Effects of a Complex, Partnered Martial Arts-based Intervention on Cognitive Function

Study Overview
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Brief Summary
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The investigators' study is designed to test whether brief exposure to a martial arts-based intervention (a coordinative, partnered training exercise known as Hubod), can improve cognitive function to a greater degree than aerobic exercise of a similar intensity.

Detailed Description
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This three-arm randomized controlled trial will compare the feasibility, and possibly the effects, of a martial arts intervention vs. aerobic exercise vs. an attentional (non-exercise) control condition. The martial arts intervention will consist of a partnered, coordinated sensitivity exercise drawn from south-east Asian martial arts, known as Hubod (also spelt hubud and hubad). Participants will be trained in the fundamental movements of Hubod. Participants will also have the history, cultural significance, risks and purpose of Hubod explained to them throughout the study. The aerobic exercise comparator group will use a stationary bicycle to match the duration and exercise intensity of the martial arts intervention group, under the supervision of trained research assistants. Participants will also receive information on aerobic exercise and the Physical Activity Guidelines for Americans 2020. Participants in the Videos Control group will watch educational videos on martial arts, physical fitness and exercise for the same duration as the intervention and exercise comparison groups. All participants, regardless of group, will be assessed for martial arts and exercise experience once at baseline. All participants will be tested for cognitive performance change. Baseline and follow-up computerized cognitive testing will take place at a specified testing facility and psychosocial questionnaires will be delivered remotely via a Qualtrics-powered survey. After baseline testing, participants will attend 5 sessions, approximately 30 minutes each. Follow-up testing will be administered more than 48 hours post-intervention to minimize established acute adaptive responses to exercise. The investigators hypothesize the martial arts training intervention group will exhibit a greater increase in performance of cognitive tasks when compared less complex movement patterns involved in the aerobic exercise group or videos control group.

Official Title
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Effects of a Complex, Partnered Martial Arts-based Intervention on Cognitive Function in Comparison to Aerobic Exercise and Attention-control Among Low-active Adults

Conditions
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Cognitive Change, Processing, Visual Spatial, Inhibition (Psychology), Working Memory

Intervention / Treatment
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* Behavioral: HUBOD
* Behavioral: Active Comparator
* Behavioral: Control Condition


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: - Men and Women between the ages of 18-45 years who are low active Exclusion Criteria: Anyone who is physically active (≥30 minutes, 3 or more times/week, for the last 3 months) and/or a regular practitioner of martial arts and/or highly complex coordination drills such as dance performance or contact improvisation (≥30 minutes, 3 or more times/week, for the last 3 months). Anyone with serious chronic medical conditions that would preclude them from participating without a physician present, or anyone with a risk of seizure, or anyone having psychiatric and/or neurological disorders. Pregnant women. Anyone incapable of performing the following movements at a moderate intensity- sitting, standing, kicking, pulling, pushing, bending one's elbows or bending one's knees. Anyone who scores 1 or more on the Physical Activity Readiness Questionnaire Anyone refusing or unwilling to be randomized into either of the conditions. Anyone who cannot commit to both 45 minute testing sessions or the five 30-minute training sessions.

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 45 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Prevention
Allocation: Randomized
Intervention Model: Parallel Assignment
Interventional Model Description: Three groups: One intervention, One Exercise Comparison, One Attentional Control
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: HUBOD martial arts practice<br>Participants will be trained in the Hubod exercise over 5 separate training sessions. Sessions will last approximately 30 minutes, involving a warm up, review of material from the previous session and the learning of the next movement in the HUBOD sequence. Heartrate will be monitored periodically to make sure the intensity of exercise is consistent with mild to moderate cardiovascular exercise as in the active comparator. | Behavioral: HUBOD<br>* Participants in the intervention group will attend 5 separate training sessions instructing them in Hubod. The Hubod exercise is a partnered coordination drill involving moves derived from numerous martial arts, most often seen in the Filipino martial art of Kali. Participants will aim to reach a level of comfort and competency in the basic, non-competitive aspects of the Hubod exercise by the end of their participation in this intervention.<br>* Other names: Hubod Training Group;|
| Active Comparator: Active Comparator - Stationary Bicycle<br>Participants will be given 5 separate sessions, each approximating 30 minutes in duration, of mild to moderate intensity cardiovascular training on a stationary bicycle. Heartrate will be monitored periodically to make sure the intensity of exercise is consistent with mild to moderate exercise as in the Experimental group. | Behavioral: Active Comparator<br>* Participants in the active comparator group will attend 5 separate training sessions. Each session will involve a 5 minute warmup of joint mobilization exercises and mild pedaling on the bicycle before the main effort of continuously using the bicycle for approximately 20 minutes. The session finishes with a 5 minute cooldown period and light stretch. Heartrate will be monitored regularly in order to prevent this exercise exceeding the relative intensity of the Martial Arts intervention group. Participants will be allowed to talk and interact with research assistants in order to keep socialization effects consistent across groups.<br>* Other names: Stationary Bike Group;|
| Placebo Comparator: Attentional Control Group<br>Participants will be given 5 separate sessions, each approximating 30 minutes in duration, of watching videos on martial arts training methods and techniques. These sessions will be completely sedentary. | Behavioral: Control Condition<br>* Participants in this group will attend 5 separate training sessions. Each session will involve watching educational videos on martial arts techniques and training methods from a sedentary position. Participants will be allowed to talk and interact with research assistants in order to keep socialization effects consistent across groups.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Digit Symbol Substitution task | Processing speed and working memory cognitive task using numbers and symbols. Participants will be presented with multiple rows of symbols, each one corresponding to a number on a 1-9 scale and they will have two minutes to correctly match (in sequential order) as many symbols to their numbers as possible. Performance is computed by adding the number of symbols correctly-matched within the allotted time. | Participants will be assessed at baseline and in the week immediately following the two-week intervention period. | 
| n-2back memory task | Working memory cognitive task involving a sequence of shapes briefly appearing on a computer screen. If the shape on screen is identical to the shape two stages before, the participant will press the 'match' key. If they are not identical, the participant should do nothing. Performance is derived by the number of correctly-matched shapes in the sequence and calculating the average reaction time across the trials. | Participants will be assessed at baseline and in the week immediately following the two-week intervention period. | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Matrix Reasoning Task | Participants will be required to identify patterns among objects in an incomplete, 3x3 matrix, according to row and column, and to select the correct object that completes the remaining empty box from a list of potential objects. Performance will be assessed from the number of correct responses within the allotted time. | Participants will be assessed at baseline and in the week immediately following the two-week intervention period. | 
| Trail-Making Test | The trail-making test is a global cognition and spatial awareness assessment involving two parts. Respondents must complete each part as quickly as possible using a single, continuous pencil-drawn line. For Trails part A, the numbers 1-26 are randomly arranged on a sheet of paper and respondents are required to connect the numbers, in order, using a single pencil line. The pencil is not allowed to leave the paper until the task is complete. The same is true for Trails part B, but the sequence is now numero-alphabetic (1, A, 2, B, 3, C and so on). The task is complete when the participant reaches the end of the sequence. Performance will be measured by how long it takes the participant to complete parts A and B. | Participants will be assessed at baseline and in the week immediately following the two-week intervention period. | 
| Flanker Task | The Flanker task paradigm assesses inhibition control. The task utilizes pictures and symbols and is delivered using an iPad. Participants will be required to correctly identify, as fast as possible, the direction a central arrow among a set of surrounding arrows that are pointing in either congruent or incongruent directions. Performance will be assessed using average reaction time responses and accuracy across the congruent and incongruent trials. Inhibition percent interference will be calculated using the formula ((incongruent reaction time - congruent reaction time)/congruent reaction time) * 100. | Participants will be assessed at baseline and in the week immediately following the two-week intervention period. | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Cognitive Performance, Complex movement