Refine
Has Fulltext
- no (47)
Year of publication
- 2022 (47) (remove)
Document Type
- Article (47) (remove)
Is part of the Bibliography
- yes (47)
Keywords
- exercise (3)
- Physical activity (2)
- Telehealth (2)
- Telemedicine (2)
- loading rate (2)
- psychosocial moderators (2)
- training (2)
- 3D motion (1)
- Adaptive Force (1)
- Aging (1)
- Akzeptanz (1)
- Athleten (1)
- Athletes (1)
- Attention (1)
- Bathyarchaea (1)
- Body mass index (1)
- Body-Mass-Index (1)
- COVID-19 (1)
- Childhood and adolescence (1)
- Children (1)
- Cognitive skills (1)
- Coronavirus disease 2019 (1)
- Developmental delay (1)
- Digital Health (1)
- Electromyography (1)
- Electronic Health (1)
- Elite sports (1)
- Europe (1)
- Exercise addiction (1)
- Exercise behavior (1)
- External loading (1)
- Gewichtsreduktion (1)
- Ground reaction force (1)
- HIV (1)
- Hazardous alcohol use (1)
- Health inequalities (1)
- ICER (1)
- Kindergarten (1)
- Kindes- und Jugendalter (1)
- Kinematic (1)
- Kinetic (1)
- Körperliche Aktivität (1)
- Lebensstilintervention (1)
- Leistungssport (1)
- Lifestyle intervention (1)
- Media (1)
- Medien (1)
- Mental (1)
- Mental health (1)
- Metabolically healthy obesity (1)
- Mobile Health (1)
- Motor skills (1)
- Muscle strength (1)
- Nursing home (1)
- Nutzung (1)
- Peptide fermentation (1)
- Physical training (1)
- Physician shortage (1)
- Psychische Erkrankungen (1)
- Psychische Gesundheit (1)
- Psychpathology (1)
- Quarantine (1)
- RSI (1)
- Regional deprivation (1)
- Rurality (1)
- Siberia (1)
- Spatial analysis (1)
- Telemedizin (1)
- Telerehabilitation (1)
- Thermokarst (1)
- Video consultations (1)
- Weight loss (1)
- Weighted running (1)
- acceptance (1)
- acute effects (1)
- acute exercise (1)
- affective intervention (1)
- alcohol (1)
- allostatic load index (1)
- anxiety (1)
- app (1)
- applied physiology (1)
- atherosclerosis (1)
- athletic performance (1)
- back-pain screening (1)
- ballistic training (1)
- bibliometric analysis (1)
- capture (1)
- cardiorespiratory fitness (1)
- cardiovascular (1)
- cardiovascular disease (1)
- carotid intima-media thickness (1)
- chronic effects (1)
- cognition (1)
- cognitive impairment (1)
- community child health (1)
- competence (1)
- congested calendar (1)
- core (1)
- cross-national (1)
- decision processes (1)
- depression (1)
- digitalization in (1)
- disease (1)
- disorders (1)
- drug and alcohol abuse (1)
- dual career (1)
- echo intensity (1)
- electroencephalography (EEG) (1)
- elite sport (1)
- emotional imagery (1)
- emotions (1)
- environmental factors (1)
- epidemiology (mental health) (1)
- exercise-cognition (1)
- flat feet (1)
- flat foot (1)
- free moment (1)
- gait (1)
- general practitioners (1)
- geriatrics (1)
- hair cortisol (1)
- health cost (1)
- health policy (1)
- heart failure (1)
- high-intensity interval training (1)
- holding capability (1)
- holding isometric muscle action (HIMA) (1)
- housing (1)
- hypocortisolemic symptom triad (1)
- hypoxic conditioning (1)
- inter-brain synchronization (1)
- inter-muscle-brain synchronization (1)
- interindividual differences (1)
- international studies (1)
- interpersonal muscle action (1)
- juvenile obesity (1)
- lactate (1)
- language (1)
- longitudinal analysis (1)
- low back pain (1)
- lower limb mechanics (1)
- manual muscle test (1)
- maximal isometric Adaptive Force (1)
- mechanisms (1)
- mechanomyography (MMG) (1)
- metabolic disease (1)
- middle-aged adults (1)
- mobile app; (1)
- monitoring (1)
- motor control (1)
- movement (1)
- multicollinearity (1)
- muscle (1)
- muscle quality (1)
- muscle strength (1)
- muscle-to-fat ratio (1)
- musculoskeletal and neural physiological phenomena (1)
- neuromuscular adaptation (1)
- obesity (1)
- of life (1)
- older adults (1)
- optimal load (1)
- orthopaedic (1)
- orthopädische Rehabilitation (1)
- overreaching (1)
- overtraining (1)
- perturbation (1)
- phase angle (1)
- physical activity; (1)
- pleasant and unpleasant imagery (1)
- primary care (1)
- prognosis (1)
- progression (1)
- public health (1)
- pushing isometric muscle action (PIMA) (1)
- quality (1)
- race (1)
- real options (1)
- recovery (1)
- rehabilitation (1)
- relationship (1)
- research framework (1)
- resistance training (1)
- rural-urban factors (1)
- sarcopenia (1)
- sarcopenic obesity (1)
- school performance (1)
- self-diagnosis (1)
- self-triage (1)
- ski jumping (1)
- sportsmen (1)
- sprint interval training (1)
- strength training (1)
- stress types (1)
- subclinical (1)
- subliminal priming (1)
- symptom checker (1)
- symptom checker apps (1)
- talent identification (1)
- tele-rehabilitation (1)
- telemedicine (1)
- telemonitoring (1)
- therapy (1)
- time (1)
- training intervention (1)
- translation-reliability (1)
- trunk stability (1)
- unstable walkway (1)
- upper secondary school (1)
- use (1)
- wavelet coherence (1)
- yellow flags (1)
- youth sports [MeSH] (1)
Institute
- Department Sport- und Gesundheitswissenschaften (47) (remove)
Ziel der Studie: Die langfristige Nutzung telemedizinischer Angebote hängt nicht nur von deren Wirksamkeit, sondern auch von der Akzeptanz und Zufriedenheit der Patienten ab. Für eine telemedizinische Bewegungstherapie für Patienten nach Implantation einer Knie- oder Hüft-Totalendoprothese und erfolgter Anschlussrehabilitation wurde die Wirksamkeit bereits in einer randomisiert kontrollierten Studie untersucht. Dieser Beitrag fokussiert die Akzeptanz und das Nutzungsverhalten der Patienten hinsichtlich des eingesetzten telerehabilitativen Systems.
Methodik: Zur Erfassung der Technikakzeptanz wurden 48 Patienten (53±7 Jahre; 26 Frauen; 35 Hüft-/13 Knie-TEP) im Anschluss an eine dreimonatige telemedizinische Bewegungstherapie mittels des Telehealth Usability Questionnaire befragt. Der Fragebogen besteht aus 21 Items (siebenstufige Likert-Skala) in sechs Skalen (z. B. Nützlichkeit, Qualität der Interaktionen, Verlässlichkeit). In einer zusätzlichen Skala wurden systemspezifische Fragen zusammengefasst. Die Ergebnisse wurden als Skalenprozent (100 ≙ vollkommene Zustimmung) dargestellt. Das Nutzungsverhalten wurde anhand systemgenerierter Prozessdaten zum Training sowie zu integrierten Sprach-/Textnachrichten untersucht.
Ergebnisse: Die TUQ-Skalen „Nützlichkeit“ (Mdn 95,2) sowie „Benutzerfreundlichkeit und Erlernbarkeit“ (Mdn 92,9) wurden am höchsten bewertet, während die „Verlässlichkeit“ (Mdn 57,1) und „Qualität der Interaktionen“ (Mdn 71,4) die geringsten Ausprägungen zeigten. Die systemspezifische Skala wurde im oberen Quartil eingeordnet (Mdn 85,7).
In der ersten Woche führten 39 Patienten (81%), in der zweiten 45 Patienten (94%) mindestens eine Trainingsübung mit dem System durch. Der Anteil aktiver Patienten (≥1 Übung/Woche) reduzierte sich im weiteren Verlauf auf 75% (n=36) in der 7. Woche und 48% (n=23) in der 12. Woche. Die systemeigenen Kommunikationsmöglichkeiten wurden nach Therapiestart zunächst häufig genutzt: in der ersten Woche sendeten 42 Patienten (88%) Nachrichten, 47 Patienten (98%) erhielten Nachrichten von ihrem Therapeuten. In der 7. Woche sendeten/erhielten 9 (19%) bzw. 13 (27%) Patienten Nachrichten über das System.
Schlussfolgerung: Die Patienten nahmen die telemedizinische Bewegungstherapie überwiegend als nützlich und benutzerfreundlich wahr und schienen im Wesentlichen mit dem System zufrieden, das sich damit für den kurzfristigen Einsatz von 6 bis 8 Wochen im Anschluss an eine Anschlussrehabilitation als gut geeignet zeigte.
Intervention in the form of core-specific stability exercises is evident to improve trunk stability. The purpose was to assess the effect of an additional 6 weeks sensorimotor or resistance training on maximum isokinetic trunk strength and response to sudden dynamic trunk loading (STL) in highly trained adolescent athletes. The study was conducted as a single-blind, 3-armed randomized controlled trial. Twenty-four adolescent athletes (14f/10 m, 16 +/- 1 yrs.;178 +/- 10 cm; 67 +/- 11 kg; training sessions/week 15 +/- 5; training h/week 22 +/- 8) were randomized into resistance training (RT; n = 7), sensorimotor training (SMT; n = 10), and control group (CG; n = 7). Athletes were instructed to perform standardized, center-based training for 6 weeks, two times per week, with a duration of 1 h each session. SMT consisted of four different core-specific sensorimotor exercises using instable surfaces. RT consisted of four trunk strength exercises using strength training machines, as well as an isokinetic dynamometer. All participants in the CG received an unspecific heart frequency controlled, ergometer-based endurance training (50 min at max. heart frequency of 130HF). For each athlete, each training session was documented in an individual training diary (e.g., level of SMT exercise; 1RM for strength exercise, pain). At baseline (M1) and after 6 weeks of intervention (M2), participants' maximum strength in trunk rotation (ROM:63 degrees) and flexion/extension (ROM:55 degrees) was tested on an isokinetic dynamometer (concentric/eccentric 30 degrees/s). STL was assessed in eccentric (30 degrees/s) mode with additional dynamometer-induced perturbation as a marker of core stability. Peak torque [Nm] was calculated as the main outcome. The primary outcome measurements (trunk rotation/extension peak torque: con, ecc, STL) were statistically analyzed by means of the two-factor repeated measures analysis of variance (alpha = 0.05). Out of 12 possible sessions, athletes participated between 8 and 9 sessions (SMT: 9 +/- 3; RT: 8 +/- 3; CG: 8 +/- 4). Regarding main outcomes of trunk performance, experimental groups showed no significant pre-post difference for maximum trunk strength testing as well as for perturbation compensation (p > 0.05). It is concluded, that future interventions should exceed 6 weeks duration with at least 2 sessions per week to induce enhanced trunk strength or compensatory response to sudden, high-intensity trunk loading in already highly trained adolescent athletes, regardless of training regime.
Background and Objectives: Low back pain is a worldwide health problem. An early diagnosis is required to develop personalized treatment strategies. The Risk Stratification Index (RSI) was developed to serve the purpose. The aim of this pilot study is to cross-culturally translate the RSI to a French version (RSI-F) and evaluate the test-retest reliability of RSI-F using a French active population. Materials and Methods: The RSI was translated from German to French (RSI-F) based on the guidelines of cross-cultural adaptation of self-report measures. A total of 42 French recreational athletes (age 18–63 years) with non-specific low back pain were recruited and filled in the RSI-F twice. The test-retest reliability was examined using intraclass correlation coefficient (ICC1,2) and Pearson correlation coefficient. Results: Finally, 33 questionnaires were analyzed (14 males and 19 females, age 31 ± 10 years, 9.5 ± 3.2 h/week of training). The test-retest of RSI-F CPI and DISS were excellent (CPI: ICC1,2 = 0.989, p < 0.001; r = 0.989, p < 0.001; DISS: ICC1,2 = 0.991, p < 0.001; r = 0.991, p < 0.001), as well as Korff pain intensity (ICC1,2 = 0.995, p < 0.001; r = 0.995, p < 0.001) and disability (ICC1,2 = 0.998, p < 0.001; r = 0.998, p < 0.001). Conclusion: The RSI-F is linguistically accurate and reliable for use by a French-speaking active population with non-specific low back pain. The RSI-F is considered a tool to examine the evolution of psychosocial factors and therefore the risk of chronicity and the prognostic of pain. Further evaluations, such as internal, external validity, and responsiveness should be evaluated in a larger population.
Muscle quality defined as the ratio of muscle strength to muscle mass disregards underlying factors which influence muscle strength. The aim of this review was to investigate the relationship of phase angle (PhA), echo intensity (EI), muscular adipose tissue (MAT), muscle fiber type, fascicle pennation angle (θf), fascicle length (lf), muscle oxidative capacity, insulin sensitivity (IS), neuromuscular activation, and motor unit to muscle strength. PubMed search was performed in 2021. The inclusion criteria were: (i) original research, (ii) human participants, (iii) adults (≥18 years). Exclusion criteria were: (i) no full-text, (ii) non-English or -German language, (iii) pathologies. Forty-one studies were identified. Nine studies found a weak–moderate negative (range r: [−0.26]–[−0.656], p < 0.05) correlation between muscle strength and EI. Four studies found a weak–moderate positive correlation (range r: 0.177–0.696, p < 0.05) between muscle strength and PhA. Two studies found a moderate-strong negative correlation (range r: [−0.446]–[−0.87], p < 0.05) between muscle strength and MAT. Two studies found a weak-strong positive correlation (range r: 0.28–0.907, p < 0.05) between θf and muscle strength. Muscle oxidative capacity was found to be a predictor of muscle strength. This review highlights that the current definition of muscle quality should be expanded upon as to encompass all possible factors of muscle quality.
In recent years digital technologies have become a major means for providing health-related services and this trend was strongly reinforced by the current Coronavirus disease 2019 (COVID-19) pandemic. As it is well-known that regular physical activity has positive effects on individual physical and mental health and thus is an important prerequisite for healthy aging, digital technologies are also increasingly used to promote unstructured and structured forms of physical activity. However, in the course of this development, several terms (e.g., Digital Health, Electronic Health, Mobile Health, Telehealth, Telemedicine, and Telerehabilitation) have been introduced to refer to the application of digital technologies to provide health-related services such as physical interventions. Unfortunately, the above-mentioned terms are often used in several different ways, but also relatively interchangeably. Given that ambiguous terminology is a major source of difficulty in scientific communication which can impede the progress of theoretical and empirical research, this article aims to make the reader aware of the subtle differences between the relevant terms which are applied at the intersection of physical activity and Digital Health and to provide state-of-art definitions for them.
Hintergrund
Steigende Adipositasprävalenzen im Kindes- und Jugendalter sind geprägt von ungesunden Lebensweisen wie geringer Bewegung durch hohen Medienkonsum. Neueste Studien nutzen die Erreichbarkeit dieser Zielgruppe durch digitale Medien, womit Technologien neue Ansätze in der Interventionsgestaltung der Gewichtsreduktion darstellen. Allerdings stellt sich die Frage, welche digitalen Kombinationen und methodischen Programmkonzepte effektive Body-Mass-Index(BMI)-Veränderungen bedingen.
Ziel
Um Erkenntnisse über effektive Maßnahmengestaltung und Medieneinsatz zu gewinnen, sollen digitale Interventionsstrategien zur BMI-Reduktion übergewichtiger Kinder und Jugendlicher analysiert und bewertet werden.
Methoden
Ein systematischer Review wurde in den Datenbanken Medline via PubMed, Science Direct und Web of Science zur Analyse von Studien aus den Jahren 2016 bis 2021 über Veränderungen im BMI und BMI-Z-Score von übergewichtigen und adipösen 6‑ bis 18-Jährigen durchgeführt. Die methodische Studienqualität wurde nach den Richtlinien des Cochrane Risk of Bias bewertet.
Ergebnisse
Aus 3974 Studien wurden 7 Artikel identifiziert, die den Einsatz von Fitnessarmbändern, Smartphones und computerbasierten Programmen beschreiben. Alle Medien erzielten BMI-Reduktionen, wobei Smartphoneinterventionen via Anrufe und Nachrichten die signifikantesten Veränderungen bewirkten.
Diskussion
Smartphones bieten als Anbieter digitaler Programme (z. B. Apps) effektive Ansatzpunkte zur Adipositasreduktion. Auf Basis der Datenlage bestätigt sich neben der Auswahl und der Kombination mehrerer Medien die Relevanz des Familieneinbezugs und die methodische Fundierung der Maßnahmen. Aufgrund des jungen Alters der Teilnehmenden müssen mediale Interventionen zielgruppengerecht zugänglich gemacht werden.
Einleitung
Mehr als ein Drittel der PatientInnen im berufsfähigen Alter in der kardiologischen Anschlussrehabilitation (AR) sind von besonderen beruflichen Problemlagen (BBPL) betroffen. Die BBPL sind durch eine negative subjektive Erwerbsprognose (SE) determiniert, die wiederum auf eine deutlich reduzierte Wahrscheinlichkeit der beruflichen Wiedereingliederung hindeutet. Diese Studie hatte die Exploration von persönlich bestimmenden Faktoren der SE zum Ziel, um Impulse für die patientInnenzentrierte Betreuung in der AR ableiten zu können.
Methoden
Die monozentrische explorative qualitative Studie basierte auf leitfadengestützten Einzelinterviews mit PatientInnen der kardiologischen AR. Hierfür wurden 20 PatientInnen mit BBPL (Hauptstichprobe) und 5 ohne BBPL (Kontraststichprobe) in QIV/2021 eingeschlossen. Die Stichprobenauswahl erfolgte nach dem Prinzip des theoretischen Samplings mit sich überschneidender Rekrutierungs- und Auswertungsphase. Die Auswertung erfolgte mittels thematischer Analyse, wobei die Interviews sinngemäß auf Aussagen (Codes) reduziert und anschließend in Schlüsselthemen zusammengefasst wurden.
Ergebnisse
Insgesamt wurden sieben Schlüsselthemen generiert. Die ersten beiden umfassen (1) umwelt- und (2) personenbezogene Aspekte (z. B. (1): Personalsituation, Auswirkungen der Pandemie; (2) Selbstwahrnehmung, Arbeitsplatzeinflüsse). Die weiteren Themen schließen (4) krankheitsbezogene Vorerfahrungen (z. B. Erfahrungen mit Gesundheitssystem, familiäre Prädisposition) und (5) Zukunftsvorstellungen (z. B. Prioritätenänderung, Rauchentwöhnung) ein. Darüber hinaus wurden drei spezifische Themen identifiziert: (5) die Gesundheitswahrnehmung einschließlich der empfundenen Belastbarkeit, (6) die Veränderbarkeit der Arbeitsbedingungen und (7) die Angst, wieder zu erkranken. Alle befragten RehabilitandInnen planten die Rückkehr in die Berufstätigkeit sowie umfassende Veränderungen des Gesundheitsverhaltens im Privatleben und am Arbeitsplatz.
Schlussfolgerung
Im Zusammenhang mit der BBPL wurden psychosoziale Aspekte deutlich häufiger thematisiert als medizinische. Auffallend war zudem, dass alle befragten RehabilitandInnen den beruflichen Wiedereinstieg planten, auch bei negativer SE. Diese wurde durch Faktoren bestimmt, die als Folge einer Neubewertung der persönlichen Prioritäten nach stattgehabten Akutereignis zu betrachten sind. Zur Unterstützung der Krankheitsverarbeitung sowie zur Förderung der Teilhabe einschließlich des Wiedereinstiegs in das Berufsleben scheint die interprofessionelle Erarbeitung eines individuell-differenzierten Handlungsplans mit Nachsorgeoptionen in der kardiologischen AR für die betroffenen PatientInnen sinnvoll.
Stress and pain
(2022)
Introduction: Low back pain (LBP) leads to considerable impairment of quality of life worldwide and is often accompanied by psychosomatic symptoms.
Objectives: First, to assess the association between stress and chronic low back pain (CLBP) and its simultaneous appearance with fatigue and depression as a symptom triad. Second, to identify the most predictive stress-related pattern set for CLBP for a 1-year diagnosis.
Methods: In a 1-year observational study with four measurement points, a total of 140 volunteers (aged 18–45 years with intermittent pain) were recruited. The primary outcomes were pain [characteristic pain intensity (CPI), subjective pain disability (DISS)], fatigue, and depressive mood. Stress was assessed as chronic stress, perceived stress, effort reward imbalance, life events, and physiological markers [allostatic load index (ALI), hair cortisol concentration (HCC)]. Multiple linear regression models and selection procedures for model shrinkage and variable selection (least absolute shrinkage and selection operator) were applied. Prediction accuracy was calculated by root mean squared error (RMSE) and receiver-operating characteristic curves.
Results: There were 110 participants completed the baseline assessments (28.2 7.5 years, 38.1% female), including HCC, and a further of 46 participants agreed to ALI laboratory measurements. Different stress types were associated with LBP, CLBP, fatigue, and depressive mood and its joint occurrence as a symptom triad at baseline; mainly social-related stress types were of relevance. Work-related stress, such as “excessive demands at work”[b = 0.51 (95%CI -0.23, 1.25), p = 0.18] played a role for upcoming chronic pain disability. “Social overload” [b = 0.45 (95%CI -0.06, 0.96), p = 0.080] and “over-commitment at work” [b = 0.28 (95%CI -0.39, 0.95), p = 0.42] were associated with an upcoming depressive mood within 1-year. Finally, seven psychometric (CPI: RMSE = 12.63; DISS: RMSE = 9.81) and five biomarkers (CPI: RMSE = 12.21; DISS: RMSE = 8.94) could be derived as the most predictive pattern set for a 1-year prediction of CLBP. The biomarker set showed an apparent area under the curve of 0.88 for CPI and 0.99 for DISS.
Conclusion: Stress disrupts allostasis and favors the development of chronic pain, fatigue, and depression and the emergence of a “hypocortisolemic symptom triad,” whereby the social-related stressors play a significant role. For translational medicine, a predictive pattern set could be derived which enables to diagnose the individuals at higher risk for the upcoming pain disorders and can be used in practice.
Forced to stay at home
(2022)
The effects of COVID-19-related lockdowns on deterioration of mental health and use of exercise to remediate such effects has been well documented in numerous populations. However, it remains unknown how lockdown restrictions impacted individuals differently and who was more likely to change their exercise behavior and experience negative well-being. The current study examined exercise dependence as a risk factor and its impact on exercise behavior and mood during the initial COVID-19 lockdowns on a global scale in 11,898 participants from 17 countries. Mixed effects models revealed that reducing exercise behavior was associated with a stronger decrease in mood for individuals at risk of exercise dependence compared to individuals at low risk of exercise dependence. Participants at high risk and exercising more prior to the pandemic reported the most exercise during lockdown. Effects of lowered mood were most pronounced in participants with high risk of exercise dependence who reported greater reduction in exercise frequency during lockdown. These results support recent etiological evidence for exercise dependence and add to a growing body of literature documenting mental health effects related to COVID-19.
Purpose
This randomised controlled trial examined the effect of an 8-week volume-equated programme of Nordic hamstring exercise (NHE) training, executed at frequencies of 1- or 2-days per week, on fitness (10 m and 40 m sprint, '505' change of direction [COD] and standing long jump [SLJ]) in male youth soccer players (mean age: 16.4 0.81 years).
Method
Players were divided into an experimental group (n = 16) which was further subdivided into 1-day (n = 8) and 2-day (n = 8) per week training groups and a control group (n = 8).
Results
There were significant group-by-time interactions for 10-m sprint (p<0.001, eta(2) = 0.120, d = 2.05 [0.57 to 3.53]), 40-m sprint (p = 0.001, eta(2) = 0.041, d = 1.09 [-0.23 to 2.4]) and COD (p = 0.002, eta(2) = 0.063, d = 1.25 [-0.09 to 2.59). The experimental group demonstrated a 'very large' effect size (d = 3.02 [1.5 to 4.54]) in 10-m sprint, and 'large' effect sizes in 40-m sprint (d = 1.94 [0.98 to 2.90]) and COD (d = 1.84 [0.85 to 2.83). The control group showed no significant changes. There were no significant differences between the 1-day and 2-day training groups. In three of the four tests (40 m, COD, SLJ) the 2-day group demonstrated larger effect sizes. Ratings of perceived exertion (RPE) were significantly lower in the 2-day group (p<0.001, 3.46 [1.83 to 5.04).
Conclusion
The NHE increases fitness in youth soccer players and there may be advantages to spreading training over two days instead of one.
Effects of intermittent hypoxia-hyperoxia on performance- and health-related outcomes in humans
(2022)
Background:
Intermittent hypoxia applied at rest or in combination with exercise promotes multiple beneficial adaptations with regard to performance and health in humans. It was hypothesized that replacing normoxia by moderate hyperoxia can increase the adaptive response to the intermittent hypoxic stimulus.
Objective:
Our objective was to systematically review the current state of the literature on the effects of chronic intermittent hypoxia-hyperoxia (IHH) on performance- and health-related outcomes in humans.
Methods:
PubMed, Web of Science (TM), Scopus, and Cochrane Library databases were searched in accordance with PRISMA guidelines (January 2000 to September 2021) using the following inclusion criteria: (1) original research articles involving humans, (2) investigation of the chronic effect of IHH, (3) inclusion of a control group being not exposed to IHH, and (4) articles published in peer-reviewed journals written in English.
Results:
Of 1085 articles initially found, eight studies were included. IHH was solely performed at rest in different populations including geriatric patients (n = 1), older patients with cardiovascular (n = 3) and metabolic disease (n = 2) or cognitive impairment (n = 1), and young athletes with overtraining syndrome (n = 1). The included studies confirmed the beneficial effects of chronic exposure to IHH, showing improvements in exercise tolerance, peak oxygen uptake, and global cognitive functions, as well as lowered blood glucose levels. A trend was discernible that chronic exposure to IHH can trigger a reduction in systolic and diastolic blood pressure. The evidence of whether IHH exerts beneficial effects on blood lipid levels and haematological parameters is currently inconclusive. A meta-analysis was not possible because the reviewed studies had a considerable heterogeneity concerning the investigated populations and outcome parameters.
Conclusion:
Based on the published literature, it can be suggested that chronic exposure to IHH might be a promising non-pharmacological intervention strategy for improving peak oxygen consumption, exercise tolerance, and cognitive performance as well as reducing blood glucose levels, and systolic and diastolic blood pressure in older patients with cardiovascular and metabolic diseases or cognitive impairment. However, further randomized controlled trials with adequate sample sizes are needed to confirm and extend the evidence. This systematic review was registered on the international prospective register of systematic reviews (PROSPERO-ID: CRD42021281248) (https://www.crd.york.ac.uk/prospero/).
Background
There is evidence that in older adults the combination of strength training (ST) and endurance training (ET) (i.e., concurrent training [CT]) has similar effects on measures of muscle strength and cardiorespiratory endurance (CRE) compared with single-mode ST or ET, respectively. Therefore, CT seems to be an effective method to target broad aspects of physical fitness in older adults.
Objectives
The aim was to examine the effects of CT on measures of physical fitness (i.e., muscle strength, power, balance and CRE) in healthy middle-aged and older adults aged between 50 and 73 years. We also aimed to identify key moderating variables to guide training prescription.
Study Design
We conducted a systematic review with meta-analysis of randomized controlled trials.
Data Sources
The electronic databases PubMed, Web of Science Core Collection, MEDLINE and Google Scholar were systematically searched until February 2022.
Eligibility Criteria for Selecting Studies We included randomized controlled trials that examined the effects of CT versus passive controls on measures of physical fitness in healthy middle-aged and older adults aged between 50 and 73 years.
Results
Fifteen studies were eligible, including a total of 566 participants. CT induced moderate positive effects on muscle strength (standardized mean difference [SMD] = 0.74) and power (SMD = 0.50), with a small effect on CRE (SMD = 0.48). However, no significant effects were detected for balance (p > 0.05). Older adults > 65 years (SMD = 1.04) and females (SMD = 1.05) displayed larger improvements in muscle strength compared with adults <= 65 years old (SMD = 0.60) and males (SMD = 0.38), respectively. For CRE, moderate positive effects (SMD = 0.52) were reported in those <= 65 years old only, with relatively larger gains in females (SMD = 0.55) compared with males (SMD = 0.45). However, no significant differences between all subgroups were detected. Independent single training factor analysis indicated larger positive effects of 12 weeks (SMD = 0.87 and 0.88) compared with 21 weeks (SMD = 0.47 and 0.29) of CT on muscle strength and power, respectively, while for CRE, 21 weeks of CT resulted in larger gains (SMD = 0.62) than 12 weeks (SMD = 0.40). For CT frequency, three sessions per week produced larger beneficial effects (SMD = 0.91) on muscle strength compared with four sessions (SMD = 0.55), whereas for CRE, moderate positive effects were only noted after four sessions per week (SMD = 0.58). A session duration of > 30-60 min generated larger improvements in muscle strength (SMD = 0.99) and power (SMD = 0.88) compared with > 60-90 min (SMD = 0.40 and 0.29, respectively). However, for CRE, longer session durations (i.e., > 60-90 min) seem to be more effective (SMD = 0.61) than shorter ones (i.e., > 30-60 min) (SMD = 0.34). ET at moderate-to-near maximal intensities produced moderate (SMD = 0.64) and small positive effects (SMD = 0.49) on muscle strength and CRE, respectively, with no effects at low intensity ET (p > 0.05). Finally, intra-session ST before ET produced larger gains in muscle strength (SMD = 1.00) compared with separate sessions (SMD = 0.55), whereas ET and ST carried out separately induced larger improvements in CRE (SMD = 0.58) compared with intra-session ET before ST (SMD = 0.49).
Conclusions
CT is an effective method to improve measures of physical fitness (i.e., muscle strength, power, and CRE) in healthy middle-aged and older adults aged between 50 and 73 years, regardless of sex. Results of independent single training factor analysis indicated that the largest effects on muscle strength were observed after 12 weeks of training, > 30-60 min per session, three sessions per week, higher ET intensities and when ST preceded ET within the same session. For CRE, the largest effects were noted after 21 weeks of training, four sessions per week, > 60-90 min per session, higher ET intensities and when ET and ST sessions were performed separately. Regarding muscle power, the largest effects were observed after 12 weeks of training and > 30-60 min per session.
The affective response during exercise is an important factor for long-term exercise adherence. Pottratz et al. suggested affective priming as a behavioral intervention for the enhancement of exercise-related affect. The present paper aims to replicate and extend upon these findings. We conducted a close replication with 53 participants completing a brisk walking task in two conditions (prime vs. no prime). Affective valence was assessed during exercise, and exercise enjoyment and remembered/forecasted pleasure were assessed postexercise. We could not replicate the findings of Pottratz et al., finding no evidence for positive changes in psychological responses in the priming condition. However, linear mixed models demonstrated significant interindividual differences in how participants responded to priming. These results demonstrate that affective priming during exercise does not work for everyone under every circumstance and, thus, provide an important contribution to the understanding of boundary conditions and moderating factors for priming in exercise psychology.
The interaction of physical activity and brain function with respect to what we now
call successful aging has been and remains extensively studied. In general, a wealth of
studies indicates that short- and long-term physical activity can induce neuroplasticity
even in the adult brain, can enhance cognitive performance positively and may reduce the
risk of neurodegenerative diseases. However, the underlying neurobiological mechanisms
of physical activity on the human central nervous systems are not yet fully understood.
Additionally, what type of exercise might be optimal for keeping the brain fit in old age
and whether imagined as opposed to real exercise has the potential to be effective as well
is not yet clear. In this Special Issue of Brain Sciences, six high-quality articles assess the
mentioned open questions.
Studies have evaluated the effectiveness of dual career (DC) support services among student-athletes by examining scholastic performances.
These studies investigated self-reported grades student-athletes or focused on career choices student-athletes made after leaving school. Most of these studies examined scholastic performances cross-sectionally among lower secondary school student-athletes or student-athletes in higher education.
The present longitudinal field study in a quasi-experimental design aims to evaluate the development of scholastic performances among upper secondary school students aged 16-19 by using standardized scholastic assessments and grade points in the subject English over a course of 3-4 years.
A sample of 159 students (54.4% females) at three German Elite Sport Schools (ESS) and three comprehensive schools participated in the study. The sample was split into six groups according to three criteria: (1) students' athletic engagement, (2) school type attendance, and (3) usage of DC support services in secondary school.
Repeated-measurement analyses of variance were conducted in order to evaluate the impact of the three previously mentioned criteria as well as their interaction on the development of scholastic performances.
Findings indicated that the development of English performance levels differ among the six groups.
Wearable resistance allows individualized loading for sport specific movements and can lead to specific strength adaptations benefiting the athlete. The objective was to determine biomechanical changes during running with lower limb light-weight wearable resistance. Fourteen participants (age: 28 +/- 4 years; height: 180 +/- 8 cm; body mass: 77 +/- 6 kg) wore shorts and calf sleeves of a compression suit allowing attachment of light loads. Participants completed four times two mins 20-m over-ground shuttle running bouts at 3.3 m*s(-1) alternated by three mins rest. The first running bout was unloaded and the other three bouts were under randomised loaded conditions (1%, 3% and 5% additional loading of the individual body mass). 3D motion cameras and force plates recorded kinematic and kinetic data at the midpoint of each 20-m shuttle. Friedman-test for repeated measures and linear mixed effect model analysis were used to determine differences between the loading conditions (alpha = 0.05). Increased peak vertical ground reaction force (2.7 N/kg to 2.74 N/kg), ground contact time (0.20 s to 0.21 s) and decreased step length (1.49 m to 1.45 m) were found with additional 5 % body mass loading compared to unloaded running (0.001 > p < 0.007). Marginally more knee flexion and hip extension and less plantarflexion was seen with higher loading. Differences in the assessed parameters were present between each loading condition but accompanied by subject variability. Further studies, also examining long term effects, should be conducted to further inform use of this training tool.
The Influence of acute sprint interval training on cognitive performance of healthy younger adults
(2022)
There is considerable evidence showing that an acute bout of physical exercises can improve cognitive performance, but the optimal exercise characteristics (e.g., exercise type and exercise intensity) remain elusive. In this regard, there is a gap in the literature to which extent sprint interval training (SIT) can enhance cognitive performance. Thus, this study aimed to investigate the effect of a time-efficient SIT, termed as "shortened-sprint reduced-exertion high-intensity interval training" (SSREHIT), on cognitive performance. Nineteen healthy adults aged 20-28 years were enrolled and assessed for attentional performance (via the d2 test), working memory performance (via Digit Span Forward/Backward), and peripheral blood lactate concentration immediately before and 10 min after an SSREHIT and a cognitive engagement control condition (i.e., reading). We observed that SSREHIT can enhance specific aspects of attentional performance, as it improved the percent error rate (F%) in the d-2 test (t (18) = -2.249, p = 0.037, d = -0.516), which constitutes a qualitative measure of precision and thoroughness. However, SSREHIT did not change other measures of attentional or working memory performance. In addition, we observed that the exercise-induced increase in the peripheral blood lactate levels correlated with changes in attentional performance, i.e., the total number of responses (GZ) (r(m) = 0.70, p < 0.001), objective measures of concentration (SKL) (r(m) = 0.73, p < 0.001), and F% (r(m) = -0.54, p = 0.015). The present study provides initial evidence that a single bout of SSREHIT can improve specific aspects of attentional performance and conforming evidence for a positive link between cognitive improvements and changes in peripheral blood lactate levels.
Sarcopenic obesity is increasingly found in youth, but its health consequences remain unclear.
Therefore, we studied the prevalence of sarcopenia and its association with cardiometabolic risk factors as well as muscular and cardiorespiratory fitness using data from the German Children's Health InterventionaL Trial (CHILT III) programme.
In addition to anthropometric data and blood pressure, muscle and fat mass were determined with bioelectrical impedance analysis.
Sarcopenia was classified via muscle-to-fat ratio. A fasting blood sample was taken, muscular fitness was determined using the standing long jump, and cardiorespiratory fitness was determined using bicycle ergometry. Of the 119 obese participants included in the analysis (47.1% female, mean age 12.2 years), 83 (69.7%) had sarcopenia. Affected individuals had higher gamma-glutamyl transferase, higher glutamate pyruvate transaminase, higher high-sensitivity C-reactive protein, higher diastolic blood pressure, and lower muscular and cardiorespiratory fitness (each p < 0.05) compared to participants who were 'only' obese.
No differences were found in other parameters. In our study, sarcopenic obesity was associated with various disorders in children and adolescents.
However, the clinical value must be tested with larger samples and reference populations to develop a unique definition and appropriate methods in terms of identification but also related preventive or therapeutic approaches.
Die Sportpsychiatrie und -psychotherapie ist ein relativ junges Arbeitsgebiet, das sich insbesondere mit zwei Schwerpunkten befasst: zum einen mit den Besonderheiten in Diagnostik und Therapie psychischer Erkrankungen bei Leistungssportler:innen sowie Bewegung und Sport in der Entstehung und Behandlung psychischer Erkrankungen. Während alle psychischen Erkrankungen prinzipiell auch bei (Leistungs‑)Sportler:innen auftreten können, gibt es darüber hinaus sport(art)spezifische psychische Erkrankungen, wie z. B. die Anorexia athletica und andere Essstörungen, die chronisch traumatische Enzephalopathie, Missbrauch und Abhängigkeit von leistungssteigernden Substanzen (Doping) oder die Muskeldysmorphie. In qualitativ hochwertigen klinischen Studien konnte die therapeutische Wirksamkeit von Bewegung und Sport bei verschiedenen psychischen Erkrankungen belegt werden. Ein sportpsychiatrisches Basiswissen sollten alle in Psychiatrie und Psychotherapie klinisch Tätigen besitzen.
The link between emotions and motor function has been known for decades but is still not clarified. The Adaptive Force (AF) describes the neuromuscular capability to adapt to increasing forces and was suggested to be especially vulnerable to interfering inputs. This study investigated the influence of pleasant an unpleasant food imagery on the manually assessed AF of elbow and hip flexors objectified by a handheld device in 12 healthy women. The maximal isometric AF was significantly reduced during unpleasant vs. pleasant imagery and baseline (p < 0.001, dz = 0.98–1.61). During unpleasant imagery, muscle lengthening started at 59.00 ± 22.50% of maximal AF, in contrast to baseline and pleasant imagery, during which the isometric position could be maintained mostly during the entire force increase up to ~97.90 ± 5.00% of maximal AF. Healthy participants showed an immediately impaired holding function triggered by unpleasant imagery, presumably related to negative emotions. Hence, AF seems to be suitable to test instantaneously the effect of emotions on motor function. Since musculoskeletal complaints can result from muscular instability, the findings provide insights into the understanding of the causal chain of linked musculoskeletal pain and mental stress. A case example (current stress vs. positive imagery) suggests that the approach presented in this study might have future implications for psychomotor diagnostics and therapeutics.
Inter-brain synchronization is primarily investigated during social interactions but had not been examined during coupled muscle action between two persons until now. It was previously shown that mechanical muscle oscillations can develop coherent behavior between two isometrically interacting persons. This case study investigated if inter-brain synchronization appears thereby, and if differences of inter- and intrapersonal muscle and brain coherence exist regarding two different types of isometric muscle action. Electroencephalography (EEG) and mechanomyography/mechanotendography (MMG/MTG) of right elbow extensors were recorded during six fatiguing trials of two coupled isometrically interacting participants (70% MVIC). One partner performed holding and one pushing isometric muscle action (HIMA/PIMA; tasks changed). The wavelet coherence of all signals (EEG, MMG/MTG, force, ACC) were analyzed intra- and interpersonally. The five longest coherence patches in 8–15 Hz and their weighted frequency were compared between real vs. random pairs and between HIMA vs. PIMA. Real vs. random pairs showed significantly higher coherence for intra-muscle, intra-brain, and inter-muscle-brain activity (p < 0.001 to 0.019). Inter-brain coherence was significantly higher for real vs. random pairs for EEG of right and central areas and for sub-regions of EEG left (p = 0.002 to 0.025). Interpersonal muscle-brain synchronization was significantly higher than intrapersonal one, whereby it was significantly higher for HIMA vs. PIMA. These preliminary findings indicate that inter-brain synchronization can arise during muscular interaction. It is hypothesized both partners merge into one oscillating neuromuscular system. The results reinforce the hypothesis that HIMA is characterized by more complex control strategies than PIMA. The pilot study suggests investigating the topic further to verify these results on a larger sample size. Findings could contribute to the basic understanding of motor control and is relevant for functional diagnostics such as the manual muscle test which is applied in several disciplines, e.g., neurology, physiotherapy.
Background:
From birth to young adulthood, health and development of young people are strongly linked to their living situation, including their family's socioeconomic position (SEP) and living environment. The impact of regional characteristics on development in early childhood beyond family SEP has been rarely investigated. This study aimed to identify regional predictors of global developmental delay at school entry taking family SEP into consideration.
Method:
We used representative, population-based data from mandatory school entry examinations of the German federal state of Brandenburg in 2018/2019 with n=22,801 preschool children. By applying binary multilevel models, we hierarchically analyzed the effect of regional deprivation defined by the German Index of Socioeconomic Deprivation (GISD) and rurality operationalized as inverted population density of the children's school district on global developmental delay (GDD) while adjusting for family SEP (low, medium and high)
Results:
Family SEP was significantly and strongly linked to GDD. Children with the highest family SEP showed a lower odds for GDD compared to a medium SEP (female: OR=4.26, male: OR=3.46) and low SEP (female: OR=16.58, male: OR=12.79). Furthermore, we discovered a smaller, but additional and independent effect of regional socioeconomic deprivation on GDD, with a higher odds for children from a more deprived school district (female: OR=1.35, male: OR=1.20). However, rurality did not show a significant link to GDD in preschool children beyond family SEP and regional deprivation.
Conclusion:
Family SEP and regional deprivation are risk factors for child development and of particular interest to promote health of children in early childhood and over the life course.
Sedentarism is a risk factor for depression and anxiety. People living with the human immunodeficiency virus (PLWH) have a higher prevalence of anxiety and depression compared to HIV-negative individuals. This cross-sectional study (n = 450, median age 44 (19-75), 7.3% females) evaluates the prevalence rates and prevalence ratio (PR) of anxiety and/or depression in PLWH associated with recreational exercise. A decreased likelihood of having anxiety (PR=0.57; 0.36-0.91; p = 0.01), depression (PR=0.41; 0.36-0.94; p=0.01), and comorbid anxiety and depression (PR = 0,43; 0.24-0.75; p=0.002) was found in exercising compared to non-exercising PLWH. Recreational exercise is associated with a lower risk for anxiety and/or depression. Further prospective studies are needed to provide insights on the direction of this association.
Introduction: The implementation of medical video consultations in nursing homes can support primary care in rural areas and counteract the shortage of physicians. So far, video consultations have been limited to pilot projects and have not yet been comprehensively implemented. The present study addresses potentials of video consultations and challenges that may arise during the implementation of medical video consultations. Methods: Twenty-one guided interviews (pre-implementation: n = 13; post-implementation: n = 8) were conducted with a total of 13 participants (physicians, nurses and medical technical assistants). The data was analyzed using qualitative content analysis. The results were contrasted in a pre-post analysis. Results: Almost all of the interviewees' expectations regarding video consultations described prior to implementation have been met: time savings, improved communication, reduction of information breaks and increase in the quality of care. After implementation, other unexpected advantages of telemedical care became apparent, such as the possibility of regular monitoring or the improved ability to plan routine visits without interrupting the daily schedule. At the same time, the implementation of video consultations is associated with the following challenges: defining responsibilities, acquiring experience in handling video consultation tools, providing for sufficient qualification and training, dealing with new billing modalities as well as missing links between nursing documentation and medical information systems. Discussion: Video consultations can improve health care routines in nursing homes, lead to a wider availability of medical services, and contribute to improving patient safety and the quality of care. However, various aspects and contextual factors need to be addressed when implementing video consultations. These include: implementation of technical requirements, initial training with test consultations, continuous interactive development of potential fields of application, and the definition of the respective responsibilities of caregivers, physicians and medical assistants.
Ethical, legal, and social implications of symptom checker Apps in primary Health Care (CHECK.APP)
(2022)
Background:
Symptom checker apps (SCAs) are accessible tools that provide early symptom assessment for users. The ethical, legal, and social implications of SCAs and their impact on the patient-physician relationship, the health care providers, and the health care system have sparsely been examined. This study protocol describes an approach to investigate the possible impacts and implications of SCAs on different levels of health care provision. It considers the perspectives of the users, nonusers, general practitioners (GPs), and health care experts.
Objective:
We aim to assess a comprehensive overview of the use of SCAs and address problematic issues, if any. The primary outcomes of this study are empirically informed multi-perspective recommendations for different stakeholders on the ethical, legal, and social implications of SCAs.
Methods:
Quantitative and qualitative methods will be used in several overlapping and interconnected study phases. In study phase 1, a comprehensive literature review will be conducted to assess the ethical, legal, social, and systemic impacts of SCAs. Study phase 2 comprises a survey that will be analyzed with a logistic regression. It aims to assess the user degree of SCAs in Germany as well as the predictors for SCA usage. Study phase 3 will investigate self-observational diaries and user interviews, which will be analyzed as integrated cases to assess user perspectives, usage pattern, and arising problems. Study phase 4 will comprise GP interviews to assess their experiences, perspectives, self-image, and concepts and will be analyzed with the basic procedure by Kruse. Moreover, interviews with health care experts will be conducted in study phase 3 and will be analyzed by using the reflexive thematical analysis approach of Braun and Clark.
Results:
Study phase 1 will be completed in November 2021. We expect the results of study phase 2 in December 2021 and February 2022. In study phase 3, interviews are currently being conducted. The final study endpoint will be in February 2023.
Conclusions:
The possible ethical, legal, social, and systemic impacts of a widespread use of SCAs that affect stakeholders and stakeholder groups on different levels of health care will be identified. The proposed methodological approach provides a multifaceted and diverse empirical basis for a broad discussion on these implications.
Restrictive means to reduce the spread of the COVID-19 pandemic have not only imposed broad challenges on mental health but might also affect cognitive health. Here we asked how restriction-related changes influence cognitive performance and how age, perceived loneliness, depressiveness and affectedness by restrictions contribute to these effects. 51 Germans completed three assessments of an online based study during the first lockdown in Germany (April 2020), a month later, and during the beginning of the second lockdown (November 2020). Participants completed nine online cognitive tasks of the MyBrainTraining and online questionnaires about their perceived strain and impact on lifestyle factors by the situation (affectedness), perceived loneliness, depressiveness as well as subjective cognitive performance. The results suggested a possible negative impact of depressiveness and affectedness on objective cognitive performance within the course of the lockdown. The younger the participants, the more pronounced these effects were. Loneliness and depressiveness moreover contributed to a worse evaluation of subjective cognition. In addition, especially younger individuals reported increased distress. As important educational and social input has partly been scarce during this pandemic and mental health problems have increased, future research should also assess cognitive long-term consequences.
Real options are widely applied in strategic and operational decision-making, allowing for managerial flexibility in uncertaincontexts. Increased scholarly interest has led to an extensive but fragmented research landscape. We aim to measure andsystematize the research field quantitatively. To achieve this goal, we conduct bibliometric performance analyses and bibliographiccoupling analyses with an in-depth content review. The results of the performance analyses show an increasing interest in realoptions since the beginning of the 2000s and identify the most influential journals and authors. The science mappings reveal sixand seven research clusters over the last two decades. Based on an in-depth analysis of their themes, we develop a researchframework comprising antecedents, application areas, internal and external contingencies, and uncertainty resolution throughreal option valuation or reasoning. We identify several gaps in that framework, which we propose to tackle in future research.
Background: In terms of physiological and biomechanical characteristics, over-pronation of the feet has been associated with distinct muscle recruitment patterns and ground reaction forces during running.
Objective: The aim of this study was to evaluate the effects of running on sand vs. stable ground on ground-reaction-forces (GRFs) and electromyographic (EMG) activity of lower limb muscles in individuals with over-pronated feet (OPF) compared with healthy controls.
Methods: Thirty-three OPF individuals and 33 controls ran at preferred speed and in randomized-order over level-ground and sand. A force-plate was embedded in an 18-m runway to collect GRFs. Muscle activities were recorded using an EMG-system. Data were adjusted for surface-related differences in running speed.
Results: Running on sand resulted in lower speed compared with stable ground running (p < 0.001; d = 0.83). Results demonstrated that running on sand produced higher tibialis anterior activity (p = 0.024; d = 0.28). Also, findings indicated larger loading rates (p = 0.004; d = 0.72) and greater vastus medialis (p < 0.001; d = 0.89) and rectus femoris (p = 0.001; d = 0.61) activities in OPF individuals. Controls but not OPF showed significantly lower gluteus-medius activity (p = 0.022; d = 0.63) when running on sand.
Conclusion: Running on sand resulted in lower running speed and higher tibialis anterior activity during the loading phase. This may indicate alterations in neuromuscular demands in the distal part of the lower limbs when running on sand. In OPF individuals, higher loading rates together with greater quadriceps activity may constitute a proximal compensatory mechanism for distal surface instability.
This study aimed at examining the effects of nine weeks of sand-based plyometric jump training (PJT) combined with endurance running on either outdoor or treadmill surface on measures of physical fitness. Male participants (age, 20.1 +/- 1.7 years) were randomly assigned to a sand-based PJT combined with endurance running on outdoor surface (OT, n = 25) or treadmill surface (TT, n = 25). The endurance miming intervention comprised a mixed training method, i.e., long slow distance, tempo, and interval running drills. A control group was additionally included in this study (CG, n = 25). Participants in CG followed their regular physical activity as OT and TT but did not receive any specific intervention. Individuals were assessed for their 50-m linear sprint time, standing long jump (SLJ) distance, cardiorespiratory fitness (i.e., Cooper test), forced vital capacity (FVC), calf girth, and resting heart rate (RHR). A three (groups: OT, TT, CG) by two (time: pre, post) ANOVA for repeated measures was used to analyze the exercise-specific effects. In case of significant group-by-time interactions, Bonferroni adjusted paired (within-group) and independent (between-group comparisons at post) t-tests were used for post-hoc analyses. Significant group-by-time interactions were found for all dependent variables (p < 0.001 - 0.002, eta(2)(p) = 0.16 - 0.78). Group-specific post-hoc tests showed improvements for all variables after OT (p < 0.001, Hedges'g effect size [g] = 0.05 - 1.94) and TT (p < 0.001, g = 0.04 - 2.73), but not in the CG (p = 0.058 - 1.000, g = 0.00 - 0.34). Compared to CG, OT showed larger SLJ (p = 0.001), cardiorespiratory fitness (p = 0.004), FVC (p = 0.008), and RHR (p < 0.001) improvements. TT showed larger improvements in SLJ (p = 0.036), cardiorespiratory fitness (p < 0.001), and RHR (p < 0.001) compared with CG. Compared to OT, TT showed larger improvements for SLJ (p = 0.018). In conclusion, sand-based PJT combined with either OT or TT similarly improved most measures of physical fitness, with greater SLJ improvement after TT. Coaches may use both concurrent exercise regimes based on preferences and logistical constrains (e.g., weather; access to treadmill equipment).
Background:
Social isolation through quarantine represents an effective means to prevent COVID-19 infection. A negative side-effect of quarantine is low physical activity.
Research question:
What are the differences of running kinetics and muscle activities of recreational runners with a history of COVID-19 versus healthy controls?
Methods:
Forty men and women aged 20-30 years participated in this study and were divided into two experimental groups. Group 1 (age: 24.1 +/- 2.9) consisted of participants with a history of COVID-19 (COVID group) and group 2 (age: 24.2 +/- 2.7) of healthy age and sex-matched controls (controls). Both groups were tested for their running kinetics using a force plate and electromyographic activities (i.e., tibialis anterior [TA], gastrocnemius medialis [Gas-M], biceps femoris [BF], semitendinosus [ST], vastus lateralis [VL], vastus medialis [VM], rectus femoris [RF], gluteus medius [Glut-M]).
Results:
Results demonstrated higher peak vertical (p = 0.029; d=0.788) and medial (p = 0.004; d=1.119) ground reaction forces (GRFs) during push-off in COVID individuals compared with controls. Moreover, higher peak lateral GRFs were found during heel contact (p = 0.001; d=1.536) in the COVID group. COVID-19 individuals showed a shorter time-to-reach the peak vertical (p = 0.001; d=3.779) and posterior GRFs (p = 0.005; d=1.099) during heel contact. Moreover, the COVID group showed higher Gas-M (p = 0.007; d=1.109) and lower VM activity (p = 0.026; d=0.811) at heel contact.
Significance:
Different running kinetics and muscle activities were found in COVID-19 individuals versus healthy controls. Therefore, practitioners and therapists are advised to implement balance and/or strength training to improve lower limbs alignment and mediolateral control during dynamic movements in runners who recovered from COVID-19.
Associations between measures of physical fitness and cognitive performance in preschool children
(2022)
Background:
Given that recent studies report negative secular declines in physical fitness, associations between fitness and cognition in childhood are strongly discussed. The preschool age is characterized by high neuroplasticity which effects motor skill learning, physical fitness, and cognitive development. The aim of this study was to assess the relation of physical fitness and attention (including its individual dimensions (quantitative, qualitative)) as one domain of cognitive performance in preschool children. We hypothesized that fitness components which need precise coordination compared to simple fitness components are stronger related to attention.
Methods:
Physical fitness components like static balance (i.e., single-leg stance), muscle strength (i.e., handgrip strength), muscle power (i.e., standing long jump), and coordination (i.e., hopping on one leg) were assessed in 61 healthy children (mean age 4.5 +/- 0.6 years; girls n = 30). Attention was measured with the "Konzentrations-Handlungsverfahren fur Vorschulkinder" [concentration-action procedure for preschoolers]). Analyses were adjusted for age, body height, and body mass.
Results:
Results from single linear regression analysis revealed a significant (p < 0.05) association between physical fitness (composite score) and attention (composite score) (standardized ss = 0.40), showing a small to medium effect (F-2 = 0.14). Further, coordination had a significant relation with the composite score and the quantitative dimension of attention (standardized ss = 0.35; p < 0.01; standardized ss = - 0.33; p < 0.05). Coordination explained about 11% (composite score) and 9% (quantitative dimension) of the variance in the stepwise multiple regression model.
Conclusion:
The results indicate that performance in physical fitness, particularly coordination, is related to attention in preschool children. Thus, high performance in complex fitness components (i.e., hopping on one leg) tends to predict attention in preschool children. Further longitudinal studies should focus on the effectiveness of physical activity programs implementing coordination and complex exercises at preschool age to examine cause-effect relationships between physical fitness and attention precisely.
This study aimed to investigate the effects of eight weeks of barefoot running exercise on sand versus control on measures of walking kinetics and muscle activities in individuals with diagnosed pronated feet. Sixty physically active male adults with pronated feet were randomly allocated into an intervention or a waiting control group. The intervention group conducted an 8-weeks progressive barefoot running exercise program on sand (e.g., short sprints) with three weekly sessions. Pre and post intervention, participants walked at a constant speed of 1.3 m/s +/- 5% on a 18 m walkway with a force plate embedded in the middle of the walkway. Results showed significant group-by-time interactions for peak impact vertical and lateral ground reaction forces. Training but not control resulted in significantly lower peak impact vertical and lateral ground reaction forces. Significant group-by-time interactions were observed for vastus lateralis activity during the loading phase. Training-induced increases were found for the vastus lateralis in the intervention but not in the control group. This study revealed that the applied exercise program is a suitable means to absorb ground reaction forces (e.g., lower impact vertical and lateral peaks) and increase activities of selected lower limb muscles (e.g., vastus lateralis) when walking on stable ground.
Introduction Physical activity among children and adolescents remains insufficient, despite the substantial efforts made by researchers and policymakers. Identifying and furthering our understanding of potential modifiable determinants of physical activity behaviour (PAB) and sedentary behaviour (SB) is crucial for the development of interventions that promote a shift from SB to PAB. The current protocol details the process through which a series of systematic literature reviews and meta-analyses (MAs) will be conducted to produce a best-evidence statement (BESt) and inform policymakers. The overall aim is to identify modifiable determinants that are associated with changes in PAB and SB in children and adolescents (aged 5-19 years) and to quantify their effect on, or association with, PAB/SB. Methods and analysis A search will be performed in MEDLINE, SportDiscus, Web of Science, PsychINFO and Cochrane Central Register of Controlled Trials. Randomised controlled trials (RCTs) and controlled trials (CTs) that investigate the effect of interventions on PAB/SB and longitudinal studies that investigate the associations between modifiable determinants and PAB/SB at multiple time points will be sought. Risk of bias assessments will be performed using adapted versions of Cochrane's RoB V.2.0 and ROBINS-I tools for RCTs and CTs, respectively, and an adapted version of the National Institute of Health's tool for longitudinal studies. Data will be synthesised narratively and, where possible, MAs will be performed using frequentist and Bayesian statistics. Modifiable determinants will be discussed considering the settings in which they were investigated and the PAB/SB measurement methods used. Ethics and dissemination No ethical approval is needed as no primary data will be collected. The findings will be disseminated in peer-reviewed publications and academic conferences where possible. The BESt will also be shared with policy makers within the DE-PASS consortium in the first instance. Systematic review registration CRD42021282874.
Fatigue has been defined differently in the literature depending on the field of research. The inconsistent use of the term fatigue complicated scientific communication, thereby limiting progress towards a more in-depth understanding of the phenomenon. Therefore, Enoka and Duchateau (Med Sci Sports Exerc 48:2228-38, 2016, [3]) proposed a fatigue framework that distinguishes between trait fatigue (i.e., fatigue experienced by an individual over a longer period of time) and motor or cognitive task-induced state fatigue (i.e., self-reported disabling symptom derived from the two interdependent attributes performance fatigability and perceived fatigability). Thereby, performance fatigability describes a decrease in an objective performance measure, while perceived fatigability refers to the sensations that regulate the integrity of the performer. Although this framework served as a good starting point to unravel the psychophysiology of fatigue, several important aspects were not included and the interdependence of the mechanisms driving performance fatigability and perceived fatigability were not comprehensively discussed. Therefore, the present narrative review aimed to (1) update the fatigue framework suggested by Enoka and Duchateau (Med Sci Sports Exerc 48:2228-38, 2016, [3]) pertaining the taxonomy (i.e., cognitive performance fatigue and perceived cognitive fatigue were added) and important determinants that were not considered previously (e.g., effort perception, affective valence, self-regulation), (2) discuss the mechanisms underlying performance fatigue and perceived fatigue in response to motor and cognitive tasks as well as their interdependence, and (3) provide recommendations for future research on these interactions. We propose to define motor or cognitive task-induced state fatigue as a psychophysiological condition characterized by a decrease in motor or cognitive performance (i.e., motor or cognitive performance fatigue, respectively) and/or an increased perception of fatigue (i.e., perceived motor or cognitive fatigue). These dimensions are interdependent, hinge on different determinants, and depend on body homeostasis (e.g., wakefulness, core temperature) as well as several modulating factors (e.g., age, sex, diseases, characteristics of the motor or cognitive task). Consequently, there is no single factor primarily determining performance fatigue and perceived fatigue in response to motor or cognitive tasks. Instead, the relative weight of each determinant and their interaction are modulated by several factors.
Introduction
Anthropometric and physical fitness data can predict sport-specific performance (e.g., canoe sprint race time) in young athletes. Of note, inter-item correlations (i.e., multicollinearity) may exist between tests assessing similar physical qualities. However, multicollinearity among tests may change across age and/or sex due to age-/sex-specific non-linear development of test performances. Therefore, the present study aimed at analyzing inter-item correlations between anthropometric, physical fitness, and sport-specific performance data as a function of age and sex in young canoe sprint athletes.
Methods
Anthropometric, physical fitness, and sport-specific performance data of 618 male and 297 female young canoe sprint athletes (discipline: male/female kayak, male canoe) were recorded during a national talent identification program between 1992 and 2019. For each discipline, a correlation matrix (i.e., network analysis) was calculated for age category (U13, U14, U15, U16) and sex including anthropometrics (e.g., standing body height, body mass), physical fitness (e.g., cardiorespiratory endurance, muscle power), and sport-specific performance (i.e., 250 and 2,000-m on-water canoe sprint time). Network plots were used to explore the correlation patterns by visual inspection. Further, trimmed means (mu(trimmed)) of inter-item Pearson's correlations coefficients were calculated for each discipline, age category, and sex. Effects of age and sex were analyzed using one-way ANOVAs.
Results
Visual inspection revealed consistent associations among anthropometric measures across age categories, irrespective of sex. Further, associations between physical fitness and sport-specific performance were lower with increasing age, particularly in males. In this sense, statistically significant differences for mu(trimmed) were observed in male canoeists (p < 0.01, xi = 0.36) and male kayakers (p < 0.01, xi = 0.38) with lower mu(trimmed) in older compared with younger athletes (i.e., >= U15). For female kayakers, no statistically significant effect of age on mu(trimmed) was observed (p = 0.34, xi = 0.14).
Discussion
Our study revealed that inter-item correlation patterns (i.e., multicollinearity) of anthropometric, physical fitness, and sport-specific performance measures were lower in older (U15, U16) versus younger (U13, U14) male canoe sprint athletes but not in females. Thus, age and sex should be considered to identify predictors for sport-specific performance and design effective testing batteries for talent identification programs in canoe sprint athletes.
Predictors and prevalence of hazardous alcohol use in middle-late to late adulthood in Europe
(2022)
Objectives:
Even low to moderate levels of alcohol consumption can have detrimental health consequences, especially in older adults (OA). Although many studies report an increase in the proportion of drinkers among OA, there are regional variations. Therefore, we examined alcohol consumption and the prevalence of hazardous alcohol use (HAU) among men and women aged 50+ years in four European regions and investigated predictors of HAU.
Methods:
We analyzed data of N = 35,042 participants of the European SHARE study. We investigated differences in alcohol consumption (units last week) according to gender, age and EU-region using ANOVAs. Furthermore, logistic regression models were used to examine the effect of income, education, marital status, history of a low-quality parent-child relationship and smoking on HAU, also stratified for gender and EU-region. HAU was operationalized as binge drinking or risky drinking (<12.5 units of 10 ml alcohol/week).
Results:
Overall, past week alcohol consumption was 5.0 units (+/- 7.8), prevalence of HAU was 25.4% within our sample of European adults aged 50+ years. Male gender, younger age and living in Western Europe were linked to both higher alcohol consumption and higher risks of HAU. Income, education, smoking, a low-quality parent-child relationship, living in Northern and especially Eastern Europe were positively associated with HAU. Stratified analyses revealed differences by region and gender.
Conclusions:
HAU was highly prevalent within this European sample of OA. Alcohol consumption and determinants of HAU differed between EU-regions, hinting to a necessity of risk-stratified population-level strategies to prevent HAU and subsequent alcohol use disorders.
Archaea belonging to the phylum Bathyarchaeota are the predominant archaeal species in cold, anoxic marine sediments and additionally occur in a variety of habitats, both natural and man-made. Metagenomic and single-cell sequencing studies suggest that Bathyarchaeota may have a significant impact on the emissions of greenhouse gases into the atmosphere, either through direct production of methane or through the degradation of complex organic matter that can subsequently be converted into methane. This is especially relevant in permafrost regions where climate change leads to thawing of permafrost, making high amounts of stored carbon bioavailable. Here we present the analysis of nineteen draft genomes recovered from a sediment core metagenome of the Polar Fox Lagoon, a thermokarst lake located on the Bykovsky Peninsula in Siberia, Russia, which is connected to the brackish Tiksi Bay. We show that the Bathyarchaeota in this lake are predominantly peptide degraders, producing reduced ferredoxin from the fermentation of peptides, while degradation pathways for plant-derived polymers were found to be incomplete. Several genomes encoded the potential for acetogenesis through the Wood-Ljungdahl pathway, but methanogenesis was determined to be unlikely due to the lack of genes encoding the key enzyme in methanogenesis, methyl-CoM reductase. Many genomes lacked a clear pathway for recycling reduced ferredoxin. Hydrogen metabolism was also hardly found: one type 4e [NiFe] hydrogenase was annotated in a single MAG and no [FeFe] hydrogenases were detected. Little evidence was found for syntrophy through formate or direct interspecies electron transfer, leaving a significant gap in our understanding of the metabolism of these organisms.
Background
The role of trunk muscle training (TMT) for physical fitness (e.g., muscle power) and sport-specific performance measures (e.g., swimming time) in athletic populations has been extensively examined over the last decades. However, a recent systematic review and meta-analysis on the effects of TMT on measures of physical fitness and sport-specific performance in young and adult athletes is lacking.
Objective
To aggregate the effects of TMT on measures of physical fitness and sport-specific performance in young and adult athletes and identify potential subject-related moderator variables (e.g., age, sex, expertise level) and training-related programming parameters (e.g., frequency, study length, session duration, and number of training sessions) for TMT effects.
Data Sources
A systematic literature search was conducted with PubMed, Web of Science, and SPORTDiscus, with no date restrictions, up to June 2021.
Study Eligibility Criteria
Only controlled trials with baseline and follow-up measures were included if they examined the effects of TMT on at least one measure of physical fitness (e.g., maximal muscle strength, change-of-direction speed (CODS)/agility, linear sprint speed) and sport-specific performance (e.g., throwing velocity, swimming time) in young or adult competitive athletes at a regional, national, or international level. The expertise level was classified as either elite (competing at national and/or international level) or regional (i.e., recreational and sub-elite).
Study Appraisal and Synthesis Methods
The methodological quality of TMT studies was assessed using the Physiotherapy Evidence Database (PEDro) scale. A random-effects model was used to calculate weighted standardized mean differences (SMDs) between intervention and active control groups. Additionally, univariate sub-group analyses were independently computed for subject-related moderator variables and training-related programming parameters.
Results
Overall, 31 studies with 693 participants aged 11-37 years were eligible for inclusion. The methodological quality of the included studies was 5 on the PEDro scale. In terms of physical fitness, there were significant, small-to-large effects of TMT on maximal muscle strength (SMD = 0.39), local muscular endurance (SMD = 1.29), lower limb muscle power (SMD = 0.30), linear sprint speed (SMD = 0.66), and CODS/agility (SMD = 0.70). Furthermore, a significant and moderate TMT effect was found for sport-specific performance (SMD = 0.64). Univariate sub-group analyses for subject-related moderator variables revealed significant effects of age on CODS/agility (p = 0.04), with significantly large effects for children (SMD = 1.53, p = 0.002). Further, there was a significant effect of number of training sessions on muscle power and linear sprint speed (p <= 0.03), with significant, small-to-large effects of TMT for > 18 sessions compared to <= 18 sessions (0.45 <= SMD <= 0.84, p <= 0.003). Additionally, session duration significantly modulated TMT effects on linear sprint speed, CODS/agility, and sport-specific performance (p <= 0.05). TMT with session durations <= 30 min resulted in significant, large effects on linear sprint speed and CODS/agility (1.66 <= SMD <= 2.42, p <= 0.002), whereas session durations > 30 min resulted in significant, large effects on sport-specific performance (SMD = 1.22, p = 0.008).
Conclusions
Our findings indicate that TMT is an effective means to improve selected measures of physical fitness and sport-specific performance in young and adult athletes. <br /> Independent sub-group analyses suggest that TMT has the potential to improve CODS/agility, but only in children. Additionally, more (> 18) and/or shorter duration (<= 30 min) TMT sessions appear to be more effective for improving lower limb muscle power, linear sprint speed, and CODS/agility in young or adult competitive athletes.
Context
For a given body mass index (BMI), both impaired metabolic health (MH) and reduced cardiorespiratory fitness (CRF) associate with increased risk of cardiovascular disease (CVD).
Objective
It remains unknown whether both risk phenotypes relate to CVD independently of each other, and whether these relationships differ in normal weight, overweight, and obese subjects.
Methods
Data from 421 participants from the Tubingen Diabetes Family Study, who had measurements of anthropometrics, metabolic parameters, CRF (maximal aerobic capacity [VO2max]) and carotid intima-media thickness (cIMT), an early marker of atherosclerosis, were analyzed. Subjects were divided by BMI and MH status into 6 phenotypes.
Results
In univariate analyses, older age, increased BMI, and a metabolic risk profile correlated positively, while insulin sensitivity and VO2max negatively with cIMT. In multivariable analyses in obese subjects, older age, male sex, lower VO2max (std. ss -0.21, P = 0.002) and impaired MH (std. ss 0.13, P = 0.02) were independent determinants of increased cIMT. After adjustment for age and sex, subjects with metabolically healthy obesity (MHO) had higher cIMT than subjects with metabolically healthy normal weight (MHNW; 0.59 +/- 0.009 vs 0.52 +/- 0.01 mm; P < 0.05). When VO2max was additionally included in this model, the difference in cIMT between MHO and MHNW groups became statistically nonsignificant (0.58 +/- 0.009 vs 0.56 +/- 0.02 mm; P > 0.05).
Conclusion
These data suggest that impaired MH and low CRF independently determine increased cIMT in obese subjects and that low CRF may explain part of the increased CVD risk observed in MHO compared with MHNW.
Purpose:
This study aimed to examine the effects of individualized-load power training (IPT) versus traditional moderate-load power training (TPT) on strength, power, jump performance, and body composition in elite young Nordic athletes.
Methods:
In a randomized crossover design, 10 young male athletes (ski jumpers, Nordic combined athletes) age 17.5 (0.6) years (biological maturity status: +3.5 y postpeak height velocity) who competed on a national or international level performed 5 weeks of IPT (4 x 5 repetitions at 49%-72% 1-repetiton maximum [RM]) and TPT (5 x 5 repetitions at 50%-60% 1-RM) in addition to their regular training. Testing before, between, and after both training blocks comprised the assessment of muscle strength (loaded back squat 3-RM), power (maximal loaded back squat power), jump performance (eg, drop-jump height, reactive strength index), and body composition (eg, skeletal muscle mass).
Results:
Significant, large-size main effects for time were found for muscle strength (P < .01; g = 2.7), reactive strength index (P = .03; g= 1.6), and drop jump height (P = .02; g= 1.9) irrespective of the training condition (IPT, TPT). No significant time-by-condition interactions were observed. For measures of body composition, no significant main effects of condition and time or time-by-condition interactions were found.
Conclusions:
Our findings demonstrate that short-term IPT and TPT at moderate loads in addition to regular training were equally effective in improving measures of muscle strength (loaded back squat 3-RM) and vertical jump performance (reactive strength index, drop jump, and height) in young Nordic athletes.
Can compression garments reduce the deleterious effects of physical exercise on muscle strength?
(2022)
Background
The use of compression garments (CGs) during or after training and competition has gained popularity in the last few decades. However, the data concerning CGs' beneficial effects on muscle strength-related outcomes after physical exercise remain inconclusive.
Objective
The aim was to determine whether wearing CGs during or after physical exercise would facilitate the recovery of muscle strength-related outcomes.
Methods
A systematic literature search was conducted across five databases (PubMed, SPORTDiscus, Web of Science, Scopus, and EBSCOhost). Data from 19 randomized controlled trials (RCTs) including 350 healthy participants were extracted and meta-analytically computed. Weighted between-study standardized mean differences (SMDs) with respect to their standard errors (SEs) were aggregated and corrected for sample size to compute overall SMDs. The type of physical exercise, the body area and timing of CG application, and the time interval between the end of the exercise and subsequent testing were assessed.
Results
CGs produced no strength-sparing effects (SMD [95% confidence interval]) at the following time points (t) after physical exercise: immediately <= t < 24 h: - 0.02 (- 0.22 to 0.19), p = 0.87; 24 <= t < 48 h: - 0.00 (- 0.22 to 0.21), p = 0.98; 48 <= t < 72 h: - 0.03 (- 0.43 to 0.37), p = 0.87; 72 <= t < 96 h: 0.14 (- 0.21 to 0.49), p = 0.43; 96 h <= t: 0.26 (- 0.33 to 0.85), p = 0.38. The body area where the CG was applied had no strength-sparing effects. CGs revealed weak strength-sparing effects after plyometric exercise.
Conclusion
Meta-analytical evidence suggests that wearing a CG during or after training does not seem to facilitate the recovery of muscle strength following physical exercise. Practitioners, athletes, coaches, and trainers should reconsider the use of CG as a tool to reduce the effects of physical exercise on muscle strength.
Biochemical markers and wellness status during a congested match play period in elite soccer players
(2022)
Objectives:
To analyze biochemical markers, wellness status, and physical fitness in elite soccer players in relation to changes in training and match exposure during a congested period of match play.
Methods:
Fourteen elite soccer players were evaluated 3 times (T1, T2, and T3) over 12 weeks (T1-T2: 6-wk regular period of match play and T2-T3: 6-wk congested period of match play). Players performed vertical jump tests, repeated shuttle sprint ability test, and the Yo-Yo Intermittent Recovery Test at T1, T2, and T3. Plasma C-reactive protein, creatinine, and creatine kinase were analyzed at T1, T2, and T3. Wellness status was measured daily using the Hopper questionnaire (delayed onset of muscle soreness, stress, fatigue, and sleep quality). Training session rating of perceived exertion was also recorded on a daily basis.
Results:
A significant increase was found in stress, fatigue, delayed onset of muscle soreness scores, and Hopper index during the congested period (between T2 and T3) compared with the regular period (between T1 and T2) (.001 < P < .008, 0.8 < ES < 2.3). Between T2 and T3, significant relationships were found between the percentage variations (Delta%) of C-reactive protein, and Delta% of creatine kinase with the Hopper Index, and the Delta% of fatigue score. In addition, the Delta% of fatigue score and Delta% of delayed onset of muscle soreness score correlated with Delta% Yo-Yo Intermittent Recovery Test and Delta% best of repeated shuttle sprint ability test (.49 < r < P < .01).
Conclusions:
An intensive period of congested match play significantly compromised elite soccer players' physical fitness and wellness status. Elite soccer players' wellness status reflects declines in physical fitness during this period while biochemical changes do not.
Introduction: Remote telemonitoring (RTM) for patients with chronic heart failure (HF) holds promise to improve prognosis and well-being beyond the standard of care (SoC). The CardioBBEAT trial assessed the health economic and clinical impact of an interactive bidirectional RTM system (Motiva(R)) versus SoC for patients with HF and a reduced ejection fraction (HFrEF), in Germany.Methods: This multicenter, randomized controlled trial enrolled 621 patients with HFrEF (mean age 63.0 +/- 11.5 years, 88% men). The primary endpoint was the integrated effect of the intervention on total costs and nonhospitalized days alive after 12 months, reported as incremental cost-effectiveness ratio (ICER). Costs (in keuro) were based on actual charges of patients' statutory health insurance. Among secondary outcome measures were mortality and disease-specific quality of life.Results: We found a neutral effect on nonhospitalized days alive (RTM mean 341 +/- 59 days, SoC 346 +/- 45 days; p = 0.298) associated with increased total costs (RTM 18.5 +/- 39.5 keuro, SoC 12.8 +/- 22.0 keuro; p = 0.046). This yielded an ICER of -1.15 keuro/day. RTM did not impact mortality risk. All quality of life scales were consistently and meaningfully improved in the RTM group at 12 months compared to SoC (all p < 0.01).Conclusions: The first 12 months of RTM were not cost-effective compared to SoC in patients with HFrEF, but associated with a relevant improvement in disease-specific quality of life. The balanced assessment of the potential benefit of RTM requires integration of both the societal and patient perspective.ClinTrials.gov (NCT02293252).