Measured and Perceived Exercise Intensity During the Performance of Single-Task, Cognitive-Motor Dual-Task, and Exergame Training: Transversal Study.

BACKGROUND: The physical and cognitive loads borne during exergaming may differ from more conventional cognitive-motor dual-task trainings. OBJECTIVE: The aim of this pilot transversal study was to compare objectively measured and perceived exercise intensity during exergame, cognitive-motor dual-task, and single-task training sessions. METHODS: We recruited apparently healthy young adults who carried out one session of each type of training: exergaming, cognitive-motor dual-tasking, and single-tasking. We used a custom-made exergame as support. The sessions lasted 30 minutes, were spaced at least 24 hours apart, and took place in random order for each group of 4 participants. We used heart rates to assess exercise intensity and the modified Borg scale to assess perception of intensity. In all, 16 apparently healthy young participants carried out all sessions. RESULTS: There was no difference between the different types of training in mean heart rates (P=.27), peak heart rates (P=.50), or Borg scale scores (P=.40). Our custom-made exergame's objectively measured and perceived physical load did not differ between cognitive-motor dual-task and single-task training. CONCLUSIONS: As a result, our exergame can be considered to be as challenging as more traditional physical training. Future studies should be conducted in older adults with or without cognitive impairments and incorporate an assessment of cognitive performance.

Feasibility and potential cognitive impact of a cognitive-motor dual-task training program using a custom exergame in older adults: A pilot study.

Introduction: Dual-task training may be relevant and efficient in the context of active aging. An issue in training programs lies in enhancing the adherence of participants. This can potentially be improved using games as support. We designed and developed a custom interactive exergame in this way. The objective of this pilot study was to explore the potential use of this exergame and the feasibility of our intervention, including the level of safety and adherence. The result's trends on cognitive and motor capacities, as well as on the level of motivation for physical activity, fear of falling, and quality of life of participants, were also explored. Methods: Older adults aged 65 years or older were recruited and realized 30 min of supervised training in groups of 4, 2-3 times a week for 12 weeks. Exercises consisted of incorporated cognitive and motor dual tasks, with an increased difficulty over the weeks. Our program's safety, engagement, attendance, and completion levels were evaluated. Participants' postural control in single-task and dual-task conditions, as well as their performances in mental inhibition, flexibility, working memory, mobility, and postural control, and their levels of motivation for physical activity, fear of falling, and quality of life were also assessed. We realized a per protocol statistical analysis with a p-value set at 0.05. Results: Thirty-nine participants (aged 84.6 ± 8.5 years) were recruited. No adverse events, and 89% adherence, 88% attendance, and 87% completion rates were observed. A potentially significant effect of our exergame on working memory in single-task conditions and on the cognitive aspect of dual-task conditions was also observed. We observed no differences in other parameters. Discussion: Our exergame seemed feasible and safe and was enjoyed by participants, mainly due to the gamification of our training program. Moreover, our exergame may be efficient for cognitive training in older adults, as well as for the maintenance of motor functions, motivation for physical activity, fear of falling, and quality of life levels. This constitutes the first step for our solution with interesting results that need to be further studied.

Management of post-traumatic stress disorder symptoms by yoga: an overview.

BACKGROUND: Posttraumatic stress disorder (PTSD) can occur after trauma. While PTSD management strategies include first-line pharmacotherapy and psychotherapy, mind-body therapies, such as yoga, are applied in the PTSD population. This overview aimed to summarize the effectiveness of yoga interventions on PTSD symptoms in adults in a systematic review (SR) including randomized controlled trials (RCTs). METHOD: We searched for SR with or without meta-analysis of RCTs involving adults with PTSD diagnosis or trauma history. The search was conducted until April 2022, through six databases (Cochrane Database, MEDLINE (Pubmed), Scopus, Embase, CINHAL and PEDro). The primary outcome was the evolution of PTSD symptoms throughout the intervention. Secondary outcomes included follow-up, safety, adherence, and cost of the intervention. Two authors independently performed the selection, data extraction and risk of bias assessment with the AMSTAR 2 tool and overlap calculation. This overview is a qualitative summary of the results obtained in the selected studies. RESULTS: Eleven SRs were analyzed, of which 8 included meta-analyses. The overlap between studies was considered very high (corrected covered area of 21%). Fifty-nine RCTs involving 4434 participants were included. Yoga had a significant small-to-moderate effect-size on PTSD symptom decrease in 7 SRs and non-significant effects in 1 SR with meta-analysis. All SR without meta-analysis found beneficial effects of yoga on PTSD. Secondary outcomes were not sufficiently assessed to provide clear evidence. Results should be interpreted with caution as 1 SR was rated as at moderate risk of bias, 3 as low and 7 as critically low. CONCLUSIONS: While yoga therapy seems promising for decreasing PTSD symptoms, future research should standardize yoga therapy duration/frequency/type and consider long-term efficacy to better delineate yoga therapy efficacy in PTSD patients.

Effects on gait and balance of home-based active video game interventions in persons with multiple sclerosis: A systematic review.

BACKGROUND: The current coronavirus disease (COVID-19) pandemic makes it difficult to obtain physical therapy in rehabilitation centres, particularly for persons with multiple sclerosis (pwMS), who are a population at high risk, since viral infections may contribute to MS exacerbations and relapses. Active video games could be a way to maintain physical therapy at home as part of the rehabilitation. The aim of this review is to summarise the current best evidence for the effectiveness of home-based active video games on gait and balance, user compliance, feasibility and safety for pwMS. METHODS: We searched for studies in five databases (PubMed, Scopus, Cochrane, CINAHL and Science direct) up to October 2020. Selection of studies, extraction of data and methodological quality assessment through the PEDro scale were made independently by two authors and discussed with a third author. RESULTS: Nine studies were included in this systematic review. We found significant improvements in balance; results were mixed concerning mobility, physical activity and gait. Home-based active video games are feasible and safe, with good compliance and adherence. The methodological quality of the studies was moderate (PEDro scale: 5.3 ± 2). CONCLUSION: Overall, home-based active video games were found safe and effective improving static and dynamic balance in pwMS. Compliance was good, probably because it is a motivating and enjoyable training. Active video games can be a relevant alternative for physical rehabilitation at home in pwMS. Future studies should follow more rigorous methodological standards (larger sample sizes, more randomised controlled trials) to improve the quality of evidence and include cost-effectiveness in the analysis.

Age-related decline in visuo-spatial working memory is reflected by dorsolateral prefrontal activation and cognitive capabilities.

INTRODUCTION: Visuo-spatial working memory (VSWM) performances undergo a decline throughout aging and are affected by the space in which the task is performed (reaching or navigational). Cerebral oxygenation and cognitive capabilities could explain this decline. We assessed the effects of age on cerebral oxygenation of the dorsolateral prefrontal cortex (dlPFC) in VSWM tasks in reaching and navigational space. We also assessed cognitive correlates of VSWM performance in each space. METHOD: Thirty-one (31) young adults (YA) and 24 healthy older adults (OA) performed a battery of neuropsychological tests and the electronic Corsi Block-tapping Test in reaching space (e-CBT) and in navigational space on the "Virtual Carpet" (VWCT). Participants were asked to memorize and recall a sequential pathway, progressively increasing from 2 to 9 blocks. Their span score reflected VSWM performance. The dlPFC oxygenation (oxyhaemoglobin: ΔO2Hb and deoxyhaemoglobin: ΔHHb) was measured by using functional Near-Infrared Spectroscopy (fNIRS) during the encoding of the sequential pathway in both tasks. RESULTS: YA had higher span scores than OA in both spaces. We identified a significantly stronger decrease of ΔHHb in YA compared to OA during encoding in VWCT. OA also exhibited significantly lower cerebral oxygenation in VWCT compared to e-CBT. A decrease of ΔHHb was also associated with a better performance in VWCT. Finally, we identified the association of mental rotation and executive functions with VSWM performance in both tasks. CONCLUSION: VSWM performance and cerebral oxygenation during encoding are impacted by aging. Space in which the task was performed was found to be associated with different cognitive functions and revealed differences in cerebral oxygenation.

Cognitive and physical impact of cognitive-motor dual-task training in cognitively impaired older adults: An overview.

Ageing is associated with cognitive decline, ranging from normal to mild cognitive impairment or dementia. This leads to physical and cognitive impairments, which are risk factors for loss of autonomy. Therefore, cognitive and physical training are important for cognitively impaired older adults. The combination of both may represent an efficiency advantage. This overview aims to summarize the effectiveness of cognitive-motor dual-task (CMDT) interventions on cognitive, physical and dual-task functions in cognitively impaired older adults, as well as the safety, adherence, and retention of benefits of these interventions. We searched for systematic reviews or meta-analyses assessing the effects of CMDT interventions on cognitive or physical functions in older adults with mild cognitive impairment or dementia through eight databases (CDSR (Cochrane), MEDLINE, Scopus, EMBASE, CINAHL, PsycINFO, ProQuest and SportDiscus). Two reviewers independently performed the selection, data extraction and risk of bias evaluation. Nine reviews were included in this overview. CMDT interventions were found to be more effective than active control groups on cognitive and physical functions in older adults with cognitive impairment, irrespective of intervention dose and modalities; no information on dual-task functions was available. Retention of benefits, adherence, need for supervision and safety are still unclear. These results should be interpreted with caution, considering the low average methodological quality of included reviews. Future intervention research should follow more rigorous methodological standards and focus on other forms of CMDT.