Cognitive and cognitive-motor interventions affecting physical functioning: A systematic review

Background Several types of cognitive or combined cognitive-motor intervention types that might influence physical functions have been proposed in the past: training of dual-tasking abilities, and improving cognitive function through behavioral interventions or the use of computer games. The objective of this systematic review was to examine the literature regarding the use of cognitive and cognitive-motor interventions to improve physical functioning in older adults or people with neurological impairments that are similar to cognitive impairments seen in aging. The aim was to identify potentially promising methods that might be used in future intervention type studies for older adults. Methods A systematic search was conducted for the Medline/Premedline, PsycINFO, CINAHL and EMBASE databases. The search was focused on older adults over the age of 65. To increase the number of articles for review, we also included those discussing adult patients with neurological impairments due to trauma, as these cognitive impairments are similar to those seen in the aging population. The search was restricted to English, German and French language literature without any limitation of publication date or restriction by study design. Cognitive or cognitive-motor interventions were defined as dual-tasking, virtual reality exercise, cognitive exercise, or a combination of these. Results 28 articles met our inclusion criteria. Three articles used an isolated cognitive rehabilitation intervention, seven articles used a dual-task intervention and 19 applied a computerized intervention. There is evidence to suggest that cognitive or motor-cognitive methods positively affects physical functioning, such as postural control, walking abilities and general functions of the upper and lower extremities, respectively. The majority of the included studies resulted in improvements of the assessed functional outcome measures. Conclusions The current evidence on the effectiveness of cognitive or motor-cognitive interventions to improve physical functioning in older adults or people with neurological impairments is limited. The heterogeneity of the studies published so far does not allow defining the training methodology with the greatest effectiveness. This review nevertheless provides important foundational information in order to encourage further development of novel cognitive or cognitive-motor interventions, preferably with a randomized control design. Future research that aims to examine the relation between improvements in cognitive skills and the translation to better performance on selected physical tasks should explicitly take the relation between the cognitive and physical skills into account.ISSN:1471-231

Extending mental practice to sleep: Enhancing motor skills through lucid dreaming

Improving motor performance without physical movements might seem counterintuitive, however, decades of research on mental practice have demonstrated its feasibility. The phenomenon of lucid dreaming – i.e. becoming aware of the current dream state during ongoing sleep – bears some resemblance to mental practice: behaviors such as motor tasks can be intentionally simulated with mental imagery. During lucid dreaming, however, the brain generates a highly immersive, VR-like environment and realistic proprioceptive impressions to match the mental practitioner’s needs. In recent years the hypothesis was thus proposed that lucid dreaming can be used to extend motor practice to the sleeping state, thereby improving motor performance during subsequent wakefulness. Here, we examine this hypothesis by exploring the theoretical foundations and efficacy of this inventive approach in sports science and beyond. Experimental studies show promising performance improvements after lucid dreaming motor practice. Similarities have been observed in brain activity, eye movements, muscle activity, and autonomic responses compared to physical practice support the potential of lucid dreaming practice. Surveys show that athlete populations already implement lucid dreaming practice as part of their training. Potential placebo effects and an increase in motivation after lucid dreaming practice in the post-test should be investigated in future studies. Also, some well-known practical challenges of lucid dream research, such as its rarity, lack of proper training, and lack of control over the dream, need to be addressed. Eliminating these limitations will strengthen the potential of this inventive approach and enable lucid dreaming practice to be incorporated into various disciplines in the future