The Effects of Single Exercise Sessions on Cognitive Flexibility and Brain Functional Connectivity in Older Adults With Cognitive Impairment

The Effects of Different Forms of Single Exercise Sessions on Cognitive Flexibility and Brain Functional Connectivity in Older Adults With Cognitive Impairment: A Single-Blind, Multicenter Randomized Controlled Trial

Objectives: To investigate the effects of different forms (physical and mental, aerobic and resistance) of single exercise on the cognitive flexibility and brain functional connectivity of elderly individuals with cognitive impairment.

Clinical trail Methods: This study employed a single-blind, multi-center randomized controlled trial. Sixty elderly individuals with cognitive impairment were recruited and randomly divided into the Qigong group (15 participants), the brisk walking group (15 participants), the elastic band group (15 participants), and the control group (15 participants). Before and after the intervention, 5-minute resting-state electroencephalogram signals were collected and cognitive flexibility tests were conducted. The Qigong group, the brisk walking group, and the elastic band group received single sessions of Qigong, brisk walking, and elastic band exercises respectively, while the control group received health education. The exercise intensity was moderate (target heart rate was 64%-76% of the maximum heart rate), and the exercise duration was 30 minutes.

Study Overview

• Status: Completed
• Conditions: Cognitive Impairment; Cognitive Flexibility
• Intervention / Treatment: Other: EXERCISE TRAINING; Other: health education materials

• Study Type: Interventional
• Enrollment (Actual): 60
• Phase: Not Applicable

Contacts and Locations

Study Locations

• China
  • Shanghai, China
    • Shanghai University of Sport

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult; Older Adult
• Accepts Healthy Volunteers: No

Description

Inclusion Criteria:

• Age ≥ 60 years old, gender not restricted;
• Patients or their guardians report subjective cognitive decline;
• Montreal Cognitive Function Assessment Scale < 26 points;
• Duration of cognitive dysfunction ≥ 6 months;
• Willing to sign the informed consent form;
• Good physical condition and able to complete the test;
• Right-handed.

Exclusion Criteria:

• History of severe mental disorders (severe depression, schizophrenia, etc.);
• Using drugs that affect cognition (such as sedatives, antidepressants, etc.);
• Limited language ability;
• Consumed caffeine or alcohol the day before the test;
• Suffering from serious diseases or injuries that make participation in the test inappropriate.

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: Single

Number of Arms

4

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Baduanjin group; This study adopted the Baduanjin Health Qigong standard issued by the General Administration of Sport of China in 2003. . The exercise intervention lasted 30 min in total, including a 2-min preparation phase, a 26-min main phase and a 2-min cool-down phase. Two weeks before the formal intervention, participants received training from a martial arts professional coach, and only those who had achieved fluent and proficient performance of the movements were allowed to take part in the formal intervention. Participants were required not to engage in any exercise during the 3 days before the intervention. The Baduanjin group received movement instruction from a professional martial arts coach and performed the exercise in an indoor dance room.	Other: EXERCISE TRAINING; exercise programm
Experimental: Brisk walking group; This study adopted the Brisk Walking standard issued by the General Administration of Sport of China in 2017. A treadmill manufactured by Topkang Technology Co., Ltd. (model: SJAI) was used. The exercise intervention lasted 30 min in total, including a 2-min preparation phase, a 26-min main phase and a 2-min cool-down phase. Before the intervention, participants received instruction and training from a professional track-and-field coach, and only those who had achieved fluent and proficient performance of the movements were allowed to participate in the formal intervention. Participants were required not to engage in any exercise during the 3 days before the intervention. The brisk walking group received movement instruction from a professional track-and-field coach and performed the exercise on an indoor treadmill.	Other: EXERCISE TRAINING; exercise programm
Experimental: Resistance band group; The resistance exercise programme in this study was based on the framework of the American College of Sports Medicine (ACSM) guidelines. A portable and safe resistance band (TheraBand progressive resistance band, USA) was used as the intervention tool. The resistance-band resistance training consisted of 10 exercises in total, including 4 upper-limb movements (seated chest press, seated reverse fly, seated biceps curl and seated shoulder press) and 6 lower-limb movements (seated knee lift, seated knee extension, seated knee flexion, seated leg press, seated hip abduction and standing calf raise). Each movement was performed for 2 sets of 12 repetitions. Rest intervals were 30-60 s within sets and 30-60 s between sets, and the movement tempo was controlled at 2 s for the eccentric phase and 2 s for the concentric phase. The resistance-band group received movement instruction from a professional fitness coach and performed the exercise in an indoor activity room.	Other: EXERCISE TRAINING; exercise programm
Active Comparator: Control group; After arrival, participants in the control group watched health education materials and received health education at the community activity center. Detailed descriptions of the exercise interventions for the four groups are provided in the Supplementary Materials.	Other: health education materials; health education materials

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Cognitive flexibility	Cognitive flexibility was assessed using the More-odd-shifting task paradigm, which was designed with E-prime software. The testing environment was quiet, well ventilated and moderately lit. The stimuli used in the More-odd-shifting task were red or green Arabic numerals from 1 to 9, excluding 5. Participants were required to make key-press responses according to the task instructions when the stimuli appeared. The More-odd-shifting task consisted of three conditions: Condition 1, judgment of numerical magnitude; Condition 2, judgment of parity; and Condition 3, mixed judgment of numerical magnitude and parity.	A total of 8 months from the beginning to the end

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Brain functional connectivity	Brain functional connectivity analysis was performed using MATLAB scripts, and graph-theoretical analysis was carried out using the BrainNet Viewer toolbox. Phase locking value (PLV) was used, and brain functional connectivity was evaluated from two dimensions: connectivity strength and density. In this study, PLV was calculated for the δ, θ, α1, α2, β1 and β2 bands of resting-state EEG using MATLAB, and the formula is shown in Equation (1). Here, i is the imaginary unit, Δt is the time interval between two consecutive samples, and N is the total number of samples. PLV is an index used to quantify phase synchrony in EEG signals and assesses whether two signals maintain a relatively stable phase relationship over time. Its value ranges from 0 to 1, where 1 indicates complete synchrony and 0 indicates no synchrony. PLV is commonly used to investigate phase synchrony between different brain regions, particularly functional connectivity related to neural oscillations.	A total of 8 months from the beginning to the end

Collaborators and Investigators

• Sponsor: Shanghai University of Sport

Study record dates

Study Major Dates

• Study Start (Actual): June 30, 2025
• Primary Completion (Actual): January 10, 2026
• Study Completion (Actual): January 20, 2026

Study Registration Dates

• First Submitted: May 21, 2026
• First Submitted That Met QC Criteria: June 2, 2026
• First Posted (Actual): June 3, 2026

Study Record Updates

• Last Update Posted (Actual): June 3, 2026
• Last Update Submitted That Met QC Criteria: June 2, 2026
• Last Verified: May 1, 2026

More Information

Terms related to this study

• Additional Relevant MeSH Terms: Mental Disorders; Neurocognitive Disorders; Cognition Disorders; Cognitive Dysfunction; Motor Activity; Movement; Musculoskeletal Physiological Phenomena; Musculoskeletal and Neural Physiological Phenomena; Exercise
• Other Study ID Numbers: DF2026001

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No