The Immediate and Sustained Effects of Exercise-Induced Hemodynamic Response on Executive Function During Fine Motor-Cognitive Tasks Using Functional Near-Infrared Spectroscopy.

BACKGROUND: Several studies have shown that acute exercise has a small positive effect on cognitive performance. However, it is still unclear what type of exercise has a sustained impact on cognitive performance during post-exercise recovery. Therefore, the purpose of our study was to investigate cognitive performance at the behavioral level, and their neural correlates after a 10-minute post-exercise recovery period with two different types of exercise intervention (high-intensity interval exercise (HIIE) vs. Moderate-intensity continuous exercise (MCE)). METHODS: A total of 29 healthy young adults (7 women) between the ages of 19 and 33 with fair to good cardiovascular fitness were submitted to two different exercise protocols and a recovery session. Cognitive function was assessed using a digital Trail-Making-Test (dTMT). Cortical activity in the prefrontal and the motor cortex using functional near-infrared spectroscopy (fNIRS) was measured before, after acute exercise, and during recovery. The statistical analysis of fNIRS data was performed by comparing the slope and mean of the hemodynamic response. RESULTS: High levels of hemodynamic responses were observed in the prefrontal and motor cortex on the brain during performing the dTMT while walking from pre- to post-exercise and decreased again in post-recovery, accompanied by improvement and maintenance of cognitive performance. Notably, a high hemodynamic response in the left motor area of the brain was maintained by HIIE in post-recovery compared with MCE. CONCLUSIONS: The high cortical activation in the left motor area from post-exercise to recovery for the HIIE group may be due to the additional availability of neural resources for fine motor and postural control by high-intensity exercise-induced fatigue. Additionally, the improved cognitive performance may have effectively utilized the available neural resources in the frontal lobe, depending on the condition (sitting and walking) and the two types of exercise protocol (HIIE and MCE).

Effect of Intermittent Exercise on Performance in 3D Multiple Objects Tracking in Children, Young and Older Adults-A Pilot Study.

BACKGROUND: Although an extensive body of literature is trying to verify the acute effects of exercise, findings are highly contradictory due to many different study protocols. The number of studies using an intermittent exercise (IE) protocol is limited, especially with regard to comparison across the life span. We examined whether the effects of a HIIE protocol on performance in a perceptual-cognitive task (NeuroTracker® (NT)) differed between children, young adults, and older adults to address this gap. METHODS: A total of 36 participants participated in the present study: 12 children (CH, 6 females, 9.83 ± 1.19 years), 12 young adults (YA, 6 females, 23.5 ± 3.55 years), and 12 older adults (OA, 4 females, 66.92 ± 4.08 years). The IE treadmill protocol used in the present study consisted of eleven 30-second intervals at 90% VO2max, interspersed with 2-minute active recovery periods at 50% VO2max. Before and during this exercise protocol, three series of the NeuroTracker® task were performed after 5, 15, and 25 minutes. RESULTS: We observed a significant main effect time and a significant main effect group regarding absolute NT scores and progression during IE. YA had significantly higher absolute NT scores than CH and OA. The normalized perceptual-cognitive task progression was observed in OA and YA but not in CH. YA, in particular, showed progression in the NT performance during IE. CONCLUSIONS: The present study confirmed previous findings on age-related differences in NT performance. Based on these findings, the effects of different exercise protocols (e.g., continuous vs. intermittent) seem to be a worthwhile subject for future investigations. Normalized speed thresholds should best capture improvement differences between groups to compare results across studies better, as pre-test values are taken as the baseline.

Does mental practice or mirror therapy help prevent functional loss after distal radius fracture? A randomized controlled trial.

STUDY DESIGN: A randomized, single-blinded controlled trial. INTRODUCTION: Therapy results after distal radius fractures (DRF) especially with older patients are often suboptimal. One possible approach for counteracting the problems are motor-cognitive training interventions such as Mental Practice (MP) or Mirror Therapy (MT), which may be applied in early rehabilitation without stressing the injured wrist. PURPOSE OF THE STUDY: The aim of the study is to investigate the effects of MP and MT on wrist function after DRF. The pilot study should furthermore provide information about the feasibility of these methods. METHODS: Thirty-one women were assigned either to one of the two experimental groups (MP, MT) or to a control group (relaxation intervention). The participants completed a training for six weeks, administered at their homes. Measurements were taken at four times (weeks 0, 3, 6 and 12) to document the progression in subjective function (PRWE, QuickDASH) and objective constraints of the wrist (ROM, grip strength) as well as in health-related quality of life (EQ-5D). RESULTS: The results indicated that both experimental groups showed higher improvements across the intervention period compared to the control group; e.g. PRWE: MT 74.0%, MP 66.2%, CG 56.9%. While improvements in grip strength were higher for the MP group, the MT group performed better in all other measures. However, time by group interactions approached significance at best; e.g. ROM: P = .076; ηp2 = .141. CONCLUSION: The superiority of MP as well as MT supports the simulation theory. Motor-cognitive intervention programs are feasible and promising therapy supplements, which may be applied in early rehabilitation to counteract the consequences of immobilization without stressing the injured wrist.

Effects of acute exercise at different intensities on fine motor-cognitive dual-task performance while walking: A functional near-infrared spectroscopy study.

Studies on the effects of acute exercises on cognitive functions vary greatly and depend on the duration and intensity of exercise and the type of cognitive tasks. This study aimed to investigate the neural correlates that underpin the acute effects of high-intensity interval (HIIE) versus moderate-intensity continuous exercise (MCE) on fine motor-cognitive performance while walking (dual-task, DT) in healthy young adults. Twenty-nine healthy right-handers (mean age: 25.1 years ± 4.04; 7 female) performed the digital trail-making-test (dTMT) while walking (5 km/h) before and after acute exercise. During task performance, the hemodynamic activation of the frontopolar area (FPA), dorsolateral prefrontal (DLPFC), and motor cortex (M1) was recorded using functional near-infrared spectroscopy (fNIRS). Both HIIE and MCE resulted in improved dTMT performance, as reflected by an increase in the number of completed circles and a reduction in the time within and between circuits (reflecting improvements in working memory, inhibition, and decision making). Notably, HIIE evoked higher cortical activity on all brain areas measured in the present study than the MCE group. To our knowledge, these results provide the first empirical evidence using a mobile neuroimaging approach that both HIIE and MCE improve executive function during walking, likely mediated by increased activation of the task-related area of the prefrontal cortex and the ability to effectively use, among other things, high fitness levels as neural enrichment resources.

Conceptualising and testing the relationship between actual and perceived motor performance: A cross-cultural comparison in children from Australia and Germany.

Previous studies investigating the relationship between motor skill, physical activity and fitness in children have not thoroughly considered the role of self-perception. Therefore, the study aim was to test a theoretical framework, which considered both actual and perceived motor skill as well as actual and perceived fitness. Potential moderating effects of sex and country were considered. Data on motor skill, fitness, as well as self-perception of motor skill and fitness were collected from 145 Australian children and 214 German children (age range 7 to 10 years). For actual motor skill and fitness, mean differences for sex, age and country were found. For perceived motor performance (perceived motor skill and perceived fitness) no mean differences were found for age. Path analyses were performed. The final model showed significant relations between actual performance (object control skill, fitness) and perceived performance (object control skill, fitness). All model paths had low to moderate regression weights with the lowest relationship reported between actual and perceived fitness. Sex and country showed no effects. This integrated approach has led to a better understanding of the relationship between children's perceived and objective performance, and cultural differences within them.

A multicomponent exercise intervention to improve physical functioning, cognition and psychosocial well-being in elderly nursing home residents: a study protocol of a randomized controlled trial in the PROCARE (prevention and occupational health in long-term care) project.

BACKGROUND: Older adults, who are living in nursing homes that provide a high level of long-term nursing care, are characterized by multimorbidity and a high prevalence of dependency in activities of daily living. Results of recent studies indicate positive effects of structured exercise programs during long-term care for physical functioning, cognition, and psychosocial well-being. However, for frail elderly the evidence remains inconsistent. There are no evidence-based guidelines for exercises for nursing home residents that consider their individual deficits and capacities. Therefore, high-quality studies are required to examine the efficacy of exercise interventions for this multimorbid target group. The purpose of this study is to determine the feasibility and efficacy of a multicomponent exercise intervention for nursing home residents that aims to improve physical and cognitive functioning as well as quality of life. METHODS: A two-arm single-blinded multicenter randomized controlled trial will be conducted, including 48 nursing homes in eight regions of Germany with an estimated sample size of 1120 individuals. Participants will be randomly assigned to either a training or a waiting time control group. For a period of 16 weeks the training group will meet twice a week for group-based sessions (45-60 min each), which will contain exercises to improve physical functioning (strength, endurance, balance, flexibility) and cognitive-motor skills (dual-task). The intervention is organized as a progressive challenge which is successively adapted to the residents' capacities. Physical functioning, cognitive performance, and quality of life will be assessed in both study groups at baseline (pre-test), after 16-weeks (post-treatment), and after 32-weeks (retention test, intervention group only). DISCUSSION: This study will provide information about the efficacy of a multicomponent exercise program in nursing homes (performance, recruitment). Results from this trial will contribute to the evidence of multicomponent exercises, which specifically focus on cognitive-motor approaches in the maintenance of mental and physical functioning. In addition, it will help to encourage older adults to actively engage in social life. Furthermore, the findings will lead to recommendations for health promotion interventions for frail nursing home residents. TRIAL REGISTRATION: The trial was prospectively registered at DRKS.de with the registration number DRKS00014957 on October 9, 2018.

Exploring the Mediating Role of Social Support and Fall Efficacy on the Association Between Falls and Physical Activity: A Cross-Sectional Study in an Assisted-Living Population.

Mobility restriction as a consequence of a fall is a major issue in assisted-living facilities. Although many factors are related to falling, little is known about the relationship between falls, social support, falls efficacy, and physical activity. The authors examined the relationship between falls and the Social Support Questionnaire, the Activities-specific Balance Confidence scale, and physical activity simultaneously in 81 older adults (66-94 years) using structural equation modeling. The structural equation model revealed that being older was associated with lower falls efficacy and a higher number of falls, and higher falls efficacy was associated with a higher number of steps per day. The development of a structural equation model illustrating the mediating effects of social support and falls efficacy on the relationship between falls and physical activity can help health care professionals in predicting risk factors of falls that may be compromised by residing in an assisted-living facility.

Feasibility of a machine vs free weight strength training program and its effects on physical performance in nursing home residents: a pilot study.

BACKGROUND: Resistance training holds promise for nursing home residents to prevent further disabilities, falls, and fractures. Free weight as well as machine training may offer an efficient option to improve physical performance, but the feasibility of these training regimes among elderly who require continuous institutional care is still open. AIMS: (1) To examine the feasibility of a 3-month machine vs. free weight strength training program in institutionalized older adults, and (2) to determine the effects on physical performance. METHODS: This study is a two-arm, single-blind, randomized controlled feasibility study within a nursing home. 45 institutionalized elderly men and women (aged 83.8 ± 8.0, 12 men, 33 women) were randomly divided into two groups. The two groups completed either a free weight (FWT) or machine training (MT) for 12 weeks, twice per week, 45-60 min per session, in an individually supervised format. Performance was assessed with the 11-step stair-climbing test, 10-m walk test, Timed Up and Go Test (TUG), 30-s Chair Rising Test (CRT), grip strength, body mass index. RESULTS: Indices of feasibility showed a recruitment and adherence rate of 53.6 and 87.5%, respectively. 35.6% of the participants dropped out after several weeks for personal reasons, illness, medical visits, or hospital stays. After the program no significant differences on motor performance were found between MT and FWT. However, there were significant improvements for both training groups on the TUG and the CRT. CONCLUSIONS: The present pilot study showed that it is feasible to conduct a strength training program in institutionalized participants. The more robust changes in motor function could serve as a basis for large randomized clinical trials.

A comparison of parent report and actual motor competence in young children.

BACKGROUND/AIM: Parent proxy reports are well used in occupational therapy, yet historically parent report instruments of motor skill have not required parents to report on the same motor skills that their children are assessed on. The aim was to examine how well a parent report of children's fundamental movement skill (FMS) was associated with children's actual FMS. METHOD: A sample of 100 children aged 7-9 years from Melbourne, Australia, were recruited. Parents/guardians completed proxy report (parent version of the 'Pictorial Scale of Perceived Movement Skill Competence' (PMSC)) and children's actual motor skills were assessed ('Test of Gross Motor Development' 3rd edition (TGMD-3)). Data were first analysed using Pearson's correlation coefficients and then hierarchical linear stepwise regression was conducted with actual skill as the outcome variable in each model. RESULTS: The PMSC-Parent (r = 0.36, P < 0.001) was moderately associated with children's actual skill. After age and sex adjustment, the PMSC-Parent explained 11.4% of variance in total skills. Parent report of their children's object control scores (PMSC object control scale) was significantly associated with children's actual object control (B = 0.36, P < 0.001) and explained 11.3% of the variance. Parent report of children's locomotion scores (PMSC locomotion scale) was associated with children's actual locomotor skills (B = 0.27, P = 0.007) and explained 6.2% of the variance. CONCLUSION: Parents are able to report to some degree on their children's FMS competency, in particular, their object control competence. Parent proxy report of FMS may help inform occupational therapists to identify children with low FMS competency to develop interventions targeting FMS.

[Trail walking test for assessment of motor cognitive interference in older adults. Development and evaluation of the psychometric properties of the procedure]. / Trail Walking Test zur Erfassung der motorisch-kognitiven Interferenz bei älteren Erwachsenen. Entwicklung und Überprüfung der psychometrischen Eigenschaften des Verfahrens.

BACKGROUND: Activities of daily living (ADL), such as walking, often involve the added complexity of walking while doing other activities (i.e. dual task walking). A complex walking task may require a greater motor and mental capacity, resulting in decrements in gait performance not seen for simple walking tasks. AIM: The purpose of this study was to determine if the trail walking test (TWT), the mobile adaptation of the trail making test (TMT), could be a reliable and valid early detection tool to discriminate between non-fallers and fallers. MATERIAL AND METHODS: This study examined dual task costs of a cognitive and a sensorimotor task (walking) in 94 older adults aged 50-81 years (average age M = 67.4 years, SD ± 7.34). Based on the idea of the paper and pencil TMT, participants walked along a fixed pathway (TWT-1), stepped on targets with increasing sequential numbers (i.e. 1, 2, 3, TWT-2), and increasing sequential numbers and letters (i.e. 1, A, 2, B, 3, C, TWT-3). The dual task costs were calculated for each task. Additionally, the following tests were conducted: TMT, block tapping test (BTT), timed up and go (TUG) test, 30s chair rising test, 10 m walking time test with and without head turns, German physical activity questionnaire (German PAQ-50 +) and the activities-specific balance confidence (ABC-D) scale. RESULTS: The TWT performance times as well as errors increased with increasing age. Reliability coefficients were high (interclass correlation ICC > 0.90). Correlations between the different TWT conditions and potential falls-related predictors were moderate to high (r = -0.430 to 0.699). Of the participants 34 % reported falling in the past year. The stepwise logistic regression analysis revealed that the dual task costs for the numbers and letters (odds ratio OR 1.162, 95 % confidence interval CI 1.058-1.277, p = 0.002), the ABC-D (OR 0.767, 95 % CI 0.651-0.904, p = 0.002) and exercise (OR 1.027, 95 % CI 1.008-1.046, p = 0.006) were significantly related to falls and 91.6 % of cases were correctly classified. CONCLUSION: The results indicate that high-level cognitive processes interfere with automatic processes such as walking. The TWT which converts a relevant fall risk-associated standard neuropsychological test (TMT) with increasing cognitive load into a mobility task, was shown to be a feasible, reliable and valid tool for older adults to discriminate between non-fallers and fallers.

Preventing functional loss during immobilization after osteoporotic wrist fractures in elderly patients: a randomized clinical trial.

BACKGROUND: Distal radius fractures are among the most common fractures and account for approximately one-sixth of all fractures diagnosed. Therapy results after distal radius fracture, especially of elderly patients, are often suboptimal. The inevitable immobilization for several weeks leads to reduction in range of motion, deterioration of muscle strength, malfunction of fine motor skills as well as changes of motor and sensory representations in the brain. Currently, there are no strategies to counteract these immobilization problems. The overall aim of the study is to investigate the therapeutic potential of motor-cognitive approaches (mental practice or mirror therapy) on hand function after wrist fracture. METHODS/DESIGN: This study is a controlled, randomized, longitudinal intervention study with three intervention groups. One experimental group imagines movements of the fractured upper extremity without executing them (mental practice). The second experimental group receives a mirror therapy program consisting of the performance of functional movement synergies using the unaffected forearm, wrist, and hand. The control group completes a relaxation training regime. Additionally, all patients receive usual care by the general practitioner. We include women aged 60 years and older having a distal radius fracture and sufficient cognitive function. All groups are visited at home for therapy sessions 5 times per week for the first 3 weeks and 3 times per week for weeks 4 to 6. Measurements are taken at therapy onset, and after 3, 6 and 12 weeks. The primary outcome measure will assess upper extremity functioning (Patient-Rated Wrist Evaluation [PRWE]), while secondary outcome measures cover subjective wrist function (Disabilities of the Arm and Shoulder; [DASH], objective impairment (range of motion, grip force) and quality of life (EuroQol-5D, [EQ5D]). DISCUSSION: Results from this trial will contribute to the evidence on motor-cognitive approaches in the early therapy of distal radius fractures. TRIAL REGISTRATION: The trial is registered at ClinicalTrials.gov with registration number NCT01394809 and was granted permission by the Medical Ethical Review Committee of the University of Tübingen in June 2011.

Mental rotation abilities of gymnasts and soccer players: a comparison of egocentric and object-based transformations. An exploratory and preliminary study.

Background and objectives: The experience obtained from motor expertise may contribute to and enhance the development of particular visuo-spatial abilities. This exploratory and preliminary study compares the response times of a mental rotation task with egocentric and object-based transformation instructions between soccer players of varying performance levels and gymnasts. Methods: Fifty-six male participants were grouped based on their sports experience. Soccer-specific novices (SS-N: n = 19; age = 15.9 ± 0.87), soccer-specific experts (SS-E: n = 17; age = 16.4 ± 0.70), gymnastic-specific experts (GS-E: n = 10; age = 16.6 ± 1.71), and gymnastic-specific novices (GS-N: n = 10; age = 16.0 ± 1.63) were recruited to perform a perceptual task (recognition of soccer-specific poses) and mental rotation tasks with different stimuli (soccer-specific poses, cubes, line-drawings of hands, letters). Results: During the perceptual task with instructions on egocentric transformation and soccer-specific poses, we observed that gymnasts had longer response times than soccer players. Our findings also suggest that experts correctly identified most of the poses in terms of accuracy. In the mental rotation task with object-based transformation, gymnasts processed all stimuli, even the soccer-specific poses, more accurately than both soccer groups. Conclusion: Our results suggest that gymnasts' motor expertise plays a role in their performance on mental rotation tasks involving both egocentric and object-based transformations, regardless of the stimuli presented.

Skillful and strategic navigation in soccer - a motor-cognitive dual-task approach for the evaluation of a dribbling task under different cognitive load conditions.

Soccer is a competitive sport that relies on distinct motor skills and cognitive processes. However, cognitive aspects are often overlooked, with a focus mainly on motor skills. Limited research has explored screening tests within motor-cognitive navigation dual-task (DT) paradigms. This study aims to validate a sensitive approach for assessing soccer-specific dribbling by evaluating the Trail-Dribbling Test (TDT) as a method to differentiate high-performance (HP) from low-performance (LP) players. Two hundred and seventy-five participants (41 females) aged between 12 and 34 completed the Trail-Making Test (TMT), the Trail-Walking Test (TWT), and the soccer-specific TDT under three levels of cognitive load. Results indicated shorter TDT durations for HP compared to LP players, with increased cognitive load accentuating differences (TDT-M: p = 0.044, d = 0.260; TDT-A: p < 0.001, d = 0.449; TDT-B: p < 0.001, d = 0.653). The TDT effectively discriminated between HP and LP players in the 14-15 (AUC = 0.712-0.820) and 16-17 age groups (AUC = 0.634-0.839). In conclusion, the ecologically valid TDT demonstrates the potential for quantifying soccer-specific dribbling, offering insights into motor and cognitive aspects of dribbling performance, especially among soccer players aged 14-17.

Associations Between Object Control Skills and Cognitive Functions in Boys, Younger and Older Men: Across-Sectional Study.

Purpose: This study aimed to explore the association of cognitive function and process- as well product-oriented outcomes of object control skills (OCS) in boys, younger and older men. Methods: A total of 77 male participants took part in this study, including 35 primary school children (9.04 ± 0.53 years), 22 younger adults (23.5 ± 2.34 years), and 20 older adults (69.5 ± 4.43 years). We assessed the process-oriented performance of throwing, kicking, and catching performance using the component approach. For the product-oriented performance, throwing and kicking velocity was recorded with a STALKER SOLO 2.0 radar gun. For catching, the number of caught balls was assessed. Cognitive function was evaluated using the Trail-Making-Test (TMT) one day later. Results: Younger adults performed better in both domains than the other two groups. The results of the children and older adults were comparable in the motor and cognitive domains. However, the older adults yielded significantly better results for the process-oriented catching and product-oriented throwing performances. Moderate to strong correlations exist between OCS- and TMT performance, with significant correlations predominantly between product-oriented OCS results and TMT in children. Conclusion: The results of both domains support a hypothetical lifespan developmental trajectory with a progression from childhood to younger adult age and a degression in older adults. Furthermore, our results suggest that the suspected relationship between motor and cognitive function depends on age, the analyzed cognitive and motor skills, and the applied methodological approach (process-oriented vs. product-oriented).

Neighborhood Socio-Economic Status Influences Motor Performance and Inhibitory Control in Kindergarten Children-Findings from the Cross-Sectional Kitafit Study.

Numerous studies have examined the role of socio-economic status on physical activity, obesity, and cognitive performance in youth or older adults, but few studies have examined the role of neighborhood socio-economic status (NSES) on motor or cognitive performance in kindergarten children. This study aimed to examine whether lower NSES (measured by the social data atlas) was associated with lower motor and inhibitory control performance in kindergarten children. One hundred twenty-nine preschoolers were recruited from eight kindergartens in low and high NSES areas in Stuttgart, one of Germany's largest metropolitan areas. Motor functioning (Movement Assessment Battery for Children, MABC-2; Manual Dexterity, Aiming and Catching, and Balance) and inhibitory control (Flanker Task, Go/NoGo Task) were assessed in a sample of 3- to 6-year-old children within a cross-sectional study. Children from a low NSES background showed the expected difficulties in inhibitory control and motor performance, as indicated by poorer performance than children from a high NSES background. Sex-specific analysis revealed girls from low NSES areas to have the lowest fine motor control; children with low NSES reach a Developmental Coordination Disorder at-risk status of 13% (boys and girls), in contrast to children with high SES (boys 9.1%, girls 0.0%). Motor performance and inhibitory control correlated positively with regard to the group from a low NSES background. Researchers and practitioners are advised to develop a more nuanced picture of motor and academic achievement in heterogeneous neighborhoods when designing early intervention programs, particularly with regard to sex differences, with the most significant disadvantage to girls with lower NSES.

Understanding factors that influence physical activity behavior in people with developmental coordination disorder (DCD): a mixed-methods convergent integrated systematic review.

This systematic review synthesizes the literature on physical activity amongst people with DCD using the COM-B framework. The review questions were: (1) what is the Capability (C), Opportunity (O) and Motivation (M) for physical activity and (2) what does physical activity behavior (B) look like? A mixed-methods systematic review was conducted by searching eight databases (PubMed, APA PsycINFO, EMBASE, Scopus, Child Development and Adolescent Studies, Cochrane Library, Web of Science, CINAHL) up to July 2023. Data were extracted, thematically analyzed, and mapped to the COM-B model. The quality of studies was assessed with the Joanna Briggs Institute (JBI) critical appraisal tool. The protocol was registered with PROSPERO (CRD42022319127). Forty-three papers, 42 of which related to children, were included. Fifteen aligned with physical activity behavior, nine with physical capability, thirteen with psychological capability, one with social opportunity, one with physical opportunity, one with reflective motivation and three with automatic motivation. Pre-school-aged children with DCD engage in comparable levels of physical activity behavior, but differences emerge from 6 years of age. Characteristics of DCD result in reduced physical capability and less varied participation in physical activity. This impacts psychological capability, whereby lower self-perceptions result in a negative feedback loop and reduce the motivation to participate. Barriers relating to social opportunities may result in poor reflective and automatic motivation, although there is evidence that interventions can enhance enjoyment in the short term.

Health status, resources, and job demands in geriatric nursing staff: A cross-sectional study on determinants and relationships.

BACKGROUND: According to current estimates, the number of people needing care will double in the next 40 years. It is expected that between 130,000 and 190,000 additional nurses will be needed by 2030 in Germany. Physical and psychological burdens associated with nursing in long-term care facilities can develop into serious health risk factors and significantly impact occupational factors such as absenteeism, especially when linked to difficult working conditions. However, demands and resources specific to the nursing profession have not been analyzed extensively to preserve and promote nurses' workability and health adequately. OBJECTIVE: Our study aimed to examine the extent to which perceived health among geriatric nursing staff in Germany is predicted by personal resources, job demands, and job resources. In addition, we analyzed the impact of different behavior and experience patterns on these relationships. DESIGN, SETTING, AND PARTICIPANTS: An observational study was conducted between August 2018 and February 2020 in 48 nursing home facilities with 854 staff members in Germany as part of the project 'PROCARE - Prevention and occupational health in long-term care'. METHODS: The survey contained instruments that measure workplace exposure, musculoskeletal complaints, physical and mental well-being, chronic stress, and work-related behavior and experience patterns. In addition, health-related information on physical activity and nutrition was collected. Data were analyzed using structural equation modeling. RESULTS: The combined physical and mental workload for geriatric nurses is very high, with 75 % showing chronic stress. In the overall model, job and personal resources have a stronger association with mental health than physical health, while job demands have an equal impact on mental and physical health. Coping behavior also plays an important key role that should be assessed and considered. A behavior and experience risk pattern (health-endangering) is more strongly associated with a lower health status than a health-promoting behavior pattern. Results of the multigroup test showed that work-related behavior and experience patterns significantly moderate the relationship between physical health and mental health (χ2 = 392/p ≤ .001/df = 256/RMSEA = 0.028/CFI = 0.958/TLI = 0.931). Only 43 % show a health-friendly coping pattern. CONCLUSIONS: Our findings underline the importance of holistic health promotion, which not only aims at changes at the behavioral level and the development of coping strategies but also takes on the task of reducing the workload and including measures to improve the working climate. TRIAL REGISTRATION NUMBER: DRKS.de (DRKS00015241); August 9, 2018. TWEETABLE ABSTRACT: Healthier coping patterns can benefit geriatric nurses' health. However, this is not a substitute for improving working conditions.

Cognitive, physical and emotional determinants of activities of daily living in nursing home residents-a cross-sectional study within the PROCARE-project.

BACKGROUND: Interdependencies of health, fitness, cognition, and emotion can promote or inhibit mobility. This study aimed to analyse pathways and interactions between individual subjective and objective physical performance, cognition, and emotions with activities of daily living (ADLs) as mobility indicators in multimorbid nursing home residents. METHODS: The study included n = 448 (77.1% females, age = 84.1 ± 7.8 years) nursing home residents. To describe the participant's demographics, frailty, number of falls, and participating institutions' socioeconomic status (SES) were assessed. ADLs were measured with the Barthel Index (BI; dependent variable). Independent variables included objective physical performance, subjective physical performance, cognition, and emotions. A structural equation model (SEM) with maximum likelihood estimation was conducted with AMOS. Direct and indirect effects were estimated using standardized coefficients (significance level of 0.05). RESULTS: Indices showed (Chi2(148) = 217, PCMIN/DF = 1.47; p < .001; Comparative Fit Index = .940; Tucker Lewes Index = .902, RMSEA = .033) that the model fitted the data adequately. While there was no direct association between emotions, subjective physical performance, and ADLs, objective physical performance and cognition predicted higher ADLs (p < .01). Emotions had a strong relationship with subjective physical performance, and cognition had a moderate relationship with objective physical performance. DISCUSSION AND CONCLUSION: Objective performance and cognition predicted higher functional status, as expressed by higher BI scores. ADLs, such as mobility, dressing, or handling tasks, require motor and cognitive performance. Subjective performance is an important predictor of ADLs and is only partly explained by objective performance, but to a large extent also by emotions. Therefore, future interventions for nursing home residents should take a holistic approach that focuses not only on promoting objective physical and cognitive performance but also on emotions and perceived physical performance. TRIAL REGISTRATION: Trial registration number: DRKS00014957.

Age-related differences in motor imagery: working memory as a mediator.

UNLABELLED: BACKGROUND/STUDY CONTEXT: Although motor imagery is a well-established phenomenon in healthy younger adults, it seems necessary to determine if older adults are still able to accurately perform imagery tasks before investigating the application of motor imagery in rehabilitation. Therefore, the purpose of this study was to determine if there is a progressive decline in motor imagery performance with age. Furthermore, we wanted to verify whether the effects of age on motor imagery were due to (or mediated by) deficits of working memory. METHODS: This study examined the key characteristics of the motor imagery ability in three groups of healthy older men and women (60-69, 70-79, and ≥80 years; mean age M = 73.8, SD = 8.3) and 40 younger subjects aged 20 to 30 years (M = 28.87, SD = 2.5). Imagery ability was measured using the Movement Imagery Questionnaire (MIQ), the Controllability of Motor Imagery (CMI) test, and two different chronometry tests. To estimate the mediational effect of working memory on age differences in the imagery measures, we employed latent variable structural equation modeling (SEM). RESULTS: The main findings indicated that motor imagery ability (generation, visual and kinesthetic imagery ability, controllability, and temporal organization) were better in young adults compared with older adults 70 years and older, but not in older adults 60 to 69 years of age. The analysis of the mediational effect of working memory on age differences in the motor imagery measures showed that the inclusion of working memory increased the amount of explained variance in the MIQ (ΔR (2) = .03), in the CMI test (ΔR (2) = .15), as well as in the mental chronometry tests (ΔR (2) = .16) CONCLUSION: Our findings suggest that there is potential for motor imagery to be compromised in the older age ranges, which may limit motor imagery as a rehabilitative strategy in older and in cognitively impaired individuals.

Object Control Skill Performance Across the Lifespan: A Cross Sectional Study.

Purpose: Studies on object control skills (OCS) have described changes in movement patterns over time, but mostly in children and adolescents, young adults, or older adults. Most of these studies focused on only one skill and usually only on the process- or product-oriented outcomes. Thus, this study aimed to explore OCS performance in children, younger adults, and older adults. Methods: A total of 120 male participants took part in this study, including 78 primary school children (7.96 ± 1.22 years), 22 young adults (23.5 ± 2.34 years), and 20 older adults (69.5 ± 4.43 years). We assessed the process-oriented performance of throwing, kicking, and catching performance using the component approach. Throwing and kicking velocity was recorded with a STALKER SOLO 2.0 radar gun. For catching, the number of caught balls was assessed. Results. Young adults had the highest component levels in all OCS; they also produced significantly higher throwing and kicking velocities than children and older adults. The proportion of participants achieving mastery or advanced skill proficiency varied significantly in children (6.4-32.1%), young adults (63.6-100.0%), and older adults (10.0-95.0%). With few exceptions, the results showed mainly moderately significant correlations between developmental levels and throwing/kicking velocity or number of successfully caught balls for all age groups. Conclusion: Our data indicate that children in particular rarely demonstrate advanced OCS and that there is a decrease in throwing and kicking but not in catching in older adults compared to the younger age groups.