Motor-cognitive exercise with variability of practice and feedback improves functional ability and cognition in older individuals.

BACKGROUND: Motor-cognitive dual-task training seems the most favorable form of exercise for functional and cognitive improvements in older individuals.  The optimal exercise regime is still uncertain, and the potential benefits of qualitative parameters of exercise prescription such as feedback provision and practice variability are mostly unknown. AIMS: To verify the effects of a motor-cognitive dual-task training with feedback provision and variability of practice for improving functional ability and cognition in older individuals. METHODS: Thirty individuals (3 men) aged over 65 years were tested on walking speed, static and dynamic balance, lower limb strength, and cognition before and after a 5-week motor-cognitive intervention. Training consisted of twice weekly, 30 min gross-motor coordination exercises with variable practice conditions combined with stimulus-response cognitive tasks generated by an interactive device. Participants were divided into an experimental group and a control group, respectively receiving and nonreceiving feedback during training. A 2 × 2 ANOVA was used to verify the effects of training. RESULTS: Both groups improved static and dynamic balance (p < 0.05), walking speeds (p < 0.05), lower limb strength (p < 0.05) and cognitive functions with greater gains observed in the experimental group (p < 0.01). DISCUSSION: Variability of practice applied to motor-cognitive dual-task training is effective for improving, in only 5 weeks, functional ability and cognitive processing in older individuals. These changes were possibly afforded through motor and cognitive enhancement induced by exercise complexity. Provision of feedback seems to particularly benefit cognitive functions. CONCLUSIONS: Brief motor-cognitive dual-task training using practice variability and feedback seems effective for counteracting the age-related cognitive and functional decline.

A Nonpharmacologic Treatment for Anxiety in Older Adults Based on Cognitive-Motor Training With Response-Generated Feedback.

OBJECTIVES: Simultaneous combinations of cognitive and physical exercises (cognitive-motor dual-task training [CMDT]) are more effective than physical and cognitive training alone in counteracting the decline of older adults and promoting physical and psychological well-being. The CMDT can be particularly effective in improving cognitive and functional abilities. Here, we validated an innovative nonpharmacologic intervention for anxiety and general well-being in older people by combining CMDT and response-generated feedback (RGF) principles. As outcomes, anxiety, cognitive functions, and functional mobility were evaluated. In addition, electroencephalographic methods were employed to investigate the neural basis of the possible intervention effects. METHODS: Thirty older adults were divided into an experimental group trained using a CMDT + RGF protocol and a control group using the CMDT only. The CMDT + RGF consisted of the simultaneous execution of whole-body exercises, cognitive tasks that were realized using interactive devices, and continuous feedback on every response. RESULTS: Results showed decreased anxiety and increased response speed in the experimental group, and both groups improved their functional ability and response accuracy after the intervention. According to electroencephalographic results, both groups showed an increase in the bilateral prefrontal cortex anticipatory activity, but the experimental group also showed a further increase in the left prefrontal cortex and in the premotor areas anticipatory functions. DISCUSSION: This study confirms the effectiveness of the proposed intervention on anxiety by adopting a nonpharmacology treatment that could affect public and individual health costs by proposing an alternative approach to expensive medications and psychotherapy and could significantly improve older adults' quality of life.

How divergent are children's divergent movements? The role of cognition and expertise in a class-randomized cross-over trial.

This study aimed at investigating (1) the cognitive and motor predictors of divergent movement ability (DMA) in childhood and (2) the role of sport and enriched physical education (PE) experience. Participants were 165 fifth graders, aged 10-11 years, with different histories (onset and duration) of participation in enriched PE. They were assessed in cognitive/attentional and motor/sport skills and active play/sport habits at baseline, and six months later in DMA. Results of regression analyses showed an overall prediction of DMA by sport practice and a nuanced prediction of individual DMA indices (fluency, flexibility, originality) by decision making and spatial attention ability. Linear mixed models revealed better DMA in children exposed to enriched PE, with differential effects on DMA indices depending on its duration and earlier/later onset. The results identify novel cognitive determinants of children's DMA and suggest that sport practice and experience of designed enrichment in PE may benefit DMA.

Giving Ideas Some Legs or Legs Some Ideas? Children's Motor Creativity Is Enhanced by Physical Activity Enrichment: Direct and Mediated Paths.

Approaches to foster motor creativity differ according to whether creative movements are assumed to be enacted creative ideas, or solutions to emerging motor problems that arise from task and environmental constraints. The twofold aim of the current study was to investigate whether (1) an enriched physical education (PE) intervention delivered with a joint constraints-led and cognitive stimulation approach fosters motor creativity, and the responsiveness to the intervention is moderated by baseline motor and cognitive skills and sex; (2) the intervention may benefit motor creativity through gains in motor coordination, executive function, and creative thinking. Ninety-five children, aged 6-9 years, participated in a 6-month group randomized trial with specialist-led enriched PE vs. generalist-led conventional PE. Before and after the intervention, Bertsch's Test of Motor Creativity, Movement Assessment Battery for Children, Random Number Generation task and Torrance Test of Creative Thinking were administered. Linear mixed models were run accounting for the random effects of data clusters. Multiple mediation analysis was performed to assess whether motor coordination, executive function and creative thinking mediated any improvement of motor creativity. Results showed that (1) specialist-led enriched PE, compared to generalist-led conventional practice, elicited a more pronounced improvement in all motor creativity dimensions (fluency, flexibility, and originality) independently of baseline levels of motor and cognitive skills and sex; and (2) improved motor creativity was partially mediated by improved motor coordination and, as regards motor flexibility, also by improved inhibitory ability. In conclusion, enriching PE with tailored manipulations of constraints and variability may enhance the ability to create multiple and original task-pertinent movements both directly and through indirect paths. The results are discussed extending to motor creativity a theoretical framework that distinguishes different creativity modes. The intervention may have fostered the generation of creative movements directly through the exposure to variation in constraints, activating the sensorimotor 'flow' mode of creativity that bypasses higher-order cognition, but also indirectly through a systematic and conscious convergence on solutions, activating the 'deliberate' mode of creativity that relies on inhibition to reject common or task-inappropriate movement categories.

The Impact of Exercise Intervention with Rhythmic Auditory Stimulation to Improve Gait and Mobility in Parkinson Disease: An Umbrella Review.

Difficulties in walking, controlling balance, and performing activities of daily living are common problems encountered by individuals affected by Parkinson disease. Scientific evidence suggests that exercise performed with music or auditory or rhythmical cues facilitates movement and improves balance, gait, mobility, and activities of daily living (ADL) performance in patients with PD. The aim of this umbrella review was to summarize available high-quality evidence from systematic reviews and meta-analyses on the effectiveness of rhythmically cued exercise to improve gait, mobility, and ADL performance in individuals with PD. PubMed, Cochrane, and Embase databases were searched from January 2010 to October 2020 for systematic reviews and meta-analyses which had to be (1) written in English, (2) include studies on populations of males and females with PD of any age, (3) analyze outcomes related to gait, mobility, and ADL, and (4) apply exercise interventions with music or auditory or rhythmical cues. Two independent authors screened potentially eligible studies and assessed the methodological quality of the studies using the AMSTAR 2 tool. Four studies, two systematic reviews and meta-analyses, one a systematic review, and one a meta-analysis, were selected. Overall results indicated positive effects for gait and mobility of the use of rhythmic auditory cueing with exercise and suggested that it should be incorporated into a regular rehabilitation program for patients affected by PD. Nonetheless, more primary level research is needed to address the identified gaps regarding the application of this method to physical exercise interventions.

Creating Well-Being: Increased Creativity and proNGF Decrease following Quadrato Motor Training.

Mind-body practices (MBP) are known to induce electrophysiological and morphological changes, whereas reports related to changes of neurotrophins are surprisingly scarce. Consequently, in the current paper, we focused on the Quadrato motor training (QMT), a newly developed whole-body movement-based MBP, which has been reported to enhance creativity. Here we report the effects of 4 weeks of daily QMT on creativity and proNGF level in two interrelated studies. In Study A, we examined the effects of QMT compared with a walking training (WT) in healthy adults, utilizing the alternate uses task. In contrast with the WT, QMT resulted in increased creativity. In addition, the change in creativity negatively correlated with the change in proNGF levels. In Study B, we examined QMT effects on creativity and additional metacognitive functions in children, using a nonintervention group as control. Similar to Study A, following QMT, we found a negative correlation of proNGF with creativity, as well as working memory updating and planning ability. Together, the current results point to the relationship between increased creativity and decreased proNGF following MBP. Thus, the current research emphasizes the importance of widening the scope of examination of "MBP in motion" in relation to metacognition and well-being.