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Efﬁcacy of Brain Gym® Training on the Cognitive Performance and Fitness

Level of Active Older Adults: A Preliminary Study
Article in Journal of aging and physical activity · February 2015

DOI: 10.1123/japa.2014-0044 · Source: PubMed
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“Efficacy of Brain Gym® Training on the Cognitive Performance and Fitness Level of Active Older Adults: A Preliminary
Study” by Cancela JM et al.
Journal of Aging and Physical Activity
© 2015 Human Kinetics, Inc.
Note: This article will be published in a forthcoming issue of

the Journal of Aging and Physical Activity. This article
appears here in its accepted, peer-reviewed form; it has not
been copy edited, proofed, or formatted by the publisher.
Section: Original Research
Article Title: Efficacy of Brain Gym® Training on the Cognitive Performance and Fitness
Level of Active Older Adults: A Preliminary Study
Authors: José María Cancela, MªHelena Vila Suárez, Jamine Vasconcelos, Ana Lima, and
Carlos Ayán
Affiliations: The authors are with the Faculty of Education and Sports Science, University of
Vigo, Pontevedra, Spain.
Running Head: Cognitive training and Brain Gym®
Journal: Journal of Aging and Physical Activity
Acceptance Date: January 15, 2015
©2015 Human Kinetics, Inc.
DOI: http://dx.doi.org/10.1123/japa.2014-0044
Efficacy of Brain Gym® training on the cognitive performance and fitness level of
active older adults: a preliminary study.
Cancela, JM.; Vila, MªH.; Vasconcelos, J.; Lima, A. and Ayan, C.
Faculty of Education and Sports Science, University of Vigo.
Cognitive training and Brain Gym
Mª Helena Vila Suárez, Campus A Xunqueira s/n, Despacho 214. 36005. Pontevedra
(Spain). Tlf.: 00 34 986 801 700. Fax: 00 34 986 801 701. Email: evila@uvigo.es
Abstract
This study evaluates the impact of Brain Gym® (BG) training in active older adults. Eighty-
five participants were assigned to four training groups: BG (n=18), BG plus water-based
exercise (n=18), land-based exercise (n=30) and land- plus water-based exercise (n=19). The
effects of the programs on the attention and memory functions were assessed by means of the
Symbol Digit Modality Test. The "2-minute step" and the "8 Foot-Up-and-Go" tests were
used to evaluate their impact on the fitness level. No program had a significant influence on
the participant’s cognitive performance s, while different effects on the sample' fitness level
were observed. These findings suggest that the effects of BG on the cognitive performance
and fitness level of active older adults are similar to those obtained after the practice of a
traditional exercise program. Whether BG is performed in isolation or combined with other
exercise programs seems to have no influence on such effects.
Keywords: cognition, physical exercise, fitness, attention, memory.

A rapidly growing literature strongly suggests that physical activity (PA) can have a
positive impact on brain aging (Lautenschlager, Cox, & Cyarto, 2012). Indeed, the findings
of several randomized trials of the effect of PA on cognition in healthy older adults have
confirmed the existence of a potential benefit, particularly on executive function, attention
and processing speed (Smithet al., 2010). This positive effect of exercise in cognition has
been related to an increment of hippocampal volume (a structure sensitive to exercise-
induced change via neurogenesis and cell proliferation) and level of BDNF (involved in cell
growth and survival and memory promotion) (Hauer, Schwenk, Zieschang, Essig, Becker, &
Oster, 2012). Regarding the above-mentioned, studies involving animal models have shown
that physical activity can stimulate angiogenesis, brain perfusion and neurovascular integrity
(Swain et al., 2003). Finally, it has been suggested that a higher level of fitness through
increased physical activity might have a positive effect on neuropathologic substrates as well
as it might lead to a decreased whole-brain and medial temporal lobe atrophy in older adults
(Makizako et al., 2011).
Most of the studies in this regard have focused on analyzing the effects of typical PA
interventions, (Ahlskog, Geda, Graff-Radford, & Petersen, 2011). For instance, it has been
observed that aerobic exercise, mainly brisk walking and/or jogging has been associated with
modest improvements in attention, memory, processing speed and executive function among
seniors (Smith et al., 2010). Similarly, scientific evidence has shown that muscular resistance
training can lead to improvements in memory (short and long term) and verbal reasoning,
while strength and balance training exercises can enhance fluid intelligence in this population
(Liu-Ambrose, & Donaldson, 2009).
It has been observed that although some evidence exists, cognitive benefits may be
obtained by means of alternative physical activity training programs (Forte et al., 2013).There
is still a need for studies aimed at identifying the effects of such exercise therapies on healthy
older adults. In this regard, Brain Gym®, a movement-based program originally designed for
children with learning disabilities, on the assumption that physical movement enhances
learning ability (Dennison &Dennison, 1994), is an interesting field of research. Brain Gym®
is a structured non-aerobic physical exercise intervention in which a combination of specific
patterns of crossing movements of the head, eyes and extremities are performed together with
brain and breathing exercises. According to its founders, the regular performance of Brain
Gym® results in stimulation and integration of different parts of the brain, especially the
corpus callosum, which, in the long term, makes communication between the two
hemispheres faster and in a more integrated form for high level reasoning (Dennison, 1985).
However, there is little evidence to support the claims made about the benefits of Brain
Gym® since scientific research has failed to support the assertion that this educational
kinesiology therapy improves academic learning (Hyatt, 2007). Moreover its theoretical
underpinning has also been subject to criticism by neuroscientists and by educators with
expertise in neuroscience and cognition (Stephenson, 2009).
In spite of all this, it has been suggested that Brain Gym® can be considered as a
useful physical therapy strategy for older adults, since it can have a positive impact on brain
functioning (Drabben-Thiemann, Hedwig, &Kenklies, 2002). In this regard, Yágüez,Shaw,
Morris, & Matthews (2011) conducted a small randomized controlled trial which showed that
the performance of Brain Gym® can enhance cognitive performance, specifically attention
and memory, in older adults with dementia (Yagüez et al., 2011). Similarly, Sidiarto,
Kusumoputro, Munir, &Nugroho (2003) carried out a quasi-experimental study involving a
group of healthy older adults who improved their cognitive performance after taking part in
an intervention based on the performance of specific patterns of movements and brain
exercises, very similar to the ones described in the Brain Gym® manual. Nevertheless,
regarding the benefits of Brain Gym® in the cognitive performance and fitness level of
community-dwelling older individuals, scientific evidence is scarce. Moreover, no research
has compared the effects of this therapy with traditional exercise interventions or has
analyzed its potential benefits when it is included as part of a more comprehensive physical
exercise program. This study aims to fill this gap.
Methods
Participants
Eligible individuals were community-dwelling older adults who had been taking part
in a PA program during the previous five years. This program, which was offered by the
council of their local town every year, was aimed at improving the functional capacity of the
participants by means of the performance of water-based exercise, however, it did not include
Brain Gym®’s realization or similar exercises destined to ameliorate cognitive performance.
For the purpose of the present study, inclusion criteria were older adults between 65 and 80
years old, with absence of a clinical diagnosis of dementia, and independent ambulation.
People who presented any comorbidities or any acute illness that would make training
inappropriate, individuals who had already participated in Brain Gym® sessions, or those
who were taking part in any other physical exercise or memory training program different to
the one offered in the present research were excluded.
The research protocol followed the guidelines provided by the Helsinki Statement
about Biomedical Research for Humans (18thMedical Assembly, 1964; revised 1983 in Italy
and 1989 in Hong Kong) at the international level; and the Arrangement for Preservation of
Human Rights and Dignity with Respect to Biological and Medical Applications (IR1999;
B.O.E. 251, 1999) at the national level. The study was approved by the local ethics
committee, and written informed consent was provided by all participants.

Measurements
Academic background and medication. An ad hoc self-completion questionnaire
was administered in order to obtain information about the educational attainment of the
sample and the type of medication that individuals were taken.
Self-perceived physical and cognitive health. A Likert-type scale was used to assess
the perceived fitness level and the existence of memory problems (range 1-5 points; lower
scores indicate worse fitness level and greater memory problems).
Mental processing, attention and memory functions. These cognitive variables
were assessed by means of the Spanish validated version of the Symbol Digit Modality Test
(SDMT) (Smith, 2002).This test involves filling nonsense symbol blanks with matching
numbers to a specific code. The scoring ranged from 0 to 110 with higher scores representing
better performance.
Fitness Level: The “2-minute step” test (2MST) (Rikli & Jones, 1999) was used to
assess aerobic endurance. This test determines the repetitions a person can do by stepping in
place alternately raising the knees to a height halfway between the iliac crest and middle of
the patella in 2 minutes. Agility, power, dynamic balance and speed were assessed by means
of the “8 Foot-Up-and-Go” test (8FGT) (Rikli, & Jones, 1999). This test measures the time it
takes to get out of a chair, walk 8-feet to and around a cone, and return to the chair.
The assessment was carried out by two physiotherapists and two physical exercise
specialists, who were blind to group allocation, one week before and one week after the
intervention.
Intervention
People were told in advance the types of programs which were going to be developed
as well as the exact date in which they were going to take place. Then they were asked about
scheduled preferences to assist to the study as well as the program they would like to
participate in. They were also informed both aspects would be taken into account in order to
include them in one of our programs. The above-mentioned with the purpose of motivating
the participants and getting a good adherence level during the study. According to their time
availability and PA preferences, participants were allocated to two groups, Brain Gym® (BG)
or traditional exercise (TG) program. Brain Gym® program participants took part in a one-
hour weekly session, performing 15 exercises focusing on fine motor involvement, balance
and hand-eye coordination. Traditional exercise program participants attended to one-hour
weekly session of land-based training, which included callisthenic exercises aimed at
improving dynamic balance, coordination and aerobic capacity. The possibility of adding a
one-hour weekly session of water-based exercise to the program was offered to participants
in both groups. Thus, four different groups were set up: Brain Gym®, Brain Gym® plus
water-based exercise, land-based exercise and land-plus water-based exercise. The total
intervention duration was 16 weeks. Water-based and land-based sessions were monitored by
a specialist with previous experience administering physical exercise programs for the older
adults. He also recorded attendance and dropouts. Brain Gym® sessions were monitored by a
physiotherapist experienced in applying this type of physical therapy. The characteristics of
the sessions can be seen in Table 1.
Data and statistical analysis
Means and standard deviations for the whole group were calculated for all continuous
variables. Discrete variables were described by percentage. All continuous variables were
tested for normality by Kolmogorov-Smirnov statistics. With the aim of analyzing intragroup
behaving of each one of the variables, a variability analysis was realized by confidence
interval and coefficient of variation calculus in every group and during the two moments of
the analysis. Paired sample tests were also used to assess changes from pre-intervention to
post-intervention (16 weeks) in each one of the programs. Repeated measures MANOVA test
was conducted to analyze the effect of the intervention programs in the cognitive
performance and fitness level of the sample. The Bonferroni multiple comparisons test was
used to compare specific means. A 2x4 Mixed MANOVAs (Moment x program) were used,
being factor Moment (pre-test and post-test) and the program factor (BrainGym, BrainGym
plus water exercise, Land-based exercise, Land plus water-based exercise), considering as
dependent : SDMT, 2MST y 8FGT. Pearson's correlation coefficient (r) was accomplished
with the aim of determining association’s degree between the ad hoc questionnaire and the
objective tests employed during the study. Significance was accepted at p<.05. All data were
analyzed using Statistical Package for the Social Sciences 17.0.
Results
A total of 85 individuals volunteered and finished the study. The characteristics of the
participants, which were distributed depending on the program in which they took part, can
be seen in Table 2.
Baseline assessment showed that the group distribution was homogeneous. The
variability analysis accomplished by means of the confidence interval and the coefficient of
variation indicated that variability intragroup of the physical analyzed variables was low
(cv<32) while cognitive variable was elevated (cv>62). According to the results obtained,
none of the four programs had a significant effect on mental processing, attention or memory
function. However, the performance of Brain Gym®, seemed to improve significantly the
participants’ self-perceived cognitive health. (Table 3).The difference between pre- and post-
intervention scores obtained in the 8FGT showed that patients significantly increased their
agility, power, dynamic balance and speed, regardless of the program to which they were
allocated. The results obtained in the 2MST showed that only those who participated in
programs including land-based exercise sessions showed a significant improvement in their
aerobic level.
Results obtained due to the comparative study accomplished by 2x4 Mixed
MANOVA (Moment x program) showed that there was difference between intervention
groups in the analyzed dependent variables. Invariant test also indicated that there was
intervention effect differences on individual 2MST, F (3, 77) = 4.433, p = 0.06, η2 = 0.147
and 8FGT, F(3, 77) = 4.031, p = 0.010, η2 = 0.136. Besides there were not differences for
variable SDMT, F (3, 77) =0 .342, p =0 .795, η2 =0 .013. Bonferroni multiple comparisons
test indicated the absence of differences in the programs on the object study variables
(SDMT, 2MST, 8FGT). Correlational analyses accomplished by means of Pearson's (r)
correlation indicated the absence of association between the ad hoc questionnaire of cognitive
health perception and the test SDMT(r=0.113; p=0.356). This analysis showed the existence
of significant associations between the ad hoc questionnaire of physical health perception and
the tests 2MST(r=0.378; p=0.001) and 8FGT (r=-0.206; p=0.042).
Discussion
This research was aimed at determining the effect of Brain Gym® on the cognition
and fitness level of healthy older adults, as well as finding out whether its effects were more
significant that those produced by a traditional exercise program. Obtained results indicate
that none of the four exercise programs had significant effects on the cognitive functions
related to mental processing, attention and memory as assessed by means of the SDMT.
Thus, it seems that de Brain Gym® practice, whether it is the only exercise or it is combined
with a water-based program, is not more effective than classical physical exercise programs
when improving cognitive performance. This contradicts the results of previous

investigations. For instance, Drabben-Thiemannet al. (2002) reported beneficial effects of
using Brain Gym® on people who had been diagnosed with dementia, and Yagüez et al.
(2011) found significant improvements in sustained attention and visual memory in people
with Alzheimer’s type dementia after applying this therapy. Two different reasons may
explain the fact that no effects were found in our research. First, it could be thought that the
reduced weekly frequency of the Brain Gym® program may not be enough to enhance the
cognitive performance of the sample. However, Yagüez et al. (2011) found some benefits
after applying the program once per week for only 6 weeks. . These differences could have
been appeared because that program included longer sessions (90’) and longer exercises (2-
3’), which suggest that the volume of Brain Gym® sessions accomplished by people in this
study could not have been enough to incite changes in cognitive performance.
Secondly, taking into account the characteristics of the sample from the two
previously mentioned studies, it could be hypothesized that the effect of Brain Gym®
depends on the individual’s cognitive state who is taking part in the program. Thus, healthy
older adults would not obtain the same benefit as older people suffering from dementia.
Nevertheless, Sidiarto et al. (2003) informed that mentally healthy older populations may
experience significant improvements in different cognitive functions after the Brain Gym®
practice.
In relation to this, it is important to point out that the initial mean values obtained
from the sample of this study in the SDMT may be classified as “too low” (Sheridan et
al.,2006). The sample would be between percentile 19 and percentile 28, according to the
reference values published about a population from the same country and similar age (Peña-
Casanova et al., 2009). Although the people who volunteered for this study did not present a
clinical diagnosis of dementia, it may be possible that they presented some type of mild
cognitive decline, considering the low mean score obtained in the SDMT. This has been
already proposed in other studies which have used this test as a cognitive screening tool
(Cherbuin, Sachdev, & Anstey, 2010). Under these circumstances, it may be reasonable to
speculate on the possibility of the Brain Gym® program having a protective effect, somehow
hindering or hampering the aforementioned mild cognitive decline. This idea could also help
to explain why the traditional exercise program had no significant effect on the cognitive
variables assessed by the SDMT, despite the fact that it produced some improvements in the
aerobic level. Nevertheless, the lack of an inactive control group makes this idea just a mere
hypothesis, thus it cannot be considered as an evident result in this study.
In relation to the effects of the different interventions, which were carried out on the
fitness level of the sample, it was observed that the participants in the groups with land-based
exercise were the only ones who improved their aerobic level. This may be a consequence of
the training session’s content because the Brain Gym® program had no aerobic component
and the water-based exercise program focused on relaxing and toning up. Indeed, only land-
based sessions included aerobic exercise.
Finally, all the programs had similar effects on agility, balance, speed, power and self-
perceived physical health. This was somehow the expected result, as their sessions included
postural control exercises and tasks aimed at enhancing coordination, balance and motor
ability in general.
The fact that no differences were found as regards the effects on cognitive
performance of both Brain Gym® and traditional training may be considered an original
contribution of this research. As to the authors’ knowledge, no comparative study on the
effects of the Brain Gym® has been published to date. Regarding this aspect of investigation,
it is necessary to point out that although it is true that Brain Gym® practice had effects on the
cognitive health perceived by participants, this was evaluated with an ad hoc questionnaire,
which was not validated and whose obtained results did not correlated with the ones obtained
in SDMT test.This is the reason why this result might be due to an information slant instead
of the intervention per se.
In any case, the absence of different effects between the two modalities, as assessed
by objective and previously validated tests seems to be in line with the findings obtained by
other authors who have carried out similar studies. Thus, Forte et al. (2013) observed that a
multicomponent training (simultaneous performance of cognitive tasks and physical
exercises) and a traditional training (muscular resistance exercises) had the same effect on
different cognitive variables in healthy older adults.
Similarly, Barnes et al. (2013) observed that the combination of mental training and
physical exercise in a sample of older adults with cognitive complaints did not produce
greater effects on the cognitive performance than those produced by a physical exercise
program which lacked this component.
The scarce existing studies on the effects of Brain Gym® show different
methodological weaknesses, such as the absence of a control group (Drabben-Thiemannet al.,
2002; Siriarto et al., 2003) or the small sample size (Yagüez et al.,2011). An attempt to
overcome these weaknesses has been made in this study. However, this research also has
certain limitations of its own, especially those related to the sample characteristics. For
instance, the entire sample was made up of people willing to exercise and who were allowed
to participate in the preferred program This facilitated adherence to the program, but it limits
results generalization and it could provoke a self-selection bias. Similarly, the sample
consisted of people who had been taking part in physical exercise programs for five years.
Consequently, a possible ceiling effect on the variables under study must be taken into
account. Finally, the participants showed very low mean values in the SDMT, which implies
that their cognitive level could be someway affected. Therefore, the data may have been
contaminated by the sampling cognitive profile. Regarding the above-mentioned, certain

limitations related to methodological design, such as the lack of an inactive control group, the
fact that group distribution was not randomized and the employment of ad hoc questionnaires
which were not tested for validity must be acknowledged so as to interpret the results with
caution. Future randomized comparative studies should include sedentary samples which
consist of older adults who do not present any type of cognitive complain, so that the results
here presented can be contrasted.
Conclusion
The results of this study indicate that the effects of Brain Gym® on the cognitive
performance and fitness level of community-dwelling older individuals are similar to those
obtained after the practice of a traditional exercise program. Whether Brain Gym® is
performed in isolation or combined with other exercise programs seems to have no influence
on the effects produced by this physical therapy. This finding must be confirmed by
investigations which include sedentary older populations who do not present any type of
cognitive complaint.
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Table 1 Exercise interventions
Land-based exercise Water-based exercise Brain Gym

WARM UP EXERCISES WARM UP EXERCISES WARM UP EXERCISES
(10 minutes) (10 minutes) (10 minutes)
Gentle walking Gentle walking in different directions Gentle walking
 Walking on different directions  Walking shifting support (heels, on tiptoe)  Walking on different directions
 Walking with long deliberate  Marching (raising knees-heels/legs apart-  Walking with long deliberate steps
steps crossed/arms in-out of the water)  Walking with small deliberate steps
 Walking with small deliberate  Walking while raising knees
steps Gentle Stretching
 Walking while raising knees
Active joint motion range Active joint motion range
GENERAL EXERCISES GENERAL EXERCISES GENERAL EXERCISES

(45 minutes) (45 minutes) (30 minutes)
Aerobic dance exercises (25`) Group games (15’)  Belly breathing (1 min).
 Low impact aerobics movements  Passing a ball among the participants  Cross-lateral walking in place (2 min).
(120 beats per minute)  Throwing balls into dispersed hoops in  Lazy Eight (2 min).
the water  Elephant (2 min).
 Cross-lateral walking in place (2 min).
Balance and coordination (15’)  Neck rolls (1 min with eyes open/ 1 min
 Standing and holding the pool wall, wide with eyes closed).
stance, with support, and shift weight left  Cross-lateral walking in place (1 min).
and right, forward and backward as far as  The owl (2 min).
possible.  Cross-lateral walking in place (1 min).
General Motor Coordination  Standing on one leg while the other leg  Arm activation (1 min for each arm).
(10’) pushes and pulls a "noodle" (long float).  Cross-lateral walking in place (1 min).
 Bouncing a ball while walking  Riding on a "noodle" and maintaining
 Foot flex (1 min for each foot).
balance.
 Throwing a rolling ball to a  Cross-lateral walking in place (1 min).
 Standing with one leg on a "noodle".
partner while walking  Calf-pump (1 min for each leg).
 Standing with both legs on the "noodle"
 Throwing a ball in the air to a  The grounder (1 min for each leg).
and maintaining
partner while walking  Gravity glider (1 min).
Balance.  Cross-lateral walking in place (1 min).
Balance (10’)  Standing with wide stance while being  Brain buttons (1min).
 Walking between cones: pushed by a partner in different directions.  Cross-lateral walking in place (1 min).
- Steady cadence (zig-zag  Earth buttons (1 min).
movements) Relaxation (15’)  Cross-lateral walking in place (1 min).
 Standing and holding the pool wall, wide  Balance buttons (1 min)
- Different walking
stance, with support, inserting the head in  Cross-lateral walking in place (1 min).
cadences (changing the
the water (breathing out underwater).  Space buttons
direction)
 Cross-lateral walking in place (1 min).
- Mild jogging between
 Lying supine on the water
cones
 Slow swimming.
COOLING-OFF ACTIVITIES COOLING-OFF ACTIVITIES (5 COOLING-OFF ACTIVITIES
(5 minutes) minutes) (5 minutes)
General stretching exercises General stretching exercises General stretching exercises
Table 2 Characteristics of the Sample (n=85)
Brain Gym® plus Land-based Land plus

Brain Gym®
water exercise exercise water-based exercise
(n=18)
Variable (n=18) (n=30) (n=19)
Age, M (SD) 71.94 (7.13) 69.89 (6.91) 71.19 (5.06) 67.95 (4.98)
Physical activity program
Years in the previous physical
4.50 (3.78) 5.06 (3.13) 4.82 (3.54) 4.00 (3.54)
activity program, M (SD)
Sex
Women, n (%) 16 (88.8) 11 (61.1) 23 (76.6) 13 (68.4)
Medication
Medication to improve memory, n (%) 5 (26.7) 6 (33.3) 10 (33.3) 5 (26.3)
Others pathologies, n (%) 18 (100) 18 (100) 30 (100) 19 (100)
Academic background
No education, n (%) 6 (33.3) 4 (22.2) 2 (6.6) 1(5.2)
Primary education, n (%) 11 (61.1) 13 (72.2) 14 (46.6) 18 (94.7)
Secondary education, n (%) 1 (5.5) 1 (5.5) 1 (3.3) -
Higher education, n (%) - - - -
“Efficacy of Brain Gym® Training on the Cognitive Performance and Fitness Level of Active Older Adults: A Preliminary Study” by Cancela JM et al.
Table 3 Effects of the different exercise programs on the cognitive variables
SDMT Cognitive Health
Pre Post Pre Post

95% CI CV 95%CI CV t student 95% CI CV 95%CI CV t student
Program M (SD) M (SD) M (SD) M (SD)
13.53 9.17- 14.12 10.11- t=-0.689 3.78 3.30- 4.22 3.80- t=-3.063
Brain Gym® 62.60 55.09 21.42 17.29
(8.47) 17.88 (7.78) 18.11 Sig=0.501 (0.81) 4.10 (0.73) 4.55 Sig=0.007
Brain Gym®
19.29 14.57- 19.94 15.71- t=-0.507 4.00 3.55- 4.33 3.94- t=-2,915
plus water 47.53 41.27 21.00 15.70
(9.17) 24.00 (8.23) 24.17 Sig=0.619 (0.84) 4.44 (0.68) 4.64 Sig=0.010
exercise
Land-based 16.17 14.24- 15.87 11.82- t=0.376 3.47 2.92- 3.29 2.72- t=1.852
41.43 44.10 30.83 33.43
exercise (6.70) 21.86 (7.00) 19.00 Sig=0.710 (1.07) 4.01 (1.10) 3.86 Sig=0.083
Land plus
18.06 12.79- 18.94 15.01- t=-0.829 3.84 3.65- 3.94 3.54- t=1.458
water-based 42.41 41.49 31.51 20.30
(7.66) 19.09 (7.86) 22.86 Sig=0.419 (1.21) 4.45 (0.80) 4.34 Sig=0.163
exercise
Note. CI = Confidence Interval; CV = Coefficient of Variation; SDMT = Symbol Digit Modalities Test.
“Efficacy of Brain Gym® Training on the Cognitive Performance and Fitness Level of Active Older Adults: A Preliminary Study” by Cancela JM et al.
Table 4 Effects of the different exercise programs on the physical variables
2MST 8FGT Physical Health
Pre Post Pre Post Pre Post

Program 95%CI CV 95%CI CV t student 95%CI CV 95%CI CV t student 95%CI CV 95%CI CV t student
M(SD) M (SD) M(SD) M(SD) M(SD) M(SD)
Brain Gym® 79.76 70.96- 76.71 69.69- t=0.938 6.78 6.03- 5.91 5.00- t=6.963 3.78 4.16 3.91- t=-2.364
20.02 14.44 16.96 12.52 3.37-4.17 21.42 12.25
(15.97) 88.53 (13.93) 83.30 Sig=0.362 (1.15) 7.62 (0.74) 6.42 Sig=0.001 (0.81) (0.51) 4.42 Sig=0.030
Brain Gym®
plus water 87.89 80.93- 85.33 77.10- t=0.987 6.38 5.71- 5.28 4.62- t=7.432 4.11 4.38 4.13- t=-2.051
23.17 31.66 15.51 29.35 3.73-4.48 18.49 11.41
exercise (20.37) 98.95 (27.02) 97.36 Sig=0.331 (0.99) 6.97 (1.55) 5.91 Sig=0.001 (0.76) (0.50) 4.63 Sig=0.046
Land-based
84.13 76.17- 90.13 82.57- t=-2.632 6.42 5.94- 5.77 5.04- t=4.912 3.71 4.11 3.80- t=-2.915
exercise 20.83 16.67 14.79 18.02 3.19-4.21 26.68 14.59
(17.53) 91.09 (15.03) 97.68 Sig=0.013 (0.95) 6.89 (1.04) 5.96 Sig=0.001 (0.99) (0.60) 4.42 Sig=0.010
Land plus
water-based 83.89 76.92- 94.89 83.87- t=-3.113 6.22 5.75- 5.16 4.21- t=6.111 4.16 4.47 4.22- t=-2.051
15.43 16.53 13.98 8.91 3.82-4.48 16.58 11.40
exercise (12.95) 90.18 (15.69) 102.79 Sig=0.006 (0.87) 6.67 (0.46) 5.08 Sig=0.001 (0.69) (0.51) 4.72 Sig=0.045
Note. CI = Confidence Interval; CV = Coefficient of Variation; 2MST = 2 Minute Step Test; 8FGT = 8 Foot up and Go Test
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Efﬁcacy of Brain Gym® Training on the Cognitive Performance and Fitness

Article in Journal of aging and physical activity · February 2015

J. M. Cancela Carral Mª Elena Vila Suárez

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Jamine Vasconcelos Martinis Carlos Ayán

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Water Polo Performance Indicators View project

Análisis de las características antropométricas y condicionales en balonmano View project

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Note: This article will be published in a forthcoming issue of

Section: Original Research

Running Head: Cognitive training and Brain Gym®

Journal: Journal of Aging and Physical Activity

Acceptance Date: January 15, 2015

©2015 Human Kinetics, Inc.

active older adults: a preliminary study.

Cancela, JM.; Vila, MªH.; Vasconcelos, J.; Lima, A. and Ayan, C.

Faculty of Education and Sports Science, University of Vigo.

Cognitive training and Brain Gym

traditional exercise program. Whether BG is performed in isolation or combined with other

exercise programs seems to have no influence on such effects.

Keywords: cognition, physical exercise, fitness, attention, memory.

confirmed the existence of a potential benefit, particularly on executive function, attention

been related to an increment of hippocampal volume (a structure sensitive to exercise-

(Makizako et al., 2011).

(Liu-Ambrose, & Donaldson, 2009).

is a structured non-aerobic physical exercise intervention in which a combination of specific

expertise in neuroscience and cognition (Stephenson, 2009).

functioning (Drabben-Thiemann, Hedwig, &Kenklies, 2002). In this regard, Yágüez,Shaw,

Kusumoputro, Munir, &Nugroho (2003) carried out a quasi-experimental study involving a

an intervention based on the performance of specific patterns of movements and brain

community-dwelling older individuals, scientific evidence is scarce. Moreover, no research

exercise program. This study aims to fill this gap.

Brain Gym®’s realization or similar exercises destined to ameliorate cognitive performance.

the one offered in the present research were excluded.

committee, and written informed consent was provided by all participants.

Academic background and medication. An ad hoc self-completion questionnaire

sample and the type of medication that individuals were taken.

scores indicate worse fitness level and greater memory problems).

Mental processing, attention and memory functions. These cognitive variables

and hand-eye coordination. Traditional exercise program participants attended to one-hour

weekly session of land-based training, which included callisthenic exercises aimed at

physiotherapist experienced in applying this type of physical therapy. The characteristics of

the sessions can be seen in Table 1.

Data and statistical analysis

analyzed using Statistical Package for the Social Sciences 17.0.

programs including land-based exercise sessions showed a significant improvement in their

Results obtained due to the comparative study accomplished by 2x4 Mixed

(SDMT, 2MST, 8FGT). Correlational analyses accomplished by means of Pearson's (r)

the tests 2MST(r=0.378; p=0.001) and 8FGT (r=-0.206; p=0.042).

when improving cognitive performance. This contradicts the results of previous

investigations. For instance, Drabben-Thiemannet al. (2002) reported beneficial effects of

hypothesis, thus it cannot be considered as an evident result in this study.

based sessions included aerobic exercise.

contribution of this research. As to the authors’ knowledge, no comparative study on the

of the intervention per se.

multicomponent training (simultaneous performance of cognitive tasks and physical

different cognitive variables in healthy older adults.

program which lacked this component.

methodological weaknesses, such as the absence of a control group (Drabben-Thiemannet al.,

contaminated by the sampling cognitive profile. Regarding the above-mentioned, certain

here presented can be contrasted.

Ahlskog, J.E., Geda, Y.E., Graff-Radford,N.R.,&Petersen, R.C.(2011). Physical exercise as a