Objective
To examine the effectiveness of virtual reality (VR)-based rehabilitation training in improving cognition, motor function, and daily functioning in patients with mild cognitive impairment ...and dementia.
Data sources
A systematic review of published literature was conducted using PubMed, Web of Science, Elsevier, Embase, Cochrane, CNKI, Networked Digital Library of Theses and Dissertations.
Methods
The search period was from inception to 7 October 2023. Eligible studies were randomized controlled trials evaluating the efficacy of VR-based rehabilitation training in patients with mild cognitive impairment or dementia versus control subjects. Methodologic quality was assessed with the Cochrane risk of bias tool, and outcomes were calculated as the standard mean difference between participant groups with 95% confidence interval.
Results
A total of 21 randomized controlled trials with 1138 patients were included. The meta-analysis showed that VR-based rehabilitation training had significant effects on Montreal Cognitive Assessment (SMD: 0.50; 95%CI: 0.05 to 0.95; P = 0.030), Trail-making test A (SMD: −0.38; 95%CI: −0.61 to −0.14; P = 0.002), and Berg Balance Scale scores (SMD: 0.79; 95%CI: 0.13 to 1.45; P = 0.020). A subgroup analysis revealed that the type of VR, and duration and frequency of interventions had statistically significant effects on cognition and motor function.
Conclusion
VR-based rehabilitation training is a beneficial nonpharmacologic approach for managing mild cognitive impairment or dementia. Immersive VR-based training had greater effects on cognition and motor function than non-immersive VR-based training, but non-immersive VR-based training was more convenient for patients with limitations imposed by their disease. Also, an intervention lasting 5–8 weeks and for >30 min at a frequency of ≥3 times/week achieved the best results. It indicated that a longer intervention cycle may not achieve the best intervention effect and training duration and schedule should be carefully considered when managing patients.
Background
Traditional Chinese medicine (TCM) based exercises have been widely used in the prevention and treatment of balance, cardiopulmonary, and other related diseases in older adults. However, ...there seems to be no consensus on the improvement and comparison of physical performance, balance, and muscle strength in the elderly population.
Objectives
To systematically examine the impact of different TCM-based exercises on physical performance, balance, and muscle strength outcomes in the elderly.
Methods
We searched PubMed, EMBASE, Scopus, and Cochrane Center, CNKI and Wan Fang between their date of inception and March 2021. This meta-analysis was performed using RevMan5.3 software. Only randomized controlled trials (RCT) or controlled clinical trials (CCT) were considered in TCM-based exercises (Tai Chi, Ba Duan Jin, Qigong). The overall mean difference (MD) or standardized mean difference (SMD), and its 95% confidence interval (CI) were calculated.
Main results
A total of 27 studies with 2580 older adults met the inclusion criteria. The pooled analysis indicated that Tai Chi could be more effective in Times up and go (TUG) (MD = − 2.62, 95% CI − 4.00 to − 1.24,
P
= 0.0002), 5 times sit-stand (MD = − 1.89; 95%CI − 3.38 to − 0.40;
P
= 0.01), and handgrip strength outcomes (SMD = 0.69; 95%CI 0.52–0.86;
P
< 0.0001) compared to Ba Duan Jin and Qigong. The older adults performing Qigong could have a better benefit in Single-bed balance (SLB) with eyes closed compared to Tai Chi and Ba Duan Jin (MD = 3.42; 95%CI 1.55 to 5.29;
P
= 0.0003). Tai Chi also had benefits in terms of balance outcomes compared to those in the control group: Berg Balance scale (BBS) (MD = 1.41; 95% CI 0.03–2.85;
P
= 0.05), Functional reach test (FRT) (MD = 1.57; 95%CI 1.22–1.93;
P
< 0.0001). The Tai Chi study meta-analysis demonstrated significant effects on lower limb strength: knee extension (SMD = 0.56; 95%CI 0.26–0.86;
P
= 0.0003), ankle dorsiflexion (SMD = 0.67; 95%CI 0.02–1.31;
P
= 0.04) compared to the controls.
Conclusion
This systematic review reveals that TCM-based exercises can effectively improve physical performance outcomes, balance outcomes, and muscle strength in the elderly population. While there is limited evidence on the efficacy of other TCM-based lifestyle interventions, more high-quality clinical trials on this topic are warranted.
Perceptual-cognitive tasks play a pivotal role in performing voluntary movements, which is crucial for good performances among soccer players. This study explored the effect of perceptual-cognitive ...tasks on the inter-joint coordination of soccer players and college students during landing. The classic multiple objective tracking (MOT) task was used to simulate the perceptual-cognitive task under a sports environment. Fifteen soccer players (age: 20.1 ± 1.5 year, height: 181.4 ± 7.4 cm, weight: 75.4 ± 10.7 kg) and twenty ordinary college students (age: 20.0 ± 2.3 years, height: 177.9 ± 4.9 cm, weight: 71.6 ± 9.9 kg) were enrolled to the study. Participants in the two groups were subjected to a single task (landing task) and dual-task (MOT task and landing task). Coordination and variability indicators were recorded using a Vicon infrared motion capture system and a force measuring platform. The results showed that the mean absolute relative phase of hip and knee joint (MARP
hip-knee
), deviation phase of hip and knee joint (DP
hip-knee
), and deviation phase of knee and ankle joint (DP
knee-ankle
) of the two groups under the dual-task were significantly different compared with the parameters when participants were subjected to the single task. The dual-task had higher effect size on DP
hip-Knee
and MARP
hip-knee
, indicating that dual-task had a greater impact on coordination of the hip and knee joints. DP
hip-knee
and DP
knee-ankle
of ordinary students were more extensive relative to those of the soccer players, and hip joint stiffness (
K
hip
) for ordinary students was lower than that of the soccer players under the different tasks. These findings implied that the perceptual-cognitive task markedly affected the inter-joint coordination of soccer players and college students, mainly by impairing the hip and knee coordination. Although there is less variability in lower extremity coordination patterns of soccer players compared to college students, the MOT task still affects their coordination ability.
In the process of walking, attentional resources are flexibly allocated to deal with varying environmental constraints correlated with attentional control (AC). A dual-task paradigm was used to ...investigate the effects of AC on gait and inter-joint coordination. Fifty students volunteered to participate in this study. Based on the reaction time (RT) in the Stroop task, the top 15 participants were assigned to the High Attentional Control (HAC) group, while the last 15 participants were assigned to the Low Attentional Control (LAC) group. The participants in the two groups were randomly asked to perform three tasks: (i) single 2-back working memory task (ST 2-back); (ii) single walking task (ST walking); and (iii) dual task (DT). Cognitive outcomes and gait spatiotemporal parameters were measured. Continuous relative phase (CRP), derived from phase angles of two adjacent joints, was used to assess inter-joint coordination. The LAC group exhibited significant task effects regarding RT, correct rate (CR), step width, gait cycle, step time, forefoot contact times, heel-forefoot times, hip-knee mean absolute relative phase (MARP), and deviation phase (DP) in the stance and swing phases (
p
< 0.05). In the HAC group, significant task effects were only detected in RT and foot progression angle of the left foot (
p
< 0.05). Under the three task conditions, the LAC group exhibited a higher CR in ST, longer heel contact times, and longer heel-forefoot times when compared with the LAC group (
p
< 0.05). Compared with the LAC group, the HAC group exhibited significantly smaller (closer to zero) MARP and weaker hip-knee DP values in the swing phase across all gait conditions (
p
< 0.05). In the stance phase, the HAC group had smaller MARP (closer to zero) values when compared with the LAC group (
p
< 0.05). In conclusion, the ability to maintain gait control and modulate inter-joint coordination patterns in young adults is affected by the level of attentional control in accommodating gait disturbances. AC is correlated with the performance of motor control, which theoretically supports the competitive selection of athletes and fall prevention strategies for a specific population.
Background: With the advent of global aging, the health of the older population has become a critical public health challenge. The purpose of this study was to investigate the effect of dual-tasking ...on gait performance in patients with sarcopenia. Methods: Thirty participants with sarcopenia (age: 70.73 ± 4.12 yr, MMSE score: 26.90 ± 3.00), including 14 males and 16 females, were selected according to the diagnostic criteria of the Asian Working Group on Sarcopenia. All participants were instructed to perform the gait test in three modes: single task (ST), cognitive–motor dual task (CMDT), and motor–motor dual task (MMDT). Statistical analyses were performed using one-way ANOVA to evaluate the effects of different task types on gait parameters of the participants. Results: (1) Compared with ST walking, gait frequency, step length, and step speed decreased, and the gait cycle and double-support phase increased in patients with sarcopenia during dual-task walking (p < 0.05); (2) Compared with ST walking, gait variability indices such as stride frequency, stride length, and support period significantly increased in patients with sarcopenia during dual-task walking (p < 0.05). Conclusions: The increased difficulty in postural control caused by dual-task interference may reduce the safety of motor strategies in patients with sarcopenia and increase the risk of falls. Future studies should focus on the effects of exercise interventions on multitasking patterns in people with sarcopenia to promote balance function in these populations.
Nutritional supplements have been extensively used as health interventions for the elderly. However, with the spread of COVID-19, no consensus exists on whether nutritional interventions could ...improve muscle mass and physical activity in community-dwelling older adults. To conduct a systematic review and meta-analysis to explore the effects of different nutritional interventions on muscle mass and physical performance in the elderly, we searched
,
,
, and
databases from their founding dates to December 2023. The meta-analysis was performed using RevMan5.3 software. Only randomized controlled trials (RCTs) were considered, and the overall mean difference (MD) or standardized mean difference (SMD) with 95% confidence interval (CI) was calculated. There were 33 studies comprising 3579 elderly persons meeting the inclusion criteria. Comprehensive analysis suggested that the intervention effect of fat-free mass (FFM), appendix skeletal muscle mass (ASMM), handgrip strength (HGS), gait speed, and short physical performance battery (SPPB) score was higher in the nutritional supplement group than in the control group. The results of subgroup analysis demonstrated that protein supplementation (SMD = 0.82,
< 0.0001) had an optimal effect on ASMM (SMD = 0.89,
< 0.0001) and FFM (MD = 2.09,
< 0.0001) in the elderly. Vitamin D supplementation (SMD = 0.52,
< 0.0001) had a marginal effect on ASMM, and energy supplementation (SMD = 0.39,
= 0.0005) had the lowest effect. Moreover, nutritional interventions had the most significant impact on HGS (MD = 1.06,
< 0.0001) and TUG (MD = 0.14,
< 0.0001) in individuals aged 65-75 years old, with positive effects on FFM (MD = 1.62,
< 0.0001) and HGS (MD = 0.82,
< 0.0001) when compared to healthy elderly individuals, and had greater effect on ASMM (SMD = 0.69,
< 0.0001) than on the elderly with sarcopenia. Nutritional supplements can enhance muscle mass and physical performance in the elderly, while protein is recommended for muscle function. The golden period for implementing nutritional interventions to improve muscle function is before the age of 75 years. However, the impact of nutritional interventions varies with age and population. Given the limited evidence on nutritional interventions, more detailed and high-quality studies are highly warranted in the future.
Introduction:
Running is one of the most popular sports in the world, but it also increases the risk of injury. The purpose of this study was to establish a modeling approach for IMU-based subdivided ...action pattern evaluation and to investigate the classification performance of different deep models for predicting running fatigue.
Methods:
Nineteen healthy male runners were recruited for this study, and the raw time series data were recorded during the pre-fatigue, mid-fatigue, and post-fatigue states during running to construct a running fatigue dataset based on multiple IMUs. In addition to the IMU time series data, each participant’s training level was monitored as an indicator of their level of physical fatigue.
Results:
The dataset was examined using single-layer LSTM (S_LSTM), CNN, dual-layer LSTM (D_LSTM), single-layer LSTM plus attention model (LSTM + Attention), CNN, and LSTM hybrid model (LSTM + CNN) to classify running fatigue and fatigue levels.
Discussion:
Based on this dataset, this study proposes a deep learning model with constant length interception of the raw IMU data as input. The use of deep learning models can achieve good classification results for runner fatigue recognition. Both CNN and LSTM can effectively complete the classification of fatigue IMU data, the attention mechanism can effectively improve the processing efficiency of LSTM on the raw IMU data, and the hybrid model of CNN and LSTM is superior to the independent model, which can better extract the features of raw IMU data for fatigue classification. This study will provide some reference for many future action pattern studies based on deep learning.
Background. There is a possible interaction between the underlying mechanisms of perceptual-cognitive tasks and motor control. For example, landing biomechanics changed during perceptual-cognitive ...tasks undertaken at different levels of fatigue of the athlete. Thus, this study explored the effect of perception-cognitive tasks interventions on male soccer players’ landing mechanisms at different levels of fatigue. Methods. Perceptual-cognitive tasks during games were simulated using classic multiple object tracking (MOT) paradigms, and 15 male soccer players completed MOT tasks under nonfatigue (NF), moderate fatigue (MF), and severe fatigue (SF). Landing-associated indicators were collected and calculated using a Vicon and force measuring platform. Results. Level of fatigue and MOT task significantly affected hip and knee flexion angles, hip and knee extension moments, and vertical ground reaction force. Specifically, hip and knee flexion angles were significantly higher in MOT than non-MOT tasks at all levels of fatigue. In NF state, hip and knee extension moments were significantly smaller during MOT than non-MOT tasks. In SF state, the hip extension moment was larger during MOT than non-MOT tasks. In both MF and SF states, vertical ground reaction force was significantly higher in MOT than non-MOT tasks. Conclusion. Although soccer players landed cautiously when not fatigued, they were significantly less able to do this and handle challenging perceptual-cognitive task movements when fatigued. Thus, landing performance is affected by perceptual-cognitive task interference in fatigue conditions.
Background. Tai chi is recognized worldwide for its rehabilitation abilities and healthcare benefits. However, in recent years, some movements associated with tai chi have been shown to damage the ...lower limb joints. The purpose of this study was to investigate and compare the effects of different movements, postures, center of mass (COM) movements, and range of knee movement of tai chi exercises on knee joint load. Methods. Fourteen professional tai chi practitioners in two postures (high and low) were enrolled to perform the following four typical tai chi movements: wild horse’s mane (WHM), repulse monkey (RM), wave-hand in cloud (WHIC), and grasp the bird’s tail (GBT). Kinematic and kinetics data were synchronously collected using the Vicon infrared high-speed motion capture system and a three-dimensional (3D) force measurement platform. Variance analysis and partial correlation analysis were performed to investigate factors influencing peak knee joint moment and vertical ground reaction force (VGRF). Results. The results showed that the peak knee extension and abduction moment were larger in WHM and RM than those in WHIC and GBT (p<0.05). WHM was associated with greater rotation moment than the other typical movements (p<0.05). VGRF and joint moment among different poses were significantly different. Low-pose tai chi typical movements were associated with greater VGRF, knee joint extension and abduction, and rotation moments than high-pose movements (p<0.05). The anteroposterior and mediolateral COM displacements were strongly and positively associated with VGRF (p<0.001), while the mediolateral COM displacement was negatively associated with knee extension moment (p<0.001). The knee internal-external rotation ROM and anteroposterior and mediolateral COM displacements were positively associated with knee abduction moment (p<0.01). Conclusion. For long-term tai chi exercises, choosing a suitable posture based on an individual exercise level and reasonable control of knee ROM and COM displacement can reduce the risk of knee injury during exercise.
This review is aimed to assess the effectiveness of virtual reality (VR) games on cognition, mobility, and emotion in elderly stroke patients. We selected relevant articles from eight databases from ...2011 to 2022 and extracted articles on cognitive ability (general cognition, mini-mental state examination (MMSE), Montreal cognitive assessment (MoCA) et al.), mobility (modified Barthel index (MBI), Fugl-Meyer assessment (FMA), Berg balance scale (BBS), functional independence measure motor (FIM MOT)), and emotion (depression/anxiety). Twenty-nine studies including 1311 participants were included in the analysis. In the results, virtual reality games were more effective in improving overall cognitive function in stroke patients compared to conventional therapies. In addition, the intervention group in the MMSE (SMD = 0.6, 95%CI = 0.26–0.95,
P
= 0.0007), MoCA (MD = 1.97, 95%CI = 1.3–2.64,
P
< 0.00001), and attention test (MD = 0.25, 95% CI = 0.01–0.49,
P
< 0.00001) scores were also higher. In terms of physical function, MBI (SMD = 0.61, 95%CI = 0.14–1.08,
P
= 0.01), FMA (SMD = 0.47, 95%CI = 0.02–0.93,
P
= 0.04), BBS (SMD = 0.78, 95%CI = 0.42–1.15,
P
< 0.0001), and FIM MOT (MD = 5.87, 95%CI = 2.57–9.17,
P
= 0.0005) indicators showed better results. It is also observed that virtual reality games can effectively relieve depression and improve mental health in stroke patients. Sports game training, especially with VR equipment, had a positive impact on improving the cognitive performance, mobility, and emotional state of stroke patients compared to a control group. Although the improvement in cognitive ability is relatively low, the effect of improving physical activity and depression is obvious.
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