Dual-task Training Research Articles

Exploring barriers and educational needs in implementing dual-task training for Parkinson's disease: insights from professionals.

There is growing evidence suggesting that dual-task training benefits people with Parkinson's disease (PD) on both physical and cognitive outcomes. However, there is no known data regarding professionals' educational needs and barriers to its implementation. This study aimed to explore the barriers and educational needs of healthcare and exercise professionals to integrate dual-task training into their practice with people with PD. We conducted a study based on a web survey. Social media channels were used to recruit a convenience sample of exercise and healthcare professionals working with people with PD. Of the 185 eligible responses, the majority were physiotherapists (68.1%) followed by occupational therapists (10.8%). Most participants attended Parkinson specific training (88.6%) and employed the treatments set up in individual one on-one sessions (58.9%). We identified several barriers to dual-task training implementation, with lack of time (to prepare materials), staying creative and/ or accessing new ideas, unreliable tools for measuring gains, and insufficient expertise as the most referred by participants. The educational needs most referred included accessing examples of interventions in general, knowing what strategies to apply and their application for people with different symptoms. Our results highlight that professionals remain challenged to integrate dualtask training into PD clinical care mainly due to knowledge gaps, difficulties in accessing new ideas, and lack of time.

A Study to Assess the Effectiveness of TAI CHI Ch-Uan Exercises on Balance Control among Older People Living in Selected Old Age Homes in Bangalore, Karnataka

Background and Purpose: The treatment of balance disorders lacks a fixed method, with identification andmanagement of external factors being crucial. Many balance disorders benefit from balance training and moderatephysical activity. Exercise programs encompass strength training, balance and coordination exercises, dual tasktraining, hydrotherapy, tai chi, and yoga, all proven to enhance balance. Tai Chi Chuan, a martial art, utilizes slow,graceful moves and precise body movements to enhance body awareness and balance, combined with breathingtechniques for mind-body harmony and energy flow. Practicing Tai Chi fosters muscle strength, flexibility, aerobicconditioning, and stress reduction, contributing to overall well-being and balance improvement.Methods: The study was conducted at Omashram Trust, Bangalore, Karnataka. The research design selectedfor the study was quasi experimental pre-test post-test with experimental and control group. Non probabilitypurposive sampling technique was adopted to select the samples. The data collection tool consisted of part I andpart II.Part I – Dealt with the interview schedule for demographic data which consist of 13 items used to collect thesample characteristics such as age in years, gender, religion, educational status, past occupation, source of income,marital status, diet, on a therapeutic diet, practice of regular exercise, presence of any physical illness, aware ofinformation about Tai Chi Chuan exercise, if yes.Part II - Berg balance scale was used to assess the balance control in older people.Results of the StudyAssociation between the body balance status and demographic variablesa) Experimental GroupThe finding of this study in the experimental group showed that there was significant association between the levelof balance control and demographic variables such as age and past occupation. Hence the research hypothesis wasaccepted at 0.05 level of significance and null hypothesis was rejected.
 Control GroupThe finding of this study in the control group proved that there was significant association between the level ofbalance control and demographic variables such as age, education and presence of any physical illness. Hence theresearch hypothesis was accepted at 0.05 level of significance and null hypothesis was rejected.Discussion: The overall findings of the study clearly showed that effectiveness of tai CHI CH-UAN exerciseson balance control among older people living in selected old age homeswas more effective for the Experimentalgroup than the Control group.

A semantic-driven coupled network for infrared and visible image fusion

In order to be adapted to high-level vision tasks, several infrared and visible image fusion methods cascade with the downstream network to enhance the semantic information of fusion results. However, due to the feature-level heterogeneities between fusion and downstream tasks, these methods suffer from the loss of pixel-level information and incomplete reconstruction of semantic-level information. To further improve the performance of fusion images in high-level vision tasks, we propose a semantic-driven coupled network for infrared and visible image fusion, terms as SDCFusion. Firstly, to address feature heterogeneity, we couple the segmentation and fusion networks into a joint framework such that both networks share the multi-level cross-modality coupled features. Based on the joint optimization of dual tasks, a joint action between fusion and downstream tasks is formed to force the cross-modality coupled features modeled on both pixel domain and semantic domain. Subsequently, to guide the semantic information reconstruction, we cascade two networks to form the semantic-based driven action, which continuously optimizes the fusion image to achieve semantic representation capacity. In addition, we introduce an adaptive training strategy to reduce the complexity of dual-task training. Specifically, an mIoU-based semantic measurement weight is designed to balance the joint action and driven action throughout the training process. We evaluate our method at both pixel information and semantic information levels, respectively. The qualitative and quantitative experiments verify the superiority of SDCFusion in terms of visual effects and metrics. The object detection and semantic segmentation experiments demonstrate that SDCFusion achieves superior performance in high-level vision tasks. The source code is available at https://github.com/XiaoW-Liu/SDCFusion.

Cortical Changes of Dual Cognitive-Task Balance Training in Patients with Chronic Ankle Instability: A Randomized Trial.

Researchers have shown that patients with chronic ankle instability (CAI) have deficits in memory and attention allocation. This functional deficit affects the lower extremity performance. Motor-cognitive dual-task training may improve lower limb dysfunction caused by central nervous system injury. Whether dual-task training is more favorable than single-task training for neuromuscular control in patients with single-task training still needs to be further proven. To determine whether balance-cognitive dual-task training can influence cortical activity and has more effective treatment effects than balance single-task training. Randomized controlled clinical trial (Clinical Trials: XXX). Rehabilitation training room. After recruitment, twenty-four patients with CAI (age=22.33±2.43 years, height=175.62±7.7 cm, mass=70.63±14.59 kg) were block randomized into two groups. Protocols were performed three times per week for six weeks. The single-task group underwent one-leg static balance training with and without vision and hopping balance training. The dual-task group underwent balance and cognitive training (backward counting task). The follow variables were assessed before and after the interventions: cortical activity, proprioception, muscle onset time, and dynamic balance. We performed MANOVAs to compare changes of main effects and interactions across groups and time. A post-hoc Bonferroni test was performed for pairwise comparisons when there were significant interactions with the MANOVAs. Twenty-four participants successfully completed the six-week interventions. Proprioception, peroneus longus muscle onset time, and dynamic postural control improved significantly after the interventions in both groups (P<0.05). Dual-task training was superior to single-task training in improving JPS plantarflexion, shortening peroneus longus muscle onset time, and altering cortical activity(P<0.05). A six-week balance training program or balance combined with cognitive training could improve the functional deficits associated with CAI. Meanwhile, the dual-task training could improve cortical activity and lower extremity function.

The effect of single and dual task training on the intracortical inhibition in healthy young adults

Introduction&#x0D; The evidence for changes in intracortical inhibition when executing two tasks simultaneously (i.e., dual tasking) is ambiguous as decreased (Corp et al., 2014) and increased (Corp et al., 2016) inhibition were reported. One way to bring more light into this question is to tests the effect of a single task training (STT) and a dual task training (DTT) on the short interval intracortical inhibition (SICI) during a single balancing task and two different dual tasks in healthy young adults.&#x0D; Methods&#x0D; Twenty-nine healthy young adults were randomly separated into two groups participating in STT (n = 15) or DTT (n = 14) consisting of 6 training sessions within 3 weeks. Before and after the training, a single task (balancing on a rocker board) was performed at two resistance levels (easy and hard). Additionally to the single task, either a cognitive (2-back number recall) or a motor (balancing a ball on a hand-held tray) dual task was executed simultaneously. During execution of these three tasks, SICI was measured with transcranial magnetic stimulation over the motor cortical area representing the right tibialis anterior.&#x0D; Results&#x0D; Training improvements in balance performance were group and task-specific over time (p = .018). While the STT group improved more in the single balance task (12.3% vs. 6.6% DTT), the DTT group had more sway reductions in the motor dual task condition (13.7% vs. 4.5% STT). Similar statistical outcome (p = .034) was observed for the dual task costs (DTC). There was a tendence for SICI (p = .075), mainly indicating higher increase in SICI for the DTT group in the motor dual task (16.0% vs. 5.8% STT). During the execution of the single balance task, the group-specific adaptations in SICI were less pronounced (13.7% DTT vs. 16.2% STT). When analyzing the SICI dual task difference (Δ) from single to dual task, SICI is altered group and task specific (p = .011). The DTT group could increase the dual task difference in SICI in the dual motor condition (Δ 3.2%), whereas the STT group had a decrease (Δ -9.6%).&#x0D; Discussion/Conclusion&#x0D; The results of this study show that DTT causes gains in balance performance and increases in SICI when the secondary task is also a motor task, but not when the second task is a cognitive one. STT is particularly beneficial in the single task. It is therefore assumed that intracortical inhibition is important during the simultaneous performance of two motor tasks, while intracortical inhibition was not modulated in a group-specific manner by the additional cognitive task.&#x0D; References&#x0D; Corp, D. T., Lum, J. A. G., Tooley, G. A., &amp; Pearce, A. J. (2014). Corticospinal activity during dual tasking: A systematic review and meta-analysis of TMS literature from 1995 to 2013. Neuroscience &amp; Biobehavioral Reviews, 43, 74-87. https://doi.org/10.1016/j.neubiorev.2014.03.017&#x0D; Corp, D. T., Rogers, M. A., Youssef, G. J., &amp; Pearce, A. J. (2016). The effect of dual-task difficulty on the inhibition of the motor cortex. Experimental Brain Research, 234, 443-452. https://doi.org/10.1007/s00221-015-4479-2

Effectiveness and cost of integrated cognitive and balance training for balance and falls in cerebellar ataxia: a blinded two-arm parallel group RCT.

In patients with cerebellar ataxia (CA), dual-tasking deteriorates the performance of one or both tasks. Evaluate the effects of 4 weeks of cognitive-coupled intensive balance training (CIBT) on dual-task cost, dynamic balance, disease severity, number of falls, quality of life, cognition and cost among patients with CA. This RCT compared CIBT (Group 1) to single-task training (Group 2) among 32 patients with CA. The intervention included either dual-task (CIBT) or single-task training for 4 weeks followed by 6 months of unsupervised home exercises. Dual-task timed up-and-go test (D-TUG) assessed dual-task cost of the physical and cognitive tasks. Assessment time points included baseline 1 (Week 0:T1), baseline 2 (Week 6:T2), post-intervention (Week 10:T3), and follow-up (Week 34:T4). Compared to single-task training CIBT improved the dual-task cost of physical task [MD -8.36 95% CI (-14.47 to -2.36, p < 0.01), dual-tasking ability [-6.93 (-13.16 to -0.70); p = 0.03] assessed using D-TUG, balance assessed using the scale for the assessment and rating of ataxia (SARAbal) [-2.03 (-4.04 to -0.19); p = 0.04], visual scores of the SOT (SOT-VIS) [-18.53 (-25.81 to -11.24, p ≤ 0.01] and maximal excursion [13.84 (4.65 to 23.03; p ≤ 0.01] of the Limits of Stability (LOS) in the forward direction and reaction time in both forward [-1.11 (-1.42 to -0.78); p < 0.01] and right [-0.18 (0.05 to 0.31); p < 0.01] directions following 4 weeks of training. CIBT did not have any additional benefits in reducing the number of falls, or improving disease severity, quality of life and cognition. The mean cost of intervention and healthcare costs for 7 months was HKD 33,380 for CIBT group and HKD 38,571 for single-task training group. We found some evidence to support the use of CIBT for improving the dual-tasking ability, dual-task cost of physical task and dynamic balance in CA. Future large fully-powered studies are needed to confirm this claim. https://clinicaltrials.gov/study/NCT04648501, identifier [Ref: NCT04648501].

Effect of Dual-Task Training on Balance and Knee Proprioception in Weight Bearing and Non-Weight Bearing Position among Older Adults

Aims To investigate the effect of dual-task training on balance and knee proprioception in both weight-bearing and non-weight-bearing conditions in older adults with significant imbalance and high risk of falling. Methods This pre-posttest experimental design included 83 older adults (43 males, 40 females), selected based on age criteria (65–75 years) and specific inclusion and exclusion criteria. Participants underwent dual-task training consisting of 30-minute sessions, three times per week, for four weeks (totaling 12-sessions). Measures included Berg Balance Scale and knee proprioception deficit before and after dual-task training. Results The study showed statistically significant effect of dual-task training on balance (p < 0.001) and knee proprioception in both weight-bearing (p < 0.001) and non-weight-bearing (p < 0.001) in older adults. Pre-and post-measurements of independent variables between male and female older adults showed no significant difference. Conclusions Dual-task training improves balance and knee proprioception in both weight-bearing and non-weight-bearing conditions in older individuals, thereby enhancing stability and reducing the risk of falls.

Dual- and Single-Task Training in Older Adults With Age-Related Hearing Loss: A Randomized Controlled Study.

We aimed to investigate the effects of dual- and single-task training in older adults with age-related hearing loss. Intervention groups included single-, dual-task training, and control groups. The dual- and single-task trainings were held 2 days a week for 40min for a total of 10 sessions for 5 weeks. We evaluated physical, cognitive, and auditory functions, quality-of-life, balance, concerns about falling, independence in activities of daily living, and dual-task performance. A total of 42 patients fully participated in this study. Statistically significant differences were observed in chair stand, chair sit-and-reach, global cognitive function, and delayed recall between the intervention groups and control group (p < .05). There was no statistically significant difference in quality-of-life, balance, falling concerns, independence in activities of daily living, and dual-task performance between all groups (p > .05). In conclusion, single- and dual-task training had a positive effect on physical and cognitive functioning in older adults with age-related hearing loss.

Current Trends in Physiotherapy Treatment Protocols in Parkinson’s Disease

Objective: Physiotherapy is prescribed for individuals with Parkinson’s Disease (PD). Conventional forms of physiotherapy have been studied extensively, however effectiveness of recent physiotherapy interventions for PD are being evaluated and assessed. Aim: To evaluate the efficacy of conventional and recent physiotherapy interventions for people with Parkinson’s disease. Materials and Methods: A systematic search using CINAHL, Embase, and PubMed, that contrasted physiotherapy with no intervention or sham treatment. Resistance training, treadmill training, strategy training, dance, martial arts, aerobic exercises, hydrotherapy, balance, gait training, dual tasking, exergaming, and Nordic walking, were twelve categories into which trials were divided. Motor symptoms, balance, gait, and quality of life were among the outcomes. To evaluate methodological quality, GRADE (Grading of Recommendations, Assessment, Development and Evaluation) was used. A total of 191 trials, with 7998 participants were taken. Active therapy was included, irrespective of the severity or stage of the disease. Results: Physiotherapy enhanced gait, quality of life, and motor symptoms. Resistance and treadmill training improved gait. Training strategies enhanced gait and balance. Nordic walking, balance and gait training, and others improved gait, balance and motor symptoms. Exergaming and hydrotherapy enhanced life quality and balance. However, none of the outcomes significantly improved by dual task training. Conclusion: This review offers data supporting the efficacy of physiotherapy treatment in Parkinson’s disease, empowering medical professionals to choose treatment based on the best available research. PD affects balance, mobility, gait, fall susceptibility. Conventional and advanced physiotherapy improves these motor symptoms, and augment quality of life.

The effect of single and dual task on spatiotemporal gait parameters in children with spastic cerebral palsy

Abstract Aim: Children can walk in clinical settings but have difficulty walking in schools, parks, and outdoor activity playgrounds. Most environmental distractors, namely noise from the background, and diverting visual and aural stimuli may be a source of this lack of carryover from indoor to outside settings, which is why they are unable to carry-out their activities of daily living successfully and precisely. This study was aimed to assess the impact of dual task activities on spatiotemporal aspects of gait in children with spastic cerebral palsy (CP). Materials and Methods: After screening and informed consent, participants were asked to walk on a 10-m walkway while performing a dual task (walking with visual, auditory recognition, and backward counting). Three trials of each task were obtained and spatiotemporal parameters, including speed, step length, step width, and stride length, cadence) were measured. Result: Spatiotemporal parameters, such as speed, step width, step length, right stride length, and cadence, showed significant difference with dual-task walking compared with normal walking. Conclusion: The results suggest that dual-task training should receive more attention in clinical evaluations, as well as therapy strategies for children with spastic CP.

Effects of motor-cognitive dual task training on cognitive and motor performance in patients with dementia: A systematic review

Effects of motor-cognitive dual task training on cognitive and motor performance in patients with dementia: A systematic review

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

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

The effect of dual-task training on cognitive ability, physical function, and dual-task performance in people with dementia or mild cognitive impairment: A systematic review and meta-analysis

Objective To summarize the effect of dual-task training on cognitive, physical function, and dual-task performance in people with mild cognitive impairment or dementia. Data sources Embase, PEDro, PsycINFO, PubMed, CINAHL, The Cochrane Library, and a forward search conducted via Web of Science have been searched from inception to July 2023. Review methods Good-quality randomized controlled trials compared dual-task training with no/placebo intervention or single-task training among people with a primary diagnosis of mild cognitive impairment or dementia were included. The PEDro scale was used to evaluate the methodological quality of individual studies. The Grading of Recommendations, Assessment, Development and Evaluations system was adopted to appraise the quality of evidence for each outcome. Results Eighteen trials (1325 participants) were included, and 17 provided data for meta-analysis. Comparing with no intervention, dual-task training led to significant improvements on attention (mean difference (MD) = −20.66, 95%CI [−39.42, −1.90]), functional mobility (MD = −2.73; 95%CI [−3.98, −1.49]). Compared with single-task training, dual-task training had greater effects on overall cognitive function (standardized mean difference (SMD) = 0.29, 95%CI [0.09, 0.49]), balance (SMD = 0.78, 95%CI [0.40, 1.15]) and functional mobility (MD = −1.17; 95%CI [−1.77, −0.58]). Its effect on dual-task performance remains inconclusive due to the inconsistent results reported. Conclusion Low- to moderate-quality evidence supports that dual-task training has beneficial effects on cognitive function and physical function in individuals with dementia or mild cognitive impairment. The optimal training protocol of dual-task training on cognitive and physical functions, and dual-task performance remains uncertain. Well-designed, randomized studies with large enough sample sizes are warranted.

Effect of Dual-task Training on the Upper Limb Functon, Muscle Tone, and Actvites of Daily Living in Women With Chronic Stroke

Background and Aims Stroke is the fifth leading cause of death in the world; which can cause disability. One of the main goals of rehabilitation in these patients is to improve their upper limb function. Dual-task training (DTT) is one of the rehabilitation methods in stroke patients, which include performing motor tasks along with mental exercises. This study aims to investigate the effect of DTT on upper limb function, elbow flexor muscle tone, wrist extension range of motion (ROM), and the ability to perform activities of daily living (ADL) in women with chronic stroke. Methods In this pilot study, 16 female patients suffering from chronic stroke for more than 6 months were selected and divided into two groups of 8 including training and control. In both groups, the routine treatment included electrical stimulation of quadriceps and dorsiflexors of the affected hand, 10 minutes of bicycling, and performing three movement tasks for the upper limb (sorting colored blocks, opening and closing the bottle cap with the affected hand, and moving the beans with a spoon towards a determined point). In the training group, DTT included performing these three movement tasks simultaneously with performing mental task (counting down from 100). The training was performed for 4 weeks at 12 sessions, three sessions per week. The upper limb function was measured by the box &amp; block test; elbow flexor muscle tone by the modified Ashworth scale; active ROM of wrist extension by a goniometer; and ADL by the Barthel index before and after the treatments. Results No significant difference was found in any variables between the two groups (P&gt;0.05). In both in groups, there was a significant improvement in the three variables of elbow flexor muscle tone, upper limb function, and the ability to perform ADL after interventions compared to baseline (P&lt;0.05). However, no significant difference was found in the active ROM of wrist extension in any groups (P&gt;0.05). Conclusion Training with and without DTT can lead to significant improvement in elbow flexor muscle tone, upper limb function, and the ability to perform ADL in women with chronic stroke. The DTT has no superior effect on these variables.

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

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

Effects of dual-task training on chronic ankle instability: a systematic review and meta-analysis

BackgroundDual-task training has been a popular intervention for individuals with balance impairments. However, the effects of dual-task training on chronic ankle instability (CAI) have not been comprehensively analyzed and reliable clinical evidence is scarce. The purpose of this systematic review and meta-analysis is to evaluate the effectiveness of dual-task training on postural stability and functional ability in individuals with CAI.MethodsPubMed, Web of Science, EBSCO, Cochrane Library, Physiotherapy Evidence Database (PEDro), and China National Knowledge Infrastructure (CNKI) were researched from inception to November 2022. This study was conducted by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Two reviewers assessed the studies for inclusion and extracted data. The Cochrane Risk of Bias list was used to assess the risk of bias in included studies. Mean differences (MD) with a 95% confidence interval (CI) were calculated with the RevMan 5.3 software.ResultsA total of 7 randomized controlled trials with 192 CAI met the inclusion criteria. The meta-analysis results showed that compared with the control group, dual-task training significantly improved the Y-balance test (MD = 1.60, 95% CI: −0.00 to 3.21, P = 0.050) and reduced COP-area (MD = − 0.94, 95% CI: −1.62 to − 0.26, P = 0.007) in individuals with CAI. However, there is no significant difference between dual-task training and the control group on COP-velocity (MD = − 0.26, 95% CI: −0.70 to 0.17, P = 0.240), hop test (MD = − 0.20, 95% CI: −0.66 to 0.26, P = 0.386) and BESS (MD = − 1.24, 95% CI: −2.95 to 0.48, P = 0.157) in individuals with CAI.ConclusionThis meta-analysis showed that dual-task training may be effective in improving static and dynamic postural stability. However, more high-quality randomized controlled trials are needed to verify the short and long-term effectiveness of dual-task training on CAI.

Current Trends in Balance Rehabilitation for Stroke Survivors: A Scoping Review of Experimental Studies.

Balance impairment is a common consequence of a stroke, which can significantly hinder individuals' participation in daily activities, social interactions, and leisure pursuits and their ability to return to work. Rehabilitation is vital for minimizing post-stroke sequelae and facilitating the recovery of patients. This review aims to identify current trends in balance rehabilitation of stroke survivors. This Scoping review followed Arksey and O'Malley's methodological framework. The literature search was conducted in electronic databases, including CINAHL Complete, MEDLINE Complete, and Nursing & Allied Health Collection. The search was performed in March 2023, and the inclusion criteria were articles published in English or Portuguese between 2013 and 2023. A total of 446 articles were identified. After selecting and analyzing the reports, fourteen publications were included in this review. Seven distinct categories of balance rehabilitation interventions were identified, covering various approaches. These categories included conventional rehabilitation exercises, gym-based interventions, vibration therapy, rhythmic auditory stimulation training, boxing therapy, dual-task training, and technology-based rehabilitation interventions. Each of these methods presents unique benefits and can significantly impact the recovery of balance in stroke survivors, enhancing their overall well-being and functional capacity.

The effects of cognitive intervention on inter-joint coordination during walking in the older adults with balance impairment

BackgroundCognitive interventions are among the effective training-on-gait parameters; however, the effects of such trainings on inter-joints coordination has not been much considered. Research questionCan dual task and executive function training affect inter-joint coordination during walking in elderly with poor balance? MethodsThirty elderly men were purposefully divided into three groups: 1) dual-task training group (DTG), 2) executive function training group (EFG) and 3) control group. After the pre-test, the experimental groups participated in 24 training sessions while the control group were required to do their normal daily tasks. VICON three-dimensional motion analysis system with four T20 series cameras was used to evaluate inter-joints coordination during the experiment. Participants had to walk a 12-meter path while kinematics of their joints was recorded. The inter-joint coordination at the sagittal plane and in four phases were assessed using the vector coding technique. ResultsThe findings of this study showed that the greatest effect of the intervention on the coordination between the joints was in the loading and mid-stance phases (p < 0.05). Also, the variability in the coupling angle showed a significant decrease in most phases (p < 0.05). SignificanceBased on the obtained results, it can be argued that the loading and mid-stance are more involved in postural control and balance because the center of gravity is transferred between the legs and the person is normally on single-leg stance in these phases.

Management of cognitive frailty: A network meta-analysis of randomized controlled trials.

We aimed to compare the effectiveness of interventions in cognitive function and frailty status and rank these interventions. Data Sources-We searched PubMed, Embase, CINAHL, PsycINFO, Web of Science, Cochrane Library, Central Register of Controlled Trials (CENTRAL), CNKI, Wanfang, VIP and Google scholar. Data synthesis-The risk of bias was assessed using the Cochrane risk bias assessment tool. Statistical heterogeneity was assessed using the Chi-square test and quantified by I2 . The results were pooled using the standardized mean difference (SMD). The rank probability for each intervention was calculated using the surface under the cumulative ranking curve (SUCRA). Additionally, the quality of the evidence was evaluated using the GRADE approach. A total of 10 randomized controlled trials (RCTs) involving 1110 patients were included in our analysis. The network map of cognitive function comprised 9 RCTs with 1347 participants, examining eight different interventions. Nutritional support (SUCRA=99.9%, SMD=3.02, 95% CI: 2.53, 3.51) may be the most effective intervention to improve cognitive function. The network map of frailty (including 9 RCTs with 1017 participants and 9 interventions) suggested that multicomponent exercises (SUCRA=96.4%, SMD=-5.10, 95% CI: -5.96, -4.23) tended to have a greater effect. Community-based multicomponent exercises have shown significant benefits for improving cognitive function and frailty status in older adults, with moderate certainty. For hospitalized older patients with Cognitive frailty (CF), current evidence suggests that nutritional support yields the most improvement. Additionally, aerobic exercise and dual-task training have proven effective in managing CF. Further studies are needed to validate these preliminary findings and exploring more accessible and effective physical and cognitive interventions to prevent CF in aging.

Neuroplastic Changes Associated With Hybrid Exercise-Cognitive Training in Stroke Survivors With Mild Cognitive Decline: A Randomized Controlled Trial

Background Exercise and cognitive training have been shown to induce neuroplastic changes and modulate cognitive function following stroke. However, it remains unclear whether hybridized exercise-cognitive training facilitates cortical activity and further influences cognitive function after stroke. Objective The study aimed to investigate the effects of 2 hybridized exercise-cognitive trainings on neuroplastic changes and behavioral outcomes in stroke survivors with mild cognitive decline. Methods This study was a single-blind randomized controlled trial. Stroke survivors were randomly assigned to 1 of 3 groups: (1) sequential exercise-cognitive training (SEQ), (2) dual-task exercise-cognitive training (DUAL), or (3) control group (CON). All groups underwent training 60 min per day, 3 days per week, for a total of 12 weeks. The primary outcome was the resting-state (RS) functional connectivity (FC) in functional magnetic resonance imaging. Secondary behavioral outcomes included cognitive and physical functions. Results After 12 weeks of training, patients in the SEQ group (n = 21) exhibited increased RS FC between the left occipital lobe and posterior cingulate gyrus with right parietal lobe, compared to the DUAL (n = 22) and CON (n = 20) groups. Additionally, patients in the DUAL group showed increased FC of the left temporal lobe. However, changes in behavioral outcome measures were non-significant among the 3 groups (all P’s > .05). Conclusions This study highlights the distinct neuroplastic mechanisms associated with 2 types of exercise-cognitive hybridized trainings. The pre-post functional magnetic resonance imaging measurements illustrated the time course of neural mechanisms for cognitive recovery in stroke survivors following different exercise-cognitive training approaches. Trial registration. NCT03230253.