Matching Items (5)
Filtering by
- All Subjects: Strokes
- All Subjects: gross motor
- Creators: Holzapfel, Simon
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
Executive function is vital for activities of daily living especially in stroke survivors because it is critical to everyday tasks (e.g., driving, cooking, etc.). An innovative way to improve executive function may be Assisted Cycling Therapy (ACT). This is among the first studies to use a Stroop task to measure inhibition, selective attention, and information processing speed following ACT in stroke survivors. Twenty-three participants post-stroke performed ACT, voluntary cycling (VC) and no cycling (NC). The results showed that there were improvements in the Stroop task following an acute session of ACT but not following VC or NC. These results suggest that ACT resulted in increased afferent information which may have resulted in increased arousal and excitability in regions of the prefrontal cortex. These factors have been shown to improve executive function.
ContributorsCooper, Aspen (Author) / Ringenbach, Shannon (Thesis director) / Holzapfel, Simon (Committee member) / Barrett, The Honors College (Contributor)
Created2017-05
Description
Upper extremity function is vital for activities of daily living especially in stroke survivors. An innovative way to improve upper extremity function has been shown with Assisted Cycle Therapy (ACT). This is among the first study to examine ACT in stroke survivors. 13 stroke survivors performed ACT, VC, and NC and pre and post measures of upper extremity function were conducted with the box and blocks test (BBT). The results showed that non-paretic upper extremity improved its function after ACT and VC, but not after NC. For the paretic arm, while the results did not reach conventional levels of significance, improvements in upper extremity function following ACT more so than VC or NC. These results were interpreted to suggest that ACT resulted in increased production of BDNF in the motor cortex, which resulted in improvements in global motor function.
ContributorsHeyer, Brittany Nicole (Author) / Ringenbach, Shannon (Thesis director) / Holzapfel, Simon (Committee member) / School of Nutrition and Health Promotion (Contributor) / Barrett, The Honors College (Contributor)
Created2016-12
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 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
This study examined upper extremity function, including manual dexterity, in chronic stroke survivors following a 10-week high intensity interval treadmill walking intervention. Six stroke survivors completed two 35-minute high intensity interval treadmill walking sessions based on ventilatory threshold per week. In addition, each participant completed one 30-minute low-intensity walking session at home. Participants completed upper extremity and manual dexterity testing at baseline, acutely, and after the 10-week intervention. Contrary to the prediction made, significant improvements in both paretic and non-paretic upper-extremity function including manual dexterity were not found. While time to complete the Nine Hole Peg Test (9HPB) somewhat decreased and the number of blocks transferred in the Box and Blocks Test (BBT) slightly increased, results were not found to be statistically significant. The results do suggest, nonetheless, that high intensity interval treadmill training may lead to improvements in upper extremity function and potentially daily living in chronic stroke survivors.
ContributorsHatty, Laura Elizabeth (Author) / Ringenbach, Shannon (Thesis director) / Bosch, Pamela (Committee member) / Holzapfel, Simon (Committee member) / School of Nutrition and Health Promotion (Contributor) / Barrett, The Honors College (Contributor)
Created2016-05