Fine-tuned Physical Training to Improve Quality of Life in Older Individuals

The overall aim of this project, which is based upon the interdisciplinary expertise of four research groups within the University of Rome Foro Italico, in the macro-areas of psychology, bioengineering, physiology, and internal medicine, is to improve the overall health and well-being of community-dwelling frail older adults, who are often suffering from non-communicable diseases, by means of an integration of innovative cognitive and resistance-core training. Forty-five frail or pre-frail community-dwelling older adults aged ≥65 years will be randomly assigned to three 8-week intervention groups: A) resistance training; B) resistance-core training; C) cognitive-resistance-core training. Comparison between groups C and B will show the effects of an innovative cognitive-motor dual-task training method, which will incorporate principles of modern psychotherapeutic approaches to boost physical training, and to improve cognitive, emotional, and mood disturbances in older ages. Comparison between groups B and A will focus on the motor component of the intervention, showing the effects of adding specific core-exercises to a traditional resistance training program on muscle strength, power, and the ability to safely carry out functional abilities of daily life. As outcomes, clinical and psychological scales, cognitive tasks, and their underlying cortical mechanisms will be measured. In addition, state-of-art physiological and biomechanical methods will be used to study human kinematics, muscle synergies, and cortico-muscular coherence furthering some important neurophysiological mechanisms of motor control underlying the execution of functional tasks. The results of this project, therefore, will be of great relevance for the advancement of training-exercise methodology as well as unravelling central and peripheral mechanisms underlying frailty with the final goal of improving the quality of life in older individuals.

We sought to exploit a method known as Bilateral Alternating Stimulation (BAS), which was introduced within the framework of Eye Movement Desensitisation and Reprocessing (EMDR) psychotherapy as a central component of a protocol designed to facilitate the processing of traumatic memories. Subsequently, this procedure was incorporated into the Adaptive Information Processing (AIP) model, according to which bilateral stimulation promotes the integration of dysfunctional information within adaptive memory networks. Various theoretical interpretations have been proposed to explain the underlying mechanisms, including the model of interhemispheric interaction, which suggests an enhancement of communication between the cerebral hemispheres (Christman et al., 2003). Furthermore, alternating bilateral stimulation modulates interhemispheric coherence, suggesting a reorganisation of communication processes between hemispheres that could facilitate the integration of cognitive and emotional information. It also modulates prefrontal cortex activity and fronto-limbic connectivity, suggesting a reorganisation of cognitive and emotional control processes. More recent electroencephalographic (EEG) evidence confirms the involvement of frontal areas, in line with theoretical models that attribute these effects to the modulation of attentional and executive systems.

Inclusion Criteria: * Pre-frail/frail community-dwelling older adults * Aged ≥65 years * Community-dwelling Exclusion Criteria: * Cognitive decline (mini-mental state examination \<25/30) * Neurological disorders * Conditions impairing the ability to carry out exercise training (e.g., Parkinson's disease; multiple sclerosis; stroke) * Depression treated with pharmacological therapy or that have incurred in falls in the last two years.