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Background and Purpose— There is limited conclusive data on both pharmacological and holistic treatment options to improve cognition in adults after stroke. In particular, there is lacking evidence for cognitive rehabilitation in the subacute and chronic phases when cognitive impairment may be more perceptible. In this meta-analytic review, our primary

Background and Purpose— There is limited conclusive data on both pharmacological and holistic treatment options to improve cognition in adults after stroke. In particular, there is lacking evidence for cognitive rehabilitation in the subacute and chronic phases when cognitive impairment may be more perceptible. In this meta-analytic review, our primary objective was to determine the cognitive effects of aerobic exercise on post-stroke adults in the post-acute phases. Secondary objectives were to investigate the differential effects of aerobic exercise on sub-domains of cognitive function.
Methods— Data were extracted and filtered from electronic databases PubMed (MEDLINE), CINAHL, Embase, PsycINFO, and Scopus. Intervention effects were represented by Hedges’ g and combined into pooled effect sizes using random effects models. Heterogeneity was evaluated using the Chi-squared (Q) and I-squared statistics.
Results— Five studies met inclusion criteria, representing data from 182 participants. The primary analysis produced a positive overall effect of aerobic exercise on cognitive performance (Hedges’ g [95% confidence interval]= 0.42 [0.007–0.77]). Effects were significantly different from zero for aerobic interventions combined with other physical activity interventions (Hedges’ g [CI] =0.59 [0.26 to 0.92]), but not for aerobic interventions alone (P= 0.40). In specific subdomains, positive moderate effects were found for global cognitive function (Hedges’ g [CI] =0.79 [0.31 to 1.26]) but not for attention and processing speed (P=0.08), executive function (P= 0.84), and working memory (P=0.92).
Conclusions— We determined that aerobic exercise combined with other modes of training produced a significant positive effect on cognition in adults after stroke in the subacute and chronic phases. Our analysis supports the use of combined training as a treatment option to enhance long-term cognitive function in adults after stroke. Further research is needed to determine the efficacy of aerobic training alone.
ContributorsMitchell, Michaela (Author) / Holzapfel, Simon (Thesis director) / Bosch, Pamela (Committee member) / College of Health Solutions (Contributor) / Barrett, The Honors College (Contributor)
Created2019-05
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Description

This study examines the effectiveness of two modes of exercise on inhibitory control in adults with Down Syndrome (DS). Thirteen participants attended four sessions: a baseline assessment, an Assisted Cycling Therapy (ACT) session, a Resistance Training (RT) session, and a session of No Training (NT). In the baseline assessment, 1-repetition

This study examines the effectiveness of two modes of exercise on inhibitory control in adults with Down Syndrome (DS). Thirteen participants attended four sessions: a baseline assessment, an Assisted Cycling Therapy (ACT) session, a Resistance Training (RT) session, and a session of No Training (NT). In the baseline assessment, 1-repetition max (1RM) measurements and voluntary pedal rate measurements were taken. In the resistance training session, the leg press, chest press, seated row, leg curl, shoulder press, and latissimus pulldown were performed. In the cycling intervention, the participant completed 30 minutes of cycling. The Erikson Flanker task was administered prior to each session (i.e., pretest) and after the intervention (i.e., post-test). The results were somewhat consistent with the hypothesis that inhibition time improved more following RT and ACT than NT. there was also a significant difference between ACT and NT. Additionally, it was hypothesized that all measures would improve following each acute exercise intervention, but the most significant improvements were seen following ACT. In conclusion, an acute session of ACT demonstrated a significant trend towards improvements in inhibitory control in adults with DS which we interpreted using a model of neural changes.

ContributorsHayes, Claire (Author) / Ringenbach, Shannon (Thesis director) / Arnold, Nate (Committee member) / Rand, Miya (Committee member) / Edson College of Nursing and Health Innovation (Contributor) / College of Health Solutions (Contributor) / Barrett, The Honors College (Contributor)
Created2021-05
ContributorsGonzalez, Xavier (Author) / Ringenbach, Shannon (Thesis director) / Ofori, Edward (Committee member) / Barrett, The Honors College (Contributor) / College of Health Solutions (Contributor)
Created2023-05
ContributorsGonzalez, Xavier (Author) / Ringenbach, Shannon (Thesis director) / Ofori, Edward (Committee member) / Barrett, The Honors College (Contributor) / College of Health Solutions (Contributor)
Created2023-05
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Description

The primary goal of this study is to assess and develop an understanding of the effects of Assisted Cycling Therapy on manual motor performance in children with Down syndrome. Seven children (Mage 11.6 years old) completed a 30-minute cycle session 2x/week for 8 weeks on the PACT bicycle at a

The primary goal of this study is to assess and develop an understanding of the effects of Assisted Cycling Therapy on manual motor performance in children with Down syndrome. Seven children (Mage 11.6 years old) completed a 30-minute cycle session 2x/week for 8 weeks on the PACT bicycle at a 35% greater rate than their self-selected rate. Pre- and post-testing of grip force with a dynamometer and unimanual and bimanual manual dexterity using the Purdue Pegboard were measured to determine changes in force production and fine motor control, respectively. Results consistently showed improvements in grip force in both hands and bimanual dexterity following PACT. My results are interpreted with respect to cerebral lateralization and neuroplasticity following PACT intervention.

ContributorsGunther, Bryn (Author) / Ringenbach, Shannon (Thesis director) / Ofori, Edward (Committee member) / Rand, Miya (Committee member) / Rafie, Fourozan (Committee member) / Barrett, The Honors College (Contributor) / College of Health Solutions (Contributor)
Created2023-05
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Description

Down syndrome (DS) is caused by either an extra copy of chromosome 21 or by extra material on chromosome 21. This causes various levels of intellectual disability and issues with gross motor skill development which can prevent these individuals from participating in activities of daily living (ADL) such as getting

Down syndrome (DS) is caused by either an extra copy of chromosome 21 or by extra material on chromosome 21. This causes various levels of intellectual disability and issues with gross motor skill development which can prevent these individuals from participating in activities of daily living (ADL) such as getting dressed, self-care, or grocery shopping. People with DS have a decreased ability to balance, an abnormal and slower gait pattern, difficulty adapting to new environments, and a lack of improvement in these areas with growth and development when compared to their neurotypical peers. The objective of this study was to determine the immediate effects of resistance training (RT) and assisted cycle therapy (ACT) on adults with DS’s balance ability and gait speed. Each participant completed one session of RT, ACT (stationary cycling with the assistance of a motor to maintain a cadence of at least 35% greater than their voluntary cycling speed), and no training in a randomly selected order. Balance and gait speed were measured by a Clinical Test of Sensory Interaction on Balance (CTSIB) (i.e., eyes open firm surface, eyes closed firm surface, eyes open foam surface, eyes closed foam surface) on a Balance Tracking System Board (Btracks board) and by a Timed Up and Go (TUG) test. A total of ten participants’ data was used for analysis. The measures of total path length (cm), anterior-posterior (AP) excursion, and medial-lateral (ML) excursion were used to analyze the CTSIB. The average time was used to analyze the TUG test. The results showed that the eyes closed foam surface balance task was the most challenging balance task for every participant in every intervention. Furthermore, the most improvement was evident in the eyes closed foam surface balance task from pre to post intervention in all of the interventions. Post hoc tests also indicated statistically significant improvements of path length from pre to post in the RT intervention with the eyes closed foam surface balance task as well as with AP excursion in the ACT intervention with the eyes closed foam surface balance task. Possible explanations for improvements from pre to post in the eyes closed foam balance task across all interventions will be discussed with respect to the length of the intervention, and the effect of strength, social and learned factors on balance in adults with DS.

ContributorsKeim, Jeannette Danielle (Author) / Ringenbach, Shannon (Thesis director) / Peterson, Daniel (Committee member) / College of Health Solutions (Contributor) / Barrett, The Honors College (Contributor)
Created2020-12
Description
The genetic disorder Down syndrome (DS), clinically known as Trisomy 21, is characterized by the presence of either a part or full extra copy of chromosome 21. When compared with children of typical development, children with DS consistently score lower on gross motor skill tasks. Balance specifically is one of

The genetic disorder Down syndrome (DS), clinically known as Trisomy 21, is characterized by the presence of either a part or full extra copy of chromosome 21. When compared with children of typical development, children with DS consistently score lower on gross motor skill tasks. Balance specifically is one of the hardest skills for individuals with DS (especially children) to acquire, and neglecting to train balance early on can predispose individuals with DS to further movement instabilities, injuries, social struggles from activity limitations, and an overall lack of independence. One of the more unique forms of physical activity that requires a large amount of both static and dynamic balance is ballet. Dance-specific therapy has been shown to improve gross motor control functioning and specifically balance in a variety of populations with neuromuscular condions, but the research around ballet-specific therapy for those with DS is lacking. The purpose of this pilot study was to further investigate the effects of ballet-specific training on balance ability and general motor functioning in young students with DS as measured by the Four Square Step Test (FSST), Pediatric Balance Scale (PBS), and the gross and fine motor domains of the Vineland Adaptive Behavior Scale lll (VABS lll). It was hypothesized that participation in the 6-week summer cohort of Ballet Arizona’s Adaptive Dance Program would lead to improved scores on the PBS and VABS lll and decreased test times in the FSST. Improvements were observed for all measures for both participants (sample size n=2), except for P1's FSST, which increased in post-testing by 2.25s. Due to the study design, no conclusive statements can be made about whether the ballet program was responsible for the improvements observed in post-testing. More rigorous research with larger sample sizes (>30) is warranted to more fully understand the impact of an adapted ballet program on the balance ability of young individuals with DS. However, the program is still recommended for young individuals with DS because of the benefits it provides outside of motor skill development.
ContributorsMitrovic, Jelena (Author) / Peterson, Daniel (Thesis director) / Holzapfel, Simon (Committee member) / Barrett, The Honors College (Contributor) / College of Health Solutions (Contributor)
Created2022-12
Description
Many children with disabilities need physical therapy treatment but it can be difficult to instruct patients with restricted or limited communication. Most exercise cards and depictions used in communicating instruction to pediatric special needs patients are not representative of children with disabilities. This project aimed to create inclusive physical therapy

Many children with disabilities need physical therapy treatment but it can be difficult to instruct patients with restricted or limited communication. Most exercise cards and depictions used in communicating instruction to pediatric special needs patients are not representative of children with disabilities. This project aimed to create inclusive physical therapy exercise cards depicting children with disabilities. The goal of these cards was to help communicate instructions and motivate children to perform their exercises in clinical settings. The exercise selection was based on observations from working with children with disabilities in a pediatric physical therapy clinic. As a result, photos of children with developmental disabilities were taken performing exercises and subsequently made into cards and provided to physical therapists (PT). The PT’s used the cards for at least a week and reported on their functionality. The feedback from PT’s regarding the use of exercise cards in therapy sessions was overwhelmingly positive. With the positive feedback from the PT’s, the cards will be published and donated to pediatric physical therapy clinics in Arizona.
ContributorsMack, Sarah (Author) / Hart, Teresa (Thesis director) / Broman, Tannah (Committee member) / Barrett, The Honors College (Contributor) / College of Health Solutions (Contributor)
Created2024-05
Description
Exercise is widely recognized for its myriad of health benefits, particularly in the realm of chronic disease prevention and treatment. Despite this knowledge, exercise remains significantly underutilized in the United States, with only a quarter of the population meeting the recommended physical activity guidelines set by the Department of Health

Exercise is widely recognized for its myriad of health benefits, particularly in the realm of chronic disease prevention and treatment. Despite this knowledge, exercise remains significantly underutilized in the United States, with only a quarter of the population meeting the recommended physical activity guidelines set by the Department of Health and Human Services (Piercy et al., 2018). Recent research has spotlighted specific regions known as Blue Zones, where natural movement is incorporated into daily lives and populations are characterized by increased longevity and improved health outcomes, including lower rates of chronic diseases. This study aimed to explore and compare exercise behaviors between the United States and the Ikaria Blue Zone in Greece, investigating their potential implications for a longer lifespan and enhanced health. Employing ethnographic methods, including immersive observation, semi-structured, qualitative interviews with locals, and the distribution of validated International Physical Activity Questionnaire (IPAQ) surveys, comprehensive data on exercise habits within the Ikarian population was collected in November 2023. The findings from this study shed light on alternative forms of physical activity that have proven successful in populations with increased longevity. By identifying and understanding these practices, there is an opportunity to implement them in the United States, potentially contributing to improved exercise adherence and the prevention and treatment of chronic diseases. This research underscores the significance of cross-cultural insights in developing effective strategies to promote healthier lifestyles and enhance overall well-being.
ContributorsUnderhill, Jackson (Author) / Hrncir, Shawn (Thesis director) / Siegler, Jason (Committee member) / Barth, Christina (Committee member) / Barrett, The Honors College (Contributor) / School of Life Sciences (Contributor) / College of Health Solutions (Contributor)
Created2024-05
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Description
Research on the correlation between exercise and mental health outcomes has been a growing field for the past few decades. It is of specific interest to look at how physical activity affects psychological outcomes and it’s efficacy for treating mental health disorders. The current treatment options for depression and

Research on the correlation between exercise and mental health outcomes has been a growing field for the past few decades. It is of specific interest to look at how physical activity affects psychological outcomes and it’s efficacy for treating mental health disorders. The current treatment options for depression and anxiety are not suitable for everyone and therefore there is a need for a more accessible and cost-effective form of treatment, like exercise. Furthermore, exercise as a treatment is also linked with many more health benefits. Indeed a wealth of studies have explored the relationships between exercise and depression as well as exercise and anxiety, showing exercise to be a positive predictor of mental health. The following paper will serve to: define depressive and anxiety disorders, explore the research on the effects of physical activity prescriptions on the outcomes of such disorders, create evidence-based applied recommendations for different disorders, and explore the mechanisms by which exercise mitigates symptoms to ultimately accredit the prescription of exercise as a form of treatment for mental health disorders.
ContributorsAddington, Rachel Anne (Author) / Hoffner, Kristin (Thesis director) / Broman, Tannah (Committee member) / College of Health Solutions (Contributor) / Barrett, The Honors College (Contributor)
Created2020-05