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Effect of exergaming versus combined exercise on cognitive function and brain activation in frail older adults: A randomised controlled trial - 12/10/21

Doi : 10.1016/j.rehab.2021.101492 
Ying-Yi Liao a, I-Hsuan Chen b, Wei-Chun Hsu c, Han-Yun Tseng a, Ray-Yau Wang d,
a Department of gerontological health care, National Taipei University of Nursing and Health Sciences, Taipei, Taiwan 
b Department of physical therapy, Fooyin University, Kaohsiung, Taiwan 
c Graduate Institute of biomedical engineering, National Taiwan University of Science and Technology, Taipei, Taiwan 
d Department of physical therapy and assistive technology, National Yang-Ming University, Taipei, Taiwan 

Corresponding author.

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Highlights

Both exergaming and combined exercise improved cognition in frail older adults.
The improved cognition was coupled with increased neural efficiency after training.
Exergaming resulted in better global cognition improvement than combined exercise.

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Abstract

Background

Cognitive impairment is prevalent among frail older adults. Traditional exercise and exergaming positively affect cognition in healthy older people. However, few studies have investigated the effects of exergaming on cognition and brain activation in frail older adults.

Objective

This study compared the effect of Kinect based exergaming (EXER) and combined physical exercise (CPE) training on cognitive function and brain activation in frail older adults in Taiwan. We hypothesised that EXER would be superior to CPE in this population.

Methods

We randomised 46 community-dwelling frail older adults to the EXER or CPE group for 36 sessions (three 60-min training sessions per week) over 12 weeks. Outcome measures for cognitive function included global cognition measured by the Montreal Cognitive Assessment, executive function measured by the Executive Interview 25, verbal memory measured by the Chinese version of the California Verbal Learning Test, attention measured by the Stroop Colour and Word Test and Trail Making Test (part B), and working memory measured by spatial n-back tests. Prefrontal cortex activation during the global cognition test was documented with functional near-infrared spectroscopy (fNIRS).

Results

Both groups improved significantly in global cognition (P<0.05), executive function (P<0.05), and attention (P<0.05) after the 12-week intervention. The group×time interaction indicated that EXER training significantly enhanced global cognition more than CPE training (F(1,44)=5.277, P=0.026). Moreover, only the EXER group showed significant improvements in verbal (P<0.05) and working (P<0.05) memory after the intervention. The fNIRS hemodynamics data revealed decreased activation in prefrontal cortices of both groups (P<0.05) during the post-training cognitive assessment, thereby suggesting greater neural efficiency; however, we found no significant group difference.

Conclusion

In frail older adults, exergaming and CPE could improve cognitive function, most likely by increasing neural efficiency. Moreover, exergaming may be superior to CPE, particularly in improving global cognition.

Le texte complet de cet article est disponible en PDF.

Keywords : Kinect-based exergaming, Cognitive function, Frailty, Brain activation, Combined physical exercise, Functional near-infrared spectroscopy (fNIRS)


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Vol 64 - N° 5

Article 101492- septembre 2021 Retour au numéro
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