Sara Trapero-Asenjo

Age-related changes increase frailty and vulnerability to stress in older adults, and stress has been linked to poorer balance and fall risk. However, the mechanisms by which emotional stress may contribute to falls remain unclear. This study explores whether: 1) emotional stressors lead to neuromuscular changes that affect postural control in older adults; and 2) technology can assist in fall prevention by detecting increased risk. A cross-sectional, laboratory-based observational study is being conducted in a single session comparing 30 young adults (18–39 years) and 30 older adults (≥65 years), in which participants are exposed to emotional stressors (high-arousal images) and their immediate neuromuscular and balance responses are recorded. The first participant was enrolled on November 27, 2024. All participants complete a sequence of physical tasks under two conditions: viewing low-arousal and high-arousal images from the International Affective Picture System. The physical tasks involve standing up from a chair, walking to a table, transferring water between bottles, returning to the chair, and sitting down. Emotional responses are assessed using heart rate variability, respiratory rate and subjective feelings of unease. Electromyographic signals are analysed using wearable sensors, ground pressure is recorded via pressure sensors and bottle manipulation is tracked with inertial measurement units. Furthermore, balance is evaluated using the Timed Up and Go Test and the Functional Reach Test, administered before the low-arousal condition and after the high-arousal condition. Comprehensive data analysis will provide new insights to aid professionals in designing interventions for detecting and preventing fall risk in older adults. The study was approved by the corresponding ethics committee and registered at ClinicalTrials.gov (NCT06682754) on November 21, 2024. It is being conducted at the University of Alcalá, Spain, and is funded by the European Union and the ‘Junta de Castilla-La Mancha’. Principal investigators are Dr. Bernardo Alarcos and Dr. Susana Nunez-Nagy ( susana.nunez@uah.es ). The collected data will be anonymized and shared in an open-access repository, in line with ethical and open science principles.

Background/Objectives: Falls are a major global issue for older adults, and emotional stress may increase the risk due to its effects on postural control and balance. However, the immediate effects of a stressful stimulus on objective measures of balance and fall risk are unknown. The study aims to explore differences in older adults’ performance on the Timed Up and Go (TUG) test before and after such exposure. Methods: In this cross-sectional study, 31 older adults (71.6 ± 4.98 years) were exposed to an emotionally stressful stimulus using high-arousal images from the International Affective Picture System. Participants performed the TUG before (t1) and after (t2) exposure as the primary outcome measure. To assess the physiological and psychological impact of the stressful stimulus, heart rate variability (HRV) was recorded before and during image viewing. A visual analogue scale (VAS) of unease was completed both before and after the stimulus. Results: During the stressful stimulus, the HRV high-frequency (HF) band decreased significantly (p = 0.001), while the low-frequency (LF) band (p = 0.002) and the LF/HF ratio (p = 0.004) showed a significant increase. Similarly, after stressful stimulus, VAS scores demonstrated a statistically significant increase (p < 0.001). The time to complete the TUG showed a statistically significant increase at t2 (p < 0.001). Conclusions: The stressful stimulus triggered both physiological and subjective stress responses. Subsequently, TUG test performance declined (increased duration), suggesting that emotionally stressful stimuli could deteriorate functional balance performance in older adults, potentially increasing fall risk.

Objectives: This study explored the experiences of second-grade children and their teachers who participated in a mind–body program to understand its impact on their development. Methods: A qualitative descriptive study was conducted. Student data were collected through seven focus groups, and semi-structured interviews were conducted with tutors in December 2021. Data analysis was performed following COREQ guidelines. Results: Three themes were generated: (1) competitiveness and restlessness in children: something needs to be done; (2) seeds sown and fruits harvested; and (3) it is necessary to advance from the occasional to the structural. Participants reported positive changes in areas of their development such as self-regulation, relaxation, attention capacity, and stress reduction. Improvements in interpersonal relationships and social skills were also observed. Conclusions: These improvements in emotional well-being and social skills highlight the importance of this type of intervention in the school environment.

Motor imagery (MI) is the mental representation of a movement without its execution. It activates internal representations of the movement without external stimulus through different memory‐related processes. Although acute stress is frequent in the population and affects supraspinal structures essential for memory functionality, it is still unknown how that stress affects MI capacity and temporal congruence (TC) between execution and movement imagination. This study aimed to discover how acute stress may influence MI capacity and TC in the subscales of internal and external visual imagery and kinesthetic imagery. A double‐blind, randomized trial was conducted. Sixty‐two young, healthy subjects (mean age = 20.65 [2.54]; 39 females and 23 males) unfamiliar with the assessment and uses of MI were recruited. Participants were assigned by stratified randomization to the stress group or the control group. Stress was induced by the Maastricht Acute Stress Test (MAST), while the control group performed the MAST control protocol. MI capacity and TC were assessed before (t1) and after (t2) MAST stress or control using the Movement Imagery Questionnaire‐3 (MIQ‐3). Electrodermal activity and heart rate variability were further recorded as control variables to assess stress induction. Thirty subjects in the stress group and 26 subjects in the control group were analyzed. No significant group differences were observed when comparing MI capacity or TC in any subscales. These findings suggest that acute stress does not significantly affect MI capacity or TC in young, healthy, non‐experienced MI subjects. MI could thus be a relevant helpful technique in stressful situations.

Motor imagery (MI) training is increasingly used to improve the performance of specific motor skills. The Movement Imagery Questionnaire-3 (MIQ-3) is an instrument for assessing MI ability validated in Spanish although its reliability has not yet been studied in the elderly population. The main objective of this study was to test its reliability in institutionalized elderly people. Secondarily, we studied whether there are differences according to gender and age in MI ability (measured by the MIQ-3) and in temporal congruency (measured by mental chronometry of elbow and knee flexion-extension and getting up and sitting down from chair movements). The subjects were 60 elderly, institutionalized, Spanish-speaking individuals without cognitive impairment or dementia, and aged between 70 and 100 years. Cronbach’s alpha showed high internal consistency in the internal visual and external visual subscales and moderate in the kinesthetic subscale. The intraclass correlation coefficient showed good test-retest reliability for all three subscales. Mixed factorial analysis of variances (ANOVAs) showed that MI ability decreased with increasing age range, the imagery time decreased concerning the execution of the same movement, and there were no gender differences in either IM ability or temporal congruence. The Spanish version of the MIQ-3 is a reliable instrument for measuring MI ability in institutionalized elderly.