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Institute
- Strukturbereich Kognitionswissenschaften (162) (remove)
Introduction
Varus knee alignment has been identified as a risk factor for the progression of medial knee osteoarthritis. However, the underlying mechanisms have not been elucidated yet in children. Thus, the aims of the present study were to examine differences in ground reaction forces, loading rate, impulses, and free moment values during running in children with and without genu varus.
Methods
Thirty-six boys aged 9–14 volunteered to participate in this study. They were divided in two age-matched groups (genu varus versus healthy controls). Body weight adjusted three dimensional kinetic data (Fx, Fy, Fz) were collected during running at preferred speed using two Kistler force plates for the dominant and non-dominant limb.
Results
Individuals with knee genu varus produced significantly higher (p = .01; d = 1.09; 95%) body weight adjusted ground reaction forces in the lateral direction (Fx) of the dominant limb compared to controls. On the non-dominant limb, genu varus patients showed significantly higher body weight adjusted ground reaction forces values in the lateral (p = .01; d = 1.08; 86%) and medial (p < .001; d = 1.55; 102%) directions (Fx). Further, genu varus patients demonstrated 55% and 36% greater body weight adjusted loading rates in the dominant (p < .001; d = 2.09) and non-dominant (p < .001; d = 1.02) leg, respectively. No significant between-group differences were observed for adjusted free moment values (p>.05). Discussion Higher mediolateral ground reaction forces and vertical loading rate amplitudes in boys with genu varus during running at preferred running speed may accelerate the development of progressive joint degeneration in terms of the age at knee osteoarthritis onset. Therefore, practitioners and therapists are advised to conduct balance and strength training programs to improve lower limb alignment and mediolateral control during dynamic movements.
It is well-documented that strength training (ST) improves measures of muscle strength in young athletes. Less is known on transfer effects of ST on proxies of muscle power and the underlying dose-response relationships. The objectives of this meta-analysis were to quantify the effects of ST on lower limb muscle power in young athletes and to provide dose-response relationships for ST modalities such as frequency, intensity, and volume. A systematic literature search of electronic databases identified 895 records. Studies were eligible for inclusion if (i) healthy trained children (girls aged 6–11 y, boys aged 6–13 y) or adolescents (girls aged 12–18 y, boys aged 14–18 y) were examined, (ii) ST was compared with an active control, and (iii) at least one proxy of muscle power [squat jump (SJ) and countermovement jump height (CMJ)] was reported. Weighted mean standardized mean differences (SMDwm) between subjects were calculated. Based on the findings from 15 statistically aggregated studies, ST produced significant but small effects on CMJ height (SMDwm = 0.65; 95% CI 0.34–0.96) and moderate effects on SJ height (SMDwm = 0.80; 95% CI 0.23–1.37). The sub-analyses revealed that the moderating variable expertise level (CMJ height: p = 0.06; SJ height: N/A) did not significantly influence ST-related effects on proxies of muscle power. “Age” and “sex” moderated ST effects on SJ (p = 0.005) and CMJ height (p = 0.03), respectively. With regard to the dose-response relationships, findings from the meta-regression showed that none of the included training modalities predicted ST effects on CMJ height. For SJ height, the meta-regression indicated that the training modality “training duration” significantly predicted the observed gains (p = 0.02), with longer training durations (>8 weeks) showing larger improvements. This meta-analysis clearly proved the general effectiveness of ST on lower-limb muscle power in young athletes, irrespective of the moderating variables. Dose-response analyses revealed that longer training durations (>8 weeks) are more effective to improve SJ height. No such training modalities were found for CMJ height. Thus, there appear to be other training modalities besides the ones that were included in our analyses that may have an effect on SJ and particularly CMJ height. ST monitoring through rating of perceived exertion, movement velocity or force-velocity profile could be promising monitoring tools for lower-limb muscle power development in young athletes.
Background
Relatively little is known about protective factors and the emergence and maintenance of positive outcomes in the field of adolescents with chronic conditions. Therefore, the primary aim of the study is to acquire a deeper understanding of the dynamic process of resilience factors, coping strategies and psychosocial adjustment of adolescents living with chronic conditions.
Methods/design
We plan to consecutively recruit N = 450 adolescents (12–21 years) from three German patient registries for chronic conditions (type 1 diabetes, cystic fibrosis, or juvenile idiopathic arthritis). Based on screening for anxiety and depression, adolescents are assigned to two parallel groups – “inconspicuous” (PHQ-9 and GAD-7 < 7) vs. “conspicuous” (PHQ-9 or GAD-7 ≥ 7) – participating in a prospective online survey at baseline and 12-month follow-up. At two time points (T1, T2), we assess (1) intra- and interpersonal resiliency factors, (2) coping strategies, and (3) health-related quality of life, well-being, satisfaction with life, anxiety and depression. Using a cross-lagged panel design, we will examine the bidirectional longitudinal relations between resiliency factors and coping strategies, psychological adaptation, and psychosocial adjustment. To monitor Covid-19 pandemic effects, participants are also invited to take part in an intermediate online survey.
Discussion
The study will provide a deeper understanding of adaptive, potentially modifiable processes and will therefore help to develop novel, tailored interventions supporting a positive adaptation in youths with a chronic condition. These strategies should not only support those at risk but also promote the maintenance of a successful adaptation.
Trial registration
German Clinical Trials Register (DRKS), no. DRKS00025125. Registered on May 17, 2021.
This study examines the access to healthcare for children and adolescents with three common chronic diseases (type-1 diabetes (T1D), obesity, or juvenile idiopathic arthritis (JIA)) within the 4th (Delta), 5th (Omicron), and beginning of the 6th (Omicron) wave (June 2021 until July 2022) of the COVID-19 pandemic in Germany in a cross-sectional study using three national patient registries. A paper-and-pencil questionnaire was given to parents of pediatric patients (<21 years) during the routine check-ups. The questionnaire contains self-constructed items assessing the frequency of healthcare appointments and cancellations, remote healthcare, and satisfaction with healthcare. In total, 905 parents participated in the T1D-sample, 175 in the obesity-sample, and 786 in the JIA-sample. In general, satisfaction with healthcare (scale: 0–10; 10 reflecting the highest satisfaction) was quite high (median values: T1D 10, JIA 10, obesity 8.5). The proportion of children and adolescents with canceled appointments was relatively small (T1D 14.1%, JIA 11.1%, obesity 20%), with a median of 1 missed appointment, respectively. Only a few parents (T1D 8.6%; obesity 13.1%; JIA 5%) reported obstacles regarding health services during the pandemic. To conclude, it seems that access to healthcare was largely preserved for children and adolescents with chronic health conditions during the COVID-19 pandemic in Germany.
Background: High-intensity muscle actions have the potential to temporarily improve the performance which has been denoted as postactivation performance enhancement.
Objectives: This study determined the acute effects of different stretch-shortening (fast vs. low) and strength (dynamic vs. isometric) exercises executed during one training session on subsequent balance performance in youth weightlifters.
Materials and Methods: Sixteen male and female young weightlifters, aged 11.3±0.6years, performed four strength exercise conditions in randomized order, including dynamic strength (DYN; 3 sets of 3 repetitions of 10 RM) and isometric strength exercises (ISOM; 3 sets of maintaining 3s of 10 RM of back-squat), as well as fast (FSSC; 3 sets of 3 repetitions of 20-cm drop-jumps) and slow (SSSC; 3 sets of 3 hurdle jumps over a 20-cm obstacle) stretch-shortening cycle protocols. Balance performance was tested before and after each of the four exercise conditions in bipedal stance on an unstable surface (i.e., BOSU ball with flat side facing up) using two dependent variables, i.e., center of pressure surface area (CoP SA) and velocity (CoP V).
Results: There was a significant effect of time on CoP SA and CoP V [F(1,60)=54.37, d=1.88, p<0.0001; F(1,60)=9.07, d=0.77, p=0.003]. In addition, a statistically significant effect of condition on CoP SA and CoP V [F(3,60)=11.81, d=1.53, p<0.0001; F(3,60)=7.36, d=1.21, p=0.0003] was observed. Statistically significant condition-by-time interactions were found for the balance parameters CoP SA (p<0.003, d=0.54) and CoP V (p<0.002, d=0.70). Specific to contrast analysis, all specified hypotheses were tested and demonstrated that FSSC yielded significantly greater improvements than all other conditions in CoP SA and CoP V [p<0.0001 (d=1.55); p=0.0004 (d=1.19), respectively]. In addition, FSSC yielded significantly greater improvements compared with the two conditions for both balance parameters [p<0.0001 (d=2.03); p<0.0001 (d=1.45)].
Conclusion: Fast stretch-shortening cycle exercises appear to be more effective to improve short-term balance performance in young weightlifters. Due to the importance of balance for overall competitive achievement in weightlifting, it is recommended that young weightlifters implement dynamic plyometric exercises in the fast stretch-shortening cycle during the warm-up to improve their balance performance.
The effects of static stretching (StS) on subsequent strength and power activities has been one of the most debated topics in sport science literature over the past decades. The aim of this review is (1) to summarize previous and current findings on the acute effects of StS on muscle strength and power performances; (2) to update readers’ knowledge related to previous caveats; and (3) to discuss the underlying physiological mechanisms of short-duration StS when performed as single-mode treatment or when integrated into a full warm-up routine. Over the last two decades, StS has been considered harmful to subsequent strength and power performances. Accordingly, it has been recommended not to apply StS before strength- and power-related activities. More recent evidence suggests that when performed as a single-mode treatment or when integrated within a full warm-up routine including aerobic activity, dynamic-stretching, and sport-specific activities, short-duration StS (≤60 s per muscle group) trivially impairs subsequent strength and power activities (∆1–2%). Yet, longer StS durations (>60 s per muscle group) appear to induce substantial and practically relevant declines in strength and power performances (∆4.0–7.5%). Moreover, recent evidence suggests that when included in a full warm-up routine, short-duration StS may even contribute to lower the risk of sustaining musculotendinous injuries especially with high-intensity activities (e.g., sprint running and change of direction speed). It seems that during short-duration StS, neuromuscular activation and musculotendinous stiffness appear not to be affected compared with long-duration StS. Among other factors, this could be due to an elevated muscle temperature induced by a dynamic warm-up program. More specifically, elevated muscle temperature leads to increased muscle fiber conduction-velocity and improved binding of contractile proteins (actin, myosin). Therefore, our previous understanding of harmful StS effects on subsequent strength and power activities has to be updated. In fact, short-duration StS should be included as an important warm-up component before the uptake of recreational sports activities due to its potential positive effect on flexibility and musculotendinous injury prevention. However, in high-performance athletes, short-duration StS has to be applied with caution due to its negligible but still prevalent negative effects on subsequent strength and power performances, which could have an impact on performance during competition.
Children’s physical fitness development and related moderating effects of age and sex are well documented, especially boys’ and girls’ divergence during puberty. The situation might be different during prepuberty. As girls mature approximately two years earlier than boys, we tested a possible convergence of performance with five tests representing four components of physical fitness in a large sample of 108,295 eight-year old third-graders. Within this single prepubertal year of life and irrespective of the test, performance increased linearly with chronological age, and boys outperformed girls to a larger extent in tests requiring muscle mass for successful performance. Tests differed in the magnitude of age effects (gains), but there was no evidence for an interaction between age and sex. Moreover, “physical fitness” of schools correlated at r = 0.48 with their age effect which might imply that "fit schools” promote larger gains; expected secular trends from 2011 to 2019 were replicated.
Age-related decline in executive functions and postural control due to degenerative processes in the central nervous system have been related to increased fall-risk in old age. Many studies have shown cognitive-postural dual-task interference in old adults, but research on the role of specific executive functions in this context has just begun. In this study, we addressed the question whether postural control is impaired depending on the coordination of concurrent response-selection processes related to the compatibility of input and output modality mappings as compared to impairments related to working-memory load in the comparison of cognitive dual and single tasks. Specifically, we measured total center of pressure (CoP) displacements in healthy female participants aged 19–30 and 66–84 years while they performed different versions of a spatial one-back working memory task during semi-tandem stance on an unstable surface (i.e., balance pad) while standing on a force plate. The specific working-memory tasks comprised: (i) modality compatible single tasks (i.e., visual-manual or auditory-vocal tasks), (ii) modality compatible dual tasks (i.e., visual-manual and auditory-vocal tasks), (iii) modality incompatible single tasks (i.e., visual-vocal or auditory-manual tasks), and (iv) modality incompatible dual tasks (i.e., visual-vocal and auditory-manual tasks). In addition, participants performed the same tasks while sitting. As expected from previous research, old adults showed generally impaired performance under high working-memory load (i.e., dual vs. single one-back task). In addition, modality compatibility affected one-back performance in dual-task but not in single-task conditions with strikingly pronounced impairments in old adults. Notably, the modality incompatible dual task also resulted in a selective increase in total CoP displacements compared to the modality compatible dual task in the old but not in the young participants. These results suggest that in addition to effects of working-memory load, processes related to simultaneously overcoming special linkages between input- and output modalities interfere with postural control in old but not in young female adults. Our preliminary data provide further evidence for the involvement of cognitive control processes in postural tasks.
Alcohol in the Aging Brain
(2019)
As our society grows older new challenges for medicine and healthcare emerge. Agerelated changes of the body have been observed in essential body functions, particularly in the loco-motor system, in the cardiovascular system and in cognitive functions concerning both brain plasticity and changes in behavior. Nutrition and lifestyle, such as nicotine intake and chronic alcohol consumption, also contribute to biological changes in the brain. This review addresses the effect of alcohol consumption on cognitive decline, changes in brain plasticity in the aging brain and on cardiovascular health in aging. Thus, studies on the interplay of chronic alcohol intake and either cognitive decline or cognitive preservation are outlined. Because of the inconsistency in the literature of whether alcohol consumption preserves cognitive functions in the aging brain or whether it accelerates cognitive decline, it is crucial to consider individual contributing factors such as culture, health and lifestyle in future studies.
Background
Eating in absence of hunger is quite common and often associated with an increased energy intake co-existent with a poorer food choice. Intuitive eating (IE), i.e., eating in accordance with internal hunger and satiety cues, may protect from overeating. IE, however, requires accurate perception and processing of one’s own bodily signals, also referred to as interoceptive sensitivity. Training interoceptive sensitivity might therefore be an effective method to promote IE and prevent overeating. As most studies on eating behavior are conducted in younger adults and close social relationships influence health-related behavior, this study focuses on middle-aged and older couples.
Methods
The present pilot randomized intervention study aims at investigating the feasibility and effectiveness of a 21-day mindfulness-based training program designed to increase interoceptive sensitivity. A total of N = 60 couples participating in the NutriAct Family Study, aged 50–80 years, will be recruited. This randomized-controlled intervention study comprises three measurement points (pre-intervention, post-intervention, 4-week follow-up) and a 21-day training that consists of daily mindfulness-based guided audio exercises (e.g., body scan). A three-arm intervention study design is applied to compare two intervention groups (training together as a couple vs. training alone) with a control group (no training). Each measurement point includes the assessment of self-reported and objective indicators of interoceptive sensitivity (primary outcome), self-reported indicators of intuitive and maladaptive eating (secondary outcomes), and additional variables. A training evaluation applying focus group discussions will be conducted to assess participants’ overall acceptance of the training and its feasibility.
Discussion
By investigating the feasibility and effectiveness of a mindfulness-based training program to increase interoceptive sensitivity, the present study will contribute to a deeper understanding of how to promote healthy eating in older age.