Cognitive-motor Training Research Articles

Effectiveness of an Individualized Exergame-Based Motor-Cognitive Training Concept Targeted to Improve Cognitive Functioning in Older Adults With Mild Neurocognitive Disorder: Study Protocol for a Randomized Controlled Trial.

Simultaneous motor-cognitive training is considered promising for preventing the decline in cognitive functioning in older adults with mild neurocognitive disorder (mNCD) and can be highly motivating when applied in the form of exergaming. The literature points to opportunities for improvement in the application of exergames in individuals with mNCD by developing novel exergames and exergame-based training concepts that are specifically tailored to patients with mNCD and ensuring the implementation of effective training components. This study systematically explores the effectiveness of a newly developed exergame-based motor-cognitive training concept (called "Brain-IT") targeted to improve cognitive functioning in older adults with mNCD. A 2-arm, parallel-group, single-blinded randomized controlled trial with a 1:1 allocation ratio (ie, intervention: control), including 34 to 40 older adults with mNCD will be conducted between May 2022 and December 2023. The control group will proceed with the usual care provided by the (memory) clinics where the patients are recruited. The intervention group will perform a 12-week training intervention according to the "Brain-IT" training concept, in addition to usual care. Global cognitive functioning will be assessed as the primary outcome. As secondary outcomes, domain-specific cognitive functioning, brain structure and function, spatiotemporal parameters of gait, instrumental activities of daily living, psychosocial factors, and resting cardiac vagal modulation will be assessed. Pre- and postintervention measurements will take place within 2 weeks before starting and after completing the intervention. A 2-way analysis of covariance or the Quade nonparametric analysis of covariance will be computed for all primary and secondary outcomes, with the premeasurement value as a covariate for the predicting group factor and the postmeasurement value as the outcome variable. To determine whether the effects are substantive, partial eta-squared (η2p) effect sizes will be calculated for all primary and secondary outcomes. Upon the initial submission of this study protocol, 13 patients were contacted by the study team. Four patients were included in the study, 2 were excluded because they were not eligible, and 7 were being informed about the study in detail. Of the 4 included patients, 2 already completed all premeasurements and were in week 2 of the intervention period. Data collection is expected to be completed by December 2023. A manuscript of the results will be submitted for publication in a peer-reviewed open-access journal in 2024. This study contributes to the evidence base in the highly relevant area of preventing disability because of cognitive impairment, which has been declared a public health priority by the World Health Organization. ClinicalTrials.gov NCT05387057; https://clinicaltrials.gov/ct2/show/NCT05387057. DERR1-10.2196/41173.

Motor Cognitive Coordination Training (MCCT) Program: Improving Concentration Ability for Beginner Tennis

Motor Cognitive Coordination Training (MCCT) Program: Improving Concentration Ability for Beginner Tennis

Feasibility and effects of cognitive–motor exergames on fall risk factors in typical and atypical Parkinson’s inpatients: a randomized controlled pilot study

BackgroundPeople with Parkinson`s disease (PD) often suffer from both motor and cognitive impairments. Simultaneous motor and cognitive training stimulates neurobiological processes which are important especially for people with PD. The aim of this study is to test the feasibility and effects of simultaneous cognitive–motor training in form of exergames in the setting of inpatient rehabilitation of persons with PD.MethodsForty participants (72.4 ± 9.54 years; Hoehn and Yahr stage 1–4) were randomly assigned to either the intervention group, which trained five times a week in addition to the conventional rehabilitation program, or the control group, which underwent the standard rehabilitation treatment only. Primary outcome was feasibility (measured by adherence rate, attrition rate, occurrence of adverse events, system usability scale (SUS), and NASA TLX score). In addition, various cognitive (Go/No-Go test, reaction time test (RTT), color word interference test (D-KEFS) and Trail Making Test A and B (TMT)) and motor (preferred gait speed, maximum gait speed, dual-task gait speed, Short Physical Performance Battery (SPPB), Timed Up and Go (TUG) and 5 times Sit-to-Stand (5xStS)) tests were conducted before and after the intervention phase in order to determine training effectsResultsAdherence rate was 97%, there were just two dropouts due to reasons unrelated to the study and there were no adverse events. The mean NASA TLX value was 56.2 and the mean value of the SUS was 76.7. Significant time–group interaction effects were observed for the 5xStS, the SPPB, the RTT, the Go/No-Go test and the D-KEFS 2.DiscussionExergaming, as applied in this study, showed to be feasible, safe and likely effective for the improvement of cognitive and motor functions of PD inpatients. Because of this future randomized controlled trials with a main focus on testing the efficacy of this new intervention are warranted.Trial registration: The study has been registered at ClinicalTrials.gov (ID: NCT04872153).

Effects of computer-based cognitive training combined with physical training for older adults with cognitive impairment: A four-arm randomized controlled trial.

Combined physical (PHY) and cognitive (COG) training in sequential (SEQ) and simultaneous (SIMUL) sessions may delay the progression of cognitive impairment. To date, no study has directly compared in older adults with cognitive impairment the effects of COG training, PHY training, SEQ motor-cognitive training and SIMUL motor-cognitve training on specific indices of cognitive performance and activities of daily living (ADL). The purpose of this study was to determine whether SEQ and SIMUL motor-cognitive training can improve treatment outcomes compared with PHY or COG training alone. We also aimed to compare the effects of SEQ versus SIMUL motor-cognitive training on cognitive functions and instrumental ADL (IADL) in older adults with cognitive impairment. A cluster randomized controlled trial was conducted. Eighty older adults with cognitive impairment were randomly assigned to COG, PHY, SEQ or SIMUL training groups. The intervention consisted of 90-min training sessions, totaling 36 sessions. Outcome measures were the Montreal Cognitive Assessment, three subtests of the Wechsler Memory Scale (WMS) and the Lawton IADL scale. Significant interaction effects between group and time were found in WMS-spatial span (p = 0.04) and WMS-word lists (p = 0.041). For WMS-spatial span, the SIMUL group showed outperformed the COG (p = 0.039), PHY (p = 0.010) and SEQ groups (p = 0.017). For WMS-word lists, the SEQ group improve more than COG (p = 0.013), PHY (p = 0.030) and SIMUL (p = 0.019) groups. No significant differences were found in IADL performance among four groups (p = 0.645). Our study showed SEQ and SIMUL motor-cognitive training led to more pronounced improvements in visuospatial working memory or verbal memory compared with isolated COG or PHY training for community-based older adults with cognitive impairment. For enhancing effects on IADL, we suggest the use of sensitive measurement tools and context-enriched cognitive training involving real-life task demands.

Acute Effects of Fitlight Training on Cognitive-Motor Processes in Young Basketball Players.

Cognitive-motor training could be used to improve open-skill sport performances, increasing cognitive demands to stimulate executive function (EF) development. Nevertheless, a distributed training proposal for the improvement of EFs is increasingly difficult to combine with seasonal sport commitments. This study aimed to investigate whether a massed basketball training program enriched with Fitlight training can improve EFs and motor performance. Forty-nine players (age = 15.0 ± 1.5 yrs) were assigned to the control and Fitlight-trained (FITL) groups, which performed 3 weeks of massed basketball practice, including 25 min per day of shooting sessions or Fitlight training, respectively. All athletes were tested in cognitive tasks (Flanker/Reverse Flanker; Digit Span) and fitness tests (Agility T-test; Yo-Yo IR1). During the intervention, exercise/session perceived effort (eRPE/sRPE) and enjoyment were collected. RM-ANOVA showed significant EFs scores increased in both groups over time, without differences between the groups. Moreover, an increased sRPE and eRPE appeared in the FITL group (p = 0.0001; p = 0.01), with no group differences in activity enjoyment and fitness tests. Three weeks of massed basketball training improved EFs and motor performance in young players. The additional Fitlight training increased the perceived cognitive effort without decreasing enjoyment, even if it seems unable to induce additional improvements in EFs.

Application of strobe training as motor-cognitive strategy in sport climbing

Strobe training is a form of cognitive-motor training where the vision is impaired intermittently. The athlete has to use more effectively the limited visual stimuli that he receives or increase the influence from other analyzers. The study was conducted

Combining physical and virtual worlds for motor-cognitive training interventions: Position paper with guidelines on technology classification in movement-related research.

Efficient movements require intact motor and cognitive function. There is a growing literature on motor-cognitive interventions to improve the overall quality of life of healthy or diseased older people. For such interventions, novel technological advances are crucial not only in terms of motivation but also to improve the user experience in a multi-stimuli world, usually offered as a mixture of real and virtual environments. This article provides a classification system for movement-related research dealing with motor-cognitive interventions performed in different extents of a virtual environment. The classification is divided into three categories: (a) type of digital device with the associated degree of immersiveness provided; (b) presence or absence of a human-computer interaction; and (c) activity engagement during training, defined by activity >1.5 Metabolic Equivalent of task. Since virtual reality (VR) often categorizes different technologies under the same term, we propose a taxonomy of digital devices ranging from computer monitors and projectors to head-mounted VR technology. All immersive technologies that have developed rapidly in recent years are grouped under the umbrella term Extended Reality (XR). These include augmented reality (AR), mixed reality (MR), and VR, as well as all technologies that have yet to be developed. This technology has potential not only for gaming and entertainment, but also for research, motor-cognitive training programs, rehabilitation, telemedicine, etc. This position paper provides definitions, recommendations, and guidelines for future movement-related interventions based on digital devices, human-computer interactions, and physical engagement to use terms more consistently and contribute to a clearer understanding of their implications.

The Influence of a Specific Cognitive-Motor Training Protocol on Planning Abilities and Visual Search in Young Soccer Players.

The benefits of sport activity on cognition and especially on executive function development are well-known, and in recent years, several kinds of cognitive-motor training (CMT) have been proven effective in adults and older people. Less is known about possible CMT benefits in children. This study aims to confirm the positive influence played by CMTs on specific executive functions (planning abilities and visual search) in young soccer players. Twenty-four 10-year-old athletes were recruited and randomly assigned to the experimental (Exp) and control (Con) groups of 12 players. Both groups were trained for 10 weeks, twice a week (90 min per training), following standard soccer training (technical-tactical exercises). The Exp group, during the first training session of the week, in the last 22 min, performed the experimental treatment, which consisted of a psychokinetic CMT. Both groups were examined before and after the ten-week training using the Tower of London and WISC-IV cancellation tests. Results revealed that the Exp group, following treatment, reported significantly better scores than the Con group in all the cognitive measures. We concluded that the proposed CMT is more effective than motor training alone at improving planning abilities and visual search abilities, even in children.

The Advanced Technology Bus and the Evolution of Workplace Expertise

The purpose of this paper is to define and explore the immediate and long term effects and the resulting organizational dynamics of advancing technology on maintenance workplace expertise in transportation. In the past ten years the face of maintenance in the transportation workplace has completely changed as computerization has taken over the control of transmissions, engines, and bus/truck environmental systems and transformed them from “closed “stand alone components to an interdependent “open system “in a state of constant communication. The immediate future brings with it the advanced technology of the Intelligent Transportation System with its Geographic Information System, in-vehicle logic system, automated annunciation, signal prioritization, global positioning and live audio and visual data links with a central control center.This complexification of the transportation maintenance workplace is being compounded by the growing use of alternative fuels, and the resultant requirement for the maintainer to learn a new operational set of skills and competencies. This evolution of technology in transportation has caused a revolution in technical training for which the maintainers of transportation resources must reskill immediately to meet the demands of the technology invasion. The paper examines the need for an accelerated evolution of workplace expertise using a combination of motor skill and cognitive training competency based learning techniques to evolve the maintainer through the phases of basic operation, to systems expert, to system creator.This evolution is accomplished through the use of a four step implementation strategy which begins with the determination of training sources, the development of an effective resource investment strategy, the development of a model trained cadre, and concludes with the expansion of this model to improve the overall baseline of workplace expertise.

Effects of Augmented Reality Game-Based Cognitive-Motor Training on Restricted and Repetitive Behaviors and Executive Function in Patients with Autism Spectrum Disorder.

Restricted and repetitive behaviors (RRBs) and executive dysfunction are widely acknowledged as core features and hallmarks in patients with autism spectrum disorder (ASD). This study aimed to investigate the effects of augmented reality (AR) using motivational games with cognitive–motor exercises on RRBs, executive function (EF), attention, and reaction time in patients with ASD. Twenty-four patients (range from 6 to 18 years) diagnosed with ASD were recruited from local social welfare centers and randomly allocated to the AR game-based cognitive–motor training group (study group) or the conventional cognitive training group (control group). Both groups completed 30 min training sessions, twice a week for four weeks. Outcome measures were conducted before and after the intervention. As a result, improvements were observed in all the subscales of the RRBs in the study group except for self-injurious and ritualistic behavior. Significant improvements were observed in EF and reaction time in the study group, which was significantly higher compared to the control group. With the present findings, we can suggest that cognitive–motor training using AR game-based content generates positive effects on improving executive function reaction time and accuracy of responses and has a limited effect on RRBs in patients with ASD. This can be proposed as a complementary intervention associated with individualized daily management.

The Effect of Dual-Task Motor-Cognitive Training in Adults with Neurological Diseases Who Are at Risk of Falling.

Falls are common in patients with neurological diseases and can be very problematic. Recently, there has been an increase in fall prevention research in people with neurological diseases; however, these studies are usually condition-specific (e.g., only MS, PD or stroke). Here, our aim was to evaluate and compare the efficacy of an advanced and innovative dual-task, motor-cognitive rehabilitation program in individuals with different neurological diseases who are at risk of falling. We recruited 95 consecutive adults with neurological diseases who are at risk of falling and divided them into four groups: 31 with cerebrovascular disease (CVD), 20 with Parkinson’s disease (PD), 23 with traumatic brain injury (TBI) and 21 with other neurological diseases (OND). Each patient completed a dual-task, motor-cognitive training program and underwent two test evaluations to assess balance, gait, fear of falling and walking performance at the pre-and post-intervention. We found that our experimental motor-cognitive, dual-task rehabilitation program was an effective method for improving walking balance, gait, walking endurance and speed, and fear of falling, and that it reduced the risk of falls in patients with different neurological diseases. This study presents an alternative approach for people with chronic neurological diseases and provides innovative data for managing this population.

The cognitive and cognitive-motor training contribution to the improvement of different aspects of executive functions in healthy adults aged 65 years and above—A randomized controlled trial

Aims The study aimed at examining the effectiveness of cognitive-motor dual-task and single-task cognitive training on executive and attention functions in participants over 65 years of age. Methods The study comprised 68 participants. They were randomly assigned to dual-task cognitive-motor training (DTT), single-task cognitive training (STT) or a control group (C). The training program in all groups encompassed 4 weeks and consisted of three, 30-min meetings a week. Specialized software was designed for the purposes of the study. Both before and after the training, the cognitive functioning was assessed using: Color Trials Test, Ruff Figural Fluency Test, Wisconsin Sorting Card Test, Digit Span, Verbal Fluency Test, Stroop Color-Word Test. Results After the cognitive-motor training, improvement was achieved in the control and inhibition of reactions. Moreover, after the cognitive training, improvements in abstract thinking and categorization were reported. Conclusion Despite the small sample limitation, the preliminary result shows each form of the training supports a different aspect of executive functions but does not contribute to the improvement in attention.

Cognitive-motor multitasking in older adults: a randomized controlled study on the effects of individual differences on training success

BackgroundMultitasking is an essential part of our everyday life, but performance declines typically in older age. Many studies have investigated the beneficial effects of cognitive, motor and combined cognitive-motor training on multitasking performance in older adults. Previous work, however, has not regarded interindividual differences in cognitive functioning and motor fitness that may affect training benefits. The current study aims to identify whether different training programs may have differential effects on multitasking performance depending on the initial level of cognitive functioning and motor fitness.MethodsWe conduct a 12-week single-blinded randomized controlled trial. A total of N = 150 healthy older adults are assigned to either a single cognitive, a single motor, or a simultaneous cognitive-motor training. Participants are trained twice per week for 45 min. A comprehensive test battery assesses cognitive functions, motor and cardiovascular fitness, and realistic multitasking during walking and driving in two virtual environments. We evaluate how multitasking performance is related not only to the training program, but also to participants’ initial levels of cognitive functioning and motor fitness.DiscussionWe expect that multitasking performance in participants with lower initial competence in either one or both domains (cognitive functioning, motor fitness) benefits more from single-task training (cognitive training and/or motor training). In contrast, multitasking performance in participants with higher competence in both domains should benefit more from multitask training (simultaneous cognitive-motor training). The results may help to identify whether tailored training is favorable over standardized one-size-fits all training approaches to improve multitasking in older adults. In addition, our findings will advance the understanding of factors that influence training effects on multitasking.Trial registrationDRKS (German Clinical Trials Register), DRKS00022407. Registered 26/08/2020 - Retrospectively registered at https://www.drks.de/drks_web/setLocale_EN.do

Study Protocol: Strategies and Techniques for the Rehabilitation of Cognitive and Motor Deficits in Patients with Multiple Sclerosis.

MS clinical features vary between patients. In approximately 60% of cases, cognitive deficits are associated with motor disabilities, with consequences on both walking and maintaining balance and cognitive efficiency. Multimodal programs are very infrequent for MS patients and cognitive rehabilitation is not provided by the Italian health system, which only favors access to motor rehabilitation. Dual-task studies showed how motor and cognitive skills are closely associated. Therefore, physiotherapy exercises may favor an indirect improvement in cognition. The aim of this study is to understand which rehabilitative approach may increase both cognitive and motor efficiency, avoiding the waste of time and resources. In this multi-site single-blind parallel controlled clinical trial, we will compare three rehabilitative approaches: cognitive training, motor training and combined cognitive-motor training. We also aim to evaluate: whether self-perception and objective improvement correspond; the impact of each rehabilitation program on patients' QoL, mood and self-perception; and long-term effects. A total of 60 patients will be randomly assigned to one of the three treatments for two 45-min sessions/week for 12 weeks. All participants will undergo a complete cognitive, motor, clinical assessment together with mood, self-perception, and QoL questionnaires before, immediately after and 6 months after the training period.

Immersive Technology for Cognitive-Motor Training in Parkinson's Disease.

Background: Parkinson’s disease (PD) is a neurodegenerative disease in which the progressive loss of dopaminergic neurons (DA) leads to initially sporadic and eventually widespread damage of the nervous system resulting in significant musculoskeletal and cognitive deterioration. Loss of motor function alongside increasing cognitive impairment is part of the natural disease progression. Gait is often considered an automatic activity; however, walking is the result of a delicate balance of multiple systems which maintain the body’s center of mass over an ever-changing base of support. It is a complex motor behavior that requires components of attention and memory to prevent falls and injury. In addition, evidence points to the critical role of salient visual information to gait adaptability. There is a growing understanding that treatment for PD needs to address movement as it occurs naturally and walking needs to be practiced in more complex environments than traditional therapy has provided.MethodsIn this single-blinded randomized-controlled pilot study, an immersive treadmill training was piloted to determine feasibility and preliminary efficacy on gait and cognition in people with PD. Eighteen participants with Hoehn and Yahr stages I-III PD were randomized to either an intervention or a waitlist control group. Following baseline data collection, the intervention group trained for 30 min, three times/week for 4 weeks on a split belt treadmill combined with a first-person immersive video game targeting visuospatial skills and working memory. Assessment was repeated after 4 weeks of training for the experimental group and 1-month after baseline for the control group. Primary motor outcomes were captured with the APDM Opal sensors during 6 MWT, TUG, and TUG Cognitive. Secondary outcomes of cognition were measured with the Montreal Cognitive Assessment (MoCA), Verbal Fluency (Fruit, Vegetable, and Animal) and the Symbol Digit Modality Test (SDMT). Within subject differences were calculated using the Wilcoxon Signed Ranked Test and between subject comparisons were analyzed using the Mann Whitney U-test.ResultsThis novel treadmill training program was well-tolerated with all participants in the intervention group completing 4 weeks of training three times a week without any adverse effects. After immersive cognitive motor training, the experimental group made clinically relevant improvements in gait speed and walking distance during the 6 MWT while members of the control group showed no change or decreased gait speed and walking distance over the 1-month trial. In addition, the experimental group demonstrated significant improvement for the TUG Cognitive (p = 0.05) and those changes were greater than the control group (between group p = 0.040). The experimental group also improved scores on MoCA (p = 0.007) and SDMT (p = 0.01) cognitive outcome measures while the control group did not.ConclusionThe use of immersive gaming technology to engage specific areas of cognition related to gait is feasible in PD. The treadmill training program paired with a customized interactive video game improved walking velocity in addition to non-significant but consistent improvements in other gait measures and cognitive performance in participants with early to mid-stage PD.

Evaluation of the cognitive-motor training effectiveness in combination with drug therapy among patients with moderate cognitive disorders: the own research results

Introduction. Non-drug methods of therapy for cognitive impairment is one of the topical areas of neurology. Studies have shown that cognitive training may be beneficial for maintaining mental alertness in healthy older adults, while patients with dementia and mild cognitive impairment are more likely to benefit from cognitive-motor training or rehabilitation. It is possible that the severity and type of cognitive disorders, as well as patients’ adherence to training, the correct construction of tasks, may affect the effectiveness of non-drug therapy for cognitive disorders.Аim. The aim of this study was to evaluate the effectiveness of cognitive-motor training developed at Sechenov University in patients with moderate cognitive impairment (MCI).Materials and methods. 41 patients were included in the study, including 8 women and 33 men, the average age of patients was 60.3 ± 8.5 years, the average level of education was 14.2 ± 8.7 years, of which 15 patients met the criteria AD, 26 – VCI criteria. Patients underwent quantitative neuropsychological testing, assessment of emotional disorders, and also assessed such indicators as satisfaction with the quality of life, adherence to therapy. Subsequently, the patients were divided into groups of individual and group cognitive training. Classes with patients were held according to the standard scheme, 30–50 minutes a day, for 40 days. After 3 months, 10 patients were randomly selected from the individual training group and received an additional course of group cognitive-motor training.Results. Тhe study showed that after 1.5 months, patients showed a significant decrease in the severity of cognitive disorders (p < 0.05). The greatest positive dynamics was noted in relation to the level of attention (p < 0.05), memory (including primary modal-nonspecific mnestic impairment, p < 0.05), logical operations (p < 0.05). The patients included in the study also showed a significant decrease in the severity of depression (p < 0.05). The analysis showed that significant positive dynamics was recorded both in patients of the individual CT group and in patients who received group CT (p < 0.05). The positive effect on cognitive functions was maintained during the three months of follow-up. Comparative analysis of study patients after 6 months showed that patients who received additional sessions with a trainer reported an additional improvement in well-being. These differences were statistically significant, despite the small number of patients included in the repeat CT group (p < 0.05).Conclusions. The effectiveness of cognitive-motor training in patients with MCI was noted. The results obtained allow us to recommend this type of cognitive-motor training for use in clinical practice by neurologists, therapists and psychiatrists as an additional effective method for the treatment of cognitive impairment.

Treatment of Children with Attention and Hyperactivity Disorders

ADHD is one of the most common disorders described, studied and treated over the last decade. Attention Deficit Hyperactivity Disorder is a massive psychological problem encountered in children 2-11 years old. The purpose of this paper is the identification of attention disorders and hyperactive behaviors in children, and the main causes of attention deficit hyperactivity disorder in children. Identifyig therapeutic treatments used to manage attention disorders and hyperactive behavior in children is also a goal of our article. The case study and qualitative analyzes were applied to conduct this study and to achieve some objectives such as: Presentation of the main problems that children with ADHD revealed; identification of the causes and factors that cause hyperactivity; exploration of the impact of early intervention of treatment therapies; identification of the role of the psychologist in the treatment of hyperactivity disorder in children. The instruments for data collection used in the study were: Case study; vertical grille observation; interview; focus groups. The results show that the treatment of children with ADHD, with Therapy and Individual Education Plans, improved the parameters of these children such are the improvement of motor parameters, cognitive training and communication training. Therapies and Individual Education Programs (IEPs) applied to children with attention disorders and hyperactive behavior positively affects their attention span, and management of their hyperactive behavior. Medication, Cognitive behavioral therapy, Psychotherapy and social behavior therapy, positively affect cognitive development and social skills, reducing hyperactivity, and focusing attention of children with ADHD.
 
 Received: 24 December 2021 / Accepted: 7 February 2022 / Published: 5 March 2022

Postoperative rehabilitation of neurosurgical patients after spinal cord surgery – results of our own study

Aim. To assess the extent to which cognitive and emotional disorders in patients undergoing spinal cord surgery affect the quality of rehabilitation and, based on the data obtained, to suggest optimization of rehabilitation measures. Materials and methods. The study included 60 patients (30 men and 30 women) whose condition required spinal cord surgery. All patients underwent assessment of somatic and neurological status, as well as quantitative neuropsychological testing. The influence of cognitive and emotional disorders before and after surgery on the severity of pain syndrome and movement disorders was assessed. When included in the study, patients were randomized into the main (30 people) and control (30 people) group. The patients of the main group received cognitive-motor training, which was carried out using the methodological manual Cognitive Training for Patients with Moderate Cognitive Impairment, developed by the staff of the Department of Nervous Diseases and Neurosurgery of the Sechenov First Moscow State Medical University (Sechenov University). Cognitive, emotional, motor disorders, severity of pain syndrome, as well as the quality of life and adherence of patients to cognitive-motor training were assessed 3 and 6 months after the surgical intervention.The severity of cognitive and emotional disorders in patients of the main and control groups did not differ before the operation. Results. After the operation, the severity of cognitive impairments was significantly higher in patients of the control group (p=0.03). Patients in the control group were significantly worse than patients in the main group in performing memory tasks (p=0.00), they also had a significantly lower rate of mental processes (p=0.00). These differences persisted 3 months after surgery (p=0.00). A week after the surgical intervention, the severity of anxiety and depression was significantly higher in patients in the control group (p=0.01). The positive effect of the operation in the form of pain reduction was achieved in all patients, but in the control group there was an increase in the severity of the pain syndrome after six months of observation compared with that after three months. An increase in the severity of the pain syndrome was associated with an increase in depression, anxiety, and cognitive impairment. The analysis showed that patients of the main group with high adherence to cognitive training showed significantly greater positive dynamics both in terms of cognitive functions and in terms of anxiety and depression (p0.05). A survey of patients after inclusion in the study with the provision of prospective recommendations for clinical care showed the following: 58 patients (96.7% of patients) noted that the proposed recommendations for clinical care, from their point of view, would significantly improve their postoperative prognosis. Important points that should be reflected in the clinical guidelines for the management of patients with spinal cord surgery, from the point of view of patients, were: discussion with the doctor of the picture of their illness, duration of hospitalization, expected outcome, prognosis (60 patients, 100%), medical education rehabilitation skills (51 patients, 85% of patients), communicating with patients who have already undergone a similar operation earlier in this surgical department (49 patients, 81.7%), ensuring continuity and discussing the entire rehabilitation route before surgery (60 patients, 100%). Conclusion. Cognitive and emotionally disorders determine the quality of life and rehabilitation of patients who have undergone surgery on the spinal cord. Our results allow us to recommend the inclusion of cognitive-motor training in the rehabilitation program for patients after spinal neurosurgical operations.

Effect of Dual-Task Motor-Cognitive Training in Preventing Falls in Vulnerable Elderly Cerebrovascular Patients: A Pilot Study.

Falling is a frequent and major clinical problem among older adults, as well as in patients with chronic cerebrovascular diseases (CVD). At present, sequential (mixed) and simultaneously (dual-task) motor-cognitive trainings are the best approaches to affording patients more autonomy in their everyday motor independence while reducing fall risks and consequences. The objective of this study was to evaluate the efficacy of an advanced and innovative dual-task motor-cognitive rehabilitation program on fall risks in vulnerable older persons with chronic CVD. To this purpose, 26 consecutive older fallers with chronic CVD were recruited, and completed a mixed motor-cognitive or a dual-task motor-cognitive training program. Each patient also underwent two test evaluations to assess balance, gait, fear of falling, and walking performance at pre-and post-intervention. We found that our experimental motor-cognitive dual-task rehabilitation program could be an effective method to improve walking balance, gait, walking speed, and fear of falling, while reducing the risk of falls in older people with chronic CVD. Furthermore, results show that the simultaneous motor-cognitive training is more effective than the sequential motor-cognitive training. Therefore, our study brings innovative data, which can contribute positively to the management of this population.

General magnet therapy and low-frequency electrostatic field in the postoperative period in patients with breast cancer

To compare the efficacy of general magnetic therapy and low-frequency electrostatic field on days 2-4 after the radical surgical treatment of breast cancer and 1.0-1.5 months after radiation therapy in combination with therapeutic physical training, motor-cognitive training, and sessions with a psychologist. Examination and medical rehabilitation of 131 patients after radical surgical treatment of breast cancer were performed. Age ranged from 30 to 75 years. Group 1 included 66 patients who received medical rehabilitation on days 2-4 after the surgery and 1.0-1.5 months later in addition to adjuvant radiotherapy; Group 2 included 65 patients who received medical rehabilitation only after 1.0-1.5 months in addition to adjuvant radiotherapy. It was shown that two courses of medical rehabilitation with the addition of physiotherapeutic treatment on days 2-4 and 1.0-1.5 months after radical breast cancer surgery in addition to radiation therapy contribute to a significant reduction of functional disorders severity in patients versus initiation of medical rehabilitation 1.0-1.5 months after the surgery in addition to radiation therapy. The feasibility of including general magnetic therapy procedures and low-frequency electrostatic field exposure in the medical rehabilitation course was demonstrated as it results in pain relief, postoperative edema reduction, and quicker recovery of the shoulder joint mobility that promotes long-term clinical benefit.