The importance of socio-cognitive-affective factors in motor skill learning has received increasing attention over the past two decades. In line with theoretical frameworks, previous studies in sports contexts have demonstrated that positive affect facilitates motor skill acquisition. However, there is a paucity of research regarding the factors that influence affective responses during motor practice. Implicit motives have emerged as a potential factor, with evidence linking motive-congruent environments to enhanced learning outcomes - though mainly in artificial laboratory settings using simple tasks. Here, we examine the associations between implicit motives, affective and hormonal responses, and motor learning in a competitive context by means of an ecologically valid, whole-body balance task. For this, 138 healthy adults participated in a fictitious one-on-one competition to practice a novel balancing task. We found that winning or losing did not directly affect task performance or learning, but that individuals' affective responses to the competition were associated with learning outcome. As expected, positive valence predicted better motor learning, which was primarily driven by participants who won the competition. Contrary to our hypotheses, the implicit power motive as well as testosterone and estradiol responses did not predict learning outcomes, and interactions between power motive and affective responses showed only a weak trend. Notably, female participants showed stronger responses to competition, highlighting the need to systematically consider biological sex in future research. Our findings highlight the importance of positive affect in motor skill learning and extend previous work to gross motor tasks practiced under competitive conditions.

Perturbation-based balance training (PBT) specifically targets fall mechanisms and holds promise for fall prevention in older adults, but its reliance on near-fall exposure may pose a barrier to engagement. Successful implementation depends on acceptability among participants and trainers, yet a mixed-methods, multi-perspective evaluation of PBT acceptability is lacking. To evaluate the acceptability of treadmill PBT in older adults at risk of falling and in trainers, and to examine associations with participant characteristics. Twenty-nine participants (79.9 ± 5.5 years) completed a 6-week treadmill PBT intervention, delivered by three trainers. Retrospective acceptability was assessed using a questionnaire (maximum score: 35 pt. for participants, 30 pt. for trainers) and semi-structured focus groups (12 participants, all trainers), guided by Theoretical Framework of Acceptability (TFA) domains and additional context-specific topics. Associations between participant characteristics and questionnaire scores were analyzed using multivariate regression. Focus-group data were analyzed deductively using the TFA. Median questionnaire scores were high for participants (28 [interquartile range, IQR 23–32] pt.) and trainers (26 [IQR 25–26] pt.). Fall history emerged as the only independent predictor of lower acceptability among participants. Focus groups revealed that both participants and trainers generally perceived PBT as acceptable. High perceived safety and effectiveness for improving reactive balance, adequate tailoring and supervision, and strong coherence were reported as facilitators. Potential barriers included anxiety, fall-related memories, the demanding nature of PBT, and setting-related factors (e.g., monotony, limited social interaction, missing handrails, narrow belt). Treadmill PBT were generally well accepted by trainers and older adults at risk of falling but showed lower acceptability among participants with fall history. Implementing PBT in individuals with no fall history may help mitigate anxiety related to prior fall experiences and support higher acceptability. DRKS00030805 (December 14, 2022).

A single bout of cardiovascular exercise (CVE) can promote neuroplasticity in an intensity-dependent manner. Consequently, performing CVE immediately after encoding may enhance motor memory consolidation, with stronger effects reported for high intensities. However, most evidence comes from fine-motor tasks, and data on complex whole-body skills are still scarce. In this pre-registered experiment, 41 neurotypical young adults practiced a balance task used to study gross-motor learning. Immediately after encoding, we randomized participants into three groups: a high-intensity interval CVE group (90/60

Background:"Keep On Keep Up" (KOKU) is a tablet-based digital program based on the well-validated Otago and Fitness and Mobility Exercise programs for older adults to decrease the risk of falling. Objective:This substudy involved a process evaluation in order to analyze the usage patterns of the KOKU digital program, specifically training frequency, volume, and intensity among older adults over a 3-month self-managed training period. Pre-post changes in physical capacity and real-world walking were examined. Methods:This study is a nested cohort study within the three-armed randomized controlled SMART-AGE trial conducted in Germany (German Clinical Trials Register ID: DRKS00034316). Participants aged 67 years or older with basic digital literacy were included. KOKU provided guided but unsupervised progressive strength and balance training for 3 months. The data on training adherence, engagement, and progression were collected. Instrumented assessments included the Timed Up and Go Test, the 30-Second Chair Rise Test, and real-world walking monitoring using wearable sensors. Results:A total of 113 participants (n=63, 56% female; mean age 74.02, SD 5.36 y) were included in the analysis. During the 3-month period, participants used KOKU for 24 (SD 15) days, that is, 2 to 3 times per week. Over the entire study period, no falls or other adverse events were reported due to KOKU usage. The number of exercises performed per participant ranged from 2 to 213, with a median value of 70. The instrumented Timed Up and Go Test results revealed a prolonged total duration (d=0.26; P=.009). In the instrumented 30-Second Chair Rise Test, improvements were observed in the number of completed repetitions (d=0.21; P=.04) and frequency of repetitions (d=0.23; P=.03). This was mainly due to a reduction in inactive time (d=-0.60; P<.001). Real-world walking parameters remained unchanged, except for a slower walking speed during walking bouts of less than 30 seconds (d=0.49; P<.001). All changes did not meet the criteria for minimally important differences. Conclusions:KOKU is a novel digital intervention for older adults, promoting balance and strength exercises. Physical capacity improvements were small. However, the use of instrumented assessments provided further insights into participants' capacity and mobility that would not have been identifiable with conventional assessments. Future improvements to the program should focus on incorporating more challenging exercises for individuals with varying levels of physical capacity.

The inability to appropriately react to balance perturbations is a common cause of falls. Perturbation-based balance training (PBT) is especially beneficial for improving reactive balance and shows high potential for fall prevention. However, its dose–response relationship, feasibility, and acceptability remain to be determined among older adults at risk of falling. The FEATURE study aimed to compare the efficacy of two treadmill PBT protocols with different session numbers to improve reactive balance, and to evaluate their feasibility and acceptability in this population. In this randomized controlled pilot trial, 36 older adults at risk of falling were allocated to receive either six (6PBT) or two treadmill PBT sessions (2PBT). Reactive balance in standing (Stepping Threshold Test [STT]) and walking (Dynamic Stepping Threshold Test [DSTT]) was assessed as primary outcome at baseline (T1), post-intervention (T2), and 6-week follow-up (T3). Secondary outcomes included measures on physical, psychological, and cognitive functioning. Feasibility was assessed via PBT adherence, planned perturbations completed, and adverse events; acceptability via questionnaire. Between-group changes over time were compared using repeated-measures analyses of variance with Bonferroni-corrected post-hoc tests. Data analyses followed the intention-to-treat principle. A significant time effect was observed for the DSTT (p = 0.008), with both groups significantly improving from T1 to T2 (ps < 0.01). A significant interaction effect (p = 0.027) revealed that only the 6PBT group maintained these improvements (T1 vs. T3: p < 0.001) and scored significantly higher than the 2PBT group at T3 (p = 0.015). No significant interaction effects were found for the STT or any secondary outcome, but improvements over time were observed for dynamic balance, gait capacity, functional mobility, physical activity, concerns about falling, and executive functioning (time effects: ps < 0.05). PBT adherence, planned perturbations completed, and acceptability were high in both groups, with no significant between-group differences. No intervention-related serious adverse events were reported. Findings suggest that a low number of treadmill PBT sessions can lead to task-specific improvements in reactive balance during walking, with a higher practice dose enhancing sustainability. Treadmill PBT appears feasible and well-accepted among older adults at risk of falling, regardless of sessions received. ; prospectively registered December 14, 2022.

Individuals with Parkinson's disease (PD) suffer from sleep disorders and maladaptive alterations in sleep architecture. These disorders, which increase in frequency and severity as the disease progresses, are multifactorial and clinically relevant. Sleep problems drastically reduce quality of life in these patients and are associated with faster cognitive and motor decline. Standard treatments for managing sleep disorders, which mainly include cognitive behavioral therapy and pharmacotherapy, have provided inconsistent results. Non-invasive brain stimulation (NIBS) has been proposed as another potential strategy for improving sleep quality in PD. We conducted a systematic review and Bayesian network meta-analysis (NMA) following the grading of recommendations, assessment, development, and evaluation (GRADE), to determine whether NIBS improves sleep quality and architecture in PD. Evidence from twenty-four studies, including 792 individuals with PD in the early-to-severe disease stages, was summarized. Our NMA indicated that low-frequency repetitive transcranial magnetic stimulation over the dorsolateral prefrontal cortex (rTMS; 0.54, 95 %CrI: 0.13,0.93; moderate certainty) may ameliorate subjective sleep quality compared to a control condition. Our review further suggested that rTMS may enhance objective sleep quality and sleep architecture. Our findings, which should be interpreted cautiously due to a high risk of bias, are examined in the context of sleep disorders in PD.

Motor learning is critical for effective motor rehabilitation, yet impaired in people with Parkinson’s Disease (pwPD). Emerging evidence suggests that cardiovascular exercise (CVE), performed close to skill practice, may promote brain plasticity and motor learning. However, research has predominantly focused on acute effects of a single CVE session in neurotypical individuals. Here, we examined whether post-practice CVE enhances motor learning over multiple weeks. Twenty-four pwPD were randomly assigned to either moderate-intensity cycling or seated rest after practicing a novel balance task across six sessions. As hypothesized, CVE significantly improved motor learning, particularly in sessions 4 and 5. This effect was reflected in a non-significant trend toward greater within-session online learning, rather than in between-session offline gains. Exploratory analyses indicate that individuals with higher cardiorespiratory fitness benefited most from CVE. Our findings highlight CVE as an effective, low-cost tool to foster motor learning in neurorehabilitation and warrant further investigation.

IntroductionEvidence systematically assessing the effects of sports schools on long-term athlete development is largely lacking. In general, sport schools play an increasingly important role in the development of new Olympic and top athletes. Additionally, talent programmes for the context of schools are a strategy for identifying and developing talent in sport. Both approaches are designed to promote long-term development of talent in sport, but benefits remain unclear. This study examines the development of athletes in the school environment within the framework of Long-Term Athlete Development (LTAD).MethodsA systematic search in PubMed, Web of Science, SportDiscus was conducted following the PRISMA guidelines, incorporating the PICO strategy. Eligible trials were selected by (i) studies conducted in school (ii) including pupils (iii) conducting a quantitative design (iv) providing physiological, physical, psychological and social data, as well as sporting and academic results. Data extraction and risk of bias assessment were performed independently by two reviewers. Findings were synthesized narratively.ResultsBased on 21 studies, talent-development approaches in schools positively impact physiological and physical aspects. In four studies, authors noted increased psychological stress, with female student-athletes more frequently affected. Two studies found no negative impact on short-term academic success, whereas two reported lower long-term educational outcomes for sport profile pupils.No consistent link was found between talent programmes and long-term sporting success. Although athletes reported enhanced social support and stronger relationships with coaches and peers, the competing demands of academics and sport frequently caused social isolation beyond the sports school context.ConclusionThis narrative synthesis provides a comprehensive understanding of school-based talent development approaches on LTAD. Talent development programmes in schools support physical performance, social networks, and short-term academic success, but pose challenges for psychological aspects and long-term academic and sporting success. Better alignment with long-term athlete development aspects, including mental health support, is needed. Due to the heterogeneous methodologies applied, a systematic approach for pooled data synthesis was not feasible. Future research should address long-term outcomes and close methodological gaps.

The importance of sleep for memory consolidation has been extensively studied, but its role for memory encoding remains less well characterized. At the molecular and cellular level, the renormalization of synaptic weights during sleep has received substantial support, which is thought to free capacity to encode new information at the behavioral level. However, at the systems level and behaviorally, support for this process playing a major role for memory function remains scarce. In the current study, we investigated the utility of moderate- and high-intensity evening exercise as a low-cost low-tech intervention to modulate sleep and its influence on subsequent encoding in the morning. Our findings indicate that high-intensity interval training (HIIT) improved post-sleep memory performance with effects lasting up to 24 h after initial encoding. In addition, we show that especially the early parts of the encoding task were affected by the HIIT intervention. Intriguingly, participants with lower encoding abilities seemed to benefit more from the HIIT intervention suggesting it not only as a tool for basic research but also as a candidate for applications to boost memory performance in mental disorders or in the elderly. These results provide first evidence that acute exercise can affect learning processes even hours after it occurs.

IntroductionThe ability to respond effectively to external perturbations is crucial for avoiding falls. The Stepping Threshold Test (STT) has been developed to assess this reactive balance, but its ability to discriminate between fallers and non-fallers is still unsubstantiated. This study aimed to evaluate the discriminant validity of the STT in distinguishing fallers and non-fallers and its convergent validity.MethodsThirty-six older adults (age = 80 ± 5 years), with 13 (36%) of them reporting a fall history in the past year, completed the STT on a perturbation treadmill. They received surface perturbations of progressively increasing magnitude while standing. Single- and multiple-step thresholds were assessed using an all-step count evaluation (STT-ACE), and a direction-sensitive evaluation strategy (STT-DSE). Receiver operating characteristics and area under the curves (AUC) were analyzed to evaluate the discriminative accuracy. Convergent validity was explored by 13 hypothesized associations with other mobility, psychological, and cognitive assessments.ResultsFallers and non-fallers significantly differed in the STT-DSE (p = 0.033), but not in the STT-ACE or other commonly used mobility assessments. Acceptable discriminative accuracy was obtained for the STT-DSE (AUC = 0.72), but not for the STT-ACE and other mobility assessments (AUC = 0.53–0.68). Twelve (92%) associations were consistent with our hypotheses for the STT-DSE, and ten (77%) for the STT-ACE.ConclusionOur findings provide preliminary evidence that the STT, when using the STT-DSE, may discriminate between older adult fallers and non-fallers. The STT appears to be a valid tool for assessing reactive balance, with its STT-DSE being recommended due to its better discriminant and convergent validity compared to the STT-ACE.

OBJECTIVES:The purpose of this trial is to (1) determine the best exercise modality to improve sleep quality and sleep architecture in people with Parkinson disease (PD); (2) investigate whether exercise-induced improvements in sleep mediate enhancements in motor and cognitive function as well as other non-motor symptoms of PD; and (3) explore if changes in systemic inflammation after exercise mediate improvements in sleep. METHODS:This is a multi-site, superiority, single-blinded randomized controlled trial. One hundred fifty persons with PD and sleep problems will be recruited and randomly allocated into 4 intervention arms. Participants will be allocated into 12 weeks of either cardiovascular training, resistance training, multimodal training, or a waiting list control intervention. Assessments will be conducted at baseline, immediately after each intervention, and 8 weeks after each intervention by blinded assessors. Objective sleep quality and sleep architecture will be measured with polysomnography and electroencephalography. Motor and cognitive function will be assessed with the Unified PD Rating Scale and the Scale for Outcomes in PD-Cognition, respectively. Subjective sleep quality, fatigue, psychosocial functioning, and quality of life will be assessed with questionnaires. The concentration of inflammatory biomarkers in blood serum will be assessed with enzyme-linked immunosorbent assays. IMPACT:This study will investigate the effect of different types of exercise on sleep quality and architecture in PD, exploring interactions between changes in sleep quality and architecture with motor and cognitive function and other non-motor symptoms of the disease as well as mechanistic interactions between systemic inflammation and sleep. The results will provide important practical information to guide physical therapists and other rehabilitation professionals in the selection of exercise and the design of more personalized exercise-based treatments aimed at optimizing sleep, motor, and cognitive function in people with PD.

Acute exercise has been shown to affect long-term memory and sleep. However, it is unclear whether exercise-induced changes in sleep architecture are associated with enhanced memory. Recently, it has been shown that exercise followed by a nap improved declarative memory. Whether these effects transfer to night sleep and other memory domains has not yet been studied. Here, we investigate the influence of exercise on nocturnal sleep architecture and associations with sleep-dependent procedural and declarative memory consolidation. Nineteen subjects (23.68 ± 3.97 years) were tested in a balanced cross-over design. In two evening sessions, participants either exercised (high-intensity interval training) or rested immediately after encoding two memory tasks: (1) a finger tapping task and (2) a paired-associate learning task. Subsequent nocturnal sleep was recorded by polysomnography. Retrieval was conducted the following morning. High-intensity interval training lead to an increased declarative memory retention (p = 0.047, d = 0.40) along with a decrease in REM sleep (p = 0.012, d = 0.75). Neither procedural memory nor NREM sleep were significantly affected. Exercise-induced changes in N2 showed a positive correlation with procedural memory retention which did not withstand multiple comparison correction. Exploratory analyses on sleep spindles and slow wave activity did not reveal significant effects. The present findings suggest an exercise-induced enhancement of declarative memory which aligns with changes in nocturnal sleep architecture. This gives additional support for the idea of a potential link between exercise-induced sleep modifications and memory formation which requires further investigation in larger scaled studies.

Background: The ability to encode and consolidate motor memories is essential for persons with Parkinson’s disease (PD), who usually experience a progressive loss of motor function. Deficits in memory encoding, usually expressed as poorer rates of skill improvement during motor practice, have been reported in these patients. Whether motor memory consolidation (i.e., motor skill retention) is also impaired is unknown. Objective: To determine whether motor memory consolidation is impaired in PD compared to neurologically intact individuals. Methods: We conducted a pre-registered systematic review (PROSPERO: CRD42020222433) following PRISMA guidelines that included 46 studies. Results: Meta-analyses revealed that persons with PD have deficits in retaining motor skills (SMD = –0.17; 95% CI = –0.32, –0.02; p = 0.0225). However, these deficits are task-specific, affecting sensory motor (SMD = –0.31; 95% CI –0.47, –0.15; p = 0.0002) and visuomotor adaptation (SMD = –1.55; 95% CI = –2.32, –0.79; p = 0.0001) tasks, but not sequential fine motor (SMD = 0.17; 95% CI = –0.05, 0.39; p = 0.1292) and gross motor tasks (SMD = 0.04; 95% CI = –0.25, 0.33; p = 0.7771). Importantly, deficits became non-significant when augmented feedback during practice was provided, and additional motor practice sessions reduced deficits in sensory motor tasks. Meta-regression analyses confirmed that deficits were independent of performance during encoding, as well as disease duration and severity. Conclusion: Our results align with the neurodegenerative models of PD progression and motor learning frameworks and emphasize the importance of developing targeted interventions to enhance motor memory consolidation in PD.