, Keyser RE, Guccione AA. Walking Endurance and Oxygen Uptake On-Kinetics in Individuals With Parkinson Disease Following Overground Locomotor Training. J Neurol Phys Ther 2023; 47:99-111. [PMID: 36538418 DOI: 10.1097/npt.0000000000000423] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
BACKGROUND AND PURPOSE Poor walking endurance in Parkinson disease (PD) may be attributable to both bioenergetic and biomechanical factors, but locomotor training methods addressing both these factors simultaneously are understudied. Our objective was to examine the effects of overground locomotor training (OLT) on walking endurance in individuals with mild-to-moderate PD, and to further explore potential cardiorespiratory contributions. METHODS A single-arm, longitudinal design was used to examine the effects of 24 biweekly sessions of OLT in people with mild-to-moderate PD (n = 12). Walking endurance was measured as total distance walked during a 10-minute walk test (10minWT). Oxygen uptake (V˙ o2 ) on-kinetic profiles were determined using a monoexponential function. Perceived fatigability was assessed following the 10minWT using a self-report scale. Magnitude of change in primary outcomes was assessed using Cohen's d and adjusted for sample size (Cohen's d(unbiased) ). RESULTS Participants executed 3036 (297) steps and maintained 65.5% (8%) age-predicted heart rate maximum in a typical session lasting 56.9 (2.5) minutes. Medium effects in total distance walked-885.9 (157.2) versus 969.5 (140.9); Cohen's d(unbiased) = 0.54-and phase II time constant of the V˙ o2 on-kinetic profile-33.7 (12.3) versus 25.9 (15.3); Cohen's d(unbiased) = 0.54-were observed alongside trivial effects for perceived fatigability-4.7 (1.4) versus 4.8 (1.5); Cohen's d(unbiased) = 0.11-following OLT. DISCUSSION AND CONCLUSIONS These preliminary findings may demonstrate the potential for moderate-intensity OLT to improve walking endurance and enhance cardiorespiratory adjustments to walking activity in adults with mild-to-moderate PD.Video Abstract available for more insights from the authors (see the Video, Supplemental Digital Content 1, http://links.lww.com/JNPT/A407 ).
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Affiliation(s)
- Andrew E Pechstein
- Department of Rehabilitation Science, George Mason University, Fairfax, Virginia (A.E.P., J.M.G., R.E.K., A.A.G.); Department of Physical Therapy, University of Delaware, Newark (A.E.P.); and Research Service, Veterans Affairs Medical Center, Washington, District of Columbia (J.M.G.)
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Wen J, Leng L, Hu M, Hou X, Huang J. Effects of whole-body vibration training on cognitive function: A systematic review. Front Hum Neurosci 2023; 17:854515. [PMID: 36845880 PMCID: PMC9947405 DOI: 10.3389/fnhum.2023.854515] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2022] [Accepted: 01/19/2023] [Indexed: 02/11/2023] Open
Abstract
Background Whole-body vibration (WBV) training is a novel training method that stimulates the human neuromuscular system by the use of vibration, the frequency and amplitude of which are controlled, thereby inducing adaptive changes in the body. WBV training is widely used as a clinical prevention and rehabilitation tool in physical medicine and neuro-rehabilitation as a clinical prevention and rehabilitation tool. Objectives The aim of the present study was to review the effects of WBV on cognitive function, provide an evidence-based foundation for future research on WBV training, and promote additional popularization and use of the methodology in clinical practice. Methods A systematic review of articles extracted from the following six databases was conducted: PubMed, Web of Science, China National Knowledge Infrastructure, Embase, Cochrane, and Scopus. A literature search was performed on articles in which the effects of WBV on cognitive function were evaluated. Results Initially, a total of 340 studies were initially identified, among which 18 articles that satisfied the inclusion criteria were selected for inclusion in the systematic review. Participants were allocated into two groups: patients with cognitive impairment and healthy individuals. The results demonstrated that WBV was both positive and ineffective in its influence on cognitive function. Conclusion The majority of studies suggested that WBV may be a useful strategy for the management of cognitive impairment and should be considered for inclusion in rehabilitation programs. However, the impact of WBV on cognition requires additional, larger, and adequately powered studies. Systematic review registration https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=376821, identifier CRD42022376821.
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Affiliation(s)
- Jiayi Wen
- Guangdong Provincial Key Laboratory of Physical Activity and Health Promotion, Scientific Research Center, Guangzhou Sport University, Guangzhou, Guangdong, China
| | - Lu Leng
- School of Foreign Languages, Jinan University, Guangzhou, Guangdong, China
| | - Min Hu
- Guangdong Provincial Key Laboratory of Physical Activity and Health Promotion, Scientific Research Center, Guangzhou Sport University, Guangzhou, Guangdong, China
| | - Xiaohui Hou
- Guangdong Provincial Key Laboratory of Physical Activity and Health Promotion, Scientific Research Center, Guangzhou Sport University, Guangzhou, Guangdong, China
| | - Junhao Huang
- Guangdong Provincial Key Laboratory of Physical Activity and Health Promotion, Scientific Research Center, Guangzhou Sport University, Guangzhou, Guangdong, China,*Correspondence: Junhao Huang,
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Sivaramakrishnan A, Subramanian SK. A Systematic Review on the Effects of Acute Aerobic Exercise on Neurophysiological, Molecular, and Behavioral Measures in Chronic Stroke. Neurorehabil Neural Repair 2023; 37:151-164. [PMID: 36703562 DOI: 10.1177/15459683221146996] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
BACKGROUND A single bout of aerobic exercise (AE) can produce changes in neurophysiological and behavioral measures in healthy individuals and those with stroke. However, the effects of AE-priming effects on neuroplasticity markers and behavioral measures are unclear. OBJECTIVES This systematic review aimed to examine the effects of AE on neuroplasticity measures, such as corticomotor excitability (CME), molecular markers, cortical activation, motor learning, and performance in stroke. METHODS A literature search was performed in MEDLINE, CINAHL, Scopus, and PsycINFO databases. Randomized and non-randomized studies incorporating acute AE in stroke were selected. Two reviewers independently assessed the risk of bias and methodological rigor of the studies and extracted data on participant characteristics, exercise interventions, and neuroplasticity related outcomes. The quality of transcranial magnetic stimulation reported methods was assessed using a standardized checklist. RESULTS A total of 16 studies were found suitable for inclusion. Our findings suggest mixed evidence for the effects of AE on CME, limited to no effects on intracortical inhibition and facilitation and some evidence for modulating brain derived neurotrophic factor levels, motor learning, and cortical activation. Exercise intensities in the moderate to vigorous range showed a trend towards better effects on neuroplasticity measures. CONCLUSION It appears that choosing a moderate to vigorous exercise paradigm for at least 20 to 30 minutes may induce changes in some neuroplasticity parameters in stroke. However, these findings necessitate prudent consideration as the studies were diverse and had moderate methodological quality. There is a need for a consensus on an exercise priming paradigm and for good-quality, larger controlled studies.
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Affiliation(s)
| | - Sandeep K Subramanian
- Department of Physical Therapy, UT Health San Antonio, TX, USA.,Department of Rehabilitation Medicine, Long School of Medicine, UT Health San Antonio, TX, USA.,Department of Physician Assistant Studies, UT Health San Antonio, TX, USA
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Ferreira S, Marmeleira J, del Pozo-Cruz J, Bernardino A, Leite N, Brandão M, Raimundo A. Acute Effects of Augmented Reality Exergames versus Cycle Ergometer on Reaction Time, Visual Attention, and Verbal Fluency in Community Older Adults. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:14667. [PMID: 36429385 PMCID: PMC9690180 DOI: 10.3390/ijerph192214667] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Revised: 10/30/2022] [Accepted: 11/04/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND This study aims to investigate the acute effects of an augmented reality session and a cycle ergometer session compared to no exercise on the reaction times, cognitive flexibility, and verbal fluency of older adults. METHODS Each participant did a familiarization with cognitive tests and the following three sessions: cycle ergometer, no exercise (control group), and augmented reality exergame (Portable Exergame Platform for Elderly) sessions. The participants were randomized in a within-group design into one of six possible combinations. Each moment had a 30 min duration, and after the session, the participants performed a Trail Making Test, a verbal fluency test, and a Deary-Liewald reaction time task. The data were analyzed with a one-way ANOVA with a Bonferroni adjustment. RESULTS The analysis between the no exercise, cycle ergometer, and augmented reality sessions showed no significant differences in the cognitive measurements. CONCLUSIONS One session of the cycle ergometer exercise or the augmented reality exergames does not acutely improve the reaction times, cognitive flexibility, or verbal fluency in the elderly.
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Affiliation(s)
- Soraia Ferreira
- Departamento de Desporto e Saúde, Escola de Saúde e Desenvolvimento Humano, Universidade de Évora, Largo dos Colegiais, 7000-727 Évora, Portugal
- Comprehensive Health Research Centre (CHRC), Palácio do Vimioso, Gabinete 256, Largo Marquês de Marialva, Apart. 94, 7002-554 Évora, Portugal
| | - José Marmeleira
- Departamento de Desporto e Saúde, Escola de Saúde e Desenvolvimento Humano, Universidade de Évora, Largo dos Colegiais, 7000-727 Évora, Portugal
- Comprehensive Health Research Centre (CHRC), Palácio do Vimioso, Gabinete 256, Largo Marquês de Marialva, Apart. 94, 7002-554 Évora, Portugal
| | - Jesus del Pozo-Cruz
- Department of Physical Education and Sports, University of Seville, 41013 Sevilla, Spain
- Epidemiology of Physical Activity and Fitness across Lifespan Research Group (EPAFit), University of Seville, 41013 Sevilla, Spain
| | - Alexandre Bernardino
- Instituto de Sistemas e Robótica, Instituto Superior Técnico, 1049-001 Lisboa, Portugal
| | - Nilton Leite
- Departamento de Desporto e Saúde, Escola de Saúde e Desenvolvimento Humano, Universidade de Évora, Largo dos Colegiais, 7000-727 Évora, Portugal
- Comprehensive Health Research Centre (CHRC), Palácio do Vimioso, Gabinete 256, Largo Marquês de Marialva, Apart. 94, 7002-554 Évora, Portugal
| | - Mafalda Brandão
- Departamento de Desporto e Saúde, Escola de Saúde e Desenvolvimento Humano, Universidade de Évora, Largo dos Colegiais, 7000-727 Évora, Portugal
| | - Armando Raimundo
- Departamento de Desporto e Saúde, Escola de Saúde e Desenvolvimento Humano, Universidade de Évora, Largo dos Colegiais, 7000-727 Évora, Portugal
- Comprehensive Health Research Centre (CHRC), Palácio do Vimioso, Gabinete 256, Largo Marquês de Marialva, Apart. 94, 7002-554 Évora, Portugal
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Mayer JF, Sandberg CW, Mozeiko J, Madden EB, Murray LL. Cognitive and Linguistic Benefits of Aerobic Exercise: A State-of-the-Art Systematic Review of the Stroke Literature. FRONTIERS IN REHABILITATION SCIENCES 2021; 2:785312. [PMID: 36188840 PMCID: PMC9397720 DOI: 10.3389/fresc.2021.785312] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Accepted: 12/06/2021] [Indexed: 12/03/2022]
Abstract
This systematic review aimed to determine how aerobic exercise affects cognition after stroke, with particular focus on aphasia and language improvement. Methodological quality was assessed with the PEDro+ scale with half of the 27 included studies rated as high quality. Data extraction focused on cognitive effects of aerobic exercise post-stroke, intervention characteristics, outcome measures, and participant characteristics. Whereas attention, memory, and executive functioning measures were common across the included studies, no study included a language-specific, performance-based measure. Seventeen studies reported positive cognitive effects, most frequently in the domains of attention, memory and executive functioning. Variability in outcome measures, intervention characteristics, and participant characteristics made it difficult to identify similarities among studies reporting positive cognitive effects of exercise or among those studies reporting null outcomes. Only three studies provided specific information about the number of individuals with aphasia included or excluded, who comprise approximately one-third of the stroke population. The review identified patent gaps in our understanding of how aerobic exercise may affect not only the cognitive domain of language post-stroke but also the broader cognitive functioning of individuals with post-stroke aphasia. Methodological limitations of the reviewed studies also warrant further examination of the direct impact of aerobic exercise on cognition post-stroke with careful attention to the selection and reporting of population, intervention, and outcomes.
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Affiliation(s)
- Jamie F. Mayer
- School of Allied Health and Communicative Disorders, Northern Illinois University, DeKalb, IL, United States
- *Correspondence: Jamie F. Mayer
| | - Chaleece W. Sandberg
- Department of Communication Sciences and Disorders, Penn State University, University Park, PA, United States
| | - Jennifer Mozeiko
- Department of Speech, Language and Hearing Science, University of Connecticut, Mansfield, CT, United States
| | - Elizabeth B. Madden
- School of Communication Science and Disorders, Florida State University, Tallahassee, FL, United States
| | - Laura L. Murray
- School of Communication Sciences and Disorders, Western University, London, ON, Canada
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Alibazi RJ, Pearce AJ, Rostami M, Frazer AK, Brownstein C, Kidgell DJ. Determining the Intracortical Responses After a Single Session of Aerobic Exercise in Young Healthy Individuals: A Systematic Review and Best Evidence Synthesis. J Strength Cond Res 2021; 35:562-575. [PMID: 33201155 DOI: 10.1519/jsc.0000000000003884] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
ABSTRACT Alibazi, RJ, Pearce, AJ, Rostami, M, Frazer, AK, Brownstein, C, and Kidgell, DJ. Determining the intracortical responses after a single session of aerobic exercise in young healthy individuals: a systematic review and best evidence synthesis. J Strength Cond Res 35(2): 562-575, 2021-A single bout of aerobic exercise (AE) may induce changes in the excitability of the intracortical circuits of the primary motor cortex (M1). Similar to noninvasive brain stimulation techniques, such as transcranial direct current stimulation, AE could be used as a priming technique to facilitate motor learning. This review examined the effect of AE on modulating intracortical excitability and inhibition in human subjects. A systematic review, according to PRISMA guidelines, identified studies by database searching, hand searching, and citation tracking between inception and the last week of February 2020. Methodological quality of included studies was determined using the Downs and Black quality index and Cochrane Collaboration of risk of bias tool. Data were synthesized and analyzed using best-evidence synthesis. There was strong evidence for AE not to change corticospinal excitability and conflicting evidence for increasing intracortical facilitation and reducing silent period and long-interval cortical inhibition. Aerobic exercise did reduce short-interval cortical inhibition, which suggests AE modulates the excitability of the short-latency inhibitory circuits within the M1; however, given the small number of included studies, it remains unclear how AE affects all circuits. In light of the above, AE may have important implications during periods of rehabilitation, whereby priming AE could be used to facilitate motor learning.
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Affiliation(s)
- Razie J Alibazi
- Non-invasive Brain Stimulation & Neuroplasticity Laboratory, Department of Physiotherapy, School of Primary and Allied Health Care, Faculty of Medicine, Nursing and Health Science, Monash University, Melbourne, Victoria, Australia
| | - Alan J Pearce
- College of Science, Health and Engineering, La Trobe University, Melbourne, Victoria, Australia
| | - Mohamad Rostami
- Department of Physiotherapy, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran; and
| | - Ashlyn K Frazer
- Non-invasive Brain Stimulation & Neuroplasticity Laboratory, Department of Physiotherapy, School of Primary and Allied Health Care, Faculty of Medicine, Nursing and Health Science, Monash University, Melbourne, Victoria, Australia
| | - Callum Brownstein
- University of Lyon, University Jean Monnet Saint-Etienne, Inter-university Laboratory of Human Movement Biology, Saint-Etienne, France
| | - Dawson J Kidgell
- Non-invasive Brain Stimulation & Neuroplasticity Laboratory, Department of Physiotherapy, School of Primary and Allied Health Care, Faculty of Medicine, Nursing and Health Science, Monash University, Melbourne, Victoria, Australia
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Wanner P, Winterholler M, Gaßner H, Winkler J, Klucken J, Pfeifer K, Steib S. Acute exercise following skill practice promotes motor memory consolidation in Parkinson's disease. Neurobiol Learn Mem 2020; 178:107366. [PMID: 33358765 DOI: 10.1016/j.nlm.2020.107366] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2020] [Revised: 12/01/2020] [Accepted: 12/15/2020] [Indexed: 02/05/2023]
Abstract
Acute cardiovascular exercise has shown to promote neuroplastic processes supporting the consolidation of newly acquired motor skills in healthy adults. First results suggest that this concept may be transferred to populations with motor and cognitive dysfunctions. In this context, Parkinson's disease (PD) is highly relevant since patients demonstrate deficits in motor learning. Hence, in the present study we sought to explore the effect of a single post-practice exercise bout on motor memory consolidation in PD. For this purpose, 17 patients with PD (Hoehn and Yahr: 1 - 2.5, age: 60.1 ± 7.9 y) practiced a whole-body skill followed by either (i) a moderate-intense bout of cycling, or (ii) seated rest for a total of 30 min. The motor skill required the participants to balance on a tiltable platform (stabilometer) for 30 s. During skill practice, participants performed 15 trials followed by a retention test 1 day and 7 days later. We calculated time in balance (platform within ± 5° from horizontal) for each trial and within- and between-group differences in memory consolidation (i.e. offline learning = skill change from last acquisition block to retention tests) were analyzed. Groups revealed similar improvements during skill practice (F4,60 = 0.316, p = 0.866), but showed differences in offline learning, which were only evident after 7 days (F1,14 = 5.602, p = 0.033). Our results suggest that a single post-practice exercise bout is effective in enhancing long-term motor memory consolidation in a population with motor learning impairments. This may point at unique promoting effects of exercise on dopamine neurotransmission involved in memory formation. Future studies should investigate the potential role of exercise-induced effects on the dopaminergic system.
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Affiliation(s)
- Philipp Wanner
- Department of Sport Science and Sport, Division of Exercise and Health, Friedrich-Alexander-University Erlangen-Nürnberg, Germany
| | | | - Heiko Gaßner
- Department of Molecular Neurology, University Hospital Erlangen, Friedrich-Alexander-University Erlangen-Nürnberg, Germany
| | - Jürgen Winkler
- Department of Molecular Neurology, University Hospital Erlangen, Friedrich-Alexander-University Erlangen-Nürnberg, Germany
| | - Jochen Klucken
- Department of Molecular Neurology, University Hospital Erlangen, Friedrich-Alexander-University Erlangen-Nürnberg, Germany
| | - Klaus Pfeifer
- Department of Sport Science and Sport, Division of Exercise and Health, Friedrich-Alexander-University Erlangen-Nürnberg, Germany
| | - Simon Steib
- Department of Sport Science and Sport, Division of Exercise and Health, Friedrich-Alexander-University Erlangen-Nürnberg, Germany; Institute of Sports and Sports Sciences, Human Movement, Training and Active Aging Department, Heidelberg University, Germany.
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Lee SH, Lee HJ, Shim Y, Chang WH, Choi BO, Ryu GH, Kim YH. Wearable hip-assist robot modulates cortical activation during gait in stroke patients: a functional near-infrared spectroscopy study. J Neuroeng Rehabil 2020; 17:145. [PMID: 33121535 PMCID: PMC7596937 DOI: 10.1186/s12984-020-00777-0] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2020] [Accepted: 10/21/2020] [Indexed: 12/21/2022] Open
Abstract
Background Gait dysfunction is common in post-stroke patients as a result of impairment in cerebral gait mechanism. Powered robotic exoskeletons are promising tools to maximize neural recovery by delivering repetitive walking practice. Objectives The purpose of this study was to investigate the modulating effect of the Gait Enhancing and Motivating System-Hip (GEMS-H) on cortical activation during gait in patients with chronic stroke. Methods. Twenty chronic stroke patients performed treadmill walking at a self-selected speed either with assistance of GEMS-H (GEMS-H) or without assistance of GEMS-H (NoGEMS-H). Changes in oxygenated hemoglobin (oxyHb) concentration in the bilateral primary sensorimotor cortex (SMC), premotor cortices (PMC), supplemental motor areas (SMA), and prefrontal cortices (PFC) were recorded using functional near infrared spectroscopy. Results Walking with the GEMS-H promoted symmetrical SMC activation, with more activation in the affected hemisphere than in NoGEMS-H conditions. GEMS-H also decreased oxyHb concentration in the late phase over the ipsilesional SMC and bilateral SMA (P < 0.05). Conclusions The results of the present study reveal that the GEMS-H promoted more SMC activation and a balanced activation pattern that helped to restore gait function. Less activation in the late phase over SMC and SMA during gait with GEMS-H indicates that GEMS-H reduces the cortical participation of stroke gait by producing rhythmic hip flexion and extension movement and allows a more coordinate and efficient gait patterns. Trial registration NCT03048968. Registered 06 Feb 2017
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Affiliation(s)
- Su-Hyun Lee
- Department of Physical and Rehabilitation Medicine, Center for Prevention and Rehabilitation, Heart Vascular Stroke Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Irwon-ro 115, Gangnam-gu, Seoul, 06355, Republic of Korea
| | - Hwang-Jae Lee
- Department of Physical and Rehabilitation Medicine, Center for Prevention and Rehabilitation, Heart Vascular Stroke Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Irwon-ro 115, Gangnam-gu, Seoul, 06355, Republic of Korea.,Department of Health Sciences and Technology, Department of Medical Device Management and Research, Department of Digital Health, SAIHST, Sungkyunkwan University, Irwon-ro 81, Gangnam-gu, Seoul, 06351, Republic of Korea
| | - Youngbo Shim
- Samsung Research, Samsung Electronics, 56, Seongchon-gil, Seocho-gu, Seoul, 06756, Republic of Korea
| | - Won Hyuk Chang
- Department of Physical and Rehabilitation Medicine, Center for Prevention and Rehabilitation, Heart Vascular Stroke Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Irwon-ro 115, Gangnam-gu, Seoul, 06355, Republic of Korea
| | - Byung-Ok Choi
- Department of Neurology, Neuroscience Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Irwon-ro 81, Gangnam-gu, Seoul, 06351, Republic of Korea
| | - Gyu-Ha Ryu
- Department of Medical Device Management and Research, SAIHST, Sungkyunkwan University School of Medicine, Irwon-ro 81, Gangnam-gu, Seoul, 06351, Republic of Korea.,The Office of R&D Strategy & Planning, Samsung Medical Center, Irwon-ro 81, Gangnam-gu, Seoul, 06351, Republic of Korea
| | - Yun-Hee Kim
- Department of Physical and Rehabilitation Medicine, Center for Prevention and Rehabilitation, Heart Vascular Stroke Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Irwon-ro 115, Gangnam-gu, Seoul, 06355, Republic of Korea. .,Department of Health Sciences and Technology, Department of Medical Device Management and Research, Department of Digital Health, SAIHST, Sungkyunkwan University, Irwon-ro 81, Gangnam-gu, Seoul, 06351, Republic of Korea.
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15
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Wanner P, Cheng FH, Steib S. Effects of acute cardiovascular exercise on motor memory encoding and consolidation: A systematic review with meta-analysis. Neurosci Biobehav Rev 2020; 116:365-381. [PMID: 32565171 DOI: 10.1016/j.neubiorev.2020.06.018] [Citation(s) in RCA: 37] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2020] [Revised: 06/03/2020] [Accepted: 06/13/2020] [Indexed: 12/18/2022]
Abstract
Emerging evidence indicates that acute bouts of cardiovascular exercise promote motor memory formation. In this preregistered meta-analysis (CRD42018106288) we synthesize data from 22 studies published until February 2020, including a total of 862 participants. We calculated standardized mean differences (SMDs) with 95 % confidence intervals (CIs) to assess exercise effects on motor memory encoding and consolidation, respectively. The pooled data indicate that exercise mainly benefits the consolidation of memories, with exercise prior to motor practice improving early non-sleep consolidation (SMD, 0.58; 95 % CI, 0.30-0.86; p < 0.001), and post-practice exercise facilitating sleep-dependent consolidation (SMD, 0.62; 95 % CI, 0.34-0.90; p < 0.001). Strongest effects exist for high exercise intensities, and motor task nature appears to be another relevant modulator. We demonstrate that acute cardiovascular exercise particularly promotes the consolidation of acquired motor memories, and exercise timing, and intensity as well as motor task nature seem to critically modulate this relationship. These findings are discussed within currently proposed models of motor memory formation and considering molecular and systemic mechanisms of neural plasticity.
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Affiliation(s)
- Philipp Wanner
- Department of Sport Science and Sport, Division of Exercise and Health, Friedrich-Alexander-University Erlangen-Nürnberg, Gebbertstraße 123b, 91058 Erlangen, Germany
| | - Fei-Hsin Cheng
- Department of Sport Science and Sport, Division of Exercise and Health, Friedrich-Alexander-University Erlangen-Nürnberg, Gebbertstraße 123b, 91058 Erlangen, Germany
| | - Simon Steib
- Department of Sport Science and Sport, Division of Exercise and Health, Friedrich-Alexander-University Erlangen-Nürnberg, Gebbertstraße 123b, 91058 Erlangen, Germany; Department of Sport and Health Sciences, Chair of Human Movement Science, Technical University of Munich, Georg-Brauchle-Ring 60/ 62, 80992 Munich, Germany.
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