Older adults who stay physically and mentally active appear to have better cognitive function compared to their less active counterparts. In fact, those who perform either regular exercise or cognitive training (CT) can maintain and improve their cognitive functioning, even in their later years. Resistance training (RT) causes an increase in specific hormones that are responsible for improved brain functioning; however, many questions about how these hormones respond to RT are unanswered. Understanding how these hormones respond to RT can help researchers and clinicians create optimal training programs for older adults. Research shows that combining exercise and CT may be better for the brain compared to either activity performed alone; however, nobody has looked at RT combined with CT. We believe that combining RT and CT where CT is performed when an individual’s hormones are highest (right after RT) could have a big effect on brain function in a short period of time. This work represents a two-part study looked at: 1) how these hormones respond to a session of RT, and 2) the effect of combined RT and CT on cognitive function in older adults. Our participants performed CT immediately after RT, 3 times per week for 8 weeks. Specific hormones which are important for brain function were measured immediately before and for 2 hours after an acute bout of RT before and after 8-weeks of RT. Cognitive function was measured before and after the RT training period. Our primary findings were: 1) significant increases in brain derived neurotrophic factor immediately after RT and 2) participants cognitive function improved after 8 weeks of training. This is important because short-term combined RT and CT can lead to significant improvements in cognitive functioning. Also, this work will allow researchers to begin designing exercise programs that can maximize the brain’s ability to change, even at an old age. / Thesis (Master, Kinesiology & Health Studies) -- Queen's University, 2012-09-21 15:29:35.509

This study investigated whether behavioural and cognitive dysfunction caused by mucopolysaccharidosis (MPS) IIIA can be detected early in affected dogs’ lives, and to describe the behaviours of these dogs. No other scientific papers have been published on this topic and the population of dogs examined in this study are the only MPS IIIA affected dog colony available worldwide for study. Three main tests were performed on the population of MPS IIIA affected dogs. Physical behavioural assessment tests were performed at six and eight weeks of age and from twenty weeks of age a cognitive function task was taught and then tested to measure the dogs’ performance. A previously validated questionnaire, the canine behavioural assessment and research questionnaire (C-BARQ), was completed at three, six and twelve months of age. The researchers in these studies were blinded to the MPS IIIA status of the dogs examined. The behaviours shown by the MPS IIIA puppies at six and eight weeks of age were not significantly different from the behaviours of the unaffected puppies. This finding supported the research of other MPS IIIA studies and suggests that clinical behavioural changes do not occur at such a young age. The behaviours shown by the MPS IIIA affected puppies appeared to be normal puppy behaviours similar to those described in previous research on puppies. The C-BARQ measured the behaviours shown by the MPS IIIA affected and unaffected dogs. Most of the MPS IIIA affected dogs’ behaviours were not significantly different from the unaffected dogs’ behaviours, but MPS IIIA affected dogs did retrieve significantly more than unaffected dogs at three months of age, and were less distractible at twelve months of age. It would be worth investigating these findings further to decide whether it suggests a subtle alteration in brain functioning. The cognitive function test showed a significant decrease in the success of the MPS IIIA affected dogs in the final maze test. This is the first study on dogs affected with MPS IIIA to find a decline in cognitive function before the occurrence of cerebellar clinical signs and this new knowledge may lead to future developments measuring therapy response and disease progression. The T-shaped maze testing may be valuable in future research on cognitive function in dogs with other diseases such as epilepsy. Thus this thesis provides valuable information on canine MPS IIIA and provides a foundation for future disease investigations.

In chronic illnesses, such as prostate cancer, multiple health outcomes need to be considered. This project focused on two types of health outcomes: health-related quality of life (HRQoL) and cognitive function. The first aim was to investigate cognitive effects of pharmacological androgen-suppressing treatment. Numerous studies have shown cognitive performance to be associated with sex hormones. One of the main groups of drugs used for hormonal ablation in men with prostate cancer, the luteinising hormone releasing hormone (LHRH) agonists, has been associated with adverse cognitive effects in controlled studies in women and in case reports of female and male patients. However, there have been no published studies on the effect of LHRH agonists and other androgen-suppressing treatments on cognitive functioning in male patients. The second aim was to investigate the effect of treatments on HRQoL in men with prostate cancer. There are few randomised treatment studies of HRQoL in these patients. The third aim was to study additional predictors of HRQoL, examining stress and coping theory as a theoretical basis for understanding individual differences in HRQoL. The fourth aim was to examine patients' subjective experiences of prostate cancer. To investigate these questions, 82 men with non-localised prostate cancer were randomly assigned to receive leuprorelin (LHRH agonist), goserelin (LHRH agonist), cyproterone (steroidal antiandrogen), or close clinical monitoring. These patients and 20 community volunteers matched for age, marital status, and general health undertook medical, psychosocial, and cognitive assessments before treatment and after 6 and 12 months of treatment. The main question for statistical analysis was whether dependent variables would show Group x Time interactions in the predicted directions. Compared with baseline assessments, men administered androgen suppression monotherapy performed worse in 3/12 tests of attention, memory, and executive function. Twenty-six percent of men randomised to active treatment demonstrated clinically significant decline in one or more cognitive tests at 6 months compared with baseline performance. By contrast, no community volunteers or patients randomised to close monitoring showed decline in test performance. Men on hormonal treatments reported impaired sexual function on treatment compared with baseline assessments. Men assigned to close monitoring and cyproterone treatment reported increased emotional distress over time. Groups did not differ in change in existential satisfaction, subjective cognitive function, physical symptoms, or social and role functioning. For individuals, hormonal treatments were more frequently associated with decreased physical, sexual, social and role functioning, but were also associated with improved HRQoL for some individuals. In hierarchical regression analysis, HRQoL was lower for men who had more comorbid illnesses, a history of neurological dysfunction, higher threat appraisals, or higher use of emotion-focused coping strategies. Coping strategies also showed some longitudinal associations with HRQoL, even when earlier levels of HRQoL had been taken into account. Subjective reports demonstrated that many patients viewed prostate cancer as a relatively manageable problem. Several patients said that other health problems affected them more than prostate cancer, whereas no patient said that prostate cancer was worse than other problems. Comments about the seriousness of prostate cancer were equally divided between patients who reported it as very serious (14.3% of patients) and those who saw it as a relatively minor problem (14.3%). Other patient observations were grouped into categories of personal responses to prostate cancer, health, and health research; life circumstances that were not directly associated with health; attributions about medication; and function prior to the study. The results demonstrated that pharmacological androgen suppression therapy was associated with impaired memory, attention, and executive function in male patients. Hormonal treatments and close monitoring had differential effects on patients' HRQoL, particularly in terms of sexual function and emotional distress. HRQoL was also associated with appraisal and coping, to a greater extent than it was associated with medical variables, supporting the applicability of stress and coping theory for these patients. Observations from participants placed these findings in the context of participants' concerns, demonstrating that issues such as cognitive and sexual function were relevant for these patients. These findings suggest that cognitive function should be given increased attention as a health outcome, not only in "neurological" disorders but also in other "non-neurological" conditions such as prostate cancer. They also support continued efforts to understand both beneficial and adverse effects of treatments for chronic illness on HRQoL and individual factors that affect health outcomes.

Author's first name and surname: Bc. Martin Dvořáček Title of the master thesis: Physiotherapy as a way to improve adherence to CPAP therapy of patients with obstructive sleep apnea syndrom Department: Department of physiotherapy Supervisor: Mgr. Petr Bitnar The year of presentation: 2018 Abstract: Obstructive sleep apnea is the most common type of sleeping disorder. It is characterized by an excessive daytime sleepiness, deficits of cognitive functions, serious cardiovascular issues and general decrease in the quality of life. The golden standard of the treatment is CPAP therapy. However the long-term disadvantage of this method is the low rate of patients adherence. The minimum requirements for CPAP machines usage are only met by approximately fifty percent of the patients. The presented thesis is divided into three main parts. Firstly, the positive effects of CPAP therapy such as reduction of excessive daytime sleepiness, improvement of cognitive functions and overall increase of life quality of the patients were reviewed. In the next part the relationship between the monitored factors and patients adherence to CPAP was investigated. Lastly, the desired increase of patients adherence to CPAP therapy was tested. Selected patients were divided into three different groups according to their therapeutical...

The goal of this thesis was to describe cognitive profile of mild cognitive impairment (MCI) in patients witch ischemic stroke (IST). The theoretical introduction focuses on IST, the concept of MCI, and neuropsychological test of cognitive deficits related to IST. The empirical part of the thesis describes the research results. 64 patients with various types of brain lesions after first-ever stroke were examined within 3-6 months after hospital admission. The cognitive performance was assessed across five cognitive domains: memory, attention, executive functions, visuospacial abilities, and language. All cognitive domains were impaired to the similar extend; the impairment quite severe, and ranged from 1.5 to 2.0 SD below the mean of the control group. The results showed that right hemisphere lesions were associated with visuospacial impairment whereas left hemisphere lesions were associated with language impairment. Also, it was examined which combination of tests differentiates best between patients from the experimental groups and the control group, and among individual experimental groups. It is necessary to develop and use sensitive and valid tests that can detect mild cognitive deficits in patients after ischemic stroke, which could be useful for rehabilitation planning. Keywords: mild...

Hintergrund: Chronische Schmerzen sind weit verbreitet in Deutschland (Häuser et al., 2014). Folgt man den Empfehlungen der NVL Kreuzschmerz (2017) für chronische Verlaufs-formen werden vor allem interdisziplinäre multimodale Therapieansätze in der Behandlung präferiert. Diese zeitlich und inhaltlich umfangreichen Therapieprogramme (Arnold et al. 2009), deren Wirksamkeit und Effektivität bereits gut untersucht ist und als im Wesentlichen positiv bewertet wurde (Kaiser, Azad und Sabatowski, 2015; Pfingsten et al., 2010; Nagel und Korb, 2009), stellen hinsichtlich der kognitiven Leistungsfähigkeit eine große Herausforderung für die Patienten dar: häufig berichten Patienten mit chronischen Schmerzen von kognitiven Beeinträchtigungen. Wenngleich sich die Studienlage sehr heterogen gestaltet, konnten zahlreiche Untersuchungen das Vorliegen kognitiver Beeinträchtigungen bereits bestätigen – sowohl auf subjektiver als auch auf objektiver Ebene (e. g. Landrø et al., 2013; Rathbone et al., 2016; Baker et al., 2016; Kuhnt, 2005; Oosterman et al., 2012). Insbesondere Defizite in Aufmerksamkeitsprozessen und Exekutivfunktionen wie Arbeitsgedächtnis und kognitiver Flexibilität wurden beobachtet. Zudem entspannt sich seit den 90er Jahren eine breite Diskussion um angemessene Bewältigungsstrategien auf chronischen Schmerz. Dabei steht u. a. die Frage, was ein angemessener Bewältigungsansatz, ist im Fokus. Verschiedene Modellansätze beschreiben verschiedene Formen von Coping (Lazarus und Folkman, 1984; Brandtstädter et al., 1990; Vlaeyen und Linton, 2000; Hasenbring, Hallner und Klasen, 2001), wobei sich deutlich ungünstige und günstige Bewältigungsstrategien herauskristallisieren: Während Flexibilität und ein Ausgleich zwischen Regeneration und Aktivität als günstige Strategien gewertet werden, werden Durchhaltestrategien und Katastrophisierung sowie Passivität und Rigidität eher als ungünstige Muster im Umgang mit chronischen Schmerzen wahrgenommen. Fragestellung: Bisher weniger Beachtung fanden Wirkmechanismen und Wechselwirkungen zwischen chronischem Schmerz, kognitiver Leistungsfähigkeit und Coping sowie den daraus resultierenden Implikationen für therapeutische Programme und deren Outcome. Interdisziplinäre multimodale Therapieprogramme verfügen jedoch über einen großen Anteil kognitiver Informationsvermittlung und erfordern ein hohes Maß an Reflexionsfähigkeit und sind daher unter Umständen maßgeblich für den Therapieerfolg. Ziel der aktuellen Studie ist es daher, die kognitive Leistungsfähigkeit bei Patienten mit chronischen Schmerzen im Rahmen eines interdisziplinären multimodalen Therapiesettings zu untersuchen. Methode: Untersucht wurden Patienten, die im Zeitraum von 02/2014 bis 01/2016 an der interdisziplinären multimodalen tagesklinischen Schmerztherapie am USC in Dresden teilnahmen. Die Indikation für die Aufnahme einer solchen Behandlung bestand u. a. dann, wenn Patienten über rezidivierende oder anhaltende Schmerzen über 6 Monaten berichteten und unter psychischer Komorbidität litten. In die Studie einbezogen wurden diejenigen, die eine Fragebogenbatterie sowie eine Testauswahl der standardisierten computergestützten Testbatterie COGBAT zur kognitiven Leistungsfähigkeit sowohl zu Therapiebeginn als auch zu Therapieende absolvierten. Die erhobenen kognitiven Leistungsparameter waren Aufmerksamkeits- und Arbeitsgedächtnisleistungen, kognitive Flexibilität, Informationsverarbeitungsgeschwindigkeit und Fähigkeit ungewollte Reaktionen zu unterdrücken. Entsprechend ergab sich eine Untersuchungsstichprobe von N=139. Das Durchschnittsalter betrug 50,73 Jahre. Ein Viertel der Patienten war Männer (24,5%). Etwas mehr als die Hälfte der befragten Patienten litt unter Rückenschmerzen (55,4%), der Anteil an mittel und stark chronifizierten Schmerzen ergab zusammen knapp 80% (42,4% MPSSII, 36,0% MPSSIII). Des Weiteren lag die durchschnittliche Schmerzstärke (NRS, 0-10) bei 5,20 (SD=1,58). Die Werte bezüglich der schmerzbedingten Beeinträchtigung (PDI) lagen im Mittel deutlich unter dem Cut-off-Point. Knapp auffällige Werte zeigten die Patienten bezüglich der psychische Komponenten der Lebensqualität (SF-12). Das Screening auf Angst, Depressivität und Stress (DASS) ergab unauffällige Werte. Zur Analyse der Zusammenhangshypothesen wurden Produkt-Moment-Korrelationen berechnet, Unterschiedshypothesen wurden unter Verwendung von T-Test und Wilcoxon-Rang-Vorzeichentest überprüft. Zur Beurteilung der klinischen Bedeutsamkeit wurden Effektstärken ermittelt. Die Analysen wurden mit SPSS Version 27.0 vorgenommen. Ergebnisse: Im Ergebnis der Analyse zeigte sich, dass diese Patienten im Vergleich mit der Normstichprobe (gesunde Erwachsene zwischen 17 und 88 J.) zum Zeitpunkt des Therapiebeginns durchschnittliche Ausprägungen bezüglich der erhobenen kognitiven Leistungsparameter aufweisen. Hingegen konnten hinsichtlich aller Parameter, bis auf die Aufmerksamkeitsleistung, Steigerungen mit mittleren Effektstärken zum Therapieende nachgewiesen werden. Die Daten bestätigen des Weiteren das gleichzeitige Vorliegen einer Depressionsdiagnose bei unterdurchschnittlich ausgeprägten kognitiven Leistungsparametern, was auf einen Zusammenhang zwischen Depressivität und kognitiver Leistungsfähigkeit spricht. Bei Patienten, die eine unterdurchschnittliche kognitive Flexibilität (Teilbereich der kognitiven Leistungsfähigkeit) aufweisen, wurde zudem der Einfluss des Alters auf die kognitive Leistungsfähigkeit bestätigt. Zusammenhänge zwischen der kognitiven Leistungsfähigkeit zu schmerzbezogenen Parametern zeigten sich im Wesentlichen keine. Ein Einfluss in Abhängigkeit der kognitiven Leistungsfähigkeit auf die angewandten Copingsstrategien konnte ebenfalls nicht bestätigt werden. Dasselbe Bild ergab sich aus den Analysen zum Einfluss der angewandten Copingstrategien auf die kognitive Leistungsfähigkeit sowie die schmerzbezogenen Parameter. Schlussfolgerung: Ein Zusammenhang zwischen Coping und kognitiver Leistungsfähigkeit sowie zwischen schmerzbezogenen Parametern und kognitiver Leistungsfähigkeit konnte nicht bestätigt werden. Die Ergebnisse legen jedoch nah, dass die angebotene interdisziplinäre multimodale Schmerztherapie Veränderungen in der kognitiven Leistungsfähigkeit bewirkt. Es ist davon auszugehen, dass die IMST einen differenzierten Therapieansatz darstellt, der ein wesentlicher Wirkfaktor zwischen kognitiver Leistungsfähigkeit und chronischen Schmerzen ist. Die genauen Wirkfaktoren innerhalb der IMST sind dabei zum aktuellen Zeitpunkt noch ungewiss. Weitere Forschungsbemühungen sollten dahingehend ausgerichtet werden.:Inhaltsverzeichnis 1. Einleitung 1 1.1. Theoretische Grundlagen 3 1.2. Grundlagen zum chronischen Schmerz 3 1.2.1. Definition chronischer Schmerz 3 1.2.2. Auftreten chronischer Schmerzen 4 1.4. Grundlagen zu den zu untersuchenden Variablen 7 1.4.1. Kognitive Leistungsfähigkeit 7 1.4.2. Aufmerksamkeit 7 1.4.3. Exekutive Funktionen 8 1.5. Allgemeine Einflussfaktoren auf die kognitive Leistungsfähigkeit 9 1.6. Allgemeiner Zusammenhang zwischen kognitiver Leistungsfähigkeit, und chronischem Schmerz 13 1.7. Coping bei chronischem Schmerz 18 1.8. Einordnung in den Kontext der Therapie: chronischer Schmerz, kognitive Leistungsfähigkeit und Coping 21 1.9. Fragestellungen 24 2. Methodik 28 2.1. Setting 28 2.2. Einschlusskriterien 28 2.3. Operationalisierung der Konstrukte 29 2.4. Ablauf der Datenerhebung 31 2.4.1. Untersuchungsdesign 31 2.4.2. Ablauf der Untersuchung 31 2.4.3. Ethik- und Datenschutz 33 2.4.4. Fallzahlberechnung 33 2.5. Geplante Auswertung 33 2.5.1. Methoden der Datenauswertung 33 2.5.2. Verfahrensbeschreibung 34 2.5.3. Stichprobenbeschreibung 36 2.5.4. Voraussetzungsprüfung 41 2.5.5. Festlegung des statistischen Vorgehens 42 3. Ergebnisse 44 3.1. Einschränkungen der kognitiven Leistungsfähigkeit und der Zusammenhang zu Depressivität und Copingverhalten zu Therapiebeginn 44 3.2. Zusammenhang zwischen Einschränkungen der kognitiven Leistungsfähigkeit und den angewandten Copingstrategien 46 3.3. Zusammenfassung der Ergebnisse 57 4. Diskussion 58 5. Zusammenfassung 68 Literaturverzeichnis 73 Tabellenverzeichnis 82 Abbildungsverzeichnis 84 Anhang 85 Danksagung 128 Erklärungen 129

Bakgrund: Obstruktiv sömnapné (OSA) är en sjukdom med återkommande andningsuppehåll i de övre luftvägarna till följd av delvis eller total tilltäppning av luftflödet vid sömn, vilket leder till en lägre syremättnad i blodet. Det är känt att OSA försämrar kognitiva funktioner såsom minne och inlärning. Det saknas evidens om samband mellan kognitiv funktion, grad av symptom och fysisk aktivitetsnivå.   Syfte: Att beskriva kognitiv funktion hos en grupp patienter med övervikt och OSA. Undersöka samband mellan kognitiv funktion (korttidsminne) och fysisk aktivitet på moderat till hög intensitet (MVPA) samt undersöka samband mellan kognitiv funktion och svårighetsgrad av OSA.   Metod: Studien är en tvärsnittsstudie med korrelerande design. Grad av OSA mättes med apné-hypopné-index (AHI), kognitiv funktion med sifferrepetitionstest och fysisk aktivitet med accelerometer. I studien inkluderades 86 patienter diagnostiserade med OSA (AHI >15), Body Mass Index (BMI) >25 och ha en självskattad fysisk aktivitetsnivå på mindre än 150 minuter per vecka.   Resultat: Resultatet av sifferrepetitionstestet i studien visade ett medelvärde på 15,7. Det fanns inget signifikant samband (r=-0,10, p=0,38) mellan mängden MVPA och kognitiv funktion hos patienter med OSA. Det fanns heller inget signifikant samband (r=0,09, p=0,40) mellan AHI och prestation på sifferrepetitionstestet.   Slutsats: Mängden fysisk aktivitet verkar inte ha någon effekt på kognitiv funktion. Det verkar inte heller finnas något samband mellan AHI och en patients kognitiva funktion. Ytterligare forskning på ämnet krävs för att kunna bekräfta resultatet från denna studie. / Background: Obstructive sleep apnea (OSA) is a disease with repeated episodes of partially or completely blocked airways during sleep, which leads to a lower blood saturation. OSA is known to decrease cognitive abilities like memory and learning. There is a lack of studies which investigate if there is an association between cognitive function, symptoms and physical activity in patients with OSA.   Purpose: To describe the cognitive function in a group of patients who are overweight and has OSA. Examine the association between cognitive function (short-term memory) and moderate to vigorous physical activity (MVPA) and examine the association between cognitive function and severity of OSA.   Method: This paper is a cross-sectional study with correlational design. The severity of the disease was measured with apnea-hypopnea index (AHI). The cognitive function was measured by digit span test and physical activity with an accelerometer. The study includes 86 patients diagnosed with OSA (AHI >15), with a BMI >25 and a self-assessed moderate intensity physical activity less than 150 minutes/week.   Results :The digit span test in this study showed a mean value of 15,7. There was no significant correlation (r=-0.10, p=0.38) between amount of MVPA and short-term memory in patients with OSA (p=0.38). There was neither any significant correlation (r=0.09, p=0.40) between patients AHI and the cognitive functions.   Conclusion: The amount of physical activity didn’t seem to have any effect on cognitive function. There doesn't seem to be any association between AHI and patients cognitive function. Further research is needed to confirm the results from this study.

The purpose of this thesis is to analyse the development of reading strategies of adolescent pupils with dyslexia using Feuerstein's Instrumental Enrichment, an internationally recognized method which is aimed at the development of cognitive functions. In the context of the actual legislative changes in the education of pupils with special educational needs, this reflects the needs of educational practice. The theoretical part summarizes the basic terminology and the state of the Czech and foreign literature related to the topic of this work. The research part of the work characterizes the research design and the research sample, and then presents individual results and conclusions for further researches and educational practice. The objectives of the research can be divided into two levels, in the qualitative part of the research there were realized special reeducations of adolescent pupils with dyslexia using set of teaching materials based on the principles of Feuerstein's Instrumental Enrichment. In this part of the thesis, the aim was to describe and analyze selected factors influencing the development of reading strategies of adolescents with dyslexia involved in the research (own learning process, behavior of pupils and lecturer); to find out what reading strategies are developed in...

Many actions we observe in nature show some kind of regularity, therefore we call them rhytms. Rhytms with a period of approximately 24 hours, so called circadian rhytms, can be distinguished in many physiological processes, with the sleep-wake cycle being one of the most prominent ones. Light is the main exogenous circadian synchronizator and thanks to the circadian rhytm influence on physiological function, it's also often spoken about an influence of light on the entire organism. Nowadays, when we spend most of the day indoors under artificial light, we often suffer from a lack of natural daylight and its synchronizing potential. This is even more prominent in elderly population living in nursing homes and in other social facilities. Lately, a new type of lighting, so called biodynamic, has been introduced. Biodynamic lighting can simulate changes in natural light conditions throughout the day and therefore partially compensate for the lack of natural daylight we suffer from, and also minimize risks of the night light. In this study we aimed to test changes in the circadian system of seniors living in the Retirement Home of TGM in Beroun using questionnaires and circadian markers. We have shown a positive effect of the installed biodynamic lighting on our participants' circadian markers and...

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