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- All Subjects: systematic review
- Creators: Schaefer, Sydney
- Creators: Beeler, Adeline
- Creators: Bosch, Pamela
- Resource Type: Text
Description
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.
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
Description
Startle-evoked-movement (SEM), the involuntary release of a planned movement via a startling stimulus, has gained significant attention recently for its ability to probe motor planning as well as enhance movement of the upper extremity following stroke. We recently showed that hand movements are susceptible to SEM. Interestingly, only coordinated movements of the hand (grasp) but not individuated movements of the finger (finger abduction) were susceptible. It was suggested that this resulted from different neural mechanisms involved in each task; however it is possible this was the result of task familiarity. The objective of this study was to evaluate a more familiar individuated finger movement, typing, to determine if this task was susceptible to SEM. We hypothesized that typing movements will be susceptible to SEM in all fingers. These results indicate that individuated movements of the fingers are susceptible to SEM when the task involves a more familiar task, since the electromyogram (EMG) latency is faster in SCM+ trials compared to SCM- trials. However, the middle finger does not show a difference in terms of the keystroke voltage signal, suggesting the middle finger is less susceptible to SEM. Given that SEM is thought to be mediated by the brainstem, specifically the reticulospinal tract, this suggest that the brainstem may play a role in movements of the distal limb when those movements are very familiar, and the independence of each finger might also have a significant on the effect of SEM. Further research includes understanding SEM in fingers in the stroke population. The implications of this research can impact the way upper extremity rehabilitation is delivered.
ContributorsQuezada Valladares, Maria Jose (Author) / Honeycutt, Claire (Thesis director) / Santello, Marco (Committee member) / Harrington Bioengineering Program (Contributor, Contributor) / Barrett, The Honors College (Contributor)
Created2016-12
Description
Previous research has shown that a loud acoustic stimulus can trigger an individual's prepared movement plan. This movement response is referred to as a startle-evoked movement (SEM). SEM has been observed in the stroke survivor population where results have shown that SEM enhances single joint movements that are usually performed with difficulty. While the presence of SEM in the stroke survivor population advances scientific understanding of movement capabilities following a stroke, published studies using the SEM phenomenon only examined one joint. The ability of SEM to generate multi-jointed movements is understudied and consequently limits SEM as a potential therapy tool. In order to apply SEM as a therapy tool however, the biomechanics of the arm in multi-jointed movement planning and execution must be better understood. Thus, the objective of our study was to evaluate if SEM could elicit multi-joint reaching movements that were accurate in an unrestrained, two-dimensional workspace. Data was collected from ten subjects with no previous neck, arm, or brain injury. Each subject performed a reaching task to five Targets that were equally spaced in a semi-circle to create a two-dimensional workspace. The subject reached to each Target following a sequence of two non-startling acoustic stimuli cues: "Get Ready" and "Go". A loud acoustic stimuli was randomly substituted for the "Go" cue. We hypothesized that SEM is accessible and accurate for unrestricted multi-jointed reaching tasks in a functional workspace and is therefore independent of movement direction. Our results found that SEM is possible in all five Target directions. The probability of evoking SEM and the movement kinematics (i.e. total movement time, linear deviation, average velocity) to each Target are not statistically different. Thus, we conclude that SEM is possible in a functional workspace and is not dependent on where arm stability is maximized. Moreover, coordinated preparation and storage of a multi-jointed movement is indeed possible.
ContributorsOssanna, Meilin Ryan (Author) / Honeycutt, Claire (Thesis director) / Schaefer, Sydney (Committee member) / Harrington Bioengineering Program (Contributor) / Barrett, The Honors College (Contributor)
Created2016-12
ContributorsBeeler, Adeline (Author) / McNally, Mikayla (Co-author) / Schaefer, Sydney (Thesis director) / Lohse, Keith (Committee member) / Barrett, The Honors College (Contributor) / Harrington Bioengineering Program (Contributor)
Created2021-12
ContributorsBeeler, Adeline (Author) / McNally, Mikayla (Co-author) / Schaefer, Sydney (Thesis director) / Lohse, Keith (Committee member) / Barrett, The Honors College (Contributor) / Harrington Bioengineering Program (Contributor)
Created2021-12
ContributorsMcNally, Mikayla (Author) / Beeler, Adeline (Co-author) / Schaefer, Sydney (Thesis director) / Lohse, Keith (Committee member) / Barrett, The Honors College (Contributor) / Watts College of Public Service & Community Solut (Contributor)
Created2021-12
ContributorsMcNally, Mikayla (Author) / Beeler, Adeline (Co-author) / Schaefer, Sydney (Thesis director) / Lohse, Keith (Committee member) / Barrett, The Honors College (Contributor) / Watts College of Public Service & Community Solut (Contributor)
Created2021-12