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Mobility Impairments from a Multimodal Neuroscience of Aging Perspective

A special issue of International Journal of Environmental Research and Public Health (ISSN 1660-4601). This special issue belongs to the section "Health Behavior, Chronic Disease and Health Promotion".

Deadline for manuscript submissions: closed (31 January 2022) | Viewed by 13668

Special Issue Editors

Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, Urbana, IL 61801, USA
Interests: mobility; balance; gait; aging; neurological disorders; neuroimaging; biomechanics
Special Issues, Collections and Topics in MDPI journals
The Saul R. Korey Department of Neurology, Albert Einstein College of Medicine, Bronx NY 10461, USA
Interests: multisensory integration; aging; gait; balance and postural stability; cognition; attention and executive functioning

Special Issue Information

Dear Colleagues,

 

Mobility impairments are prevalent in older adults over 65 years of age and are associated with adverse health outcomes such as injurious falls, fear of falling, and a poor quality of life. Whereas balance and walking had traditionally been viewed as autonomous processes, evidence over the last decade has revealed that cognitive (specifically attention and executive function) and sensory integration processes have significant impacts on balance, gait, and falls in aging. These findings have real-world significance, considering that many routine activities of daily living require the ability to perform two or more tasks concurrently while properly allocating attentional resources in complex urban environments. Given that even in the absence of major clinical pathologies, aging is associated with changes in brain structure and function, it is important to examine the behavioral and neural correlates of mobility impairments and interventions aimed at restoring mobility function in older adults.

For the current Special Issue, we invite cutting-edge studies integrating innovative technologies (such as virtual, augmented, or mixed reality, neuroimaging, wearable sensors, and machine learning/artificial intelligence) and multimodal approaches to uncover the relationship that other systems (sensory and cognitive) have on mobility function in older adults with and without clinical pathologies.

Dr. Manuel E. Hernandez
Dr. Jeannette R. Mahoney
Guest Editors

Manuscript Submission Information

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Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. International Journal of Environmental Research and Public Health is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2500 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • Mobility
  • Aging
  • Neuroscience
  • Intervention
  • Cognition
  • Multisensory integration
  • Falls
  • Fear of falling
  • Quality of life
  • Technology

Published Papers (5 papers)

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Research

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13 pages, 1514 KiB  
Article
Effect of Heart Rate Reserve on Prefrontal Cortical Activation While Dual-Task Walking in Older Adults
by Alka Bishnoi, Gioella N. Chaparro and Manuel E. Hernandez
Int. J. Environ. Res. Public Health 2022, 19(1), 47; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph19010047 - 21 Dec 2021
Cited by 2 | Viewed by 1838
Abstract
Hypertension is considered a risk factor for cardiovascular health and non-amnestic cognitive impairment in older adults. While heart rate reserve (HRR) has been shown to be a risk factor for hypertension, how impaired HRR in older adults can lead to cognitive impairment is [...] Read more.
Hypertension is considered a risk factor for cardiovascular health and non-amnestic cognitive impairment in older adults. While heart rate reserve (HRR) has been shown to be a risk factor for hypertension, how impaired HRR in older adults can lead to cognitive impairment is still unclear. The objective of this study was to examine the effects of HRR on prefrontal cortical (PFC) activation under varying dual-task demands in older adults. Twenty-eight older adults (50–82 years of age) were included in this study and divided into higher (n = 14) and lower (n = 14) HRR groups. Participants engaged in the cognitive task which was the Modified Stroop Color Word Test (MSCWT) on a self-paced treadmill while walking. Participants with higher HRR demonstrated increased PFC activation in comparison to lower HRR, even after controlling for covariates in analysis. Furthermore, as cognitive task difficulty increased (from neutral to congruent to incongruent to switching), PFC activation increased. In addition, there was a significant interaction between tasks and HRR group, with older adults with higher HRR demonstrating increases in PFC activation, faster gait speed, and increased accuracy, relative to those with lower HRR, when going from neutral to switching tasks. These results provide evidence of a relationship between HRR and prefrontal cortical activation and cognitive and physical performance, suggesting that HRR may serve as a biomarker for cognitive health of an older adult with or without cardiovascular risk. Full article
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10 pages, 474 KiB  
Article
Status of Constipation and Its Association with Sarcopenia in Older Adults: A Population-Based Cohort Study
by Hyungchul Park, Jihye Lim, Ji Yeon Baek, Eunju Lee, Hee-Won Jung and Il-Young Jang
Int. J. Environ. Res. Public Health 2021, 18(21), 11083; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph182111083 - 21 Oct 2021
Cited by 5 | Viewed by 2105
Abstract
(1) Background: As the clinical relevance of constipation and sarcopenia is not well studied, we aimed to investigate the association between them in older adults. (2) Methods: A cross-sectional study was conducted on 1278 community-dwelling older adults in South Korea. The Rome IV [...] Read more.
(1) Background: As the clinical relevance of constipation and sarcopenia is not well studied, we aimed to investigate the association between them in older adults. (2) Methods: A cross-sectional study was conducted on 1278 community-dwelling older adults in South Korea. The Rome IV criteria were used to identify patients with clinically defined constipation, while sarcopenia was defined by the Asian Working Group for Sarcopenia consensus. The cohort was classified into three groups: no constipation, self-reported constipation only, and clinically defined constipation. (3) Results: The presence of constipation was associated with sarcopenia and slow gait speed (p < 0.001). After adjustment for possible covariates, the association with sarcopenia attenuated, while that for slow gait speed persisted. In terms of geriatric parameters, both groups with clinically defined and self-reported constipation had a higher burden of cognitive impairment, IADL disability, and lower QOL scores (p < 0.05) compared with those without constipation. (4) Conclusions: Sarcopenia and slow gait speed associated with constipation in community-dwelling older adults. Individuals with self-reported constipation symptoms alone showed comparable sarcopenic and geriatric burden to those with clinically defined constipation. Clinical suspicion for possible co-existing sarcopenia is warranted in older patients with constipation. Full article
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12 pages, 1102 KiB  
Article
Dual-Task-Based Drum Playing with Rhythmic Cueing on Motor and Attention Control in Patients with Parkinson’s Disease: A Preliminary Randomized Study
by Jin-Kyoung Park and Soo Ji Kim
Int. J. Environ. Res. Public Health 2021, 18(19), 10095; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph181910095 - 26 Sep 2021
Cited by 14 | Viewed by 2435
Abstract
Although there have been increasing reports regarding the effectiveness of dual-task interventions in rehabilitation, the scope of this research is limited to gross motor movement, such as gait among patients with Parkinson’s disease (PD). To expand the dual-task paradigm to upper extremity motor [...] Read more.
Although there have been increasing reports regarding the effectiveness of dual-task interventions in rehabilitation, the scope of this research is limited to gross motor movement, such as gait among patients with Parkinson’s disease (PD). To expand the dual-task paradigm to upper extremity motor and attention control in PD, drum playing with modulation of musical elements was attempted. The objective of this study was to evaluate the effects of a drum playing intervention with rhythmic cueing on upper extremity motor control and attention control in patients with PD. Twelve participants were randomly assigned to the drum playing intervention with rhythmic cueing group or the control group. The results showed that the drum playing with rhythmic cueing (DPRC) group significantly increased their sustained time of entrainment (45 BPM) and their latency time until entrainment from pretest to posttest. For the DPRC group, the latency time until entrainment was significantly improved, and improvements in cognitive measures were also found. This study shows that DPRC has great potential to improve upper extremity motor control and attention control and supports the development of new interventions that include this technique for rehabilitation in patients with PD. Full article
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10 pages, 834 KiB  
Article
Cognitive Function and Whole-Brain MRI Metrics Are Not Associated with Mobility in Older Adults with Multiple Sclerosis
by Jessica F. Baird and Robert W. Motl
Int. J. Environ. Res. Public Health 2021, 18(8), 4232; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph18084232 - 16 Apr 2021
Cited by 7 | Viewed by 1790
Abstract
Due to advances in disease-modifying medications and earlier management of comorbidities, adults with multiple sclerosis (MS) are living longer, and this coincides with the aging of the general population. One major problem among older adults with and without MS is limited mobility, a [...] Read more.
Due to advances in disease-modifying medications and earlier management of comorbidities, adults with multiple sclerosis (MS) are living longer, and this coincides with the aging of the general population. One major problem among older adults with and without MS is limited mobility, a consequence of aging that often negatively affects quality of life. Identifying factors that contribute to mobility disability is needed to develop targeted rehabilitation approaches. This study examined cognitive processing speed and global brain atrophy as factors that may contribute to mobility disability in older adults with and without MS. Older adults (≥55 years) with MS (n = 31) and age- and sex-matched controls (n = 22) completed measures of mobility (Short Physical Performance Battery) and cognitive processing speed (Symbol Digit Modalities Test) and underwent an MRI to obtain whole-brain metrics (gray matter volume, white matter volume, ventricular volume) as markers of atrophy. Mobility was significantly worse in the MS group than in the control group (p = 0.004). Spearman correlations indicated that neither cognitive processing speed (MS: rs = 0.26; Control: rs = 0.08) nor markers of global brain atrophy (MS: rs range = −0.30 to −0.06; Control: rs range = −0.40 to 0.16) were significantly associated with mobility in either group. Other factors such as subcortical gray matter structures, functional connectivity, exercise/physical activity, and cardiovascular fitness should be examined as factors that may influence mobility in aging adults with and without MS. Full article
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Review

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23 pages, 983 KiB  
Review
Effect of Treadmill Training Interventions on Spatiotemporal Gait Parameters in Older Adults with Neurological Disorders: Systematic Review and Meta-Analysis of Randomized Controlled Trials
by Alka Bishnoi, Rachel Lee, Yang Hu, Jeannette R. Mahoney and Manuel E. Hernandez
Int. J. Environ. Res. Public Health 2022, 19(5), 2824; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph19052824 - 28 Feb 2022
Cited by 9 | Viewed by 4689
Abstract
Objective: Treadmill interventions have been shown to promote ‘normal’ walking patterns, as they facilitate the proper movement and timing of the lower limbs. However, prior reviews have not examined which intervention provides the most effective treatment of specific gait impairments in neurological populations. [...] Read more.
Objective: Treadmill interventions have been shown to promote ‘normal’ walking patterns, as they facilitate the proper movement and timing of the lower limbs. However, prior reviews have not examined which intervention provides the most effective treatment of specific gait impairments in neurological populations. The objective of this systematic review was to review and quantify the changes in gait after treadmill interventions in adults with neurological disorders. Data Sources: A keyword search was performed in four databases: PubMed, CINAHL, Scopus, and Web of Science (January 2000–December 2021). We performed the search algorithm including all possible combinations of keywords. Full-text articles were examined further using forward/backward search methods. Study Selection: Studies were thoroughly screened using the following inclusion criteria: study design: Randomized Controlled Trial (RCT); adults ≥55 years old with a neurological disorder; treadmill intervention; spatiotemporal gait characteristics; and language: English. Data Extraction: A standardized data extraction form was used to collect the following methodological outcome variables from each of the included studies: author, year, population, age, sample size, and spatiotemporal gait parameters including stride length, stride time, step length, step width, step time, stance time, swing time, single support time, double support time, or cadence. Data Synthesis: We found a total of 32 studies to be included in our systematic review through keyword search, out of which 19 studies included adults with stroke and 13 studies included adults with PD. We included 22 out of 32 studies in our meta-analysis that examined gait in adults with neurological disorders, which only yielded studies including Parkinson’s disease (PD) and stroke patients. A meta-analysis was performed among trials presenting with similar characteristics, including study population and outcome measure. If heterogeneity was >50% (denoted by I2), random plot analysis was used, otherwise, a fixed plot analysis was performed. All analyses used effect sizes and standard errors and a p < 0.05 threshold was considered statistically significant (denoted by *). Overall, the effect of treadmill intervention on cadence (z = 6.24 *, I2 = 11.5%) and step length (z = 2.25 *, I2 = 74.3%) in adults with stroke was significant. We also found a significant effect of treadmill intervention on paretic step length (z = 2.34 *, I2 = 0%) and stride length (z = 6.09 *, I2 = 45.5%). For the active control group, including adults with PD, we found that overground physical therapy training had the largest effect on step width (z = −3.75 *, I2 = 0%). Additionally, for PD adults in treadmill intervention studies, we found the largest significant effect was on step length (z = 2.73 *, I2 = 74.2%) and stride length (z = −2.54 *, I2 = 96.8%). Conclusion: Treadmill intervention with sensory stimulation and body weight support treadmill training were shown to have the largest effect on step length in adults with PD and stroke. Full article
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