Distinct effects of long-term Tai Chi Chuan and aerobic exercise interventions on motor and neurocognitive performance in early-stage Parkinson's disease: a randomized controlled trial.

BACKGROUND: Parkinson's disease (PD) is a neurodegenerative condition characterized by movement disorders and probable cognitive impairment. Exercise plays an important role in PD management, and recent studies have reported improvement in motor symptoms and cognitive function following aerobic and Tai Chi Chuan exercise. AIM: To explore the different effects of Tai Chi Chuan and aerobic exercise on the clinical motor status and neurocognitive performance of patients with early-stage PD. DESIGN: A randomized controlled trial. SETTING: Parkinson's Disease Center at Kaohsiung Chang Gung Memorial Hospital and National Cheng Kung University Hospital. POPULATION: Patients with idiopathic PD. METHODS: Fifty-six patients with PD were recruited and divided into three groups: aerobic exercise (AE, N.=14), Tai Chi Chuan exercise (TE, N.=16), and control (CG, N.=13). Before and after a 12-week intervention period, we used unified Parkinson's disease rating scale Part III (UPDRS-III) scores and neuropsychological (e.g., accuracy rates [ARs] and reaction times [RTs]) and neurophysiological (e.g., event-related potential [ERP] N2 and P3 latencies and amplitudes) parameters to respectively assess the patients' clinical motor symptoms and neurocognitive performance when performing a working memory (WM) task. RESULTS: Compared to baseline, UPDRS-III scores were significantly lower in the AE and TE groups after the intervention period, whereas those for the CG group were higher. In terms of the neurocognitive parameters, when performing the WM task after the intervention period, the AE group exhibited significantly faster RTs and larger ERP P3 amplitudes, the TE group exhibited an improvement only in ERP P3 amplitude, and the CG group exhibited a significantly reduced ERP P3 amplitude. However, neither the TE nor the AE group exhibited improved ARs and ERP N2 performance. CONCLUSIONS: The present study supported the distinct effectiveness of Tai Chi Chuan and aerobic exercise for improving motor symptoms and providing neurocognitive benefits in PD patients. CLINICAL REHABILITATION IMPACT: These results have important implications regarding the use of these exercise interventions for managing PD, particularly in the early stages.

Neurocognitive performance of badminton players at different competitive levels in visuospatial attention tasks.

Visuospatial attention (VSA) is a cognitive function that enables athletes, particularly those engaged in open-skill sports, to allocate attentional resources efficiently to the appropriate target and in the appropriate direction. Studies have indicated that expert players exhibit superior cognitive performance to that of novices. However, no study has investigated differences in VSA performance among elite, expert, and intermediate badminton players or the potential neurophysiological mechanisms underlying such differences. Accordingly, the present study explored neuropsychological and neurophysiological parameters during VSA tasks among badminton players of varying competitive levels. The study included 54 participants and divided them into three groups according to their competition records: elite (n = 18), expert (n = 18), and intermediate (n = 18). Their neuropsychological performance and brain event-related potentials (ERPs) during the Posner cueing paradigm were collected. Although the three groups did not differ in their accuracy rates, ERP N2 amplitudes, or N2 or P3 latencies, the elite and expert groups exhibited notably faster reaction times and more pronounced P3 amplitudes than did the intermediate group during the cognitive task. However, we did not observe these between-group differences when we controlled for the covariate training years. Additionally, the elite and expert groups exhibited comparable neurocognitive performance. These findings indicate that badminton players' competitive levels influence their VSA. However, the beneficial effects on neuropsychological and neurophysiological performance could stabilize after a certain level of badminton competence is reached. Year of training could also be a major factor influencing badminton players' neurocognitive performance in VSA tasks.

Visual responses of patients with generalized anxiety disorder who cycling in the virtual sportscapes with different tree cover densities.

The tree density of virtual sportscape is the main factor that determines the benefits that generalized anxiety disorder (GAD) patients can obtain when they exercise with virtual environment. By using pupil size, fixation count and time as metrics, this research aimed to clarify the relationship between tree cover density and stress in the virtual environment. Ninety GAD patients were randomly grouped into the 36-60% tree density (high tree density, HTDS), 20-35% tree density (medium tree density, MTDS), or control groups (n = 30). Researchers used eye-tracking technology to analyze fixation time, fixation count and changes in pupil size to evaluate the stress changes of participants after 20 min of aerobic exercise in a virtual environment. The results showed that pupil size expanded in GAD patients after exercising in the virtual environment. Furthermore, GAD patient cycling in the MTDS group can show smaller pupil size than those in HTDS. Those results suggest that GAD patient cycling 20 min in the MTDS group can perceived lower stress. The results of eye tracking analysis showed that GAD patients spend more time and counts observing tree elements in HTDS and MTDS sportscapes. Specifically, they spent more 48% and 27% time on tree and green plants in the HTDS condition and MTDS condition, respectively, than in non-natural sportsscapes. Although 36-60% tree density of virtual natural sportscape can get more visual attention from GAD patients, 20-35% tree density of virtual natural sportscape is more capable of reducing their stress.

Visual Attention, Behavioral Intention, and Choice Behavior Among Older Consumers Toward Sports Marketing Images: An Eye-Tracking Study.

Mental health benefits (i.e., relaxing and relieving pressure) can influence consumers' consumption decisions. However, there is still no clear understanding of the impact of mental health benefits on visual attention, behavioral intention, and choice behavior. Study 1 was thus aimed at exploring the visual attention and behavioral intention of older consumers with respect to exercise consumption. A sample of 186 older consumers was investigated. An eye-tracking analysis was used to evaluate the visual attention of participants observing health promotion messages, and questionnaires were used to assess the behavioral intention of the older consumers under consideration in this work. The findings confirmed that marketing pictures combining natural sportscapes with prevention focus messages (i.e., conveying information to consumers that it is safe and not easy to be injured when engaging in yoga activities in natural settings) can best capture older consumers' visual attention (e.g., fixation numbers and fixation times) and behavioral intentions. In Study 2, 75 participants were recruited. It was found that marketing pictures combining natural sportscapes with prevention focus messages were selected more by the participants, with health communication images successfully attracting them to choose the sports program products being presented. The findings of the two studies suggested that marketing pictures can effectively stimulate consumers' visual attention and has effects on their behavioral intention and choices toward exercising in a safe, natural environment.

The Visual Attention and Psychological Responses from Older Customers to Wellness Service Pictures of Hotels.

Understanding the visual attention and psychological responses of consumers to marketing pictures allows hotel managers to design more attractive advertisements. Therefore, the purposes of the present study were to use an eye-tracking analysis to explore whether there were different effects from tourist hotels' wellness service pictures based on whether they had natural or built clues. The psychological responses with regard to perceived well-being and willingness to pay were also examined. Eighty-five older consumers were recruited. Their eye movement performance while observing marketing pictures with different visual clues and their subsequent psychological responses were measured. It was found that wellness service pictures with natural clues captured more visual attention and induced higher willingness-to-pay perceptions than those with built clues in these older consumers. The present results suggest that marketing pictures with natural clues may create positive visual responses in older customers and further enhance their purchase intention.

Acute Effects of Different Exercise Intensities on Executive Function and Oculomotor Performance in Middle-Aged and Older Adults: Moderate-Intensity Continuous Exercise vs. High-Intensity Interval Exercise.

A wealth of evidence has shown that a single bout of aerobic exercise can facilitate executive function. However, none of current studies on this topic have addressed whether the magnitude of the acute-exercise benefit on executive function and oculomotor performance is influenced by different aerobic exercise modes. The present study was thus aimed toward an investigation of the acute effects of high-intensity interval exercise (HIIE) vs. moderate-intensity continuous exercise (MICE) on executive-related oculomotor performance in healthy late middle-aged and older adults. Using a within-subject design, twenty-two participants completed a single bout of 30 min of HIIE, MICE, or a non-exercise-intervention (REST) session in a counterbalanced order. The behavioral [e.g., reaction times (RTs), coefficient of variation (CV) of the RT], and oculomotor (e.g., saccade amplitude, saccade latency, and saccadic peak velocity) indices were measured when participants performed antisaccade and prosaccade tasks prior to and after an intervention mode. The results showed that a 30-min single-bout of HIIE and MICE interventions shortened the RTs in the antisaccade task, with the null effect on the CV of the RT in the late middle-aged and older adults. In terms of oculomotor metrics, although the two exercise modes could not modify the performance in terms of saccade amplitudes and saccade latencies, the participants' saccadic peak velocities while performing the oculomotor paradigm were significantly altered only following an acute HIIE intervention. The present findings suggested that a 30-min single-bout of HIIE and MICE interventions modulated post-exercise antisaccade control on behavioral performance (e.g., RTs). Nevertheless, the HIIE relative MICE mode appears to be a more effective aerobic exercise in terms of oculomotor control (e.g., saccadic peak velocities) in late middle-aged and older adults.

Acute effects of high-intensity interval training and moderate-intensity continuous exercise on BDNF and irisin levels and neurocognitive performance in late middle-aged and older adults.

The purposes of the present study were (1) to explore and compare the acute effects of high-intensity interval training (HIIT) and moderate-intensity continuous exercise (MICE) on neurocognitive performance and molecular biomarkers in late middle-aged and older adults, and (2) to examine the relationships of HIIT/MICE exercise-induced neurocognitive changes with changes in circulating irisin and BDNF levels elicited by different acute exercise modes. Using a within-subject design, twenty-one participants completed an acute bout of 30 min of HIIT, MICE, or a non-exercise-intervention (REST) session in a counterbalanced order. The neuropsychological [i.e., accuracy rate (AR) and reaction time (RT)] and neurophysiological [i.e., event-related potential (ERP) P3 latency and amplitude] indices were simultaneously measured when the participants performed a working memory task at baseline and after an intervention mode. Blood samples were also taken before and after the intervention mode. The results showed that, although ARs were significantly increased only via the MICE intervention mode, the acute HIIT and MICE interventions improved RT performance and increased ERP P3 amplitudes in the late middle-aged and older adults under consideration. Serum BDNF levels were significantly increased with the acute HIIT and MICE interventions, and significant irisin level increases were only observed following the HIIT intervention. However, changes in the levels of Irisin and BDNF pre- and post-intervention were not correlated with changes in neurocognitive performance, with the exception of the correlation between the changes in irisin levels and RTs with acute exercise in the MICE intervention mode. The present findings suggested similar beneficial effects on neurocognitive performance (i.e., RTs and ERP P3 amplitudes) and peripheral BDNF levels following MICE and HIIT interventions in the middle-aged and older adults. In terms of ARs and irisin, the two acute exercise modes appear to induce divergent effects. Irisin may play a potential facilitating role in the neuropsychological (e.g., RT) performance of working memory in such a group. However, the mechanisms remain to be determined.

Psychological and Physiological Responses in Patients with Generalized Anxiety Disorder: The Use of Acute Exercise and Virtual Reality Environment.

Virtual exercise therapy is considered a useful method by which to encourage patients with generalized anxiety disorder (GAD) to engage in aerobic exercise in order to reduce stress. This study was intended to explore the psychological and physiological responses of patients with GAD after cycling in a virtual environment containing natural images. Seventy-seven participants with GAD were recruited in the present study and randomly assigned to a virtual nature (VN) or a virtual abstract painting (VAP) group. Their electroencephalogram alpha activity, perceived stress, and levels of restorative quality and satisfaction were assessed at baseline and after an acute bout of 20 min of moderate-intensity aerobic exercise. The results showed that both the VN and VAP groups showed significantly higher alpha activity post-exercise as compared to pre-exercise. The VN group relative to the VAP group exhibited higher levels of stress-relief, restorative quality, and personal satisfaction. These findings imply that a virtual exercise environment is an effective way to induce a relaxing effect in patients with GAD. However, they exhibited more positive psychological responses when exercising in such an environment with natural landscapes.

The Effect of Cycling Through a Projection-Based Virtual Environment System on Generalized Anxiety Disorder.

Virtual reality (VR) has the potential to help clinical medicine manage generalized anxiety disorder (GAD). However, patients with GAD who use traditional head-mounted VR to cycle may cause them to feel motion sickness and fatigue. To solve this problem, a projection-based virtual environment (VE) system was built to provide GAD patients with a sense of immersion while they are cycling. This projection-based VE system allows patients with GAD to interact with the virtual environment and produce experiences similar to cycling in the outdoors. Sixty GAD patients met several screening criteria and were selected as participants. All participants were randomly assigned to one of the two 20-min conditions: (1) Observing watercolor paintings projected by the projector while engaged in cycling with a stationary bicycle; or (2) observing the scenes (i.e., forest or park) projected by the VE system and engaging in cycling with a stationary bicycle. Finally, this study confirmed that patients with GAD in the projection-based VE group exhibited higher alpha values and lower galvanic skin responses (GSR) after cycling than those cycling in the control group. These results showed that cycling in the projection-based VE group allowed the patient with GAD to achieve higher exercise intensity and lower perceived emotional stress.