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Query: "author" (Bettina Wollesen) .

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1.
Evidence-based exercise recommendations to improve functional mobility in older adults - A study protocol for living systematic review and meta-analysis
Bettina Wollesen, Tamar Yellon, Antoine Langeard, Vera Belkin, Anna Wunderlich, Eleftheria Giannouli, Guoping Qian, Rafael A. Bernades, Zbigniew Ossowski, Uroš Marušič, Rajesh Sighdel, Claudia Voelcker-Rehage, 2025, original scientific article

Abstract: Background and objectives This is a protocol for a living systematic review and meta-analysis. This review will assess the effects of state-of-the-art exercise interventions designed to promote functional mobility. Therefore, after identifying all potential interventions, we will use the F.I.T.T. principles (frequency, intensity, time, type) as well as the physical and health status of the participants as moderators to analyse the mechanisms for the positive benefits of exercise interventions. The main research questions are: Which exercise types are most beneficial for improving functional mobility in various populations of older adults? Which physical exercise characteristics in terms of frequency, intensity, time and duration will achieve the greatest benefit in terms of the defined outcomes, i.e, the functional mobility of older adults? Methods The systematic literature research according to PRISMA guidelines will search databases like MEDLINE, APA Psych-Info and Web of Science. Inclusion criteria are: healthy older people ≥ 50 years, randomized-controlled trials including exercise intervention and a walking or mobility assessments (eg., TUG, SPPB) as an outcome measure. A preliminary search revealed more than 33,000 hits that will be screened by pairs of independent reviewers. The results will be summarized according to the effects regarding functional mobility and potential dose-response relations via respective meta-analysis. Conclusion The systematic review will comprise the knowledge of the existing literature with regards to the effects of the physical activity interventions compared to an active or inactive control group. We will summarize the effects with respect to the F.I.T.T.. They provide a foundation for structuring an optimal exercise training program. If possible, we will also compare interventions from the different categories (eg. cardiovascular, resistance, motor-coordinative, multicomponent or mind-body exercise) as a network analysis and report the influence of moderator variables. Based on the results evidence-based guidelines following GRADE for physical exercise interventions to improve functional mobility in older adults will be provided. Functional mobility of older adults is a crucial determinant of health and independence. Mobility can reverse or delay age-related health issues and promote independence, while immobility or limitations in mobility (such as difficulty rising from a chair, balance problems, or reduced walking capacity) can cause or increase dependency. This underscores the significance of fostering mobility among the growing population of older adults. The development of tailored exercise programs targeting the independence of older adults is one of the motivators for the improvement of crucial policy action areas described by WHO in the Equity Policy Tool, namely ʻliving conditionsʼ and ʻsocial and human capitalʼ (WHO, 2019). The key outcomes related to functional mobility in older age include gait, walking capacity, and balance. Additionally, aspects of life-space mobility, such as the overall walking distance within the environment, are significant factors that characterize mobility in older adults. Exercise can be seen as a preventive measure, so that, without adequate physical activity levels, the ageing process may be associated with premature development of disease and dysfunction. However, different training types will enhance outcomes of functional mobility via specific pathways. For example, walking capacity has an endurance and a strength component. Accordingly, aerobic training will improve walking capacity by enhancing cardio-respiratory fitness, as shown within different clinical trials with older patient cohorts. Resistance training helps to increase muscle strength in the lower limb, which increases gait stability. However, recent literature reviews showed that a combination of both interventions might be more sufficient to gain most benefits on walking capacity. This review will systematically assess the effects of state-of-the-art exercise interventions designed to promote mobility. The ultimate aim is to provide evidence-based guidelines for the optimal type and dose of exercise to preserve and enhance functional mobility in diverse populations of older adults
Keywords: functional mobility, older adults, exercise programs, systematic review
Published in DiRROS: 10.03.2025; Views: 334; Downloads: 243
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2.
Neuromuscular assessment of force development, postural, and gait performance under cognitive-motor dual-tasking in healthy older adults and early Parkinson's disease patients : study protocol for a cross-sectional Mobile Brain/Body Imaging (MoBI) study
Uroš Marušič, Manca Peskar, Maja Maša Šömen, Miloš Kalc, Aleš Holobar, Klaus Gramann, Bettina Wollesen, Anna Wunderlich, Christoph M. Michel, Aleksandar Miladinović, Mauro Catalan, Alex B. Stella, Miloš Ajčević, Paolo Manganotti, 2023, original scientific article

Abstract: Background: Neuromuscular dysfunction is common in older adults and more pronounced in neurodegenerative diseases. In Parkinson's disease (PD), a complex set of factors often prevents the effective performance of activities of daily living that require intact and simultaneous performance of the motor and cognitive tasks. Methods: The cross-sectional study includes a multifactorial mixed-measure design. Between-subject factor grouping the sample will be Parkinson’s Disease (early PD vs. healthy). The within-subject factors will be the task complexity (single- vs. dual-task) in each motor activity, i.e., overground walking, semi-tandem stance, and isometric knee extension, and a walking condition (wide vs. narrow lane) will be implemented for the overground walking activity only. To study dual-task (DT) effects, in each motor activity participants will be given a secondary cognitive task, i.e., a visual discrimination task for the overground walking, an attention task for the semi-tandem, and mental arithmetic for the isometric extension. Analyses of DT effects and underlying neuronal correlates will focus on both gait and cognitive performance where applicable. Based on an a priori sample size calculation, a total N = 42 older adults (55-75 years) will be recruited. Disease-specific changes such as laterality in motor unit behavior and cortical control of movement will be studied with high-density surface electromyography and electroencephalography during static and dynamic motor activities, together with whole-body kinematics. Discussion: This study will be one of the first to holistically address early PD neurophysiological and neuromuscular patterns in an ecologically valid environment under cognitive-motor DT conditions of different complexities. The outcomes of the study aim to identify the biomarker for early PD either at the electrophysiological, muscular or kinematic level or in the communication between these systems.
Keywords: Parkinson's disease, mobile brain imaging, body brain imaging, MoBi, dual tasking, neuromuscular function, older adults
Published in DiRROS: 15.09.2023; Views: 1118; Downloads: 509
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3.
Does standing up enhance performance on the stroop task in healthy young adults? : a systematic review and meta-analysis
Maja Maša Šömen, Manca Peskar, Bettina Wollesen, Klaus Gramann, Uroš Marušič, 2023, review article

Abstract: Understanding the changes in cognitive processing that accompany changes in posture can expand our understanding of embodied cognition and open new avenues for applications in (neuro)ergonomics. Recent studies have challenged the question of whether standing up alters cognitive performance. An electronic database search for randomized controlled trials was performed using Academic Search Complete, CINAHL Ultimate, MEDLINE, PubMed, and Web of Science following PRISMA guidelines, PICOS framework, and standard quality assessment criteria (SQAC). We pooled data from a total of 603 healthy young adults for incongruent and 578 for congruent stimuli and Stroop effect (mean age = 24 years). Using random-effects results, no difference was found between sitting and standing for the Stroop effect (Hedges’ g = 0.13, 95% CI = −0.04 to 0.29, p = 0.134), even when comparing congruent (Hedges’ g = 0.10; 95% CI: −0.132 to 0.339; Z = 0.86; p = 0.389) and incongruent (Hedges’ g = 0.18; 95% CI: −0.072 to 0.422; Z = 1.39; p = 0.164) stimuli separately. Importantly, these results imply that changing from a seated to a standing posture in healthy young adults is unlikely to have detrimental effects on selective attention and cognitive control. To gain a full understanding of this phenomenon, further research should examine this effect in a population of healthy older adults, as well as in a population with pathology.
Keywords: healthy young adults, dual tasks, posture, Stroop task, cognitive-motor interference, sit-to-stand workstations
Published in DiRROS: 30.01.2023; Views: 1182; Downloads: 553
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4.
Dual-task performance in hearing-impaired older adults : study protocol for a cross-sectional mobile brain/body imaging study
Anna Wunderlich, Oliver Vogel, Maja Maša Šömen, Manca Peskar, Madeleine Fricke, Klaus Gramann, Janna Protzak, Uroš Marušič, Bettina Wollesen, 2021, original scientific article

Abstract: Background: Hearing impairments are associated with reduced walking performance under Dual-task (DT) conditions. Little is known about the neural representation of DT performance while walking in this target group compared to healthy controls or younger adults. Therefore, utilizing the Mobile Brain/Body Imaging approach (MoBI), we aim at gaining deeper insights into the brain dynamics underlying the interaction of cognitive and motor processes during different DT conditions (visual and auditory) controlling for age and the potential performance decrements of older adults with hearing impairments. Methods: The cross-sectional study integrates a multifactorial mixed-measure design. Between-subject factors grouping the sample will be age (younger vs. older adults) and hearing impairment (mild vs. not hearing impaired). The within-subject factors will be the task complexity (single- vs. DT) and cognitive task modality (visual vs. auditory). Stimuli of the cognitive task will vary according to the stimulus modality (visual vs. auditory), presentation side (left vs. right), and presentation-response compatibility (ipsilateral vs. contralateral). Analyses of DT costs and underlying neuronal correlates focus either on gait or cognitive performance. Based on an a priori sample size calculation 96 (48 healthy and 48 mildly hearing impaired) community-dwelling older adults (50%70 years) and 48 younger adults (20%30 years) will be recruited. Gait parameters of speed and rhythm will be captured. EEG activity will be recorded using 64 active electrodes. Discussion: The study evaluates cognitive-motor interference (CMI) in groups of young and older adults as well as older adults with hearing impairment. The underlying processes of the interaction between motor and cognitive tasks will be identified at a behavioral and neurophysiological level comparing an auditory or a visual secondary task. We assume that performance differences are linked to different cognitive-motor processes, i.e., stimulus input, resource allocation, and movement execution. Moreover, for the different DT conditions (auditory vs. visual) we assume performance decrements within the auditory condition, especially for older, hearing-impaired adults. Findings will provide evidence of general mechanisms of CMI (ST vs. DT walking) as well as task-specific effects in dual-task performance while over ground walking.
Keywords: older adults, overground walking, dual-tasks, MoBi, hearing impairments
Published in DiRROS: 23.11.2021; Views: 1313; Downloads: 1284
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