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What Works Best? A Global Comparative-Analysis of Alzheimer’s Disease Treatment and Care

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The purpose of this project is to present research within three main categories of treatment and care such as exercise, socialization and alternative therapies (art, pet, and reminiscent therapies) for Alzheimer’s Disease (AD). These categories will be examined in the

The purpose of this project is to present research within three main categories of treatment and care such as exercise, socialization and alternative therapies (art, pet, and reminiscent therapies) for Alzheimer’s Disease (AD). These categories will be examined in the following countries: United Kingdom, United States, Brazil, and China. Then, the synthesized material will be analyzed and placed into a comparison and contrast model showcasing what each country is currently using and the success of the particular resource within a heat map. According to the research found on the following categories of exercise, socialization and alternative therapies, I will conclude that a combination of aerobic and resistance training, routine support groups and art/pet therapies are the most effective treatment options against Alzheimer’s Disease.

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2019-05

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Targeting the Prefrontal Cortex with Assisted Cycle Therapy (ACT) to Improve Sleep in Adult Down Syndrome (DS) Populations

Description

Individuals with Down syndrome (DS) display significantly earlier symptoms of Alzheimer's disease (AD) beginning around age 35. Because AD-like symptoms tend to be ever present in those with DS, it is difficult to accurately evaluate those with DS for earlier

Individuals with Down syndrome (DS) display significantly earlier symptoms of Alzheimer's disease (AD) beginning around age 35. Because AD-like symptoms tend to be ever present in those with DS, it is difficult to accurately evaluate those with DS for earlier onset of AD. It has been suggested that physical activity and sleep are potential measures to monitor for manifestations of early AD-like symptoms in people with DS. Our lab has previously shown remarkable improvements in physical activity, cognition, and motor control while using Assisted Cycle Therapy (ACT) for adolescents with DS, Parkinson's disease (PD), and stroke populations. This novel exercise intervention is suggested to mediate improvements in cerebral activation through upregulated neurogenesis, angiogenesis, and neuro-plastic mechanisms. Despite prior research, there remains to be limited studies behind these concepts in adults with DS and sleep, which is suspected to be an accurate metric for AD-like manifestations. Fifteen older adult participants with DS were assigned to one of two cycling interventions: ACT or VC. All participants were provided Fitbit HR devices for sleep and physical activity tracking. Only five adults had viable continuous collection of data for both sleep and physical activity. While none of our results reached conventional levels of significance, there were trends towards significance in the VC group for total steps taken and in the ACT group for sleep-onset latency (SOL). Individual cases of improvement were noted but it globally can be supported that Fitbit devices are not optimistic for adults with DS due to poor long-term compliance. It comes to no surprise to those involved with these groups that cooperativity tends to be low with long term interventions in research design. In spite of this significant barrier, Fitbit devices offer to be a reliable and inexpensive record keeper of physical activity and sleep. Future research should lean to investigate the viability of Fitbit devices within younger populations, the role of heart rate variability on sleep efficiency and sleep onset latency in DS, and utilize more extensive compliance reinforcement to obtain volume of data collection needed to establish significant measurements of physical activity and sleep in populations with DS.

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2018-12

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The Effect of an Exercise Program for Adults with Down Syndrome (ExDS) on Balance

Description

Individuals with Down Syndrome (DS) are subject to a spectrum of behavioral, cognitive and physical impairments. This population is more predisposed to comorbidity and typically has an increased risk of inactivity resulting in a lower level of fitness. Previous studies

Individuals with Down Syndrome (DS) are subject to a spectrum of behavioral, cognitive and physical impairments. This population is more predisposed to comorbidity and typically has an increased risk of inactivity resulting in a lower level of fitness. Previous studies on physical activity have shown that routine exercise has similar health benefits for those with DS as those individuals without a disability and in turn progresses their balance ability. Due to limited exercise program opportunities and studies that intentionally investigate the benefits of specific modes of exercise on the DS population, a community-based Exercise Program for Adults with DS (ExDS) was created with the goal of improving their physical and mental health and measuring changes in their balance capabilities throughout the program. ExDS partnered with Arizona State University (ASU) students to create biweekly customized workouts, that followed exercise prescription guidelines, consisting of an aerobic warm-up, main aerobic exercise bout, resistance training, balance training, and stretching for each participant with DS. Participant dynamic and static balance ability was measured using the Berg Balance Scale (BBS) during program pre- and post-assessments. The BBS composite score did not change and no significant improvement was seen in the p-values for each line item of the BBS from pre- to post-testing. For follow-up analyses, the participants with low treatment fidelity were removed. Follow-up analyses showed significant increases in BBS composite score and line item 13 from pre- to post-testing. Treatment fidelity was a limitation in this study and future studies should aim to increase fidelity and consistency of tester for pre- and post-testing. In conclusion, holistic exercise programming for adults with DS appears to benefit balance as long as treatment fidelity is high. It is unclear which mode of exercise had the greatest impact on changes in balance.

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2018-12

The Effect of Exercise on Adaptive Behavior in Adults with Down Syndrome

Description

Adaptive behavior consists of the social, conceptual and practical skills an individual must execute to function independently in their everyday life. Individuals with Down syndrome have limitations in their adaptive behavior due to cognitive and physical deficits. The aim of

Adaptive behavior consists of the social, conceptual and practical skills an individual must execute to function independently in their everyday life. Individuals with Down syndrome have limitations in their adaptive behavior due to cognitive and physical deficits. The aim of this study was to examine if an exercise program would improve the adaptive behavior skills in persons with Down syndrome. The exercise intervention, Exercise for Adults with Down Syndrome (ExDS), was a semester long program where adults with Down syndrome participate in twice weekly workouts planned and executed by Arizona State University students. The workouts consisted of an aerobic warm up, aerobic exercises, resistance exercises, balance exercises and stretches. The participants' adaptive behavior and cognitive planning ability were assessed before ExDS and after ExDS. The Adaptive Behavior Assessment System Second Edition (ABAS-II) was used to measure adaptive behavior. The ABAS-II consisted of a forum that addressed the Social, Conceptual and Practical domains of adaptive behavior and was filled out by the participants' caregiver. The Tower of London (ToL) was used to measure cognitive planning ability. The change in the ABAS-II scores from pre- to post-testing were statistically insignificant. The change from pre- to post-testing in the ToL scores approached statistical significance. Limitations included bias caregiver perception and respondent inconsistency. There is a need for further research on the effect of exercise on the adaptive behavior in adults with Down syndrome.

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2018-12

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Effects of Aerobic Exercise on Cognition in Adults 3 Months or More Post-Stroke: A Meta-Analysis

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

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.

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Date Created
2019-05

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VO2max Testing in Chronic Stroke Survivors

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The maximal amount of oxygen a person’s body can use while exercising is their VO2max. It is important to test VO2max in chronic stroke survivors who experience stroke-related deficits. The American College of Sports Medicine defines criteria for determining if

The maximal amount of oxygen a person’s body can use while exercising is their VO2max. It is important to test VO2max in chronic stroke survivors who experience stroke-related deficits. The American College of Sports Medicine defines criteria for determining if a VO2max was reached. These criteria appear not to be applicable for this population. We explored an alternative set of criteria that appears more appropriate. Criteria for VO2max testing post-stroke should be further tested and defined.

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2020-05

Contact Theory-Busted

Description

The intergroup contact theory purports positive effects of intergroup contact on both implicit and explicit attitudes. Implicit attitudes refer to the lack of awareness of the attitude, whereas explicit attitudes are conscious to each individual. The purpose of this study

The intergroup contact theory purports positive effects of intergroup contact on both implicit and explicit attitudes. Implicit attitudes refer to the lack of awareness of the attitude, whereas explicit attitudes are conscious to each individual. The purpose of this study was to examine the effects of direct interaction with people with intellectual disabilities on both the conscious and unconscious attitudes of college students without intellectual disabilities. The intergroup contact was accomplished through the Exercise Program for Adults with Down Syndrome (ExDS) at Arizona State University (ASU). ExDS is a semester long program integrating ASU students with adults with Down syndrome to design and perform workouts in a buddy system twice a week. ASU students enrolled in unrelated on-ground courses served as control participants. Implicit attitudes were tested using the Implicit Association Task at the beginning and end of the semester. Explicit attitudes were also tested using a self-report questionnaire--Community Living Attitudes Scale-ID version before and after enrollment in the program. Results were analyzed using a two-way ANOVA, where the interaction effects were statistically insignificant for both the IAT and CLAS-ID. Limitations included inconsistencies in the data collection process, the type of contact with those with intellectual disabilities, possible testing effects of learning both measures pre- and post- testing and a small sample size. Further research is necessary to determine the most effective way to measure implicit and explicit biases to those with intellectual disabilities.

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2020-05

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My PTPro App - Circadian Health

Description

Physical therapy patients still receive their plan of care onto a piece of paper when there are hundreds of engaging physical therapy exercise videos on the internet. These exercise videos are way more appealing to watch and physical therapists should

Physical therapy patients still receive their plan of care onto a piece of paper when there are hundreds of engaging physical therapy exercise videos on the internet. These exercise videos are way more appealing to watch and physical therapists should consider delivering Home Exercise Programs (HEP) digitally. There are apps and online services such as Physioadvisor, Physprac app, Anterior Cruciate Ligament repair app, and work-out apps for people to create their own plan of care and are easily accessible with any electronic device. Most people are receiving information and learning through a lit screen anyways so it may only be a matter of time before people start using these resources instead of a physical therapist. Physical Therapists need to provide better resources for their patients and an app may be all they need. Figures of the results of the Qualtrics survey both Physical Therapists and Patient responses and were provided. A data analysis of each question and responses were interpreted to determine whether patients and physical therapists would like to use a physical therapy app as part of their rehab program. A Physiotherapy research journal with Switzerland researchers conducted a case study in a hospital and determined whether a HEP app testing was effective for patients to utilize.

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2020-05

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Cognitive Planning Improved after Cycling Exercise in Older Adults with Down Syndrome

Description

Executive function is a crucial part of daily living and activities for individuals with Down Syndrome (DS). The aim of this study was to examine if Assisted Cycle Therapy (ACT) would improve cognitive planning as measured by the Tower of

Executive function is a crucial part of daily living and activities for individuals with Down Syndrome (DS). The aim of this study was to examine if Assisted Cycle Therapy (ACT) would improve cognitive planning as measured by the Tower of London (TOL), set switching as measured by the modified Wisconsin Card Sorting Test, and spatial memory as measured by the Corsi Block Test in older adults with DS. Twenty-six participants were randomly assigned to one of three interventions over eight weeks. 1) Thirteen older adults with DS completed the ACT intervention, which is stationary cycling with the assistance of a motor to maintain a cadence at least 35% greater than voluntary cycling. 2) Eleven older adults with DS completed voluntary cycling (VC) and 3) Two older adults with DS were in our no cycling intervention. There were tests administered a week prior to the invention (or no intervention) and one week after their completed intervention (or no intervention). The pre- and post-tests were used to assess different measures, which could have been influenced from the eight-week intervention. The measures analyzed from our study were as followed; Tower of London, Card Sorting Test, and the Corsi Block Test. Our results showed that cognitive planning improved after ACT and VC, but not NC. Cognitive planning was assessed through the TOL task and showed improvements after the eight-week intervention (due to its sensitive nature in analyzing smaller changes pre- and post-intervention). Our results are discussed with respect to upregulation of neurotrophic factors that increase functioning in the prefrontal cortex that accompanies exercise.

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2017-12

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Assisted Cycling Therapy Improves Self-Efficacy and Exercise Perception in Older Adults with Down Syndrome

Description

The aim of this study was to examine the effects of Assisted Cycle Therapy (ACT) on self-efficacy and exercise perception in older adults with Down syndrome (DS) after a three times a week for 8 weeks intervention. Thirteen participants were

The aim of this study was to examine the effects of Assisted Cycle Therapy (ACT) on self-efficacy and exercise perception in older adults with Down syndrome (DS) after a three times a week for 8 weeks intervention. Thirteen participants were in the ACT group in which a motor assisted their cycling to be performed at least 30% faster than voluntary cycling (VC), 11 participants were in the voluntary cycling group and two participants were in the no cycling (NC) group. The results showed that both exercise groups (i.e., ACT and VC) improved in their self-efficacy after the 8 week intervention. In addition, exercise perception improved following ACT and not VC or NC. Our results are discussed with respect to their future implications for exercise in the DS population. It might be that the yielded results were due to differences in effort required by each intervention group as well as the neurotrophic factors that occur when muscle contractions create synaptic connections resulting in improvement in cognition and feelings of satisfaction. In the future, research should focus on the psychological factors such as social accountability and peer interaction as they relate to ACT and physical activity in person's with DS.

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2018-05