To explore the effects of a group-based multicomponent exercise program on general cognitive functioning, depression, and social functioning in community-dwelling older adults with mild cognitive impairment (MCI) and whether the effects can be maintained.Fifty older adults with MCI were conveniently recruited from two communities in the study area and randomly assigned to the intervention group or control group. The intervention group received three sessions of 60-minute, multicomponent exercise per week for 3 months, plus MCI-related health education. The control group only received MCI-related health education. Mini-Mental State Examination (MMSE) and Montreal Cognitive Assessment Beijing Version (MoCA-BJ) were used to assess general cognitive function. The Functional Activities Questionnaire (FAQ) and Geriatric Depression Scale (GDS-30) were used to evaluate participants' social function and depression, respectively. Participants' exercise intensity was assessed using the Category Ratio Scale.After the 3-month intervention, there were significant improvements in general cognitive function (p = 0.046), attention (p = 0.009), delayed recall (p = 0.015), and social function (p = 0.011) in the intervention group compared with the control group. However, after 3-month postintervention follow up, no significant differences in MMSE, MoCA-BJ, GDS-30, and FAQ scores were noted between groups.The 3-month multicomponent exercise program improved general cognitive function and social functioning in community-dwelling older adults with MCI. However, there was no evidence that these benefits lasted for another 3 months after stopping the exercise program. [Research in Gerontological Nursing, 17(2), 65-79.]. 

Effects of Multicomponent Exercise on Community-Dwelling Older Adults With Mild Cognitive Impairment

ABSTRACT This review summarizes meta-analyses (MAs) of randomized controlled trials (RCTs) that assessed the effectiveness of aerobic exercise and dance interventions on cognitive functions in adults with mild cognitive impairment (MCI). Five databases, MEDLINE, EMBASE, PsycINFO, PubMed, and CENTRAL, were searched. MAs that exclusively pooled the effect sizes of aerobic exercise or dance on cognitive functions in adults aged 50 and above with MCI were included. We summarized 20 MAs, including 59 unique RCTs on aerobic exercise and 12 unique RCTs on dance. The meta-meta-analysis results demonstrated that both aerobic exercise (SMD = 0.28 [.13, .43]) and dance (SMD = 0.39 [.28, .49]) significantly improve overall cognition in adults with MCI. When considering specific cognitive domains, aerobic exercise significantly improves global cognition (SMD = 0.42 [.21, .64]) but does not significantly impact executive function and memory. Dance significantly enhances global cognition (SMD = 0.4 [.01, .09]), executive function (SMD = 0.18 [.03, .32]), and memory (SMD = 0.46 [.32, .61]). The moderator analysis also supported dance's superior effect on memory. This finding suggests that the cognitively demanding nature of dance, which involves memorizing complex choreography and coordinating movements with accompanying music, provides additional benefits for memory. Overall, the current review supports that aerobic exercise and dance are effective non-pharmacological interventions to stabilize and even improve cognitive functions in adults with MCI.

The effectiveness of aerobic exercise and dance interventions on cognitive function in adults with mild cognitive impairment: an overview of meta-analyses

There is evidence that health promotion interventions can support people with MCI and dementia to improve or maintain their cognitive function, through multicomponent physical activity combined with cognitive training. More evidence is needed for nutritional recommendations, psychological interventions, and social inclusion interventions. 

Evidence for health promotion interventions to improve cognitive and physical functioning outcomes in older adults with MCI: A state-of-the-art review

Objective To assess the methodological quality of meta-analytic literature on exercise interventions for cognitive function in patients with mild cognitive impairment (MCI) and the certainty of evidence for its outcome indicators, and to provide clinicians and researchers with more reliable data for making decisions. Methods Meta-analytic literature related to the effect of exercise intervention on cognitive function in patients with mild cognitive impairment was searched through PubMed, Cochrane Library, Embase, Scopus, Physiotherapy Evidence Database and Web of Science, all with a search period frame of each database until June 1, 2024. The AMSTAR2 scale was used to evaluate the methodological quality of the included studies. Results Seventeen meta-analyses were included. The AMSTAR2 scale evaluation results showed that there was one medium-quality studies (5.55%), seven low-quality studies (38.88%), and 10 very low-quality studies (55.55%). Methodological deficiencies included failure to prepare a plan and provide a registration number, literature screening, data extraction, reasons for exclusion not described in detail, poor implementation process for systematic evaluation, and failure to describe the source of funding for the included studies or relevant conflicts of interest. Conclusion The overall methodological quality of the meta-analytic literature is low, and the certainty of evidence is low. We encourage the conduction of high-quality randomized trials to generate stronger evidence. Subsequent systematic reviews can then synthesize this evidence to inform future research and clinical guidelines. 

A methodological and reporting quality assessment of systematic reviews/meta-analyses on exercise interventions for cognitive function in older adults with mild cognitive impairment

<title>Abstract</title> The objective of this study was to evaluate the specific effects of aerobic exercise on overall cognitive function, memory, executive function, and quality of life among older adults diagnosed with Mild Cognitive Impairment (MCI). Additionally, the study aimed to analyze the impact of exercise interventions on older adults with MCI, taking into account the measurement tools, exercise type, frequency, and duration, while also evaluating recommended interventions from randomized controlled trials(RCTs). We reviewed 22 studies from Web of Science, PubMed, Cochrane Library, and EMBASE. The findings of this study indicate that aerobic dance markedly enhances overall cognitive function, effectively elevates quality of life, and demonstrates a modest improvement in memory and executive function among individuals with MCI. Moreover, Subgroup analyses revealed that square dancing had a notably beneficial intervention effect, given its low-cost, easy-to-learn, and inclusive nature. This suggests its suitability for exercise interventions in MCI patients. Additionally, interventions twice a week, each lasting over 50 minutes, yielded better aerobic exercise outcomes. However, due to the unknown optimal mechanisms, further rigorous, large-scale randomized controlled trials are imperative to enhance our understanding and refine intervention strategies. 

Effects of aerobic exercise interventions on cognitive function and quality of life in older adults with mild cognitive impairment: A systematic review and meta-analysis

Objectives To summarise the effects of various types of aerobic exercise on the global cognitive function of the elderly with mild cognitive impairment (MCI). Design A meta-analysis of randomised controlled trials (RCTs). Data sources PubMed, EMBASE and the Cochrane Library were searched for clinical RCTs from the earliest available records to March 2022. Eligibility criteria for selecting studies We included RCTs of subjects older than 60 years with MCI. The outcome indicators of cognitive function of interest were the Mini-Mental State Examination (MMSE) and the Montreal Cognitive Assessment (MoCA). Data extraction and synthesis Two researchers independently screened the literature, extracted data and evaluated the quality of the included studies, with disagreements resolved by a third researcher. The Cochrane Handbook for Systematic Reviews of Interventions was used to assess the risk of bias. Meta-analysis was performed by Review Manager V.5.3 software. Random-effect models were used for meta-analysis. Results A total of 1680 patients who participated in 20 RCTs were included in this study. Based on outcomes of MMSE analysis, the aerobic exercise, which was beneficial for global cognitive function in MCI patients, included multicomponent aerobic exercise (MD=1.79, 95% CI (1.41 to 2.17), p<0.01) and mind–body exercise (MD=1.28, 95% CI (0.83 to 1.74), p<0.01). The results of the meta-analysis of conventional aerobic exercise (MD=0.51, 95% CI (0.09 to 0.93), p=0.02) turned out to be statistically insignificant after sensitivity analysis (MD=0.14, 95% CI (-0.47 to 0.75), p=0.65). With the evaluation of MoCA, multicomponent aerobic exercise (MD=5.74, 95% CI (5.02 to 6.46), p<0.01), mind–body exercise (MD=1.29, 95% CI (0.67 to 1.90), p<0.01) and conventional aerobic exercise (MD=2.06, 95% CI (1.46 to 2.65), p<0.01) were showed significant beneficial effects for the patient. However, there was a high degree of heterogeneity between the results of multicomponent aerobic exercise (MMSE) and conventional aerobic exercise (MoCA), which was analysed and explored. Conclusions In general, multicomponent aerobic exercise and mind–body exercise were beneficial in improving global cognitive function in the elderly with MCI. Nevertheless, the improvement effect of mind–body exercise is more reliable compared with multicomponent aerobic exercise and conventional aerobic exercise. PROSPERO registration number CRD42022327386.

Effects of different aerobic exercises on the global cognitive function of the elderly with mild cognitive impairment: a meta-analysis

Abstract Background After stroke, an abnormal gait pattern gradually leads to knee pain and joint lesions, resulting the gait instability. However, the correlation between the knee hyperextension and gait pattern, the meniscus volume, and the water content of meniscus in paretic and non-paretic legs has not been fully investigated. Moreover, most of physicians tend to ignore this knee hyperextension. This study attempted to emphasize the importance of knee hyperextension using gait analysis and Magnetic resonance imaging (Trial registration number ChiCTR2000039641, date of registration 04/11/2020). Methods Eight patients with chronic hemiplegic (6 male, 2 female) volunteered to participate in this study. Participants was recruited if they had a hemiplegia following a stroke occurring more than 6 months, had an ability to walk 10 m without aids, had a Function Ambulation Category level at least 3 and above, and had a hemiplegic lower extremity identified as Brunnstrom state III or above identification. The spatial–temporal gait parameters and kinematic parameters in the paretic and the non-paretic legs and the percentage of free water content in deep and shallow layers. Results Longer time since hemiplegia led to larger angles of knee hyperextension (R = 0.56, p = 0.016), larger angles of knee hyperextension led to more tears in meniscus (R = − 0.53, − 0,57 and − 0.70), and larger angles of knee hyperextension decreased water content of the lateral meniscus in the non-paretic leg (R = − 0.91) but increased water content of the medial meniscus (R = 0.53 and 0.63). Conclusions The knee hyperextension could not be ignored by physicians and needed to be diagnosed and treated as early as possible, the time since hemiplegia could be an indicator of sign of knee hyperextension. 

https://bmcsportsscimedrehabil.biomedcentral.com/counter/pdf/10.1186/s13102-022-00611-1

Does higher knee hyperextension in patients with hemiplegia affect lateral and medial meniscus volume in the paretic leg? A cross-sectional study

Are more exercise components in combined cognitive and physical training better for older adults?: A systematic review and network meta-analysis of randomized controlled trials

Chronic cerebral ischemia (CCI) can lead to vascular cognitive impairment, but therapeutic options are limited. Cognitive‐exercise dual‐task (CEDT), as a potential rehabilitation intervention, can attenuate cognitive impairment. However, the related mechanisms remain unclear. In this study, 2‐vessel occlusion (2‐VO) in male SD rats was performed to establish the CCI model. The rats were treated with cognitive, exercise, or CEDT intervention for 21 days. The Morris water maze (MWM) test was used to assess cognitive ability. TUNEL staining was used to detect the neuronal apoptosis. Immunofluorescence, RT‐qPCR and Western blot were used to detect the protein or mRNA levels of EphrinA3, EphA4, p‐PI3K, and p‐Akt. The results showed that CEDT could improve performance in the MWM test, reverse the increased expression of EphrinA3 and EphA4, and the reduced expression of p‐PI3K and p‐Akt in CCI rats, which was superior to exercise and cognitive interventions. In vitro, oxygenglucose deprivation (OGD) challenge of astrocytes and neuronal cells were used to mimic cerebral ischemia. Immunofluorescence assay revealed that the levels of MAP‐2, p‐PI3K, and p‐Akt were reduced in EphrinA3 overexpressed cells after OGD stimulation. Finally, the knock‐down of EphrinA3 by shRNA significantly promoted the recovery of cognitive function and activation of PI3K/Akt after CEDT treatment in CCI rats. In conclusion, our study suggests that CEDT promotes cognitive function recovery after CCI by regulating the signaling axis of EphrinA3/EphA4/PI3K/Akt.

Cognitive‐exercise dual‐task promotes cognitive function recovery in chronic cerebral ischemia male rats through regulating PI3K/Akt signaling pathway via inhibition of EphrinA3/EphA4

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Effects of different aerobic exercises on the global cognitive function of the elderly with mild cognitive impairment: a meta-analysis

Does higher knee hyperextension in patients with hemiplegia affect lateral and medial meniscus volume in the paretic leg? A cross-sectional study

Are more exercise components in combined cognitive and physical training better for older adults?: A systematic review and network meta-analysis of randomized controlled trials

Cognitive‐exercise dual‐task promotes cognitive function recovery in chronic cerebral ischemia male rats through regulating PI3K/Akt signaling pathway via inhibition of EphrinA3/EphA4