Browsing by Author "Health Sciences, School of Health and Human Sciences"
Now showing 1 - 10 of 49
Results Per Page
Sort Options
Item Alexa, let's train now! - A systematic review and classification approach to digital and home-based physical training interventions aiming to support healthy cognitive aging(Elsevier, 2023) Herold, Fabian; Theobald, Paula; Gronwald, Thomas; Kaushal, Navin; Zou, Liye; de Bruin, Eling D.; Bherer, Louis; Müller, Notger G.; Health Sciences, School of Health and Human SciencesBackground There is mounting evidence that regular physical activity is an important prerequisite for healthy cognitive aging. Consequently, the finding that almost one-third of the adult population does not reach the recommended level of regular physical activity calls for further public health actions. In this context, digital and home-based physical training interventions might be a promising alternative to center-based intervention programs. Thus, this systematic review aimed to summarize the current state of the literature on the effects of digital and home-based physical training interventions on adult cognitive performance. Methods In this pre-registered systematic review (PROSPERO; ID: CRD42022320031), 5 electronic databases (PubMed, Web of Science, PsycInfo, SPORTDiscus, and Cochrane Library) were searched by 2 independent researchers (FH and PT) to identify eligible studies investigating the effects of digital and home-based physical training interventions on cognitive performance in adults. The systematic literature search yielded 8258 records (extra 17 records from other sources), of which 27 controlled trials were considered relevant. Two reviewers (FH and PT) independently extracted data and assessed the risk of bias using a modified version of the Tool for the assEssment of Study qualiTy and reporting in EXercise (TESTEX scale). Results Of the 27 reviewed studies, 15 reported positive effects on cognitive and motor-cognitive outcomes (i.e., performance improvements in measures of executive functions, working memory, and choice stepping reaction test), and a considerable heterogeneity concerning study-related, population-related, and intervention-related characteristics was noticed. A more detailed analysis suggests that, in particular, interventions using online classes and technology-based exercise devices (i.e., step-based exergames) can improve cognitive performance in healthy older adults. Approximately one-half of the reviewed studies were rated as having a high risk of bias with respect to completion adherence (≤85%) and monitoring of the level of regular physical activity in the control group. Conclusion The current state of evidence concerning the effectiveness of digital and home-based physical training interventions is mixed overall, though there is limited evidence that specific types of digital and home-based physical training interventions (e.g., online classes and step-based exergames) can be an effective strategy for improving cognitive performance in older adults. However, due to the limited number of available studies, future high-quality studies are needed to buttress this assumption empirically and to allow for more solid and nuanced conclusions.Item Applying theory to overcome internal barriers for healthy behavior change in adults with intellectual disabilities(Sage, 2021-06) Oliver, Amy; Munk, Niki; Stanton-Nichols, Kathleen A; Health Sciences, School of Health and Human SciencesAdults with disabilities are 57% less physically active than individuals without disabilities and two times as likely to be obese. With obesity, adults with disabilities also face increased risk of comorbid disabilities stemming from obesity. The purpose of this theoretical case study was to identify key behavioral change theories which may be utilized to increase physical activity levels in adults with intellectual disabilities. The Self-Efficacy Theory and Self-Determination Theory both present constructs for understanding behavior change, and many of these constructs are interrelated which strongly suggests many behavioral change theories identify internal barriers for change. With theoretical case studies, these theories are examined within the context of adapted physical activity to depict how the Self-Efficacy Theory and Self-Determination Theory could be utilized to increase physical activity in individuals with intellectual disabilities.Item Arterial Stiffness And Age Moderate The Association Between Physical Activity And Cognition In Older Adults(Oxford University Press, 2021) de la Colina, Adrian Noriega; Badji, Atef; Lamarre-Cliche, Maxime; Bherer, Louis; Girouard, Hélène; Kaushal, Navin; Health Sciences, School of Health and Human SciencesBackground: Evidence supports that time spent on physical activity has beneficial effects on cognition in older adults. Nevertheless, this beneficial effect is likely to change in function of individual modifying factors like age and level of arterial stiffness. This study aims to reveal whether arterial stiffness and age modulate the positive impact of physical activity on cognition by developing a double moderation model. Methods: 110 healthy older adults aged 60 to 75 years old were examined for arterial stiffness (carotid-femoral Pulse Wave Velocity [cf-PWV]), global cognition (composite score of Montreal Cognitive Assessment, and Mini-Mental State Examination), and self-reported physical activity (PACED diary). Using PROCESS macro for SPSS, we evaluated if cf-PWV (moderator 1), and age (moderator 2) moderate the relationship between physical activity (X) and global cognition (Y). The threshold for high stiffness was set at 8.5 m/s based on previous studies that reported this cut-off more appropriate for classifying cerebrovascular risk groups. Results: The interaction of arterial stiffness x age moderated the effect of physical activity on global cognition (β=-.89, SE=.42, p=.037) (Model: R2=.15, p=.018). Physical activity had a positive effect on cognition in younger-older adults (aged 60 to 68.5 years) with cf-PWV>8.5 m/s (β=.57, SE=.222, p=.011, 95% CI.133 to 1.014) and on older-older adults (aged 68.6 to 75 years) with cf-PWV<8.5 m/s (β=.49, SE=.190, p=.010, 95% CI=.116 to .869). Conclusions: Identifying the right age groups and arterial stiffness levels at which physical activity can have beneficial effects on cognition is a key step in providing tailored behavioral interventions.Item Assessment of Discordance Between Surrogate Care Goals and Medical Treatment Provided to Older Adults With Serious Illness(JAMA Network, 2020-05) Comer, Amber R.; Hickman, Susan E.; Slaven, James E.; Monahan, Patrick O.; Sachs, Greg A.; Wocial, Lucia D.; Burke, Emily S.; Torke, Alexia M.; Health Sciences, School of Health and Human SciencesImportance: An important aspect of high-quality care is ensuring that treatments are in alignment with patient or surrogate decision-maker goals. Treatment discordant with patient goals has been shown to increase medical costs and prolong end-of-life difficulties. Objectives: To evaluate discordance between surrogate decision-maker goals of care and medical orders and treatments provided to hospitalized, incapacitated older patients. Design, setting, and participants: This prospective cohort study included 363 patient-surrogate dyads. Patients were 65 years or older and faced at least 1 major medical decision in the medical and medical intensive care unit services in 3 tertiary care hospitals in an urban Midwestern area. Data were collected from April 27, 2012, through July 10, 2015, and analyzed from October 5, 2018, to December 5, 2019. Main outcomes and measures: Each surrogate's preferred goal of care was determined via interview during initial hospitalization and 6 to 8 weeks after discharge. Surrogates were asked to select the goal of care for the patient from 3 options: comfort-focused care, life-sustaining treatment, or an intermediate option. To assess discordance, the preferred goal of care as determined by the surrogate was compared with data from medical record review outlining the medical treatment received during the target hospitalization. Results: A total of 363 dyads consisting of patients (223 women [61.4%]; mean [SD] age, 81.8 [8.3] years) and their surrogates (257 women [70.8%]; mean [SD] age, 58.3 [11.2] years) were included in the analysis. One hundred sixty-nine patients (46.6%) received at least 1 medical treatment discordant from their surrogate's identified goals of care. The most common type of discordance involved full-code orders for patients with a goal of comfort (n = 41) or an intermediate option (n = 93). More frequent in-person contact between surrogate and patient (adjusted odds ratio [AOR], 0.43; 95% CI, 0.23-0.82), patient residence in an institution (AOR, 0.44; 95% CI, 0.23-0.82), and surrogate-rated quality of communication (AOR, 0.98; 95% CI, 0.96-0.99) were associated with lower discordance. Surrogate marital status (AOR for single vs married, 1.92; 95% CI, 1.01-3.66), number of family members involved in decisions (AOR for ≥2 vs 0-1, 1.84; 95% CI, 1.05-3.21), and religious affiliation (AOR for none vs any, 4.87; 95% CI, 1.12-21.09) were associated with higher discordance. Conclusions and relevance: This study found that discordance between surrogate goals of care and medical treatments for hospitalized, incapacitated patients was common. Communication quality is a modifiable factor associated with discordance that may be an avenue for future interventions.Item BAILA: A Randomized Controlled Trial of Latin Dancing to Increase Physical Activity in Spanish-Speaking Older Latinos(Oxford Academic, 2022-12) Marquez, David X.; Wilbur, JoEllen; Hughes, Susan; Wilson, Robert; Buchner, David M.; Berbaum, Michael L.; McAuley, Edward; Aguiñaga, Susan; Balbim, Guilherme M.; Vásquez, Priscilla M.; Marques, Isabela G.; Wang, Tianxiu; Kaushal, Navin; Health Sciences, School of Health and Human SciencesBACKGROUND: Latinos are the fastest growing minority group of the older adult population. Although physical activity (PA) has documented health benefits, older Latinos are less likely to engage in leisure time PA than older non-Latino whites. Dance, popular among Latinos, holds promise as a culturally relevant form of PA. PURPOSE: To describe self-reported and device-assessed changes in PA as a result of a randomized controlled trial of BAILAMOS, a 4-month Latin dance program with a 4-month maintenance program, versus a health education control group. METHODS: Adults, aged 55+, Latino/Hispanic, Spanish speaking, with low PA levels at baseline, and risk for disability were randomized to the dance program (n = 167) or health education condition (n = 166). Data were analyzed using multilevel modeling with full information maximum likelihood. RESULTS: A series of multilevel models revealed significant time × group interaction effects for moderate-to-vigorous physical activity (MVPA), dance PA, leisure PA, and total PA. Exploring the interaction revealed the dance group to significantly increase their MVPA, dance PA, leisure PA, and total PA at months 4 and 8. Household PA and activity counts from accelerometry data did not demonstrate significant interaction effects. CONCLUSIONS: The study supports organized Latin dance programs to be efficacious in promoting self-reported PA among older Latinos. Efforts are needed to make dancing programs available and accessible, and to find ways for older Latinos to add more PA to their daily lives. CLINICAL TRIAL INFORMATION: NCT01988233.Item Benefits of Higher Cardiovascular and Motor Coordinative Fitness on Driving Behavior Are Mediated by Cognitive Functioning: A Path Analysis(Frontiers Media, 2021-06-29) Stojan, Robert; Kaushal, Navin; Bock, Otmar Leo; Hudl, Nicole; Voelcker-Rehage, Claudia; Health Sciences, School of Health and Human SciencesDriving is an important skill for older adults to maintain an independent lifestyle, and to preserve the quality of life. However, the ability to drive safely in older adults can be compromised by age-related cognitive decline. Performing an additional task during driving (e.g., adjusting the radio) increases cognitive demands and thus might additionally impair driving performance. Cognitive functioning has been shown to be positively related to physical activity/fitness such as cardiovascular and motor coordinative fitness. As such, a higher fitness level might be associated with higher cognitive resources and may therefore benefit driving performance under dual-task conditions. For the first time, the present study investigated whether this association of physical fitness and cognitive functioning causes an indirect relationship between physical fitness and dual-task driving performance through cognitive functions. Data from 120 healthy older adults (age: 69.56 ± 3.62, 53 female) were analyzed. Participants completed tests on cardiovascular fitness (cardiorespiratory capacity), motor coordinative fitness (composite score: static balance, psychomotor speed, bimanual dexterity), and cognitive functions (updating, inhibition, shifting, cognitive processing speed). Further, they performed a virtual car driving scenario where they additionally engaged in cognitively demanding tasks that were modeled after typical real-life activities during driving (typing or reasoning). Structural equation modeling (path analysis) was used to investigate whether cardiovascular and motor coordinative fitness were indirectly associated with lane keeping (i.e., variability in lateral position) and speed control (i.e., average velocity) while dual-task driving via cognitive functions. Both cardiovascular and motor coordinative fitness demonstrated the hypothesized indirect effects on dual-task driving. Motor coordinative fitness showed a significant indirect effect on lane keeping, while cardiovascular fitness demonstrated a trend-level indirect effect on speed control. Moreover, both fitness domains were positively related to different cognitive functions (processing speed and/or updating), and cognitive functions (updating or inhibition), in turn, were related to dual-task driving. These findings indicate that cognitive benefits associated with higher fitness may facilitate driving performance. Given that driving with lower cognitive capacity can result in serious consequences, this study emphasizes the importance for older adults to engage in a physically active lifestyle as it might serve as a preventive measure for driving safety.Item Bridging the Gap between Research and the Community: Implementing Physical and Cognitive Interventions to Improve Spontaneous Walking Speed in Older Adults(MDPI, 2022-12-31) Pothier, Kristell; Kaushal, Navin; Vrinceanu, Tudor; Lussier, Maxime; Bailly, Nathalie; Comte, Francis; Minh Vu, Thien Tuong; Berryman, Nicolas; Bherer, Louis; Health Sciences, School of Health and Human SciencesThe application of interventions to enhance mobility in ecological settings remain understudied. This study was developed to evaluate the feasibility of training methods in a community centre and to evaluate their impact on mobility outcomes. Fifty-four participants were randomized to one of three 12-week training programs (three times/week): aerobic (AE), gross motor abilities (GMA) or cognitive (COG). Feasibility was evaluated by calculating adherence, feedback from participants and long-term participation. The impact of these interventions on mobility was assessed by comparing pre- and post-program on Timed-up-and-go (TUG) and spontaneous walking speed (SWS) performances. Results showed relatively high rates of adherence (85.1%) and long-term participation (66.7%), along with favorable feedbacks. SWS significantly improved in COG (0.10 ± 0.11 m.s−1; p = 0.004) and AE (0.06 ± 0.11 m.s−1; p = 0.017) groups, and TUG performance was maintained in all groups. Results of this feasibility study demonstrated successful implementation of physical and cognitive training programs, encouraging the development of real-world applications.Item Can Relational Feed-Forward Enhance Students' Cognitive and Affective Responses to Assessment?(University of Calgary, 2021) Hill, Jennifer; Berlin, Kathy; Choate, Julia; Cravens-Brown, Lisa; McKendrick-Calder, Lisa; Smith, Susan; Health Sciences, School of Health and Human SciencesAssessment feedback should be an integral part of learning in higher education, but students can find this process emotionally and cognitively challenging. Instructors need to consider how to manage students' responses to feedback so that students feel capable of improving their work and maintaining their wellbeing. In this paper, we examine the role of instructor-student relational feed-forward, enacted as a dialogue relating to ongoing assessment, in dissipating student anxiety, enabling productive learning attitudes and behaviours, and supporting wellbeing. We undertook qualitative data collection within two undergraduate teaching units that were adopting a relational feed-forward intervention over the 2019-2020 academic year. Student responses were elicited via small group, semi-structured interviews and personal reflective diaries, and were analysed inductively using thematic analysis. The results demonstrate that relational feed-forward promotes many elements of student feedback literacy, such as appreciating the purpose and value of feedback, judging work against a rubric, exercising volition and agency to act, and managing affect. Students were keen for instructors to help them manage their emotions related to assessment, believing this would promote their wellbeing. We conclude by exploring academic strategies and pedagogies that position relational instructor feedforward as an act of care, and we summarize the key characteristics of emotionally resonant relational feed-forward meetings.Item Care ally-assisted massage for Veterans with chronic neck pain: TOMCATT results(Elsevier, 2024-07) Munk, N.; Daggy, J. K.; Slaven, J. E.; Evans, E.; Foote, T.; Laws, B.; Matthias, M. S.; Bair, M. J.; Health Sciences, School of Health and Human SciencesPurpose Chronic neck pain (CNP) is prevalent and challenging to treat. Despite evidence of massage's effectiveness for CNP, multiple accessibility barriers exist. The Trial Outcomes for Massage: Care Ally-Assisted vs. Therapist Treated (TOMCATT) study examined a care ally-assisted massage (CA-M) approach compared to a waitlist control prior to a study design modification (WL-C0). Methods CA-M consisted of in-person training for veteran/care-ally dyads to learn a standardized 30-minue massage routine, instructional DVD, and printed treatment manual. Participants were to complete three care ally-assisted massage sessions weekly for 12-weeks. Outcomes collected at baseline, 1-, 3-, and 6-months included validated measures of neck pain severity and associated disability. Linear mixed-model approaches were used for analysis with 3-months as the primary outcome timepoint. Results Participants (N = 203) were 56.7 ± 14 years old, 75% White, 15% female, and 75% married/partnered. Among 102 CA-M participants, 45% did not attend the in-person training and subsequently withdrew from the study and were more likely to be younger (p = .016) and employed (p = .004). Compared to WL-C0, CA-M participants had statistically significant reductions in pain-related disability at 3-months (−3.4, 95%CI = [−5.8, −1.0]; p = .006) and 6-months (−4.6, 95%CI = [−7.0, −2.1]; p < .001) and pain severity at 3-months (−1.3, 95%CI = [−1.9, −0.8]; p < .001) and 6-months (−1.0, 95%CI = [−1.6, −0.4]; p = .007), respectively. Conclusion In this analysis, CA-M led to greater reductions in CNP with disability and pain severity compared to WL-C0, despite treatment engagement and retention challenges. Future work is needed to determine how to better engage Veterans and their care-allies to attend CA-M training.Item The career transition experiences of military Veterans: A qualitative study(Taylor & Francis, 2021) Shue, Sarah; Matthias, Marianne S.; Watson, Dennis P.; Miller, Kristine K.; Munk, Niki; Health Sciences, School of Health and Human SciencesTransitioning out of a military career can be difficult and stressful for Veterans. The purpose of this study was to gain an in-depth understanding of the challenges and needs of career transitioning Veterans. Fifteen United States Veterans from a larger mixed methods research project completed a qualitative semi-structured interview regarding their career transition. Interview questions invited participants to define their transition experience, identify influential psychosocial factors, resources utilized or needed, what it meant to transition out of the military, role changes experienced, and how the participant had adapted to the transition. Emergent thematic analysis revealed 4 themes: 1) it is necessary to actively prepare for the transition; 2) a variety of factors impacted the military career transition process; 3) transitioning out of a military career equated to the loss of structure; and 4) the transition required Veterans to establish themselves outside of the military. Findings from this study identified barriers, desired assistance, and facilitators to the career transition process, which should be considered by those assisting transitioning Veterans and when developing transition-related resources. Continuing to expand on this knowledge will positively impact service members as they exit their military career.