Effects of computerized cognitive training on biomarker responses in older adults with mild cognitive impairment: A scoping review.

Background and Aims: Mild cognitive impairment (MCI) is a widespread condition in older individuals, posing significant risk of dementia. However, limited research has been conducted to explore effective interventions and clarify their impact at the neural level. Therefore, this study aimed to investigate the effects of computerized cognitive training (CCT) and explore the associated neural mechanisms in preventing dementia in older individuals with MCI, with a view to inform future intervention efforts. Methods: We reviewed the effects of CCT on biomarker outcomes in older adults with MCI. The search was conducted for studies published between 2010 and May 10, 2023, using three search engines: PubMed, Scopus, and Cumulative Index to Nursing and Allied Health Literature. The inclusion criteria were as follows: studies that involved participants diagnosed with MCI, included CCT, included quantitative assessment of biomarker results, and conducted randomized controlled trials. Results: Sixteen studies that used biomarkers, including magnetic resonance imaging, electroencephalography (EEG), functional near-infrared spectroscopy (fNIRS), and blood or salivary biomarkers, were extracted. The results showed that CCT caused changes in structure and function within the main brain network, including the default mode network, and decreased both theta rhythm activity on EEG and prefrontal activity on fNIRS, with improvement in cognitive function. Furthermore, CCT combined with physical exercise showed more significant structural and functional changes in extensive brain regions compared with CCT alone. Virtual reality-based cognitive training improved not only executive function but also instrumental activities of daily living. Conclusion: CCT causes functional and structural changes in extensive brain regions and improves cognitive function in older adults with MCI. Our findings highlight the potential of individualized intervention methods and biomarker assessment according to the specific causes of MCI. Future research should aim to optimize these personalized therapeutic strategies to maximize the benefits of CCT in older adults with MCI.

Effects of voluntary and forced exercises on motor function recovery in intracerebral hemorrhage rats.

Motor paralysis is a severe consequence of intracerebral hemorrhage (ICH) that reduces patient quality of life. Rehabilitation is beneficial for stroke patients. However, functional recovery depends on the exercise type, and which factors are effective during rehabilitation are unknown. We aimed to clarify the effect of voluntary and forced exercises for functional recovery in ICH rats. Male Sprague-Dawley rats were divided into three groups: forced treadmill running (F-Ex.), voluntary wheel cage running (V-Ex.) and no exercise (Non-Ex.). The effects of the two exercises on motor recovery were analyzed by determining the motor deficit score and using the beam walking test. Stress and motivation status after rehabilitation were determined by corticosterone concentrations (ELISA) and immunoreactivity of ΔFosB (immunohistochemistry) in the nucleus accumbens, respectively. Significantly enhanced motor functional recovery was observed in the two trained groups compared with that in the Non-Ex. group. Of note, recovery in the V-Ex. group was greater than that in the F-Ex. group. To investigate the motivation and stress related to the exercises, the expression of ΔFosB in the nucleus accumbens and corticosterone concentration were compared after rehabilitation. In the V-Ex. group, there was a significant increase of ΔFosB, and in the F-Ex. Group, there was a high concentration of corticosterone. These data suggest that the effect of training for motor recovery was enhanced by motivation and reduced by stress.

Ultrasound irradiation before high-load exercise reduces muscle rigidity associated with delayed-onset muscle soreness.

[Purpose] We investigated the occurrence of delayed-onset muscle soreness and the suppression of muscle rigidity by ultrasound irradiation before high-load exercise. [Participants and Methods] The study was a randomized crossover controlled trial. The participants were 28 healthy university students (12 males, 16 females). Delayed-onset muscle soreness was induced in the biceps brachii muscle; ultrasound (3 MHz, 1.5 W/cm2, 10 min) was applied before high-load exercise. Pain during elbow motion was evaluated on a visual analog scale. Muscle rigidity was evaluated using a muscle rigidity meter. [Results] After exercise on the second day, the ultrasound group showed significantly less muscle rigidity. [Conclusion] The heat stimulus of ultrasound therapy before high-load exercise reduces muscle rigidity.

Improved underpants to reduce toileting problems in patients with poor standing balance.

[Purpose] We developed and assessed improved underpants allowing patients to easily and completely open the crotch by pulling upward a string on the back of the underpants while seated. [Subjects and Methods] Healthy subjects tested commercial open-crotch underpants for disabled people and our improved open-crotch underpants by opening the crotch while seated. Measurement parameters included the percentage of crotch opening and the degree of genital or anal exposure before and after opening the crotch, as well as fit. The percentage of crotch opening and the degree of genital or anal exposure were recorded with a digital camera, and fit was determined with a visual analog scale. The measurements for both types of underpants were then compared. [Results] The commercial underpants for disabled people allowed opening of the crotch while seated, but the exposure of the genital and anal areas was insufficient to allow waste elimination. The improved underpants allowed sufficient opening of the crotch while seated and adequately exposed the genital and anal areas. The fit score of the improved underpants was significantly better than that of the commercial underpants. [Conclusion] The improved open-crotch underpants may allow for more effective opening of the crotch while seated than commercial open-crotch underpants for disabled people.

Approaches for improving the toileting problems of hemiplegic stroke patients with poor standing balance.

[Purpose] Our objective was to evaluate the residual dynamic and static functionality in the sitting position of hemiplegic stroke patients who require help to pull their lower garments up and down during toileting. [Subjects and Methods] The subjects were 11 hemiplegic patients. We gathered data on the patients' motor paralysis, sensory capacity, lower extremity muscle strength, trunk control, ability to roll and sit up from a lying position, sitting balance, and ability to pull the lower garments up and down. We then compared 2 groups: those able to pull the lower garments up and down independently while standing (the "independent group"), and those who were unable to do so (the "non-independent group"). [Results] Though the non-independent group had severely and significantly reduced trunk control and abilities as a whole, there was no significant difference from the independent group in static and dynamic sitting balance. [Conclusion] We conclude that, to enable hemiplegic patients with poor standing balance to pull their lower garments up and down, it is necessary to do these maneuvers in a sitting, rather than a standing, position, or to develop garments that are easier to put on and take off.