Physical Activity Control Group Research Articles

UPRIGHT BIPEDAL EXERCISE TRAINING IMPROVES INTERVERTEBRAL DISC HEALTH: A SYSTEMATIC REVIEW AND META-ANALYSIS

INTRODUCTION & AIMS The structure and function of human tissue, such as bone, muscle and tendon, can be improved with targeted exercise training. However, the effects of exercise training on intervertebral disc tissue has received comparably less attention. With a scope to identify types of exercise training that improve intervertebral disc health, this study examined the impact of historical exercise, sport and/or physical activity on quantitative intervertebral disc outcomes. METHODS The protocol was prospectively registered with PROSPERO (CRD42022366391). Five databases (inception to 30th September 2022), 17 trial registries and reference lists and forwards/backwards citations were searched. Inclusion criteria followed the Participants (human), Exposure (exercise, sport or physical activity for greater than one week), Comparators (non-exercise, sport or physical activity control group), Outcomes (magnetic resonance imaging measures of lumbar intervertebral disc health on a continuous scale [e.g. T2, signal intensity, intervertebral disc height]) and Study design (any) framework. Pairwise random-effects restricted maximum likelihood meta-analysis estimated standardised mean difference (Hedges g). RESULTS From the search yield of 2,150 records, 12 reports representing 10 studies (participants: 874) were deemed eligible. When compared to any comparator, upright bipedal exposures (g [95%CI]: 0.31 [0.06, 0.55]; P=0.014; studies: 6; participants: 346; I2: 87%), were associated with greater intervertebral disc health. However, no physical loading exposure (g [95%CI]: 0.29 [-0.23, 0.82]; P=0.275; studies: 10; participants: 874), non-upright/non-contact exposures (g [95%CI]: 0.70 [1.25, 2.64]; P=0.336; studies: 5; participants: 260), extreme trunk range of motion exposures (g [95%CI]: -0.28 [-1.60, 1.04]; P=0.456; studies: 3; participants: 230) and aerobic-based exposures (g [95%CI]: 0.48 [0.08, 1.04]; P=0.094) were associated. Sensitivity analyses supported the robustness of primary and secondary effect estimates. CONCLUSION Greater intervertebral disc health associated with a prior history of upright bipedal physical loading indicates prospective interventions examining upright bipedal exercise effects on intervertebral disc health are warranted.

Baduanjin exercise modulates the hippocampal subregion structure in community-dwelling older adults with cognitive frailty.

Regular Baduanjin exercise intervention was proven to be beneficial in improving the cognitive ability and physical performance of older adults with different health conditions but was unclear to influence the structural plasticity of the hippocampus. This study aimed to explore the modulation of hippocampal subregions as a mechanism by which Baduanjin exercise improves cognitive frailty in older adults. A total of 102 community-dwelling older adults with cognitive frailty were recruited and randomly allocated to the Baduanjin exercise training group and usual physical activity control group. The participants in the Baduanjin exercise training group participated in a 24-week Baduanjin exercise intervention program with an exercise frequency of 60 min per day, 3 days per week. Cognitive ability and physical frailty were assessed, and MRI scans were performed on all participants at baseline and after 24 weeks of intervention. The structural MRI data were processed with MRIConvert (version 2.0 Rev. 235) and FreeSurfer (version 6.0.0) software. Data analyses were performed using the independent sample t tests/Mann-Whitney U tests with the Bonferroni correction, mixed linear model, correlation, or mediation analysis by the SPSS 24.0 software (IBM Corp, Armonk, NY, United States). After 24 weeks of intervention, a statistically significant increase was found for the Montreal Cognitive Assessment (MoCA) scores (p = 0.002) with a large effect size (Cohen's d = 0.94) and the significant interaction effect (P goup × time < 0.05), Memory Quotient (MQ) scores (p = 0.019) with a medium effect size (Cohen's d = 0.688) and the significant interaction effect (P goup × time < 0.05), and other parameters of WMS-RC test including pictures (p = 0.042), recognition (p = 0.017), and association (p = 0.045) test with a medium effect size (Cohens' d = 0.592, 0.703, and 0.581) for the Baduanjin training group, while significant decrease for the Edmonton Frailty Scale (EFS) score (p = 0.022), with a medium effect size (Cohen's d = -0.659) and the significant interaction effect (P goup × time < 0.05) for the Baduanjin training group. The differences in the left parasubiculum, Hippocampal Amygdala Transition Area (HATA), right Cornu Ammonis Subfield 1 (CA1) and presubiculum volumes from baseline to 24 weeks after intervention in the Baduanjin training group were significantly greater than those in the control group (p < 0.05/12). Further analysis showed that the changes in right CA1 volume were positively correlated with the changes in MoCA and MQ scores (r = 0.510, p = 0.015; r = 0.484, p = 0.022;), the changes in right presubiculum and left parasubiculum volumes were positively correlated with the changes in MQ (r = 0.435, p = 0.043) and picture test scores (r = 0.509, p = 0.016), respectively, and the changes in left parasubiculum and HATA volumes were negatively correlated with the changes in EFS scores (r = -0.534, p = 0.011; r = -0.575, p = 0.005) in the Baduanjin training group, even after adjusting for age, sex, years of education and marital status; furthermore, the volume changes in left parasubiculum and left HATA significantly mediated the Baduanjin exercise training-induced decrease in the EFS scores (β = 0.376, 95% CI 0.024 ~ 0.947; β = 0.484, 95% CI 0.091 ~ 0.995); the changes of left parasubiculum and right CA1 significantly mediated the Baduanjin exercise training-induced increase in the picture and MO scores (β = -0.83, 95% CI-1.95 ~ -0.002; β = -2.44, 95% CI-5.99 ~ -0.32). A 24-week Baduanjin exercise intervention effectively improved cognitive ability and reduced physical frailty in community-dwelling older adults with cognitive frailty, and the mechanism might be associated with modulating the structural plasticity of the hippocampal subregion.

Effect of Baduanjin exercise on cerebral blood flow and cognitive frailty in the community older adults with cognitive frailty: A randomized controlled trial

Background/ObjectivesRegular Baduanjin exercise training has been shown to be beneficial to the physical and cognitive health of older adults, but the underlying mechanisms remain to be investigated. This study examined the influence of Baduanjin on cerebral hemodynamics in community-dwelling older adults with cognitive frailty. DesignRandomized controlled trial. MethodsA total of 102 eligible participants were randomly allocated into the Baduanjin exercise intervention group (BEG) or usual physical activity control group (CG) for 24 weeks. Cerebral hemodynamic parameters of bilateral middle/anterior cerebral artery and basilar artery, cognitive ability and physical frailty were assessed using Transcranial Doppler (TCD), Montreal Cognitive Assessment (MoCA) and Edmonton Frailty Scale (EFS) at baseline and 24 weeks post-intervention. ResultsAfter 24 weeks intervention, the changes in peak systolic velocity (PSV), mean blood flow velocity (MBFV), and end diastolic velocity (EDV) in the right middle cerebral artery and basilar artery were better in the BEG than in the CG; the increase in MoCA scores and the decrease in EFS scores were significantly higher in the BEG than in the CG. Moreover, the interaction of exercise and time on those variables showed obvious significance. ConclusionsThe 24 weeks Baduanjin exercise training had a positive beneficial effect on cerebral blood flow in community-dwelling older adults with cognitive frailty. This may be a potential mechanism by which Baduanjin exercise improves the cognitive frailty in older adults. Trial registrationChinese Clinical Trial Registry, ChiCTR1800020341. Date of registrationDecember 25, 2018, http://www.chictr.org.cn/showproj.aspx?proj=29846.

Baduanjin exercise for balance function in community-dwelling older adults with cognitive frailty: a randomized controlled trial protocol

BackgroundBalance function provides a physiological link between the physical and cognitive function, and is a potential predictor for cognitive frailty. As a gentle mind–body exercise, Baduanjin can develop flexibility and co-ordination, thus would be is helpful for the improvement of balance function. This trial will evaluate the effect of Baduanjin on balance function in older adults with CF.Methods/designA total of 72 community-dwelling older adults with CF will be recruited and randomly allocated (1:1) into the Baduanjin exercise group or usual physical activity control group. All participants will undergo a health education program on nutrition and diet-related knowledge for 6 sessions (30 min per session) during the intervention period. Moreover, participants in the Baduanjin exercise group will receive a 24-week Baduanjin training course of 60 min per session and 3 sessions per week, while those in the usual physical activity control group will be required to maintain their original physical activity. Primary and secondary outcomes will be measured at baseline and after the 24-week intervention period. A mixed linear model will be constructed to analyse the intervention effects.DiscussionThis protocol presents an objective design of a randomized, single-blind trial that will evaluate the effectiveness and safety of traditional Chinese mind–body exercise Baduanjin training on the balance ability of community-dwelling older adults with cognitive frailty. If the results are as expected, this trial will provide evidence of the effect of Baduanjin exercise on balance in an older community-based population.Trial registrationThis trial was registered in the Chinese Clinical Trial Registry with code ChiCTR2100050857 and was approved on 5 September 2021.

Effects of mind–body exercise Baduanjin on cognition in community-dwelling older people with mild cognitive impairment: A randomized controlled trial

ABSTRACT Objective To determine the effect of a 6-month traditional Chinese mind-body Baduanjin exercise intervention on cognitive ability in older people with Mild cognitive impairment (MCI). Methods A total of 135 community-dwelling seniors with MCI were randomized into either the Baduanjin group (BDJ), the brisk walking group (BWK) or the usual physical activity control group (UPA). Cognitive ability was assessed at baseline, 2, 4 and 6 months post-intervention, and 3 months after the intervention ended. Results After 6 months of intervention, the MoCA score of the BDJ group was significantly higher than that of the UPA group (P < 0.05), The Go/No-go correct numbers of the BDJ group and BWK group were significantly higher than those of the UPA group (P < 0.05). There was no statistical difference in other outcomes, or there were only a tiny effect size. Three months after the intervention, there was no significant difference between the primary and secondary outcomes(P > 0.05). Conclusion The 6-month period of Baduanjin training has positive benefits on global cognitive function and attention function in community-dwelling elderly individuals with MCI. The effect seems to have been transient and needs to be confirmed by additional studies.

Aerobic exercise improves episodic memory in late adulthood: a systematic review and meta-analysis

BackgroundAerobic exercise remains one of the most promising approaches for enhancing cognitive function in late adulthood, yet its potential positive effects on episodic memory remain poorly understood and a matter of intense debate. Prior meta-analyses have reported minimal improvements in episodic memory following aerobic exercise but have been limited by restrictive inclusion criteria and infrequent examination of exercise parameters.MethodsWe conducted a meta-analysis of randomized controlled trials to determine if aerobic exercise influences episodic memory in late adulthood (M = 70.82 years) and examine possible moderators. Thirty-six studies met inclusion criteria, representing data from 2750 participants.ResultsHere we show that aerobic exercise interventions are effective at improving episodic memory (Hedges’g = 0.28; p = 0.002). Subgroup analyses revealed a moderating effect of age (p = 0.027), with a significant effect for studies with a mean age between 55–68 but not 69–85. Mixed-effects analyses demonstrated a positive effect on episodic memory among studies with a high percentage of females (65–100%), participants with normal cognition, studies reporting intensity, studies with a no-contact or nonaerobic physical activity control group, and studies prescribing >3900 total minutes of activity (range 540–8190 min).ConclusionsAerobic exercise positively influences episodic memory among adults ≥55 years without dementia, with larger effects observed among various sample and intervention characteristics—the clearest moderator being age. These results could have far-reaching clinical and public health relevance, highlighting aerobic exercise as an accessible, non-pharmaceutical intervention to improve episodic memory in late adulthood.

Episodic Memory in Older Adults Without Dementia: A Meta-Analysis of Aerobic Exercise Interventions

The effect of aerobic exercise interventions on episodic memory performance among older adults without dementia remains a matter of intense debate. Prior meta-analyses examining this association have reported minimal improvements in episodic memory performance following exercise training but have also been plagued by several limitations, including restrictive inclusion criteria, combined sample populations, and infrequent examination of the effect of exercise parameters (e.g., volume). To address these gaps, we conducted a meta-analysis of randomized controlled trials (RCTs) to determine if aerobic exercise interventions influence episodic memory performance in older adults without dementia and to examine potential moderators of these effects (e.g., sample and intervention characteristics). Included studies met the following criteria: (1)Studies of adults (M≥55 years) with normal cognition, subjective cognitive decline, or mild cognitive impairment; (2)Aerobic exercise RCTs; and (3)Assessment of episodic memory. Intervention effects were represented by Hedges’ g and combined into pooled effect sizes using random- and mixed-effects models. Thirty-three studies met inclusion criteria, representing data from 2,488 participants. The primary analysis yielded a significant positive effect of aerobic exercise on episodic memory (Hedges’ g[CI]=0.28[0.10-0.47]; p=0.003). Mixed-effects analyses demonstrated a positive effect on episodic memory among studies with a high percentage of females (>66%), participants with normal cognition, studies reporting intensity, studies with a no-contact or nonaerobic physical activity control group, and studies prescribing 2,100–3,900 total minutes of activity (range 540–8,190 minutes). These results suggest that aerobic exercise may act as an accessible, non-pharmaceutical intervention to improve episodic memory in late adulthood before changes in cognition are detected.

Traditional Chinese Mind-Body Exercise Baduanjin Modulate Gray Matter and Cognitive Function in Older Adults with Mild Cognitive Impairment: A Brain Imaging Study.

Background:Previous studies found traditional Chinese mind-body exercise Baduanjin could modulate cognition of community older adults.Objective:This study aims to investigate the effect of 6 months of Baduanjin exercise on brain structure and cognitive function in older adults with mild cognitive impairment (MCI).Methods:The MCI older adults were randomly assigned into either Baduanjin training, brisk walking training or usual physical activity control group. Magnetic Resonance Imaging (MRI), Montreal Cognitive Assessment (MoCA) and Wechsler Memory Scale-Chinese Revised (WMS-CR) were applied to measure gray matter volume (GMV), global cognitive ability and memory at baseline and end of intervention.Results:Compared to usual physical activity, Baduanjin exercise significantly improved MoCA, WMS-CR scores, WMS-MQ, and mental control and comprehension memory subscores of the WMS-CR; significantly increased the GMV in the temporal gyrus, frontal gyrus, parietal gyrus, medial occipital gyrus, cingulate gyrus and angular gyrus after 6 months of intervention. Compared to brisk walking, Baduanjin significantly improved MoCA scores and picture reproduction subscores of memory, and significantly increased the GMV in the right frontal gyrus, precentral gyrus, occipital gyrus. Furthermore, the increased GMV in the right medial temporal gyrus was significantly associated with improvement in the MoCA scores.Conclusion:The present study suggested that regular Baduanjin training could have a positive effect in increasing brain gray matter and improving cognitive function in older adults with MCI.

Effects of a traditional Chinese mind–body exercise, Baduanjin, on the physical and cognitive functions in the community of older adults with cognitive frailty: study protocol for a randomised controlled trial

IntroductionCognitive frailty (CF) is a clinical manifestation characterised by the simultaneous presence of both physical frailty and cognitive impairment among older adults without dementia and has become a new target...

Effect of Baduanjin exercise on cognitive function in older adults with mild cognitive impairment: study protocol for a randomised controlled trial

IntroductionMild cognitive impairment (MCI) is an intermediate stage between the cognitive changes of normal aging and dementia characterised by a reduction in memory and/or other cognitive processes. An increasing number...

Primary prevention for risk factors of ischemic stroke with Baduanjin exercise intervention in the community elder population: study protocol for a randomized controlled trial

BackgroundStroke is a major cause of death and disability in the world, and the prevalence of stroke tends to increase with age. Despite advances in acute care and secondary preventive strategies, primary prevention should play the most significant role in the reduction of the burden of stroke. As an important component of traditional Chinese Qigong, Baduanjin exercise is a simple, safe exercise, especially suitable for older adults. However, current evidence is insufficient to inform the use of Baduanjin exercise in the prevention of stroke.The aim of this trail is to systematically evaluate the prevention effect of Baduanjin exercise on ischemic stroke in the community elder population with high risk factors.MethodsA total of 170 eligible participants from the community elder population will be randomly allocated into the Baduanjin exercise group and usual physical activity control group in a 1:1 ratio. Besides usual physical activity, participants in the Baduanjin exercise group will accept a 12-week Baduanjin exercise training with a frequency of five days a week and 40 minutes a day. Primary and secondary outcomes will be measured at baseline, 13 weeks (at end of intervention) and 25 weeks (after additional 12-week follow-up period).DiscussionThis study will be the randomized trial to evaluate the effectiveness of Baduanjin exercise for primary prevention of stroke in community elder population with high risk factors of stroke. The results of this trial will help to establish the optimal approach for primary prevention of stroke.Trial registrationChinese Clinical Trial Registry: ChiCTR-TRC-13003588.Registration date: 24 July, 2013.

Effects of Tai Chi and resistance training on cardiovascular risk factors in elderly Chinese subjects: a 12‐month longitudinal, randomized, controlled intervention study

Tai Chi is rapidly gaining in popularity, worldwide. This study was performed to assess its impact on cardiovascular risk factors in comparison with resistance training exercises in elderly Chinese subjects. A total of 207 healthy elderly participants (65-74 years, 113/207 (55%) men) were randomly assigned to one of three intervention groups: (1) Tai Chi, three times/week for 1 h/session (n = 64); (2) resistance training exercise, three times/week for 1 h/session (n = 65); (3) usual level of physical activity control group (n = 78). Anthropometric measures, dual X-ray densitometry body composition, blood pressure, lipids, glycaemic and insulin sensitivity indices were measured at baseline and 12 months. Repeated-measures analysis of variance (anova) was used to assess the between-group changes using a last-observation-carried-forward intention-to-treat approach. A total of 180 (87.0%) subjects completed the study. No significant changes were identified in the Tai Chi group compared to the resistance training or control group. Of the primary outcomes, only the improvement in the insulin sensitivity index differed, being significantly greater in the resistance training than in the control group [mean difference 0.018 (95% confidence interval ( CI) 0.000-0.037) mmol glucose/min, P = 0.02), and tending to be greater than in the Tai Chi group (mean difference 0.019 (95% CI 0.000-0.038) mmol glucose/min, P < 0.06). Tai Chi had no significant effect on any measure compared to the controls, whereas resistance training improved the insulin sensitivity index in this 12-month study.