PhD, Associate Professor N.N. Mugallimova¹
Yu.S. Shirshaeva^1
1Volga Region State University of Physical Culture, Sport and Tourism, Kazan

Keywords: cognitive-motor interventions, elderly people, methodological principles, ethics, and social communication.

Introduction. Age-related changes and disorders of coordination and motor functions and cognitive activity correlate with each other and, together with social self-determination, determine the functional and intellectual status, independence, and quality of life of an elderly person. Our long-term practice has shown the high efficiency of the cognitive-motor intervention program (CMI), which is a structured set of exercises that integrate physical activity and cognitive stimulation [1].
CDI is based on the principles of neuroplasticity and the interplay between the motor and intellectual spheres, requiring the simultaneous engagement of both cognitive processes (attention, memory, thinking, perception, and executive functions) and motor activity (spatial orientation, postural control, and fine and gross motor skills). Group-based sessions provide an additional advantage due to the social and communicative interaction between participants, resulting in particularly high performance.
At the same time, it is necessary to understand that the use of CDI in working with the elderly raises a number of ethical issues that require careful consideration.
The purpose of the study is to identify the features of methodological and ethical application of CDI in physical culture and health classes in healthcare institutions (HI).
Research results and their discussion. When compiling the questionnaire, it was explained what should be referred to as the term “cognitive-motor interventions”. A survey of 27 physical training/aerobic exercise instructors from 18 healthcare facilities in the Republic of Tatarstan showed that more than half (16 specialists; 59.3%) do not use physical exercises that are associated with a targeted impact on the motor and intellectual spheres. The reasons include limited training time, reluctance to improvise, and a focus on using conventional physical therapy methods. The remaining 11 respondents (40.7%), with a higher level of professional motivation, indicated that they use elements of CDE, but not systematically and mainly for the rehabilitation of neurological diseases (after stroke and traumatic brain injuries). At the same time, all specialists confirmed the potential effectiveness of this approach in geriatric practice. However, the following problematic aspects of using CDI were noted: the risk of psychological discomfort and physical injury to participants, forced participation, protection of confidentiality, and potential increased anxiety in older adults about their cognitive status.
Among the methodological principles, the respondents highlighted the personalization (26 people; 96.3%) and individualization (24; 88.9%) of the CPI program, taking into account the intellectual and physical condition. 20 people (74.1%) emphasized the importance of gradual service provision and maintaining an optimal level of task complexity, while 23 people (85.2%) highlighted the need for regular monitoring of patients' conditions and the creation of a supportive environment.
Conclusions. The methodological support for CCI should be based on the principles of individualization, gradualness, systematicity, and comprehensiveness, taking into account the initial level of participants and their dynamics during the sessions. The ethical component of CCI includes respect for the autonomy of the elderly person, ensuring confidentiality, creating a psychologically and physically safe environment, and prohibiting discrimination based on age or cognitive status.

References

1. Shirshaeva Yu.S., Parfenova L.A. Fizicheskaya reabilitatsiya lits pozhilogo vozrasta, perenesshikh koronavirusnuyu infektsiyu COVID-19 [Post-covid-19 physical rehabilitation of elderly people]. Teoriya i praktika fizicheskoy kultury. 2021. No. 7. P. 72.