Cognitive-motor Training Research Articles

Cognitive and emotional disorders in neurosurgical patients and their impact on postoperative rehabilitation

To evaluate the severity of emotional and cognitive disorders, as well as the effectiveness of cognitive-motor training in patients who have undergone spinal cord surgery. Sixty patients (30 men and 30 women), who were scheduled and subsequently underwent spinal cord surgery, were studied. The patients underwent clinical, somatic and neurological status examinations and quantitative neuropsychological testing. The study was conducted before surgery, a week later, 3 months and 6 months after surgery. The patients were randomly assigned to the main and control groups of 30/30 people by the method of random numbers. The patients did not significantly differ in gender, age and level of education. Patients of the main group, in addition to drug therapy, received cognitive training, which was conducted using the methodological manual «Cognitive training for patients with moderate cognitive disorders» developed by the staff of the Department of Nervous Diseases and Neurosurgery of the A.Ya. Kozhevnikov Clinic of the I.M. Sechenov First Moscow State Medical University on the basis of the I.M. Sechenov First Moscow State Medical University (Sechenov University). Cognitive and emotional disorders have an impact on the quality of rehabilitation of patients after spinal neurosurgery. Cognitive-motor training included in the rehabilitation program of patients has a positive effect on the cognitive functions of patients and the level of anxiety. Evaluation of the results of postoperative rehabilitation show that the patients of the main group have significantly higher quality of life. Cognitive and emotional-affective disorders in patients after spinal neurosurgery have a negative impact on the quality of life. The inclusion of cognitive-motor training in the rehabilitation program makes it possible to reduce the severity of cognitive and emotional disorders in the postoperative period and improves the quality of life of patients. The results allow us to recommend the inclusion of cognitive-motor training in the rehabilitation program of patients after spinal neurosurgical operations.

Innovative technologies and multimodal correction in medical rehabilitation of motor and neuropsychological disturbances due to stroke

The article presents an overview of innovative technologies based on the methods of sensorimotor retraining of the patient using various types of biofeedback (BFB) as the most promising in the medical rehabilitation (MR) of patients with cerebral stroke (CS). The works of a high level of evidence (RCTs, national and international clinical guidelines, meta-analyses, systematic reviews) of the Medline, Pubmed, PubMed Cochrane Library databases are analyzed, ClinicalTrials.gov. It is emphasized that training with multisensory effects on visual, auditory, vestibular and kinesthetic analyzers have a beneficial effect on cognitive-motor training and retraining, neuropsychological status of the patient and increase the level of motivation to achieve success in the rehabilitation process. The synergy of multimodal effects of digital technologies, BFB, virtual reality, and the brain-computer interface will expand the capabilities and improve the efficiency of MR of after stroke-patients.

Effects of a Cognitive-Motor Training on Anticipatory Brain Functions and Sport Performance in Semi-Elite Basketball Players.

The aim of this research was to test the possible effects of cognitive–motor training (CMT) on athletes’ sport performance and cognitive functions. Namely, specific athletic tests, brain processes associated with anticipatory event-related potential (ERP) components and behavioral performance during a cognitive discrimination response task were evaluated pre- and post-training. Twenty-four young semi-professional basketball players were recruited for the study and randomly divided into an experimental (Exp) group executing the CMT training and a control (Con) group performing standard motor training. The CMT training protocol included exercises in which participants performed cognitive tasks during dribbling exercises using interactive devices which emitted visual and auditory stimuli, in which athletes’ responses were recorded. Results showed that following training, only the Exp group improved in all sport-specific tests (17%) and more than the Con group (88% vs. 60%) in response accuracy during the cognitive test. At brain level, post-training anticipatory cognitive processes associated with proactive inhibition and top-down attention in the prefrontal cortex were earlier and heightened in the Exp group. Our findings confirm previous studies on clear improved efficacy of CMT training protocols on sport performance and cognition compared to training based on motor exercises only, but extend the literature in showing that these effects might be explained by enhanced anticipatory brain processing in the prefrontal cortex. The present study also suggests that in order to achieve specific athletic goals, the brain adapts cognitive functions by means of neuroplasticity processes.

The Motor-cognitive Training on Cognition and Physical Performance in the Older Adults with Mild Cognition Impairment : A Literature Review

The Motor-cognitive Training on Cognition and Physical Performance in the Older Adults with Mild Cognition Impairment : A Literature Review

Cognitive, emotional and motor disorders and their impact on the postoperative rehabilitation of neurosurgical patients

Pathological post-anesthetic changes can be determined by the type and duration of anesthesia, the somatic and neurological status of the patient in the preoperative period, age, etc.Objective: to assess the severity of cognitive (CI), emotional and motor impairments in patients who underwent spinal surgery.Patients and methods. The clinical study included 60 patients aged 30-74 years who underwent spinal surgery under general anesthesia. The neuropsychological, emotional, somatic, and neurological status were assessed at the baseline and one week, 3, and 6 months after the surgery. Thirty patients underwent a course of cognitive training (main group), and 30 patients were included in a comparison group.Results and discussion. In the postoperative period, pain indicators decreased in both groups. There was an improvement in cognitive functions, emotional state, and quality of life (QoL) in the main group 3 and 6 months after surgery. The inclusion of cognitive training in the rehabilitation program for patients undergoing neurosurgical spinal surgery improved cognitive and motor functions and the QoL of patients. Evaluation and treatment of neurosurgical patients are discussed, which are helpful to improve the results of rehabilitation and QoL in the postoperative period.Conclusion. Additional positive impact of cognitive-motor training for pain regression in patients after spinal surgery was observed.

Feasibility of Cognitive-Motor Exergames in Geriatric Inpatient Rehabilitation: A Pilot Randomized Controlled Study.

Objective: The aim of this pilot randomized clinical trial was to test the feasibility and efficacy of an exergame-based cognitive-motor training program in geriatric inpatients.Methods: The study participants were randomly allocated to either the exergame intervention group or the control group. The control group received the standard rehabilitation treatment offered in the clinic. In addition to the standard rehabilitation program, the intervention group conducted supervised exergame training on 5 days per week using the Dividat Senso, an exergame system specifically designed for older adults. The primary outcome was feasibility, as measured by e.g., adherence rate, attrition rate, occurrence of adverse events, System Usability Scale (SUS) and NASA-TLX score. Secondary outcomes included measures of physical and cognitive functioning such as comfortable walking speed, maximal walking speed, dual task walking speed, Short Physical Performance Battery (SPPB), Timed Up and Go test (TUG), Color-Word Interference test (D-KEFS), Trail Making test A and B (TMT), Go/No-Go test and Step Reaction Time test (SRTT). All secondary outcome measures were assessed pre- and post-intervention.Results: Thirty-nine persons were included in the study. Average adherence rate was 99%, there were no intervention-related dropouts and no adverse events. The mean System Usability Scale (SUS) score was 83.6 and the mean NASA-TLX score 45.5. Significant time-group interaction effects were found for the dual task walking speed, the Go/No-Go test and Step Reaction Time test (SRTT).Conclusion: Exergaming is a feasible, safe and effective cognitive-motor training approach in inpatient rehabilitation of geriatric patients. Incorporating exergaming in the rehabilitation program of geriatric patients offers potential to reduce fall risk factors and to increase patients’ exercise motivation and rehabilitation success.

Requirements of a\xa0cognitive-motor spatial orientation training for nursing home residents: an\xa0iterative feasibility study

A sedentary lifestyle in nursing home residents is often accompanied with reduced life space mobility and in turn affects satisfaction with life. One of the reasons for this may be limited ability to find one’s way around the care facility and its environment. However, spatial orientation exercises might reduce these problems if they are integrated into an adequate cognitive-motor training. Therefore, we integrated six novel and target group-specific spatial orientation exercises into an established multicomponent cognitive-motor group training for nursing home residents and evaluated its feasibility. Forty nursing home residents (mean age: 87.3 ± 7 years) participated in the spatial orientation cognitive motor training (45–60 min, twice a week over a period of 12 weeks). The main outcomes included the feasibility criteria (adherence, completion time, acceptance, instructions, motor performance, materials/set up, complexity) and first measurements of mobility and satisfaction with life (SPPB [Short Physical Performance Battery], SWLS [Satisfaction with Life Scale]). Adherence increased over time. The increase was associated with the adaptions and modifications of the spatial orientation exercises that were made to meet the participants’ requirements. A positive trend was discerned for mobility and life satisfaction, comparing pre- and posttraining data. In summary, the feasibility analysis revealed that future interventions should consider that (a) instructions of demanding spatial tasks should be accompanied by an example task, (b) trainers should be encouraged to adjust task complexity and materials on an individual basis, (c) acceptance of the training should be promoted among nursing staff, and (d) surroundings with as little disturbance as possible should be selected for training.

Feasibility and Effects of Virtual Reality Motor-Cognitive Training in Community-Dwelling Older People With Cognitive Frailty: Pilot Randomized Controlled Trial.

BackgroundCognitive frailty refers to the coexistence of physical frailty and cognitive impairment, and is associated with many adverse health outcomes. Although cognitive frailty is prevalent in older people, motor-cognitive training is effective at enhancing cognitive and physical function. We proposed a virtual reality (VR) simultaneous motor-cognitive training program, which allowed older people to perform daily activities in a virtual space mimicking real environments.ObjectiveWe aimed to (1) explore the feasibility of offering VR simultaneous motor-cognitive training to older people with cognitive frailty and (2) compare its effects with an existing motor-cognitive training program in the community on the cognitive function and physical function of older people with cognitive frailty.MethodsA two-arm (1:1), assessor-blinded, parallel design, randomized controlled trial was employed. The eligibility criteria for participants were: (1) aged ≥60 years, (2) community dwelling, and (3) with cognitive frailty. Those in the intervention group received cognitive training (ie, cognitive games) and motor training (ie, cycling on an ergometer) simultaneously on a VR platform, mimicking the daily living activities of older people. Those in the control group received cognitive training (ie, cognitive games) on tablet computers and motor training (ie, cycling on the ergometer) sequentially on a non-VR platform. Both groups received a 30-minute session twice a week for 8 weeks. Feasibility was measured by adherence, adverse outcomes, and successful learning. The outcomes were cognitive function, physical frailty level, and walking speed.ResultsSeventeen participants were recruited and randomized to either the control group (n=8) or intervention group (n=9). At baseline, the median age was 74.0 years (IQR 9.5) and the median Montreal Cognitive Assessment score was 20.0 (IQR 4.0). No significant between-group differences were found in baseline characteristics except in the number of chronic illnesses (P=.04). At postintervention, the intervention group (Z=–2.67, P=.01) showed a significantly larger improvement in cognitive function than the control group (Z=–1.19, P=.24). The reduction in physical frailty in the intervention group (Z=–1.73, P=.08) was similar to that in the control group (Z=–1.89, P=.06). Improvement in walking speed based on the Timed Up-and-Go test was moderate in the intervention group (Z=–0.16, P=.11) and greater in the control group (Z=–2.52, P=.01). The recruitment rate was acceptable (17/33, 52%). Both groups had a 100% attendance rate. The intervention group had a higher completion rate than the control group. Training was terminated for one participant (1/9, 11%) due to minimal VR sickness (Virtual Reality Sickness Questionnaire score=18.3/100). Two participants (2/8, 25%) in the control group withdrew due to moderate leg pain. No injuries were observed in either group.ConclusionsThis study provides preliminary evidence that the VR simultaneous motor-cognitive training is effective at enhancing the cognitive function of older people with cognitive frailty. The effect size on frailty was close to reaching a level of significance and was similar to that observed in the control group. VR training is feasible and safe for older people with cognitive frailty.Trial RegistrationClinicalTrials.gov NCT04467216; https://clinicaltrials.gov/ct2/show/NCT04467216

The effectiveness of cognitive-motor training on reconstructing cognitive health components in older male adults, recovered from the COVID-19.

ObjectiveThe incidence of COVID-19 disease in the elderly can accelerate normal degenerative process of cognitive functions. Interactive cognitive-motor training (CMT) is an intervention that integrates cognitive and motor tasks to promote individuals’ physical and psychological health. The present study aimed to examine the effect of CMT on reconstructing cognitive health components in older men, who have recently recovered from COVID-19.Materials and methodsThis study is a quasi-experimental repeated measure (without control group). Participants were 42 elderly men (65–80 years) who recovered from the COVID-19 disease that individually participated in a 4-week CMT program twice a week. The cognitive health components of the participants were assessed by the General Health Questionnaire (GHQ-2) and the Mini-Mental State Examination (MMSE) at 3 stages before the beginning of the intervention (baseline assessment); 2 weeks after the intervention (short-term follow-up); and 3 months after the intervention (long-term follow-up).ResultsThe results showed that the scores of depression, anxiety, physical symptoms, and social performance components and the overall GHQ score improved significantly in short-term follow-up (P < 0.05) and also in long-term follow-up compared to baseline assessment (P < 0.05). It was also found that attention and calculation, recall, lingual skill, and action performance components and the overall score of MMSE were also improved at three stages of assessments. Other components did not differ among stages.ConclusionsThis study adds to the research on the effectiveness of using CMT for reconstructing cognitive health components in older adults, recovered from the COVID-19, and supports CMT as a viable intervention practice.

A novel virtual reality approach for functional lateralization in healthy adults

Functional lateralization relates to a natural asymmetry in the dominance right or left body side, and is a fundamental principle of the brain. The hemispheres of the brain control the contralateral body side, and show subtle, yet striking, anatomical asymmetries and functional lateralization. Innovative technologies, including Virtual Reality (VR), are entering the areas of experimental research, modeling and simulation related to the study of lateralization, with new perspectives of different applications in modern medical practice. Researchers/clinicians note that there are fewer VR studies with healthy participants, and which are important in evaluating/interpreting clinical outcomes, and testing the usefulness, limitations, and sensitivity of VR. The presented influence of the domination of upper/lower limbs on the performance of VR exercises was studied in healthy right-handed adults. Virtual testing sessions were performed independently with both/ dominant/ non-dominant hands, and the similar VR sessions were conduced on a Wii Balance Board (WBB) with the choice of body side, at different levels of the difficulty. The obtained results are consistent with other studies which show that cognitive-motor training in VR with the WBB platform is a very sensitive and promising tool for recognizing/assessing functional asymmetries of the right-left body side not only in disturbed lateralization, but also in the test training of healthy subjects.

Can Exergames Be Improved to Better Enhance Behavioral Adaptability in Older Adults? An Ecological Dynamics Perspective.

Finding effective training solutions to attenuate the alterations of behavior and cognition in the growing number of older adults is an important challenge for Science and Society. By offering 3D computer-simulated environments to combine perceptual-motor and cognitive exercise, exergames are promising in this respect. However, a careful analysis of meta-analytic reviews suggests that they failed to be more effective than conventional motor-cognitive training. We analyzed the reasons for this situation, and we proposed new directions to design new, conceptually grounded, exergames. Consistent with the evolutionary neuroscience approach, we contend that new solutions should better combine high level of metabolic activity with (neuro)muscular, physical, perceptual-motor, and cognitive stimulations. According to the Ecological Dynamics rationale, we assume that new exergames should act at the agent–environment scale to allow individuals to explore, discover, and adapt to immersive and informationally rich environments that should include cognitively challenging tasks, while being representative of daily living situations.

Cognitive-Postural Multitasking Training in Older Adults - Effects of Input-Output Modality Mappings on Cognitive Performance and Postural Control.

Older adults exhibit impaired cognitive and balance performance, particularly under multi-task conditions, which can be improved through training. Compatibility of modality mappings in cognitive tasks (i.e., match between stimulus modality and anticipated sensory effects of motor responses), modulates physical and cognitive dual-task costs. However, the effects of modality specific training programs have not been evaluated yet. Here, we tested the effects of cognitive-postural multi-tasking training on the ability to coordinate task mappings under high postural demands in healthy older adults. Twenty-one adults aged 65–85 years were assigned to one of two groups. While group 1 performed cognitive-postural triple-task training with compatible modality mappings (i.e., visual-manual and auditory-vocal dual n-back tasks), group 2 performed the same tasks with incompatible modality mappings (i.e., visual-vocal and auditory-manual n-back tasks). Throughout the 6-weeks balance training intervention, working-memory load was gradually increased while base-of-support was reduced. Before training (T0), after a 6-week passive control period (T1), and immediately after the intervention (T2), participants performed spatial dual one-back tasks in semi-tandem stance position. Our results indicate improved working-memory performance and reduced dual-task costs for both groups after the passive control period, but no training-specific performance gains. Furthermore, balance performance did not improve in response to training. Notably, the cohort demonstrated meaningful interindividual variability in training responses. Our findings raise questions about practice effects and age-related heterogeneity of training responses following cognitive-motor training. Following multi-modal balance training, neither compatible nor incompatible modality mappings had an impact on the observed outcomes.

Rehabilitation of elderly patients at risk of falling: the value of psychophysiological parameters and cognitive-motor training using virtual reality

Due to the slowing of the neurodynamic and cognitive processes, as well as changes in the musculoskeletal system that accompany aging, attention, reaction, and movement coordination are impaired in elderly patients. Decreased overall brain adaptability leads to an increased risk of falls and disability, thus reducing the age of active aging. According to the World Health Organization, 37.3 million falls occur annually that are not fatal but have serious consequences requiring medical attention. These falls are most common among people over the age of 65 years. An objective assessment of psychophysiological characteristics identified a correlation between the duration of simple and complex reactions and the risk of falls and served as a tool for evaluating the effectiveness of balance retraining. Studies have shown that cognitive-motor training improves postural stability and functional performance in daily life. This type of training is widely used to rehabilitate patients with balance disorders, and virtual reality systems are increasingly being used in its implementation. There is a theory that the virtual environment can improve responses to rapid environmental changes, as well as modulate various characteristics of attention, spatiotemporal memory, and planning, which favorably affects postural function. This review describes the changes in psychophysiological parameters in the elderly, as well as balance retraining techniques using cognitive-motor training, including the use of virtual reality technology.

The effect of virtual reality based cognitive-motor training on psychophysiological parameters and balance function in the elderl

Background: Balance dysfunction is one of the most common problems in older people. Nevertheless, there is no objective tool for assessing psychophysiological indicators of adaptation of functional systems of the brain, and the effect of training in a virtual environment on neurodynamic processes has not been sufficiently studied. Aims: To study the status and dynamics of psychophysiological indicators and their relationship with the balance function after cognitive-motor training in a virtual environment in patients with CCI. Materials and methods: The study involved 24 people. The experimental group included 14 patients with a confirmed diagnosis of chronic cerebral ischemia. A group of 10 healthy volunteers were tested on the UPFT-1/30 "Psychophysiologist" system. Patients included in the experimental group were tested using clinical scales (the Berg balance assessment scale and the MOCA scale) and instrumental assessment on UPFT-1/30 "Psychophysiologist". All patients underwent cognitive-motor training on the Rehabunculus virtual reality system (Russia), aimed at restoring the balance function. Results: After the course of cognitive-motor training in a virtual environment, the patients showed a significant (p = 0.01) improvement in the balance functions, assessed by the Berg Balance Scale, as well as a decrease in the number of errors and an improvement in the stability of visual-motor reaction test. In addition, a negative correlation was found between the median response time and the balance function on the Berg scale (r = -0.715). Conclusions: The speed of reaction to a visual stimulus can serve as markers of the adaptation processes of the nervous system to cognitive-motor training in virtual environment, which, in turn, have a positive effect on balance function.

Combining Stochastic Resonance Vibration With Exergaming for Motor-Cognitive Training in Long-Term Care; A Sham-Control Randomized Controlled Pilot Trial.

Purpose: Physical and mental functions allow classifying older adults as “Go-Go” (independent functioning); “Slow-Go” (in need of care with a slight handicap); and “No-Go” (in need of care with severe functional limitation). The latter group exhibits reduced exercise tolerance. More recently technology-based motor-cognitive types of training services emerged as a possible training service. This study examined the use of technology including stochastic resonance whole-body vibration and Exergame-dance training for motor-cognitive training in care home dwelling adults.Methods: Seventeen older adults (10 women, 7 men, age range: 79–98) were randomly assigned to the intervention (IG, n = 9) or the sham group (SG, n = 8). IG performed five sets of 1-min whole-body vibration with 1-min rest in between, three times a week for the first 4 weeks of the training period with varying frequency. From weeks five to eight the Exergame-dance training was conducted after the vibration sessions. SG performed a stochastic resonance whole-body vibration training with the same terms applied, however, with a fixed frequency of 1 Hz, Noise 1. From weeks five to eight a passive trampoline-programme of 5 min was applied following the vibration sessions. Primary outcome was the Short Physical Performance Battery (SPPB). Secondary outcomes were the Trail Making Test A and B (TMT A & B) and the Falls Efficacy Scale–International (FES-I). Outcomes were measured at baseline, after 4 and 8 weeks of intervention and at follow-up (4 weeks after the intervention). The non-parametric Puri and Sen rank-order test was applied, followed by an ANOVA for repeated measures to analyse main and interaction effects. Mann–Whitney U-Test was used to determine differences between the groups.Results: The post-hoc analysis showed significant effects on the SPPB total score with large effect sizes from baseline to 8 weeks (+72%, p = 0.005, η2 = 0.423). The TMT part B displayed significant improvements with large effect sizes from baseline to 8 weeks (+17.5%, p = 0.002, η2 = 0.779) and to follow-up (+21%, p = 0.001, η2 = 0.827).Conclusion: The technology based 8-week training programme consisting of a combination of stochastic resonance whole-body vibration and Exergame-dance training showed beneficial effects on both physical and cognitive performance in older care home dwelling adults.

A three-armed cognitive-motor exercise intervention to increase spatial orientation and life-space mobility in nursing home residents: study protocol of a randomized controlled trial in the PROfit project

BackgroundIn nursing home residents, the combination of decreasing mobility and declining cognitive abilities, including spatial orientation, often leads to reduced physical activity (PA) and life-space (LS) mobility. As a consequence of sedentary behavior, there is a lack of social interaction and cognitive stimulation, resulting in low quality of life. It has not yet been examined whether cognitive-motor training including spatial cognitive tasks is suitable to improve spatial orientation and, as a consequence, to enlarge LS mobility, and increase well-being and general cognitive-motor functioning. Therefore, the overall goal of this multicentric randomized controlled trial (RCT) is to compare the effect of three different intervention approaches including functional exercise and orientation tasks on PA, LS and spatial orientation in nursing home residents.MethodsA three-arm single-blinded multicenter RCT with a wait-list control group will be conducted in a sample of 513 individuals (needed according to power analysis) in three different regions in Germany. In each nursing home, one of three different intervention approaches will be delivered to participating residents for 12 weeks, twice a week for 45 min each: The PROfit basic group will perform functional strength, balance, flexibility, and walking exercises always at the same location, whereas the PROfit plus group changes the location three times while performing similar/the same exercises as the PROfit basic group. The PROfit orientation group receives navigation tasks in addition to the relocation during the intervention. Physical and cognitive functioning as well as psychological measures will be assessed in all study groups at baseline. Participants will then be randomized into either the intervention group or the wait-list control group. After 12 weeks, and after 24 weeks the measures will be repeated.DiscussionThis study evaluates whether the three different interventions are feasible to reduce the decline of or even improve PA, LS, and spatial orientation in nursing home residents. By adding different training locations in PROfit plus, the program is expected to be superior to PROfit basic in increasing physical and cognitive parameters. Moreover, we expect the PROfit orientation intervention to be most effective in terms of PA, LS, and spatial orientation due to two mechanisms: (1) increased physical and cognitive activity will enhance cognitive-motor capacity and (2) the spatial training will help to build up cognitive strategies to compensate for age-related loss of spatial orientation abilities and related limitations.Trial registrationThe trial was prospectively registered at DRKS.de with registration number DRKS00021423 on April 16, 2020 and was granted permission by the Technical University Berlin local ethics committee (No. GR_14_20191217).

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

Study DesignA randomized, single-blinded controlled trial. IntroductionTherapy 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 StudyThe 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. MethodsThirty-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). ResultsThe 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. ConclusionThe 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.

Post-stroke cognitive impairments and responsiveness to motor rehabilitation: A review.

a)This review discusses the prevalence of cognitive deficits following stroke and their impact on responsiveness to therapeutic intervention within a motor learning context. b)Clinical and experimental studies have established that post-stroke cognitive and motor deficits may impede ambulation, augment fall risk, and influence the efficacy of interventions. Recent research suggests the presence of cognitive deficits may play a larger role in motor recovery than previously understood. c)Considering that cognitive impairments affect motor relearning, post-stroke motor rehabilitation therapies may benefit from formal neuropsychological testing. For example, early work suggests that in neurotypical adults, cognitive function may be predictive of responsiveness to motor rehabilitation and cognitive training may improve mobility. This sets the stage for investigations probing these topics in people post-stroke. Moreover, the neural basis for and extent to which these cognitive impairments influence functional outcome remains largely unexplored and require additional investigation.

Effect of a training program of overground walking on BTS gait parameters in elderly women during single and dual cognitive tasks.

We tested the hypothesis that a regular training program might reduce gait disturbances during dual cognitive-motor tasks in elderly women. This open-label experimental study comprised 53 postmenopausal women aged over 65, who were assigned to a 10-week training program (360 min/week). A BTS SMART system examination during free walking and during dual tasks [i.e., walking while performing either a simple (SCT) or a complex (CCT) cognitive task] was performed prior to the training program and again after it had finished. After the 10-week walking training program, a significant decrease was found in the duration of single support phase, double support phase, total support phase, and gait cycle, whereas values for such BTS parameters as swing speed, step length, and gait speed increased significantly. The greatest percentage deltas between the final and initial values of the respective BTS parameters concerned swing speed and gait speed irrespective of the kind of task undertaken while measurements were taken. A cognitive task, irrespective of the level of difficulty, performed during walking had the opposite effect on step width than expected. A 10-week training program significantly improved the cadency and manner of gait in elderly women, but did not change step width. Therefore, further study is needed to estimate the usefulness of cognitive-motor training programs for significant improvement in gait coordination during dual tasks in elderly women.

Reviewing the Evidence: In Pursuit of a Framework for Parkinson Disease Rehabilitation with Games.

Exercise gaming has been receiving a significant interest from both consumers and researchers. Be it for the purposes of weight loss, physical fitness or even just enjoyment, the potential of games to support rehabilitation has also been under investigation for a while. Due to our aging society, game based therapies could be a solution for optimizing resources and reducing rehabilitation costs. This paper aims to discuss the potential capacity of games as systems to enhance the relation of physical exercise and cognition for the rehabilitation of Parkinson Disease. Our investigation demonstrates that there is no established methodology for games in rehabilitation of Parkinson's addressing how games can encapsulate physical exercise strategies while providing safety, continuous monitoring and cognitive development exercises in facilitation of rehabilitation. Since rehabilitation with games is trending, yet to be developed rehabilitation strategies would benefit from new insights into the relationship between game worlds, physical exercise and motor-cognitive training. Therefore, it is useful to do further research into realizing (1) a relational model that demonstrates the relation between game world (composed of game features including formal game elements, audio-visual features, mechanics and dynamics), motor skills, cognition and physical exercise for both generic and specific rehabilitation purposes, (2) a structured task creation approach for game features that reconciles specific rehabilitation outcomes, correct level of engagement, task difficulty and safety requirements for target demographic.