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Browsing by Author "Kaushal, Navin"
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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 Augmenting the Health Belief Model to Promote Knee Massage as Self-Management Among Individuals with Knee Osteoarthritis: A Roadmap for Future Research and Intervention Development(2023-08) Nemati, Raheleh; Munk, Niki; Kaushal, Navin; Keith, NiCole; Naugle, KellySelf-administered massage is a form of self-management that has been shown to alleviate symptoms among individuals with knee osteoarthritis. However, existing interventions have yielded inconsistent results in terms of promoting the practice of self-administered massage, highlighting a critical gap in the application of a theoretical or conceptual model. The current study utilized an expanded health belief model that integrates constructs from the theory of planned behavior aimed to identify the behavioral determinants associated with the practice of self-administered knee massage. An observational study was designed to address the objectives using an online survey. A total of 268 participants with knee osteoarthritis completed the survey. Data regarding the clinical characteristics of participants, including the year of diagnosis, chronicity of pain, affected knee(s), and the intensity of pain in terms of current, average, and worst levels, were collected. Structural equation modeling was used to test the predictive validity of the proposed model. The model revealed self-administered massage behavior to be predicted by intention (β = .21, p < .014). Intention was predicted by cues (β = .29, p <.001), task self-efficacy (β = .29, p <.001), affective attitudes (β = .14, p =.011), perceived severity (β = .27, p <.001), and perceived facilitators (β = .22, p <.001), but not response self-efficacy, instrumental attitudes, or barriers. Intention mediated the effects between cues (β = .06, 95% CI .025, .129) and perceived severity (β = .06, 95% CI .014, .127) and behavior. Model determinants were found to mediate between age and behavior (β = -.16, 95% CI -.224, -.093). Interventions aimed at promoting self-administered massage should focus on enhancing individuals' perception of the severity of their knee OA progression and their confidence in performing the massage by teaching them the common massage techniques.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 Comparing exercise determinants between Black and White older adults with heart failure(Springer, 2023-09-30) Kaushal, Navin; Nemati, Donya; Mann-Krzisnik, Dylan; de la Colina , Adrián Noriega; Health Sciences, School of Health and Human SciencesBackground Heart Failure is a leading cause of mortality among older adults. Engaging in regular exercise at moderate-to-vigorous intensity has been shown to improve survival rates. Theory-informed methodologies have been recommended to promote exercise, but limited application of theoretical framework has been conducted for understanding racial disparities among older adults with heart failure. This study aimed to use the Health Belief Model to compare exercise behavior determinants between Black and White older adults diagnosed with heart failure. Methods The HF-ACTION Trial is a multi-site study designed to promote exercise among individuals with heart failure that randomized participants to an experimental (three months of group exercise sessions followed by home-based training) or control arm. The present study used structural equation modeling to test the change in Health Belief Model constructs and exercise behavior across 12 months among older adults. Results Participants (n = 671) were older adults, 72.28 (SD = 5.41) years old, (Black: n = 230; White, n = 441) diagnosed with heart failure and reduced ejection fraction. The model found perceived benefits, self-efficacy, perceived threats, and perceived barriers to predict exercise behavior among Black and White older adults. However, among these constructs, only perceived benefits and self-efficacy were facilitated via intervention for both races. Additionally, the intervention was effective for addressing perceived barriers to exercise only among White participants. Finally, the intervention did not result in a change of perceived threats for both races. Conclusions Among health belief model constructs, perceived threats and barriers were not facilitated for both races in the experimental arm, and the intervention did not resolve barriers among Black older adults. Racial differences need to be considered when designing interventions for clinical populations as future studies are warranted to address barriers to exercise among Black older adults with heart failure.Item Comparison Between Dance-Based and Traditional Exercise on Health-Related Quality of Life: A Cross-Sectional Analysis(2022) Alamilla, Rafael A.; Dent, Shaquitta R.; Soliven Jr., Robert C.; Holt, Tharon; Kaushal, Navin; Keith, NiCole R.Health-related quality of life (HRQoL) includes physical health, cognitive well-being, and the presence of social support. Declines in HRQoL can result in physical impairment, social isolation, and impaired cognition. Regular exercise (EX) participation may lead to better HRQoL among older adults. Dance-oriented group fitness classes (DANCE) can provide participants with structured EX that involves high levels of coordination and social comradery. DANCE EX may be a viable alternative to traditional EX (TRAD) for the maintenance of HRQoL. PURPOSE: To determine whether participation in regular DANCE EX displays higher HRQoL in older adults when compared to those who participate in TRAD EX. METHODS: Twenty-nine older adults (age 69.8 ± 9.6 yrs; 28 females; 93.1% white) enrolled in a cross-sectional study examining those who either participated in DANCE EX or TRAD EX at the time of enrollment. All participants completed the following assessments: the Medical Outcomes Study Short Form 36 subscale for physical functioning (SF-36); the International Physical Activity Questionnaire (IPAQ); the Mini Mental State Examination (MMSE); the Duke Social Support Index (DSSI); and the Senior Fitness Test (SFT). RESULTS: A MANOVA test demonstrated a statistically significant difference in SFT scores between groups (F(2,29) = 3.11 p < 0.02; Wilk's λ = 0.29, partial η2 = 0.17). Univariate ANOVA tests detected a significant different between groups for chair stand (F(2,29) = 18.63, DANCE: 15.38 ± 4.05, TRAD: 9.07 ± 3.69; p < 0.001), 8 ft up-and-go (F(2,29) = 6.57, DANCE: 5.53 ± 1.02, TRAD: 7.87 ± 3.15; p = 0.02), 2 min step test (F(2,29) = 17.09, DANCE: 100.69 ± 19.58, TRAD: 66.47 ± 30.94; p < 0.001), and SF-36 (F(2,29) = 4.14, DANCE: 92.31 ± 5.25, TRAD: 79.31 ± 22.46; p = 0.05). Neither perceived social support nor cognitive function were significantly different between groups (p > 0.05). Weekly MET-mins of moderate (DANCE: 2,487.7 ± 2,226.3, TRAD: 1,752.0 ± 1,734.5) and vigorous (DANCE: 2,870.8 ± 2,829.8, TRAD: 1,920.0 ± 3,301.5) physical activity did not differ between groups (p > 0.05). CONCLUSIONS: DANCE EX supported higher levels of physical health—and no effect on cognitive well-being and social support—when compared to TRAD EX. DANCE EX may be a viable form of EX to support HRQoL in older adults.Item COVID-19: Implications for Physical Activity, Health Disparities, and Health Equity(Sage, 2021-07-27) Hasson, Rebecca; Sallis, James F.; Coleman, Nailah; Kaushal, Navin; Nocera, Vincenzo G.; Keith, NiCole; Exercise & Kinesiology, School of Health and Human SciencesPhysical activity is one of the most efficacious pathways to promoting mental and physical health, preventing disease, and, most important during the COVID-19 pandemic, bolstering a stronger immune system. Efforts to “flatten the curve” have resulted in the temporary closure of exercise facilities and gyms, suspension of sport activities, and advisories to avoid public recreational spaces. All of these changes have made traditional opportunities to be physically active difficult to access. These changes have also exacerbated existing disparities in access to social and environmental supports for physical activity, potentially contributing to a widening gap in physical activity participation among those at greatest risk for COVID-19. Physical activity can play a special role in reducing the inequitable consequences of COVID-19; however, expansion and better targeting of evidence-informed interventions are needed that address the unique barriers present in communities that have been economically and socially marginalized to achieve health equity in COVID-19 outcomes. This review highlights effective and feasible strategies that provide more equitable access to physical activity programs and spaces across the United States. With a renewed investment in physical activity, this behavior can play a crucial role in improving population health and reducing disparities during the COVID-19 pandemic and beyond.Item Describing Emerging Adulthood in Individuals with Intellectual Disability Using Photo-Elicitation Methodology(2022-05) Gano, Laura Ann; Munk, Niki; Berlin, Kathy; Kaushal, Navin; Stanton-Nichols, KathleenFor adults with intellectual disability life as an adult is more constrained, with fewer opportunities; the literature indicates that intellectual disability negatively impacts people across multiple life domains. Despite this adverse influence, it is largely unknown how those with intellectual disability describe their experiences with adulthood. The current study utilizes photo-elicitation interviewing methodology in an attempt to rectify this deficit. Photo-elicitation research methodology uses images, rather than text, to construct queries and prompt responses. This approach is generally undertaken in disability studies to accommodate participants’ verbal and cognitive challenges, to make abstract concepts concrete, to provide opportunity for meaningful participation, and to empower subjects within the research environment. In this study, photo-elicitation interviewing was employed with a sample of 11 young adults with intellectual disability to discover how adulthood might differ in comparison with typical peers. Participants shared their perceptions of adulthood and experiences related to family, learning/education; community/volunteering/spiritual or faith community/employment/vocation; housing/neighborhood; friends/supportive relationships/personal connections; hobbies/fun; personal health. Results replicate participants’ endorsement of the same broad criteria for adulthood attainment as typified by normative peers in the emerging adulthood literature: acceptance of responsibility for oneself; independent decision-making; financial independence. Salient emergent findings specific to the study population indicated that adulthood differs in comparison with typical peers in relation to (1), advocacy efforts to increase awareness and value of the disability experience; (2), the effect of the COVID-19 pandemic; (3), the need for continued access to support services. Access to services can only be achieved through increasing awareness of this need, recognizing the importance of this need, and prioritizing policy change to meet this need. Participants in this study have indicated that they are more than up to the task of increasing awareness through advocacy, yet it falls to social institutions such as education and government to recognize this need for ongoing support and to prioritize this need by implementing service provision policy change.Item Exploring Exercise Outcomes, Preferences, and Barriers in Adolescent and Young Adult Cancer Survivors(2024-08) Sherman, Melissa Marie; Keith, NiCole R.; Kaushal, Navin; Naugle, Kelly; Renbarger, JamiePhysical activity (PA) improves physiology and cognition including Quality of Life (QoL), fatigue, depression, anxiety, and emotional well-being. Despite the positive effects of PA, adolescent, and young adult (AYA) cancer survivors (15-39 yrs.) do not meet the American College of Sports Medicine (ACSM) recommended PA guidelines to elicit positive health outcomes. AYA survivors may have unique physical and psychological experiences that impact motivation, barriers, and preferences for participation in PA. The overarching purpose of this dissertation is to better understand the outcomes, motivation, preferences, and barriers to exercise adherence when completing exercise and PA interventions among AYA survivors of cancer. This dissertation addresses this purpose through three distinct studies: AYA Cancer Survivors and One-on-One Exercise in an In-person setting, AYA Cancer Survivors and One-on-One Exercise in a Virtual Setting, and subsequent focus groups that utilized the participants from both virtual and in-person studies. Results indicated that the nature of cancer and cancer treatment, type of cancer, age at diagnosis, and experience within treatment (i.e. surgery, radiation, chemotherapy, stem cell transplants) varied significantly across AYA survivors of cancer. Despite the differences in experience, cancer-related fear and anxiety were common among participants but were offset by a sense of control and accountability experienced during the larger study. Working one-on-one with a wellness coach or exercise trainer provided participants with a sense of accountability and a sense of control that otherwise was missing post-cancer treatment and remission. The extra support is needed to help alleviate fears and anxiety and to promote accountability, acceptability, and adherence to exercise. A multi-disciplinary approach with wellness coaching and individualized PA guidance is suggested for future programming in this population group. While AYA survivors of cancer are an often understudied population, future research must target more racially and ethnically diverse groups to understand this group as a whole better.
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