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.

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).

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.

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.

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.

Which motor-cognitive abilities underlie the digital Trail-Making Test? Decomposing various test scores to detect cognitive impairment in Parkinson's disease-Pilot study.

Since Parkinson's disease (PD) is a heterogeneous disorder with symptoms, such as tremors, gait and speech disturbances, or memory loss, individualized diagnostics are needed to optimize treatment. In their current form, the typical paper-pencil methods traditionally used to track disease progression are too coarse to capture the subtleties of clinical phenomena. For this reason, digital biomarkers that capture, for example, motor function, cognition, and behavior using apps, wearables, and tracking systems are becoming increasingly established. However, given the high prevalence of cognitive impairment in PD, digital cognitive biomarkers to predict mental progression are important in clinical practice. This pilot study aimed to identify those components of our digital version of the TMT (dTMT) that allow discrimination between PD patients with and without cognitive deficits. A total of 30 healthy control (age 66.3 ± 8.61) and 30 participants with PD (age 68.3 ± 9.66) performed the dTMT using a touch-sensitive tablet to capture enhanced performance metrics, such as the speed between and inside circles. The decomposition of cognitive abilities based on integrating additional variables in the dTMT revealed that the Parkinson's disease group was significantly more sensitive to parameters of inhibitory control. In contrast, the mild cognitive impairment group was sensitive to parameters of cognitive flexibility and working memory. The dTMT allows objective, ecologically valid, and long-term cognitive and fine-motor performance tracking, suggesting its potential as a digital biomarker in neurodegenerative disorders.

Profiles of Motor-Cognitive Interference in Parkinson's Disease-The Trail-Walking-Test to Discriminate between Motor Phenotypes.

Background and Aims. Most research on Parkinson's disease (PD) focuses on describing symptoms and movement characteristics. Studies rarely focus on the early detection of PD and the search for suitable markers of a prodromal stage. Early detection is important, so treatments that may potentially change the course of the disease can be attempted early on. While gait disturbances are less pronounced in the early stages of the disease, the prevalence, and severity increase with disease progression. Therefore, postural instability and gait difficulties could be identified as sensitive biomarkers. The aim was to evaluate the discriminatory power of the Trail-Walking Test (TWT; Schott, 2015) as a potential diagnostic instrument to improve the predictive power of the clinical evaluation concerning the severity of the disease and record the different aspects of walking. Methods. A total of 20 older healthy (M = 72.4 years, SD = 5.53) adults and 43 older adults with PD and the motor phenotypes postural instability/gait difficulty (PIGD; M = 69.7 years, SD = 8.68) and tremor dominant (TD; M = 68.2 years, SD = 8.94) participated in the study. The participants performed a motor-cognitive dual task (DT) of increasing cognitive difficulty in which they had to walk a given path (condition 1), walk to numbers in ascending order (condition 2), and walk to numbers and letters alternately and in ascending order (condition 3). Results. With an increase in the cognitive load, the time to complete the tasks (seconds) became longer in all groups, F(1.23, 73.5) = 121, p < 0.001, ɳ2p = 0.670. PIGD showed the longest times in all conditions of the TWT, F(2, 60) = 8.15, p < 0.001, ɳ2p = 0.214. Mutual interferences in the cognitive and motor domain can be observed. However, clear group-specific patterns cannot be identified. A differentiation between the motor phenotypes of PD is especially feasible with the purely motor condition (TWT-M; AUC = 0.685, p = 0.44). Conclusions. PD patients with PIGD must be identified by valid, well-evaluated clinical tests that allow for a precise assessment of the disease's individual fall risk, the severity of the disease, and the prognosis of progression. The TWT covers various aspects of mobility, examines the relationship between cognitive functions and walking, and enables differentiation of the motor phenotypes of PD.

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.

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).

Dual-Task Interference in Children with Down Syndrome and Chronological and Mental Age-Matched Healthy Controls.

BACKGROUND: On the assumption that motor actions result from the interaction between cognitive, perceptual, and neurological mechanisms, neuromotor dysfunction-such as in children with Down Syndrome (DS)-is expected to affect the central coordination processes required for dual-task (DT) performance. There are few dual-task (DT) studies in individuals with DS, so the current study examined the effects of dual-tasking (DT) on walking performance in children with DS. METHOD: In this study, a motor-cognitive DT was used in 12 children with DS (10.5 ± 1.08 years, 6 female), 12 typically developed (TD) children with the same mental age (TD-MA: 5.98 ± 1.21 years, 6 female), and 12 with the same chronological age (TD-CA: 10.5 ± 1.07 years, 6 female). Children were asked to enumerate animals for one minute while walking straight ahead. RESULTS: All groups showed lower performances under the DT condition than the single-task (ST) condition. Children with DS appear to have the most difficulties in motor and cognitive tasks and ST- and DT-conditions. Concerning the DT costs (DTC), difficulties were mainly observed with the motor task, with motor DTC being greater than cognitive DTC. CONCLUSION: The interplay of different systems seems to play a crucial role in walking, especially in children with DS. DT walking paradigms with directional changes are recommended for future studies, as this is more appropriate for the everyday demands of children.

Associations of Motor Performance and Executive Functions: Comparing Children with Down Syndrome to Chronological and Mental Age-Matched Controls.

BACKGROUND: Children with Down syndrome (DS) exhibit lower motor and cognitive performance than typically developing children (TD). Although there is a relationship between these two developmental domains, only a few studies have addressed this association in children with DS compared to groups of the same chronological age (CA) or mental age (MA) within one study. This study aimed to fill this research gap. METHOD AND PROCEDURES: The Movement Assessment Battery for Children-2 and the Trail-Making Test was used to assess motor and cognitive performances in 12 children (M = 10.5 ± 10.08) with DS, 12 CA-matched, and 12 MA-matched controls. RESULTS: There are significant group differences in the motor dimension (total test score; p < 0.001, η2p = 0.734), for processing speed (p < 0.001, η2p = 0.396), and cognitive flexibility (p < 0.001, η2p = 0.498). Between TD-CA and both other groups, the differences in the magnitude of correlations for the motor dimension balance are also significant (compared to DS: z = -2.489; p = 0.006, and to TD-MA: z = -3.12; p < 0.001). CONCLUSIONS: Our results suggest that the relationships depend on the studied cognitive and motor skills. It seems crucial to select a wide range of tasks for both domains that are as isolated as possible for future studies, to better understand the relationships between cognitive and motor skills in children with DS.

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.

The trail-making-test: Comparison between paper-and-pencil and computerized versions in young and healthy older adults.

One of the key challenges in assessing cognitive performance is to detect not only apparent impairment but to also pick up on subtle differences. Computerized tests benefit especially from the acquisition of fine-grained outcome measures. However, the equivalency of paper-based and computerized tests cannot be assumed. The Trail-Making-Test is a paper-pencil cognitive assessment tool (ppTMT) that has been used in many research studies to evaluate visuomotor abilities and mental flexibility. A digital version of the extended TMT (including a condition measuring fine motor speed) called the dTMT has been developed. This study aims to test (1) reliability, (2) equivalence, and (3) agreement of the ppTMT and dTMT. A total of 53 healthy individuals aged 19 to 82 years of age (22 men, 31 women; mean age 42.2, SD = 22.8) completed three trials per ppTMT and dTMT condition. Part M involves following a predefined path, Part A links numbers randomly distributed in space, in ascending order, and Part B alternates between linking numbers and letters. dTMT scores were highly reproducible, correlated strongly with paper-pencil administered durations, and discriminated young from older adults. Measures of reliability, sensitivity, and clinical meaning for dTMT scores were favorable compared with ppTMT-based testing. Our findings support the comparability of TMT-indices in computerized assessments. While many digital biomarker efforts are in progress (e.g., neurodegenerative disorders), the dTMT sets itself apart through its high sensitivity, the alternate forms, and the additional component measures. In this light, it could serve as a starting point for an early diagnostic tool.

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.

The Effects of the Combination of High-Intensity Interval Training with 3D-Multiple Object Tracking Task on Perceptual-Cognitive Performance: A Randomized Controlled Intervention Trial.

The ability to process goal-related visual information while ignoring goal-irrelevant information is essential for the human attention system. The study aimed to investigate how perceptual-cognitive performance was affected during high-intensity interval training (HIIT) using a 3D-multiple object tracking (3D-MOT) task called Neurotracker (NT). In an experimental design, 42 healthy adults (age M = 23.3 SD = 2.94, VO2max 52.8 ± 5.66 mL·kg-1·min-1) were randomly assigned to an intervention (HIIT + NT, NT, HIIT) or control group. NT performance (20 trials per session) was measured pre-and post-test (at 5, 15, and 25 min while running on the treadmill). The participants trained twice a week for a 4-week intervention period. There was a significant interaction effect between pre/post-test and groups regarding perceptual-cognitive performance, indicating similar enhancements in the HIIT + NT and the NT group during exercise. HIIT influences physical fitness but did not show any impact on perceptual-cognitive performance. Due to the specific NT task characteristics, improved physical abilities may not directly impact sport-specific perceptual-cognitive performance. Our findings suggest that training resulted in substantial task-specific gains. Therefore, combination training may be proposed as a training program to improve perceptual-cognitive, and physical performance in a time-efficient way.

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.

The effects of visual impairment on motor imagery in children and adolescents.

BACKGROUND: While the development of motor imagery (MI) has been extensively studied in sighted children, it is not clear how children with different severities of visual impairment (VI) represent motor actions by using the motor representations constructed through the remaining intact senses, especially touch. AIMS: Mental chronometry and generation/manipulation of MI were examined in children with and without VI. METHODS AND PROCEDURES: Participants included 64 youth with and without VI (33 without visual impairments, 14 moderate-to-severe, and 17 blind). Mental chronometry was assessed with the imagined Timed-Up-and-Go-Test (iTUG), and generation/manipulation of MI with the Controllability-of-Motor-Imagery-Test (CMI). In addition, the effect of working memory performance (Letter-Number-Sequencing) and physical activity upon MI were evaluated. RESULTS: Mental duration for the iTUG was significantly shorter than the active durations. Results also provided evidence of better haptic representation than motor representation in all participants; however, only for the CMI-regeneration condition controls outperformed children with visual impairments and blindness (CVIB). Exercise and working memory performance showed a significant contribution only on a few MI tests. CONCLUSION AND IMPLICATIONS: Our results suggest a possible relationship between motor performance, body representation deficits and visual impairment which needs to be addressed in the evaluation and treatment of CVIB. The design of new rehabilitation interventions that focus on strengthening adequate body perception and representation should be proposed and tested to promote motor development in CVIB.

Physical activity and health promotion for nursing staff in elderly care: a study protocol for a randomised controlled trial.

INTRODUCTION: Nursing staff is burdened by high workload and stress. Furthermore, heavy lifting, as well as transferring nursing home residents, cause lumbar tissue damage and back pain. Exercise intervention studies to reduce work-related problems are rare and the evidence for efficacy of studies among nurses is limited. Studies including targeted analysis of requirements are necessary to generate effective recommendations and tailored interventions for health promotion programmes. The purpose of this multicentred intervention study is to identify work-related problems, to implement health promotion programmes and to evaluate their effectiveness. METHODS AND ANALYSIS: A randomised controlled trial will be conducted, including a total of 48 nursing home facilities in eight regions of Germany with an estimated sample size of 700 nurses. Standardised ergonomics and posture training (10 weeks, once a week for 20-30 min) and subsequently, back-fitness training (12 weeks, once a week for 45-60 min) will be administered. Following the implementation of standardised health promotion programmes, further demand-oriented interventions can be implemented. The perceived exposure to work-related demands, work-related pain in different parts of the body, health-related quality of life, perceived stress, work-related patterns of behaviour and experience, presentism behaviour, work environment as well as general needs and barriers to health promotion, will be assessed at baseline (pre-test), at 10 weeks (post-test, after ergonomics training), at 22 weeks (post-test, after back-fitness training) and at 34 weeks of the programme (follow-up). ETHICS AND DISSEMINATION: The study was reviewed and approved by the local ethics committee of the University of Hamburg (AZ: 2018_168). The results of the study will be published in open-access and international journals. Furthermore, the results will be presented in the participating nursing homes and at national and international conferences. TRIAL REGISTRATION NUMBER: DRKS.de (DRKS00015241).

Exploring motor-cognitive interference in children with Down syndrome using the Trail-Walking-Test.

BACKGROUND AND AIMS: The dual-task (DT) paradigm is an ecologically valid approach to assess cognitive function in relation with motor demands, particularly for children with Down syndrome (DS). This study aimed to determine DT performance for a complex Change-of-Direction (CoD_W) walking task in children with DS. METHODS: The sample included 12 children with DS (10.2 ±â€¯1.19 years), 12 typically developing (TD) children matched for chronological (TD-CA: 10.2 ±â€¯1.19 years) and 12 TD children matched for mental age (TD-MA: 5.50 ±â€¯1.24 years). We examined DT performance with the Trail-Walking-Test (TWT): participants (1) walked along a fixed pathway, following a prescribed path, delineated by target markers of (2) increasing sequential numbers, and (3) increasing sequential numbers and letters. Motor and cognitive dual-task costs (DTC) were calculated. RESULTS: For the TWT, an ANOVA with repeated measures revealed significant differences between DS and the CA, but not the MA group. Overall, there were significant decreases in speed with increasing cognitive demands. In addition, all children produced higher cognitive compared to motor DTC, which were more pronounced in the cognitively more challenging condition. CONCLUSION: The assessment of motor and cognitive performance in a DT paradigm provided insight in how motor and/or cognitive impairment constrains the ability of children to successfully perform activities in a complex and dynamical environment.

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.