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Efects of chronic physical exercise on executive functions and episodic memory in clinical and healthy older adult populations : a systematic review and meta-analysis protocol
Soledad Ballesteros, Andreea Badache, Vera Belkin, Christoforos D. Giannaki, Antonia Kaltsatou, Uroš Marušič, Mohammad Mosaferi Ziaaldini, Manca Peskar, José M. Reales, Jennifer A. Rieker, 2024, review article

Abstract: Background Executive functions (EFs) and episodic memory are fundamental components of cognition that deteriorate with age and are crucial for independent living. While numerous reviews have explored the effect of exercise on these components in old age, these reviews screened and analyzed selected older adult populations, or specific exercise modes, thus providing only limited answers to the fundamental question on the effect of exercise on cognition in old age. This article describes the protocol for a systematic review and multilevel meta-analytic study aiming at evaluating the effectiveness of different types of chronic exercise in improving and/or maintaining EFs and long-term episodic memory in older adults. Methods and analysis The study protocol was written in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Several databases will be searched. Randomized controlled trials (RCTs) conducted in older adults aged ≥ 60 years providing any kind of planned, structured, and repetitive exercise interventions, and EFs and/or episodic memory measures as outcomes, published in English in peer-reviewed journals and doctoral dissertations will be included. Two independent reviewers will screen the selected articles, while a third reviewer will resolve possible conflicts. The Cochrane risk-of-bias tool will be used to assess the quality of the studies. Finally, data will be extracted from the selected articles, and the formal method of combining individual data from the selected studies will be applied using a random effect multilevel meta-analysis. The data analysis will be conducted with the metafor package in R. Discussion and conclusion This review will synthesize the existing evidence and pinpoint gaps existing in the literature on the effects of exercise on EFs and episodic memory in healthy and unhealthy older adults. Findings from this meta-analysis will help to design effective exercise interventions for older adults to improve and/or maintain EFs and episodic memory. Its results will be useful for many researchers and professionals working with older adults and their families.
Keywords: diseased older adults, healthy older adultsi, episodic memory, executive functions, exercises, three level meta analysis, tri-nivojska meta-analiza
Published in DiRROS: 03.04.2024; Views: 274; Downloads: 115
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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: 480; Downloads: 214
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Effects of digital-based interventions on muscular strength in adults : a systematic review, meta-analysis and meta-regression of randomized controlled trials with quality of evidence assessment
Armin Paravlić, Luka Šlosar, Ensar Abazović, Uroš Marušič, 2023, review article

Abstract: Background: In the last three decades, both medical and sports science professionals have recognized the considerable potential of digital-based interventions (DBI) to enhance the health-related outcomes of their practitioners.Objectives: This study aimed to investigate the effectiveness and potential moderators of DBI on measures of muscular strength.Methods: Six databases (PubMed/MEDLINE, Web of Science, SportDiscus, Embase, Cochrane Register of Controlled Trials and Google Scholar) were searched for eligible studies up to June 2022. The GRADE, PEDRO, and TIDieR checklists were used to assess the quality of evidence, methodology, and completeness of intervention descriptions, respectively.Results: A total of 56 studies were included in the meta-analysis (n = 2346), and participants were classified as healthy (n = 918), stroke survivors (n = 572), diagnosed with other neurological disorders (n = 683), and frail (n = 173). The DBI showed a small effect (standardized mean difference [SMD] = 0.28, 95% CI 0.21 to 0.31; p < 0.001) on strength, regardless of the type of intervention, control group, or tested body part. More specifically, while splitting the studies into different subgroups, a meta-analysis of 19 studies (n = 918) showed a small effect (SMD = 0.38, 95% CI 0.12 to 0.63; p = 0.003) on strength in the asymptomatic population. Similarly, small but positive effects of DBI were observed for stroke survivors (SMD = 0.34, 95% CI 0.13 to 0.56; p = 0.002), patients diagnosed with other neurological disorders (SMD = 0.17, 95% CI 0.03 to 0.32; p = 0.021), and the frail population (SMD = 0.25, 95% CI 0.0 to 0.5; p = 0.051). Sub-group analysis and meta-regression revealed that neither variable modified the effects of the DBI on measures of strength.Conclusions: Overall, DBI may serve as an effective method to improve measures of strength in adults, regardless of their health status as well as the type of digital device, the presence of human-computer interaction, and the age of participants. In addition, the DBI was found to be more effective than traditional training or rehabilitation methods.
Keywords: cognitive training, physical function, strength, neurodegenerative disorders, older adults
Published in DiRROS: 07.08.2023; Views: 521; Downloads: 269
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Fat mass to fat- free mass ratio and body composition in participants with chronic leg problems
Mihaela Jurdana, Ana Tomažič, Boštjan Žvanut, 2022, original scientific article

Keywords: fat-mass, fat-free mass, waist circumference, older adults, knee, hip
Published in DiRROS: 20.04.2023; Views: 462; Downloads: 288
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Does an active lifestyle matter? : a longitudinal study of physical activity and health-related determinants in older adults
Kaja Teraž, Saša Pišot, Boštjan Šimunič, Rado Pišot, 2022, original scientific article

Abstract: Introduction: It is well-known that regular physical activity, and thus an active lifestyle, has positive eects on aging and general wellbeing. However, the question remains as to whether regular or increased physical activity can improve self-perception of health status and quality of life in older adults. Methods: We conducted a longitudinal study on a group of active older adults between 2013 and 2021. At baseline, i.e., the 1st measurements (baseline), 147 participants were enrolled (mean age 68.4 ± 5.6). After 8 years, in 2021 (follow up), 52 older adults (mean age 75.9 ± 5.3 years) were measured. For the purpose of this study, we included 52 older adults participated at both time-points. For both measurements, participants reported their physical activity and sedentary behavior using the Global physical activity questionnaire (GPAQ), socio-demographic and environmental determinants, recording their self-perception in terms of overall wellbeing. Furthermore, we conducted a qualitative study using semi-structured interviews to obtain subjective data on the changes and events that may have aected physical abilities and general health over an 8-year period. Results: At the follow up, participants reported lower physical activity and sedentary behavior compared to baseline, but still met health-enhancing physical activity (HEPA) standards for total self-reported physical activity (>3,000 METmin/week). In addition, they rated their overall health (p < 0.001), physical fitness (p < 0.001), psychological wellbeing (p < 0.001) and overall quality of life (p < 0.001) as better. The qualitative data confirmed that the 8-year period involved changes in physical activity. Specifically, they have continued to carry out physical work (gardening, working in the vineyards, olive groves), but previously organized physical activities were replaced by walks in nature, which probably also influenced the reduction of sedentary behavior. Conclusion: After 8 years, as expected, participants reported a decrease in physical activity and a lower level of sedentary behavior. It appears from the interview that healthy older adults filled their days with daily tasks and found more time for walking. Individuals who were more active in the past 8 years also reported better overall health and wellbeing. Selected variables correlated with an active lifestyle and better perceptions of quality of life.
Keywords: older adults, aging, physical activity, wellbeing, quality of life, leisure time
Published in DiRROS: 30.08.2022; Views: 620; Downloads: 510
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A perspective on implementation of technology-driven exergames for adults as telerehabilitation services
Cécil J. W. Meulenberg, Eling D. de Bruin, Uroš Marušič, 2022, review article

Abstract: A major concern of public health authorities is to also encourage adults to be exposed to enriched environments (sensory and cognitive-motor activity) during the pandemic lockdown, as was recently the case worldwide during the COVID-19 outbreak. Games for adults that require physical activity, known as exergames, offer opportunities here. In particular, the output of the gaming industry nowadays offers computer games with extended reality (XR) which combines real and virtual environments and refers to human-machine interactions generated by computers and wearable technologies. For example, playing the game in front of a computer screen while standing or walking on a force plate or treadmill allows the user to react to certain infrastructural changes and obstacles within the virtual environment. Recent developments, optimization, and minimizations in wearable technology have produced wireless headsets and sensors that allow for unrestricted whole-body movement. This makes the virtual experience more immersive and provides the opportunity for greater engagement than traditional exercise. Currently, XR serves as an umbrella term for current immersive technologies as well as future realities that enhance the experience with features that produce new controllable environments. Overall, these technology-enhanced exergames challenge the adult user and modify the experience by increasing sensory stimulation and creating an environment where virtual and real elements interact. As a therapy, exergames can potentially create new environments and visualizations that may be more ecologically valid and thus simulate real activities of daily living that can be trained. Furthermore, by adding telemedicine features to the exergame, progress over time can be closely monitored and feedback provided, offering future opportunities for cognitive-motor assessment. To more optimally serve and challenge adults both physically and cognitively over time in future lockdowns, there is a need to provide long-term remote training and feedback. Particularly related to activities of daily living that create opportunities for effective and lasting rehabilitation for elderly and sufferers from chronic non-communicable diseases (CNDs). The aim of the current review is to envision the remote training and monitoring of physical and cognitive aspects for adults with limited mobility (due to disability, disease, or age), through the implementation of concurrent telehealth and exergame features using XR and wireless sensor technologies.
Keywords: older adults, telemedicine, virtual reality, rehabilitation, active video games
Published in DiRROS: 17.03.2022; Views: 675; Downloads: 540
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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: 835; Downloads: 865
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