This review addresses the role of exercise as an intervention for treating neurological disease. It focuses on three major neurological diseases that either present in acute or neurodegenerative forms—Parkinson’s disease, cerebellar ataxia, and cortical stroke. Each of the diseases affects primarily different brain structures, namely the basal ganglia, the cerebellum, and the cerebrum. These structures are all known to be involved in motor control, and the dysfunction of each structure leads to distinct movement deficits. The review summarizes current knowledge on how exercise can aid rehabilitation or therapeutic efforts. In addition, it addresses the role of robotic devices in enhancing available therapies by reviewing how robot-aided therapies may promote the recovery for stroke survivors. It highlights recent scientific evidence in support of exercise as a treatment for brain dysfunction, but also outlines the still open challenges for unequivocally demonstrating the benefits of exercise.
Exercise as Medicine for the Treatment of Brain Dysfunction: Evidence for Cortical Stroke, Cerebellar Ataxia, and Parkinson’s Disease
Yu-Ting Tseng, Sanaz Khosravani, Arash Mahnan, and Jürgen Konczak
Exercise is Medicine for the Aging Brain
Teresa Liu-Ambrose and John R. Best
Cognitive decline is a common feature of aging. Physical activity is a modifiable lifestyle factor that has been identified as positively impacting cognitive health of older adults. Here, we review the current evidence from epidemiological (i.e., longitudinal cohort) and intervention studies on the role of physical activity and exercise in promoting cognitive health in older adults both with and without cognitive impairment. We highlight some of the potential underlying mechanisms and discuss some of the potential modifying factors, including exercise type and target population, by reviewing recent converging behavioral, neuroimaging, and biomarker evidence linking physical activity with cognitive health. We conclude with limitations and future directions for this rapidly expanding line of research.
Frontiers in Kinesiology: Introduction
Catherine D. Ennis
Is the Sky Falling? The Persistent Effects of Concussion
Steven P. Broglio
Sport concussion has been thrust into the national spotlight with growing concern over both the acute and chronic risk for injury. While much has been learned and applied to medical practice in the previous decade, how the injury may affect individuals years later remains largely unknown. The opaqueness of the unknown has led some to ask if certain sports should be banned. Without immediate answers, what is currently known must be extrapolated and the risks and benefits of sport participation must be balanced.
The Mis-Education of the African American Student-Athlete
Louis Harrison Jr., Albert Y. Bimper Jr., Martin P. Smith, and Alvin D. Logan
The African American male student-athlete occupies one of the most peculiar positions in American society. While lauded for their sport performance, they are often viewed as problematic in the broader society. While their performance generates millions of dollars for universities and the NCAA, for most, their labor often produces comparatively little personal gain. While they are recruited as student-athletes, they soon realize that the demands of their athletic commitment renders them athlete-students. Many outside of sport would argue that this is a choice and an informed decision. But we argue much of this is a consequence of the mis-education of the African American student-athlete. We examine this phenomenon through the lens of Critical Race Theory to provide an alternative view of the issues faced by African American student-athletes and suggest an alternative pedagogy that might be investigated to meet their needs.
The Patience for Policy—Building Networks to Make a Difference
Pamela S. Hyde
Pedagogical Cases: A New Translational Mechanism to Bridge Theory/Research Practice Gaps in Youth Physical Activity Education (PAE)
Kathleen M. Armour
This paper considers long-standing concerns about research/theory practice gaps in kinesiology, and proposes one potential solution. An analysis of the problem is followed by an overview and illustration of a new translational research mechanism: pedagogical cases (Armour, 2014). This mechanism has been designed to support the training and career-long development of practitioners in the broad field of physical activity education (PAE). It is argued that PAE practice is always interdisciplinary, therefore researchers in the kinesiology sub/disciplines have a responsibility to collaborate across disciplinary boundaries to develop new, interdisciplinary knowledge that meets the needs of practitioners. It is also argued that researchers and practitioners have a responsibility to work together to do the difficult synthesis work required to improve both research and practice.
Physiological Activation to Acute Mental Challenge: Implications for Cardiovascular Health
Edmund O. Acevedo and Aaron L. Slusher
The relationship between stress and disease, in particular cardiovascular disease, has long been recognized, whereas the study of the physiological mechanisms that explain this link has only more recently received attention. The acute response to stress is generally thought to be a critically important adaptation designed to activate the system in preparation to cope with the stressor. However, prolonged stimulation of the system (acute and chronic) can lead to deleterious adaptations including the release of inflammatory cytokines (small proteins important in cell signaling) that play a critical role in the development of atherosclerosis. Scientists have therefore used a breadth of protocols and methods to identify the complexity of our fight-or-flight response and demonstrate the synergy between perception, the stress response, physical activity, and health. In addition, the critical assessment of cellular health, the gut microbiome, and genetic polymorphisms have further advanced our understanding of additional therapeutic targets against CVD.
Preventing Death from Exertional Heat Stroke—The Long Road from Evidence to Policy
Douglas J. Casa, Yuri Hosokawa, Luke N. Belval, William M. Adams, and Rebecca L. Stearns
Exertional heat stroke (EHS) is among the leading causes of sudden death during sport and physical activity. However, previous research has shown that EHS is 100% survivable when rapidly recognized and appropriate treatment is provided. Establishing policies to address issues related to the prevention and treatment of EHS, including heat acclimatization, environment-based activity modification, body temperature assessment using rectal thermometry, and immediate, onsite treatment using cold-water immersion attenuates the risk of EHS mortality and morbidity. This article provides an overview of the current evidence regarding EHS prevention and management. The transfer of scientific knowledge to clinical practice has shown great success for saving EHS patients. Further efforts are needed to implement evidence-based policies to not only mitigate EHS fatality but also to reduce the overall incidence of EHS.
Robotic Devices to Enhance Human Movement Performance
Daniel P. Ferris and Bryan R. Schlink
Robotic exoskeletons and bionic prostheses have moved from science fiction to science reality in the last decade. These robotic devices for assisting human movement are now technically feasible given recent advancements in robotic actuators, sensors, and computer processors. However, despite the ability to build robotic hardware that is wearable by humans, we still do not have optimal controllers to allow humans to move with coordination and grace in synergy with the robotic devices. We consider the history of robotic exoskeletons and bionic limb prostheses to provide a better assessment of the roadblocks that have been overcome and to gauge the roadblocks that still remain. There is a strong need for kinesiologists to work with engineers to better assess the performance of robotic movement assistance devices. In addition, the identification of new performance metrics that can objectively assess multiple dimensions of human performance with robotic exoskeletons and bionic prostheses would aid in moving the field forward. We discuss potential control approaches for these robotic devices, with a preference for incorporating feedforward neural signals from human users to provide a wider repertoire of discrete and adaptive rhythmic movements.