Effectiveness of multi-modal home-based videoconference interventions on sleep in older adults: study protocol for a randomized controlled trial.

Aging is characterized by substantial changes in sleep architecture that negatively impact fitness, quality of life, mood, and cognitive functioning. Older adults often fail to reach the recommended level of physical activity to prevent the age-related decline in sleep function, partly because of geographical barriers. Implementing home-based interventions could surmount these obstacles, thereby encouraging older adults to stay active, with videoconference administration emerging as a promising solution. Increasing the availability of biological rhythms synchronizers, such as physical activity, light exposure, or vestibular stimulation, represents a viable non-pharmacological strategy for entraining circadian rhythms and potentially fortifying the sleep-wake cycle, thereby enhancing sleep in aging. This study aims to (1) assess the impact of remote physical exercise training and its combination with bright light exposure, and (2) investigate the specific contribution of galvanic vestibular stimulation, to sleep quality among healthy older adults with sleep complaints. One hundred healthy older adults aged 60-70 years with sleep complaints will be randomly allocated to one of four groups: a physical exercise training group (n = 25), a physical exercise training combined with bright light exposure group (n = 25), a galvanic vestibular stimulation group (n = 25) or a control group (i.e., health education) (n = 25). While physical exercise training and health education will be supervised via videoconference at home, bright light exposure (for the physical exercise training combined with bright light exposure group) and vestibular stimulation will be self-administered at home. Pre-and post-tests will be conducted to evaluate various parameters, including sleep (polysomnography, subjective questionnaires), circadian rhythms (actigraphy, temperature), fitness (physical: VO2 peak, muscular function; and motor: balance, and functional mobility), cognition (executive function, long-term memory), quality of life and mood (anxiety and depression). The findings will be anticipated to inform the development of recommendations and non-pharmaceutical preventive strategies for enhancing sleep quality in older adults, potentially leading to improvements in fitness, cognition, quality of life, and mood throughout aging.

Non-inferiority of a home-based videoconference physical training program in comparison with the same program administered face-to-face in healthy older adults: the MOTION randomised controlled trial.

BACKGROUND: older adults often fail to reach the recommended amount of physical activity to prevent the age-related decline in metabolic, cardiorespiratory and muscular function. Effective home-based physical training programs could neutralise barriers preventing older adults from being active, and administration/supervision through videoconference may be an optimal solution. The present randomised controlled trial aimed to test the non-inferiority of training program administered through videoconference against the same program administered face-to-face in healthy older adults. METHODS: participants were randomised in a no-training control group (n = 13), a face-to-face training group (n = 15) and a videoconference training group (n = 13). The intervention groups completed the same home-based, structured, progressive and combined training program for 16 weeks, 1-h twice a week. Pre-intervention and post-intervention evaluations included body composition, cardiorespiratory fitness and muscle function measures. RESULTS: non-inferiority of videoconferencing against face-to-face training was observed for changes in body weight (P < 0.01), fat mass (P = 0.015), maximal aerobic power (P = 0.013), maximal heart rate (P = 0.034), maximal oxygen consumption (P < 0.01), knee extension strength (P = 0.044) and lower limb power (P = 0.019), but not for muscle mass (P = 0.067), handgrip strength (P = 0.171), trunk extension strength (P = 0.241) and knee flexion strength (P = 0.462). CONCLUSION: a training program administered through videoconferencing was not inferior to the same program administered face-to-face for reducing body weight and fat mass, and for improving maximal aerobic power and oxygen consumption as well as lower limb power and knee extension strength in healthy older subjects. However, videoconferencing training was not as effective as face-to-face training for improving handgrip, trunk extension and knee flexion isometric strength.

Videoconference-Based Adapted Physical Exercise Training Is a Good and Safe Option for Seniors.

Videoconference-based adapted physical exercise combines the benefits of supervised exercise training with staying at home, when conventional training is inaccessible. However, exercising with the use of a screen can be considered an optokinetic stimulation, and could therefore induce changes in sensory processing, affecting postural stability. The objectives of this study were to compare the effectiveness of the training delivered Face-to-Face and by Videoconferencing in improving physical capacities of older adults, and to evaluate the possible effects of the Videoconference mode on the processing of sensory information that could affect postural control. Twenty eight older adults underwent the supervised exercise program for sixteen weeks either Face-to-Face or by Videoconference. Muscular strength of knee and ankle flexors and extensors, maximum oxygen uptake, postural stability and horizontal rotational vestibulo-ocular reflex were evaluated before and after the training. Both modes of training similarly increased the VO2 peak and strength of the motor muscles of lower limbs in all participants. The use of the Videoconference did not modify the vestibulo-ocular reflex in subjects or the importance of vision for postural control. Therefore, the Videoconference-based exercise training can be considered a safe and effective way to maintain good functional capacity in seniors.

Ankle dorsiflexors and plantarflexors neuromuscular electrical stimulation training impacts gait kinematics in older adults: A pilot study.

BACKGROUND: While ankle muscles, highly affected by aging, are highly implicated in the changes in gait kinematics and involved in the limitation of seniors' mobility, whether neuromuscular electrical stimulation (NMES) training of these muscles could impact gait kinematics in older adults has not been investigated yet. RESEARCH QUESTION: What are the effects of 12 weeks of ankle plantar and dorsiflexors NMES training on strength and gait kinematics in healthy older adults? METHODS: Fourteen older adults (73.6 ± 4.9 years) performed a three-time per week, three months long NMES training of both ankle plantar and dorsiflexors. Before and after training, neuromuscular parameters, gait kinematic parameters, and daily physical activity were measured. RESULTS: The participants significantly increased their lower limb muscle mass and their plantar and dorsiflexors isometric strength after training. They reduced the hip abduction/adduction and the pelvic anterior tilt range of motion and variability during gait. However, the participants became less active after the training. SIGNIFICANCE: NMES training of ankle muscles, by increasing ankle muscle mass and strength,modified gait kinematics. NMES training of ankle muscles is feasible and effective to lower the hip implication and increment foot progression angle during gait. Further study should determine if this could lower the risk of falling.

A web-based adapted physical activity program (e-APA) versus health education program (e-HE) in patients with schizophrenia and healthy volunteers: study protocol for a randomized controlled trial (PEPSY V@Si).

Patients with schizophrenia (SZ) have a high level of cardiovascular morbidity and some clinical symptoms of illness remain resistant to pharmacological approaches. A large number of studies support the effectiveness of physical activity (PA) in SZ. The aims of this trial is to assess the effects of a remote, web-based adapted PA program (e-APA) compared to a health education program (e-HE) on brain plasticity in SZ and healthy volunteers (HV) and on psychiatric, neurocognitive, circadian and physical variables. The study is an interventional, multicenter, randomized open-label trial. Forty-two SZ will be randomized to either the active group (e-APA, N = 21) or nonactive group (e-HE, N = 21), and 21 HV will be matched to SZ according to age, gender, and level of PA in both e-APA and e-HE groups. Interventions will consist of 32 sessions (2 × 60 min/week, for 16 weeks) via supervised home-based videoconferencing. Cerebral magnetic resonance imaging, psychiatric symptoms, neurocognitive and circadian rhythms assessments as well as physical tests and biological analyses will be assessed at baseline and 16 weeks after the intervention. To our knowledge, this is the first study aiming to evaluate the efficacy of APA delivered by supervised home-based videoconferencing in SZ. Moreover, using multimodal MRI, this study could clarify the pathophysiological mechanisms underlying the efficacy of APA. Finally, this innovative approach might also increase participation in long-term PA since PA-based programs are known to have low adherence and early dropout. Trial registration: ClinicalTrials.gov identifier: NCT03261817. Registered on 16 August 2017.

Plantar Flexor Strength Training With Home-Based Neuromuscular Electrical Stimulation Improves Limits of Postural Stability in Older Adults.

BACKGROUND: The study aimed to determine whether improved muscle strength after 12 weeks of neuromuscular electrical stimulation (NMES) of plantar and dorsiflexors could result in better limits of stability in older adults. METHODS: Twenty-seven participants were divided into a control group and a neuromuscular home-based training group. The training group performed a 3-month long NMES training of both plantar and dorsiflexors. Ankle flexor strength and limits of stability were measured. A mediation analysis was conducted to determine whether the NMES effect on the limits of stability was mediated by increased strength. RESULTS: The NMES training increased plantar flexor strength (+47%; ß = 0.217, P = .02), and this increase predicted the anterior limits of stability improvement (+27%; ß = 0.527, P = .02). The effect of the NMES on the limits of stability was fully mediated by the plantar flexor strength increase (indirect effect: ß = 0.1146; 95% confidence interval, 0.020-0.240). CONCLUSION: It seems that NMES improves the limits of stability through its positive effect on muscle strength. NMES may be utilized in fall-prevention programs.

Does neuromuscular electrical stimulation training of the lower limb have functional effects on the elderly?: A systematic review.

The lower limb muscle functions of the elderly are known to be preferentially altered by ageing. Traditional training effectively counteracts some of these functional declines but is not always accessible due to its cost and to the accessibility of the training centers and to the incapacities of some seniors to practice some exercises. Neuromuscular electrical stimulation (NMES) could provide an interesting alternative muscle training technique because it is inexpensive and transportable. The aim of this systematic review was to summarize the current evidence on the effect of the use of lower limb NMES as a training technique for healthy elderly rehabilitation. Electronic databases were searched for trials occurring between 1971 (first occurrence of NMES training) and November 2016. Ten published articles were retrieved. Training programs either used NMES alone, or NMES associated with voluntary muscle contraction (NMES+). They either targeted calves or thigh muscles and their training length and intensity were heterogeneous but all studies noted positive effects of NMES on the elderly's functional status. Indeed, NMES efficiently improved functional and molecular muscle physiology, and, depending on the studies, could lead to better gait and balance performances especially among less active elderly. Given the association between gait, balance and the risk of falls among the elderly, future research should focus on the efficiency of NMES to reduce the high fall rate among this population.