1. Evidence-based exercise recommendations to improve functional mobility in older adults - A study protocol for living systematic review and meta-analysisBettina 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: 671; Downloads: 476
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2. Combining physical and virtual worlds for motor-cognitive training interventions : position paper with guidelines on technology classification in movement-related researchLuka Šlosar, Claudia Voelcker-Rehage, Armin Paravlić, Ensar Abazović, Eling D. de Bruin, Uroš Marušič, 2022, review article Abstract: 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.
Keywords: extended reality, virtual reality, augmented reality, mixed reality, exergaming, taxonomy, classification
Published in DiRROS: 21.12.2022; Views: 1335; Downloads: 799
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