View of Comparison of Brain Gym and Dynamic Movement Skill on Verbal Memory in Middle - Aged Women

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Comparison of Brain Gym and Dynamic Movement Skill on Verbal Memory in Middle - Aged Women

C.Rajeswari ¹, Dr.M.S. Sundaram², Dr.P. Senthil Selvam ³,

Dr.A. Viswanath Reddy⁴,Dr.S. Senthil Kumar⁵, P. Suganya⁶, Priya Kumari⁷

1Research scholar MPT, School of physiotherapy, VISTAS, Chennai, Tamilnadu,

2ProfessorSchool of physiotherapy,VISTAS, Chennai, Tamilnadu,

3HOD,Professor School of physiotherapy,VISTAS, Chennai, Tamilnadu,

4Associate professor MPT PhD, College of Physiotherapy, SVIMS Tirupati, AndraPradesh,

5Professor MPT PhD,Shri IndraGanesan Institute of Medical Science College of Physiotherapy, Trichirappalli,Tamilnadu,

6Research scholar, School of physiotherapy,VISTAS, Chennai, Tamilnadu.

7 Assistant Professor, Research scholar, School of physiotherapy,VISTAS, Chennai, Tamilnadu.

ABSTRACT

Exercise is recognized as a promising approach to counteract aging – associated declines in cognitive functions. Emerging literature suggests that exercise which involves with attention, concentration, memory, thinking have a positive effect on cognition.

Objective:

The aim of the current study is to compare Brain Gym and Dynamic Movement Skill on Verbal Memory in Middle – Aged Women.

Outcome Tool:

Rey Auditory Verbal Learning Test (RAVLT) is used. In this Immediate Recall (IR), Delayed Recall (DR), and Recognition Memory (RM)scores are evaluated. Using t-test, Pre and post test scores are taken to compare within the group and between the group.

Method:

It is an experimental study. Participants randomly assigned into two groups. Group A (n=50) Brain Gym and Group B(n=50) Dynamic Movement Skill. Both groups received their sessions 5 days/week for 12 weeks.

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1421 Result:

From the collected data, it shows that significant difference exists in IR, DR, RM in pre and posttest values P<0.01. For IR Mean % increase in Group B – 34.05 for Group A - 13.21, followed by DR Mean % increase in Group B – 52.12for Group A – 19.48 and RM Mean % increase in Group B - 22.62 and for Group A – 9.66. Posttest IR, DR & RM % increase Mean in Group B is greater than Group A.

ANOVA shows that there is significant difference between Mean % increase in Group B. % increase maximum in DR – Mean (52.12) followed by IR – Mean (34.05) and RM – Mean (22.62).

Conclusion:

Hence, it was concluded that each group shows improvement. But Group B shows highest improvement. % increase mean in Group B is greater than Group A.

BACKGROUND OF THE STUDY:

Cognitive decline is a normal part of the aging process. However, cognitive decline can become more severe in older adults, which is the manifestation of clinical conditions such as Mild cognitive impairment, Dementia and Alzheimer’s disease¹. Many studies argue that physical activity is the most important of these factors for maintaining cognitive function (Bhernet al., 2013; King and kitchen 2014).

A growing body of evidence suggests physical activity is integral to keeping cognitive process sharp and brain can be changed by certain kinds of stimuli, including movements¹. In previous studies aerobics, strengthening, resistance and coordination exercise are given to enhance cognitive function in elderly population^1,2,3,8.

NEED FOR THE STUDY:

An Important healthcare need in our aging society is the development of easily applicable noninvasive strategies to aid the functional independence of elderly with cognitive complaints⁴.

Hence, strengthening of neural network integrity is considered a prime target for intervention strategies.

Strengthening exercise, aerobic exercise may not be sufficient by themselves, since these methods do not necessarily target large networks⁴. In the current study, aims effect of newly developed intervention to improve whole brain neural network integrity through exercises that require direct integration of cognitive functions.

INTRODUCTION:

According to World Health Organization recorded a decline in cognitive function of elderly an estimated 121 million people of which 5.8% of men and 9.5% of women⁵. Increasing age also decreased the work function of the brain will affect the process of information with the loss of orientation, registration, attention, memory, language making elderly daily activities become interrupted⁵.

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Various forms of dementia are increasingly considered neural network disorders, emphasizing the importance of white matter dysfunction as a prime aspect of early-stagedisease pathology. Especially in Alzheimer’s disease, the most common dementia etiology, it is emerging that diminished neural integrity in large. Whole brain functional network mayprecede the manifestation of traditional clinical symptoms such as hippocampal atrophy and memory loss⁴. Exercise is recognized as a promising approach to counteract aging – associated decline in cognitive function. An important healthcare need in our aging society is development of easily applicable, non-invasive strategies to aid the functional independence of elderly with cognitive complaints⁴. Brain plasticity is a lifetime developmental process and continues to play a significant role in older adulthood. Cognitive and motor activities have to be intellectually stimulating and physically appropriate to bring about maximal benefits to the aging brain⁶. Dynamic Movement Skill is a training and rehabilitation methodology that stimulates the CNS & PNS. The newly obtained experience will alter the neural maps, networks, pathways or circuits made up of countless neurons and synapses⁶. Brain gym is a program of exercises that focus on the performing of specific physical activities that activate the brain, thereby enhancing cognitive performance and making it more receptive to learning⁷.

REVIEW OF LITERATURE

1. Arthur F. Kramer, Krish I. Erickson etal.,2006⁸ :Exercise cognition and the aging brain, Journal of Applied Physiology. The research reviewed in thispaperhighlights the positive effects that exercise has on the aging brain in clinical populations.

2. MuchsinDoewesetal.,.,june 2009⁹ : Exercise and brain health in elderly . Research concluded that regular exercise on elderly is a very effective modality to reduce and prevent cognitive decline in function associated with aging problems.

3. Casper de Boer, Holly V.Echlinetal.,., 2018⁴ :Thinking while - moving exercise may improve cognition in elderly with mild cognitive deficits. It concluded that cognitive motor exercise induce improved test scores, which is most prominent in elderly with only mild cognitive deficits; It improves altered visuomotor behaviour and improvements in measures of general cognition.

4. Liuyangcaietal., March 2014⁶ :Brain plasticity and motor practice in cognitive aging. It concluded that Dynamic movement activities of older adults may enhance their cognitive motor functionality due to brain plasticity and eventually, increase their quality of life over a long period of time.

5. BungawaliAbduhetal., 2018 ¹⁰ :The effectiveness of brain gym and brain training intervention on working memory performance of student with learning disability . The findings shows a significant increment for Digit span memory and spatial memory skillsamong participants in the Brain Gym intervention group.

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1423 6. Yakindo, Brain gym journal., March 2008¹¹ :To measure the impact of Brain gym at the junior high school level for the learning achievement. The data suggest that Brain gym is even more effective for students with low average grades.

7. DiniMeiwetal.,July 2017¹² :The effect of brain gym on cognitive function of the elderly in surabaya. The data suggested that the intervention group with Brain gym effect to repair the cognitive function than the control group with out brain gym.

8. Kunartietal., March 2018⁵ : Effects of brain gym on adult memory . It concluded that brain gym activities are carried out regularly by a group of middle aged adult and elderly are expected to prevent and slow down memory loss as a result of the aging process.

9. Ah.Ysufetal., April 2010¹³ : Brain gym improves cognitive function in elderly. The research concluded that brain gym improves cognitive function in elderly.

10. Catherine Alexandra Gregoire etal.,Apri2019¹⁴ :Gross motor skills training leads to increased Brain derived Neurotrophic factor levels in healthy older adults. The result shows that Gross Motor Skills induced a large increase in plasma BDNF concentration.

11. Elaheh Moradi etal.,2017¹⁵ : Rey Auditory verbal Learning Test Scores can be predicted from whole brain MRI in Alzheimer’s disease. It concluded that RAVLT were found to be reliable for Alzhiemer’s disease diagnosis and reflect well the underlying AD pathology.

12. Sabrina de souse Magalhaesetal.,2012¹⁶ :validity Convergent and reliability Test – Retest of the Rey Auditory verbal Learning test. It concluded that It had adequate convergent and divergent validity and good reliability in terms of internal consistency.

13. MehrnazRezanfard etal.,2017¹⁷: The Rey Auditory verbal Learning test: Alternate Forms Equivalency and Reliability for the Italian Adult Population. It concluded that RAVLT is a reliable instrument for repeated neuropsychological testing.

14. Ziad S. Nasreddine MD Natalie A etal.,2005 ¹⁸ :The Montreal cognitive Assessment, MOCA: A brief screening tool for mild cognitive impairment. It concluded that MOCA is a brief cognitive screening tool with high sensitivity and specificity for detecting MCI

15. Paula T. Trzepaczetal., 2015¹⁹: Relationship between the Montreal Cognitive Assessment and Mini-mental State Examination for assessment of mild Cognitive impairment in older adults. It concluded that MOCA and MMSE were more similar for dementia cases, but MOCA distributes MCI cases across a broader score range with less ceiling effect.

METHODOLOGY

Study Setting:School of Physiotherapy VISTAS, Thalambur, Chennai

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Study Design: Experimental Study

Sample Size:100 Group A =50, Group B = 50 Exercise Session:5 days/week for 6 months Inclusion Criteria:

 Age: 40 – 50 years

 BMI: 18.5 – 24.9 kg/m2

 Gender: Female

 MOCA Score: 19 – 25/30 ^18,19

 VO2 MAX: Range 31 – 41 ml/kg.min²⁰

VO2 MAX calculated by using Personalised step test ^21,22,23 Exclusion Criteria:

 History of DM, HT, Psychiatric or systemic disease, Substance abuse, Movement disorder.

 Restricted Mobility (Disabled Person, Major visual or hearing impairment)

 Diagnosis of Orthopedic, Neurological & Cardiovascular disease.

 History of any Surgery in last six months

 Bone density problem

 In Physical Activity readiness questionnaire if they answered yes to one of the questions they are excluded^.24

Materials:

 Dynamic Movement skill Mat

 HR Monitor

 Weighing Machine

 Height Adjustable wooden Stepper.

Intervention:

A total of 110 participants were recruited for the study through Vels mission hospital, VISTAS, Thalambur. Out of which five were not shown interest to participate in the study; three withdraw during the study and two not met the inclusion criteria. Participants were completely voluntary and all subjects gave the written informed consent form. 60 – 80% as target heart rate should maintain during exercise

25,26

. Max HR is calculated by using the formula HR max = 208 – (0.7 x age) Randomization:

Those who met the inclusion criteria were randomly assigned into two groups.

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1425 Group A (n=50) – Brain Gym

Group B (n=50) – Dynamic Movement Skill Group A (n=50) – Brain gym

Warm up – 5 min (Low speed stepping, Active stretching, Breathing Exercise) Exercise duration: 30 min

Lateralization:

 Cross crawl (2 min)

 Hook ups (2 min)

 Lazy 8’s (2min)

 Double doddle (2min)

 The Elephant (2min) Focalization:

 The Owl (2min)

 The active arm (2min)

 The gravitational glider (2min)

 The Rocker (2 min) Centralization:

 Brain Button (2 min)

 Earth Button (2min)

 Balance Button (2min)

 Space Button (2min)

 Thinking Cap (2min)

 Energetic Yawn (2 min)

Cool down: 5 min (Diaphragmatic breathing, slow shoulder movements) Group B (n=50) – Dynamic Movement Skill

Warm up – 5 min (Low speed stepping, Active stretching, Breathing Exercise) Exercise duration: 30 min

 Quick feet forward to A Left Lead (1 min)

 Quick feet forward to A Right Lead (1 min)

 Quick feet backward to C LeftLead (1 min)

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 Quick feet backward to C RightLead (1 min)

 Open step 3 with right-handed catch (1 min)

 Open step 4 with left-handedcatch(1 min)

 Closed step 4 with left-handedcatch (1 min)

 Closed step 3 with Right-handedcatch (1 min)

 Reverse closed step to 3 with right-handedcatch (2 min)

 Reverse closed step to 3 with left-handedcatch (2 min)

 Reverse closed step to 4 with left-handedcatch (2 min)

 Reverse closed step to 4 with right-handedcatch (2 min)

 Quick feet to A with two handed catch left lead (2 min)

 Quick feet to A with two handed catch right lead (2 min)

 Quick feet to D with two handed catch Left lead (2 min)

 Quick feet to B with two handed catch right lead (2 min)

 Quick feet to A with two handed Juggle left Lead (2 min)

 Quick feet to A with two handed Juggle right lead(2 min)

 Double leg jumps to C with two handed Juggle(2 min)

Cool down: 5 min (Diaphragmatic breathing, slow shoulder movements) OUTCOME MEASUREMENTS:

Rey Auditory Verbal Learning Test (RAVLT):

To evaluate the verbal episodic memory. It consists of orally presenting a list of 15 concrete nouns (List A) to the participants. The list was read aloud in the same order five consecutive times. After each reading, a free recall test of the words presented was given. Participants were free to say the words as they remembered them. After the fifth reading, participants were presented with the distractor list (list B), with 15 different concrete nouns followed by free recall test from list B. Immediately afterward Immediate Recall (IR) of List A was tested without repeating the list to the participants. After 20 min interval participants were asked again to recall the words from the List A Delayed Recall (DR). Finally, the final task was orally presenting to the participants a list of 50 nouns, including those from List A & B, and 20 phonologically (or) semantically similar words to List A & B. The participants needed to identify and recognize the words that were part of List A & B. For all trials total up each word recalled correctly and place the totals at the bottom of each column ^16,17.

STATISTICAL ANALYSIS:

The aforementioned statistical analysis was performed using SPSS software. A t-test were performed to determine mean difference of pre and post-test comparison for IR, DR& RM for Group A &

B. P<0.01 which is highly significant. There is significant difference in the pre and post - test values in Group A & B. 1- tailed t - test is used to determine how much difference between pre-test and post-test

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1427 scores in Group A & B. Between group % increase comparison were performed using t-test and 1-tailed t- test. ANOVA were used to determine % increase values in Group B. P<0.01 there is significant difference between mean % increase in Group B.

Table 1-Mean and SD of RAVLT in Group A

RAV LT

Trial 1 Trial 2 Trial 3 Trial 4 Trial 5 ListB Trial 6 (IR)

Trial 7 (DR)

Trial 8 (RM) Pr

e Po

st Pr

e Po

st Pr

e Pos

t Pre Pos

t Pre Pos t

Pr e

Po st

Pr e

Po st

Pr e

Po

st Pre Pos t Mea

n 9.

04 9.

24 9.

12 9.

44 9.

84 10.

42 10.

14 10.

86 10.

72 11.

36 9.

14 9.

80 7.

78 8.

76 6.

42 7.

50 19.

58 21.

40 SD 1.

66 1.

54 1.

72 1.

60 1.

70 1.5

5 1.7

4 1.6

1 1.8

0 1.5

8 1.

60 1.

52 1.

58 1.

61 1.

75 1.

60 3.9

0 4.0

5

Table 2-Mean and SD of RAVLT in Group B

RAV LT

Trial 1 Trial 2 Trial 3 Trial 4 Trial 5 ListB Trial 6 (IR)

Trial 7 (DR)

Trial 8 (RM) Pr

e Po

st Pr

e Po

st Pr

e Pos

t Pr

e Pos

t Pr

e Pos

t Pr

e Po

st Pr

e Po

st Pr

e Po

st Pre Po st Mea

n 7.

92 9.

56 8.

04 9.

78 8.

68 10.

46 8.

98 10.

88 9.

64 11.

88 8.

04 9.

78 7.1

6 9.

32 5.9

8 8.

64 18.4

8 22

.4 SD 2.

00 1.

81 2.

06 1.

78 2.

15 1.8

6 2.

09 1.8

1 2.

19 1.8

3 1.

91 1.

96 2.0

0 1.

93 1.9

9 2.

07 3.66 3.

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Table 3-Comparison of Immediate Recall Pre & Post Test Score in Group A GROUP A -Immediate Recall (IR)

Descriptive

Statistics

Variable Mean SD Std Err

Lower 95%

CL

Upper 95%

CL N IR pre 7.780 1.582 0.224 7.330 8.230 50 IR post 8.760 1.611 0.228 8.302 9.218 50

1-tailed t-

Test

Ho. Diff Mean SE t' value DF 'p'

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Diff. Diff. value 0.000

-

0.980 0.067 -14.639 49.000 0.000

Significant

'p' <

0.01

Variable Mean SD IR pre 7.780 1.582

IR post 8.760 1.611

INFERENCE:

There is a significant difference in the IR score between Pre and Post tests Post-test IR mean is greater than the Pre-test mean in Group A

Table 4-Comparison of Immediate Recall Pre & Post Test Score in Group B GROUP B -Immediate Recall (IR)

Descriptive Statistics

Variable Mean SD Std Err Lower 95%

CL Upper 95%

CL N

IR pre 7.160 2.004 0.283 6.591 7.729 50

IR post 9.320 1.932 0.273 8.771 9.869 50

1-tailed t-Test

Ho. Diff Mean

Diff. SE

Diff. t' value DF 'p' value

0.000 -2.160 0.144 -15.012 49.000 0.000

Significant 'p' <

0.01

Variable Mean SD.

IR pre 7.160 2.004

IR post 9.320 1.932

INFERENCE:

There is a significant difference in the IR score between Pre and Post tests Post-test IR mean is greater than the Pre-test mean in Group B

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1429 Table5-Comparison of Immediate Recall % increase in Group A&B

Variable Mean % increase SD. Std Err

Lower 95% CL

Upper

95% CL N

IR% increase B 34.055 19.588 2.770 28.488 39.622 50

IR% increase A 13.214 7.292 1.031 11.142 15.287 50

1-tailed t-Test (% increase B >

% increase A)

Ho. Diff Mean Diff. SE Diff. t' value DF 'p' value

0.000 20.841 2.956 7.051 62.326 0.000

Significant

'p' <

0.01

Variable

Mean % increase SD IR% increase B 34.055 19.588 IR % increase A 13.214 7.292

INFERENCE:

There is a significant difference in the IR % increase in post test score between group A and Group B Post- test IR % increase mean in Group B is greater than the % increase in Group A

Table 6-Comparison of Delayed Recall Pre & Post Test Score in Group A GROUP A -Delayed Recall (DR)

Variable Mean SD Std Err Lower 95% CL Upper 95% CL N

DR post 7.500 1.607 0.227 7.043 7.957 50

DR pre 6.420 1.751 0.248 5.922 6.918 50

1-tailed t-Test

0.000 1.080 0.075 14.453 49.000 1.000

Significant 'p' < 0.01

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Variable Mean SD DR post 7.500 1.607

DR pre 6.420 1.751

INFERENCE:

There is a significant difference in the DR score between Pre and Post tests Post-test DR mean is greater than the Pre-test mean in Group A

Table 7-Comparison of Delayed Recall Pre & Post Test Score in Group B GROUP B -Delayed Recall (DR)

DR post 8.640 2.078 0.294 8.050 9.230 50

DR pre 5.980 1.995 0.282 5.413 6.547 50

1-tailed t-Test

0.000 2.660 0.191 13.939 49.000 0.000

Variable Mean SD

DR post 8.640 2.078

DR pre 5.980 1.995

INFERENCE:

There is a significant difference in the DR score between Pre and Post tests Post-test DR mean is greater than the Pre-test mean in Group B

Table 8-Comparison of Delayed Recall % increase in Group A & B

Lower 95%

CL

Upper 95%

CL N

% increase B 52.122 34.428 4.869 42.338 61.907

5 0

% increase A 19.487 13.954 1.973 15.521 23.452

5 0

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1431 1-tailed t-Test (% increase B > % increase

A)

Ho. Diff Mean Diff.

SE

Diff. t' value DF 'p' value

0.000 32.636 5.254 6.212 64.676 0.000

Significan

t 'p' < 0.01

Variable Mean SD

% increase

B 52.122 34.428

% increase

A 19.487 13.954

INFERENCE:

There is a significant difference in the DR % increase in post test score between group A and Group B

Post-test DR % increase mean in Group B is greater than the % increase in Group A

Table 9-Comparison of Recognition Memory Pre & Post Test Score in Group A GROUP A -Recognition Memory (RM)

RM post 21.400 4.051 0.573 20.249 22.551 50

RM pre 19.580 3.908 0.553 18.469 20.691 50

1-tailed t-Test

0.000 1.820 0.127 14.355 49.000 0.000

Variable Mean SD

RM post 21.400 4.051

RM pre 19.580 3.908

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INFERENCE:

There is a significant difference in the RM score between Pre and Post tests Post-test RM mean is greater than the Pre-test mean in Group A

Table 10-Comparison of Recognition Memory Pre & Post Test Score in Group B GROUP B -Recognition Memory (RM)

RM post 22.400 3.574 0.505 21.384 23.416 50

RM pre 18.480 3.666 0.518 17.438 19.522 50

1-tailed t-Test (P8B post > P8B pre)

0.000 3.920 0.176 22.304 49.000 0.000

Variable Mean SD

RM post 22.400 3.574

RM pre 18.480 3.666

INFERENCE:

There is a significant difference in the RM score between Pre and Post tests Post-test RM mean is greater than the Pre-test mean in Group B

Table 11-Comparison of Recognition Memory % increase in Group A & B

Lower 95%

CL Upper

95% CL N

% increase B 22.623 10.530 1.489 19.63

1 25.616 50

% increase A 9.660 5.307 0.751 8.152 11.169 50

1-tailed t-Test (% increase B > %

increase A)

Ho. Diff Mean Diff. SE Diff. T DF P

0.000 12.963 1.668 7.773 72.38

8 0.000

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Variable Mean SD.

% increase B 22.623 10.530

% increase A 9.660 5.307

INFERENCE:

There is a significant difference in the RM % increase in post test score between group A and Group B

Post testRM % increase mean in Group B is greater than the % increase in Group A

Table12-Comparing IR, DR and RM % increase values in Group B

Y Variable Group Mean SD. Std Err N

% increase in group B IR 34.055 19.588 2.770 50

DR 52.122 34.428 4.869 50

RM 22.623 10.530 1.489 50

Analysis of Variance comparing increase in group B between the IR,

DR and RM

Source Type III SS Df Mean Sq. F -

Statistic 'p' value

Between treatments 22121.490 2 11060.745 19.753 0.000

There is significant difference between

mean % increase in Group B

significant 'p' < 0.01

Within treatments 82312.993 147 559.952

Total 104434.482 149

Post Hoc tests for Treatments

mean values

Test Group 1 Group

2 Mean Diff. SE q -

Statistic 'p' value

Tukey IR DR -18.067 3.346 5.399 0.000 significant 'p' < 0.01

RM RM 11.431 3.346 3.416 0.042 significant 'p' < 0.05

DR RM 29.499 3.346 8.815 0.000 significant 'p' < 0.01

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INFERENCE:

There is significant difference between mean % increase in Group B

% increase Maximum in DelayedRecall (DR) - Mean 52.122 followed by Immediate Recall(IR)- Mean 34.055

and Recognition Memory (RM) - Mean 22.623

RESULT:

From baseline to 6 Months a total of 120 Brain Gym Sessions and 120 Dynamic Movement Skill sessions are offered to the participants in the intervention group. No adverse events were reported (or) observed over 6 Monthsof study period.

i. General Characteristics:

There was no difference between the group in general characteristics. All participant had a high school or high education level.

ii. Within group comparison of outcome:

Participants in Group A and Group B improved significantly P<0.01. Post – test Immediate Recall (IR), Delayed Recall (DR) and Recognition Memory (RM) mean is greater than the pre – test mean (Table 3,4,6,7,9,10).

iii. Between group % of increase comparison of outcome:

There is significant difference in the Immediate Recall (IR), Delayed Recall (DR) and Recognition Memory (RM) % increase in post test scores between group A and group B P<0.01.

Post-test % increase mean in Group B is greater than % increase in Group A (Table 5,8,11).

iv. ANOVA is used to compare Immediate Recall, Delayed Recall, Recognition Memory % increase values in

Group B:

There is significant difference between mean % increase in Group B. % of increase maximum in Delayed Recall- Mean 52.12 followed by Immediate Recall – Mean 34.05 and Recognition Memory - Mean 22.62 (Table 12).

Y Variable Group Mean SD

% increase in group B IR 34.055 19.588

DR 52.122 34.428

RM 22.623 10.530

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1435 DISCUSSION:

The RAVLT is a very efficient neuropsychological instrument for assessing Verbal Memory. The test allows the evaluation of the components of acquisition and recall of information and permits the investigation of separate process (Mitrushinaet al., 2005) ²⁷. The aim of current study is to compare Brain Gym and Dynamic Movement Skill on verbal memory in Middle –Aged Women. Cognitive decline is the normal part of aging process. Aging related differences in cognition were detected in the transition from middle age (50) to old age (65). Several age-related differences were evidenced before the age of 50. A temporality of cognitive decline occurring between the age of 40 and 65 can be described by integrating all the results. Daniel Ferreira et al., 2014 conducted a study and report for a first time a differentiation and temporalization of different verbal, visual and procedural memory components during middle age.

The typical ageing-related memory impairment defined by alterations in acquisition and or free retrieval but not in consolidation (Luo &craik, 2008) was present already before the age of 50. Difficulties in verbal learning during middle age have also been reported in a recent study (Singh Manouxet al., 2012) ²⁸. Brain plasticity is a lifetime developmental process and continues to play a significant role in older adulthood. Cognitive and motor activities have to be intellectually stimulating and physically appropriate to bring about maximal benefits to the aging brain (colcombeet al., 2003,2006). Brain plasticity, neural maturation and cognitive development play an important role in cognitive and motor learning (Ungerleider et al.,2002 ;Lacourseet al., 2004; Wright and Harding 2004). Neural Plasticity refers to the capacity of central nervous system (CNS) to alter its existing cortical structure and functions in response to experience, learning, training or injury (Hubel and Weisel 1970; kolb and Whishaw 1998; Wall et al., 2002; Kolb et al., 2003; Ballantyne et al., 2008). When an individual acquires novel or dynamic movement skill or information, the newly obtained experience will alter the neural map, network pathways or circuits made up of countless neurons and synapses (Wall et al., 2002). Neural Plasticity is therefore a biological foundation to the learning brain. Experience dependent changes in the lower neocortical region can reshape the activation pattern and the anatomy of cerebral cortex (Wall et al., 2002). Sensory input, knowledge and motor learning activities stimulate cortical changes (Rakie., 2002;

Taubertet al., 2010). In skill learning or repeated exposure to stimulations and experiences, relevant neurons often fire together and wire together. The associated neurons of a given response will be activated simultaneously in response to similar stimuli in the future. Learning endeavors or experiences modify the existing cortical structures or mechanism via neurogenesis, gliogenesis and synaptogenesis (Buonomano and Merzenich 1998; Cotman and Berchtold, 2002; Dong and Greenough, 2004; oelcker-Rehage and Willimczik, 2006; Ponti et al.,2008)⁶.

Brain Gym is a program of exercise that focus on performing of specific physical activities that activate the brain, thereby enhancing cognitive performance and making it more receptive to learning. Brain Gym exercise are designed to develop the brain neural pathways the way the nature does through movement²⁹. Dynamic Movement Skill is a training and rehabilitation methodology that stimulate the CNS and PNS.

The DMS methodology help to refine and develop neuromuscular efficiency and to change motor pattern to make movement more efficient. By combining unusual or new movement that require us to concentrate

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and by using us many of the body driers as possible. The type of movement is directly linked to improvement of cognitive process like concentration, memory enhancement andreading³⁰.

This study demonstrates that both group shows significant difference in pre and post-testvalues P<0.01.

Post-test mean is greater than pre-test mean in Group A and B (Table no: 1,2,3,4,6,7,9,10). Comparison of

% increase in Group A and B in IR, DR, RM (Table no 5,8,11) shows there is significant difference P<0.01. Post-test IR, DR, RM % increase mean in Group B is greater than Group A.

ANOVA is used to compare IR, DR & RM % increase in Group B (Table 12). It shows that there is significant difference between mean % increase in Group B P<0.01. % increase maximum in DR – Mean 52.12 followed by IR – Mean 34.05 and RM – Mean 22.62. The findings in this study are similar to some previous studies showing positive results for the intervention group after implementing the Dynamic Movement Skill ^6,14.

CONCLUSION:

This study concluded that both Brain Gym and Dynamic Movement Skill show a significant improvement of verbal memory in Middle Aged Women. Post – test mean values show higher % increase in Dynamic Movement Skill than Brain Gym.

REFERENCES

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