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Institute
- Strukturbereich Kognitionswissenschaften (424) (remove)
Background
The aim of this study was to analyze the shoulder functional profile (rotation range of motion [ROM] and strength), upper and lower body performance, and throwing speed of U13 versus U15 male handball players, and to establish the relationship between these measures of physical fitness and throwing speed.
Methods
One-hundred and nineteen young male handball players (under (U)-13 (U13) [n = 85]) and U15 [n = 34]) volunteered to participate in this study. The participating athletes had a mean background of sytematic handball training of 5.5 ± 2.8 years and they exercised on average 540 ± 10.1 min per week including sport-specific team handball training and strength and conditioning programs. Players were tested for passive shoulder range-of-motion (ROM) for both internal (IR) and external rotation (ER) and isometric strength (i.e., IR and ER) of the dominant/non-dominant shoulders, overhead medicine ball throw (OMB), hip isometric abductor (ABD) and adductor (ADD) strength, hip ROM, jumps (countermovement jump [CMJ] and triple leg-hop [3H] for distance), linear sprint test, modified 505 change-of-direction (COD) test and handball throwing speed (7 m [HT7] and 9 m [HT9]).
Results
U15 players outperformed U13 in upper (i.e., HT7 and HT9 speed, OMB, absolute IR and ER strength of the dominant and non-dominant sides; Cohen’s d: 0.76–2.13) and lower body (i.e., CMJ, 3H, 20-m sprint and COD, hip ABD and ADD; d: 0.70–2.33) performance measures. Regarding shoulder ROM outcomes, a lower IR ROM was found of the dominant side in the U15 group compared to the U13 and a higher ER ROM on both sides in U15 (d: 0.76–1.04). It seems that primarily anthropometric characteristics (i.e., body height, body mass) and upper body strength/power (OMB distance) are the most important factors that explain the throw speed variance in male handball players, particularly in U13.
Conclusions
Findings from this study imply that regular performance monitoring is important for performance development and for minimizing injury risk of the shoulder in both age categories of young male handball players. Besides measures of physical fitness, anthropometric data should be recorded because handball throwing performance is related to these measures.
Aims: High intensity interval training (HIIT) improves mitochondrial characteristics. This study compared the impact of two workload-matched high intensity interval training (HIIT) protocols with different work:recovery ratios on regulatory factors related to mitochondrial biogenesis in the soleus muscle of diabetic rats.
Materials and methods: Twenty-four Wistar rats were randomly divided into four equal-sized groups: non-diabetic control, diabetic control (DC), diabetic with long recovery exercise [4–5 × 2-min running at 80%–90% of the maximum speed reached with 2-min of recovery at 40% of the maximum speed reached (DHIIT1:1)], and diabetic with short recovery exercise (5–6 × 2-min running at 80%–90% of the maximum speed reached with 1-min of recovery at 30% of the maximum speed reached [DHIIT2:1]). Both HIIT protocols were completed five times/week for 4 weeks while maintaining equal running distances in each session.
Results: Gene and protein expressions of PGC-1α, p53, and citrate synthase of the muscles increased significantly following DHIIT1:1 and DHIIT2:1 compared to DC (p ˂ 0.05). Most parameters, except for PGC-1α protein (p = 0.597), were significantly higher in DHIIT2:1 than in DHIIT1:1 (p ˂ 0.05). Both DHIIT groups showed significant increases in maximum speed with larger increases in DHIIT2:1 compared with DHIIT1:1.
Conclusion: Our findings indicate that both HIIT protocols can potently up-regulate gene and protein expression of PGC-1α, p53, and CS. However, DHIIT2:1 has superior effects compared with DHIIT1:1 in improving mitochondrial adaptive responses in diabetic rats.
Objective: A role for microRNAs is implicated in several biological and pathological processes. We investigated the effects of high-intensity interval training (HIIT) and moderate-intensity continuous training (MICT) on molecular markers of diabetic cardiomyopathy in rats.
Methods: Eighteen male Wistar rats (260 ± 10 g; aged 8 weeks) with streptozotocin (STZ)-induced type 1 diabetes mellitus (55 mg/kg, IP) were randomly allocated to three groups: control, MICT, and HIIT. The two different training protocols were performed 5 days each week for 5 weeks. Cardiac performance (end-systolic and end-diastolic dimensions, ejection fraction), the expression of miR-206, HSP60, and markers of apoptosis (cleaved PARP and cytochrome C) were determined at the end of the exercise interventions.
Results: Both exercise interventions (HIIT and MICT) decreased blood glucose levels and improved cardiac performance, with greater changes in the HIIT group (p < 0.001, η2: 0.909). While the expressions of miR-206 and apoptotic markers decreased in both training protocols (p < 0.001, η2: 0.967), HIIT caused greater reductions in apoptotic markers and produced a 20% greater reduction in miR-206 compared with the MICT protocol (p < 0.001). Furthermore, both training protocols enhanced the expression of HSP60 (p < 0.001, η2: 0.976), with a nearly 50% greater increase in the HIIT group compared with MICT.
Conclusions: Our results indicate that both exercise protocols, HIIT and MICT, have the potential to reduce diabetic cardiomyopathy by modifying the expression of miR-206 and its downstream targets of apoptosis. It seems however that HIIT is even more effective than MICT to modulate these molecular markers.
Background: There is evidence that fully recovered COVID-19 patients usually resume physical exercise, but do not perform at the same intensity level performed prior to infection. The aim of this study was to evaluate the impact of COVID-19 infection and recovery as well as muscle fatigue on cardiorespiratory fitness and running biomechanics in female recreational runners.
Methods: Twenty-eight females were divided into a group of hospitalized and recovered COVID-19 patients (COV, n = 14, at least 14 days following recovery) and a group of healthy age-matched controls (CTR, n = 14). Ground reaction forces from stepping on a force plate while barefoot overground running at 3.3 m/s was measured before and after a fatiguing protocol. The fatigue protocol consisted of incrementally increasing running speed until reaching a score of 13 on the 6–20 Borg scale, followed by steady-state running until exhaustion. The effects of group and fatigue were assessed for steady-state running duration, steady-state running speed, ground contact time, vertical instantaneous loading rate and peak propulsion force.
Results: COV runners completed only 56% of the running time achieved by the CTR (p < 0.0001), and at a 26% slower steady-state running speed (p < 0.0001). There were fatigue-related reductions in loading rate (p = 0.004) without group differences. Increased ground contact time (p = 0.002) and reduced peak propulsion force (p = 0.005) were found for COV when compared to CTR.
Conclusion: Our results suggest that female runners who recovered from COVID-19 showed compromised running endurance and altered running kinetics in the form of longer stance periods and weaker propulsion forces. More research is needed in this area using larger sample sizes to confirm our study findings.
Background
The aim of this study was to analyze the shoulder functional profile (rotation range of motion [ROM] and strength), upper and lower body performance, and throwing speed of U13 versus U15 male handball players, and to establish the relationship between these measures of physical fitness and throwing speed.
Methods
One-hundred and nineteen young male handball players (under (U)-13 (U13) [n = 85]) and U15 [n = 34]) volunteered to participate in this study. The participating athletes had a mean background of sytematic handball training of 5.5 ± 2.8 years and they exercised on average 540 ± 10.1 min per week including sport-specific team handball training and strength and conditioning programs. Players were tested for passive shoulder range-of-motion (ROM) for both internal (IR) and external rotation (ER) and isometric strength (i.e., IR and ER) of the dominant/non-dominant shoulders, overhead medicine ball throw (OMB), hip isometric abductor (ABD) and adductor (ADD) strength, hip ROM, jumps (countermovement jump [CMJ] and triple leg-hop [3H] for distance), linear sprint test, modified 505 change-of-direction (COD) test and handball throwing speed (7 m [HT7] and 9 m [HT9]).
Results
U15 players outperformed U13 in upper (i.e., HT7 and HT9 speed, OMB, absolute IR and ER strength of the dominant and non-dominant sides; Cohen’s d: 0.76–2.13) and lower body (i.e., CMJ, 3H, 20-m sprint and COD, hip ABD and ADD; d: 0.70–2.33) performance measures. Regarding shoulder ROM outcomes, a lower IR ROM was found of the dominant side in the U15 group compared to the U13 and a higher ER ROM on both sides in U15 (d: 0.76–1.04). It seems that primarily anthropometric characteristics (i.e., body height, body mass) and upper body strength/power (OMB distance) are the most important factors that explain the throw speed variance in male handball players, particularly in U13.
Conclusions
Findings from this study imply that regular performance monitoring is important for performance development and for minimizing injury risk of the shoulder in both age categories of young male handball players. Besides measures of physical fitness, anthropometric data should be recorded because handball throwing performance is related to these measures.
Objective: A role for microRNAs is implicated in several biological and pathological processes. We investigated the effects of high-intensity interval training (HIIT) and moderate-intensity continuous training (MICT) on molecular markers of diabetic cardiomyopathy in rats.
Methods: Eighteen male Wistar rats (260 ± 10 g; aged 8 weeks) with streptozotocin (STZ)-induced type 1 diabetes mellitus (55 mg/kg, IP) were randomly allocated to three groups: control, MICT, and HIIT. The two different training protocols were performed 5 days each week for 5 weeks. Cardiac performance (end-systolic and end-diastolic dimensions, ejection fraction), the expression of miR-206, HSP60, and markers of apoptosis (cleaved PARP and cytochrome C) were determined at the end of the exercise interventions.
Results: Both exercise interventions (HIIT and MICT) decreased blood glucose levels and improved cardiac performance, with greater changes in the HIIT group (p < 0.001, η2: 0.909). While the expressions of miR-206 and apoptotic markers decreased in both training protocols (p < 0.001, η2: 0.967), HIIT caused greater reductions in apoptotic markers and produced a 20% greater reduction in miR-206 compared with the MICT protocol (p < 0.001). Furthermore, both training protocols enhanced the expression of HSP60 (p < 0.001, η2: 0.976), with a nearly 50% greater increase in the HIIT group compared with MICT.
Conclusions: Our results indicate that both exercise protocols, HIIT and MICT, have the potential to reduce diabetic cardiomyopathy by modifying the expression of miR-206 and its downstream targets of apoptosis. It seems however that HIIT is even more effective than MICT to modulate these molecular markers.
Background: There is evidence that fully recovered COVID-19 patients usually resume physical exercise, but do not perform at the same intensity level performed prior to infection. The aim of this study was to evaluate the impact of COVID-19 infection and recovery as well as muscle fatigue on cardiorespiratory fitness and running biomechanics in female recreational runners.
Methods: Twenty-eight females were divided into a group of hospitalized and recovered COVID-19 patients (COV, n = 14, at least 14 days following recovery) and a group of healthy age-matched controls (CTR, n = 14). Ground reaction forces from stepping on a force plate while barefoot overground running at 3.3 m/s was measured before and after a fatiguing protocol. The fatigue protocol consisted of incrementally increasing running speed until reaching a score of 13 on the 6–20 Borg scale, followed by steady-state running until exhaustion. The effects of group and fatigue were assessed for steady-state running duration, steady-state running speed, ground contact time, vertical instantaneous loading rate and peak propulsion force.
Results: COV runners completed only 56% of the running time achieved by the CTR (p < 0.0001), and at a 26% slower steady-state running speed (p < 0.0001). There were fatigue-related reductions in loading rate (p = 0.004) without group differences. Increased ground contact time (p = 0.002) and reduced peak propulsion force (p = 0.005) were found for COV when compared to CTR.
Conclusion: Our results suggest that female runners who recovered from COVID-19 showed compromised running endurance and altered running kinetics in the form of longer stance periods and weaker propulsion forces. More research is needed in this area using larger sample sizes to confirm our study findings.
Timing of initial school enrollment may vary considerably for various reasons such as early or delayed enrollment, skipped or repeated school classes. Accordingly, the age range within school grades includes older-(OTK) and younger-than-keyage (YTK) children. Hardly any information is available on the impact of timing of school enrollment on physical fitness. There is evidence from a related research topic showing large differences in academic performance between OTK and YTK children versus keyage children. Thus, the aim of this study was to compare physical fitness of OTK (N = 26,540) and YTK (N = 2586) children versus keyage children (N = 108,295) in a representative sample of German third graders. Physical fitness tests comprised cardiorespiratory endurance, coordination, speed, lower, and upper limbs muscle power. Predictions of physical fitness performance for YTK and OTK children were estimated using data from keyage children by taking age, sex, school, and assessment year into account. Data were annually recorded between 2011 and 2019. The difference between observed and predicted z-scores yielded a delta z-score that was used as a dependent variable in the linear mixed models. Findings indicate that OTK children showed poorer performance compared to keyage children, especially in coordination, and that YTK children outperformed keyage children, especially in coordination. Teachers should be aware that OTK children show poorer physical fitness performance compared to keyage children.
Peripersonal space is the space surrounding our body, where multisensory integration of stimuli and action execution take place. The size of peripersonal space is flexible and subject to change by various personal and situational factors. The dynamic representation of our peripersonal space modulates our spatial behaviors towards other individuals. During the COVID-19 pandemic, this spatial behavior was modified by two further factors: social distancing and wearing a face mask. Evidence from offline and online studies on the impact of a face mask on pro-social behavior is mixed. In an attempt to clarify the role of face masks as pro-social or anti-social signals, 235 observers participated in the present online study. They watched pictures of two models standing at three different distances from each other (50, 90 and 150 cm), who were either wearing a face mask or not and were either interacting by initiating a hand shake or just standing still. The observers’ task was to classify the model by gender. Our results show that observers react fastest, and therefore show least avoidance, for the shortest distances (50 and 90 cm) but only when models wear a face mask and do not interact. Thus, our results document both pro- and anti-social consequences of face masks as a result of the complex interplay between social distancing and interactive behavior. Practical implications of these findings are discussed.
Peripersonal space is the space surrounding our body, where multisensory integration of stimuli and action execution take place. The size of peripersonal space is flexible and subject to change by various personal and situational factors. The dynamic representation of our peripersonal space modulates our spatial behaviors towards other individuals. During the COVID-19 pandemic, this spatial behavior was modified by two further factors: social distancing and wearing a face mask. Evidence from offline and online studies on the impact of a face mask on pro-social behavior is mixed. In an attempt to clarify the role of face masks as pro-social or anti-social signals, 235 observers participated in the present online study. They watched pictures of two models standing at three different distances from each other (50, 90 and 150 cm), who were either wearing a face mask or not and were either interacting by initiating a hand shake or just standing still. The observers’ task was to classify the model by gender. Our results show that observers react fastest, and therefore show least avoidance, for the shortest distances (50 and 90 cm) but only when models wear a face mask and do not interact. Thus, our results document both pro- and anti-social consequences of face masks as a result of the complex interplay between social distancing and interactive behavior. Practical implications of these findings are discussed.
The prevalence of obesity in the pediatric population has become a major public health issue. Indeed, the dramatic increase of this epidemic causes multiple and harmful consequences, Physical activity, particularly physical exercise, remains to be the cornerstone of interventions against childhood obesity. Given the conflicting findings with reference to the relevant literature addressing the effects of exercise on adiposity and physical fitness outcomes in obese children and adolescents, the effect of duration-matched concurrent training (CT) [50% resistance (RT) and 50% high-intensity-interval-training (HIIT)] on body composition and physical fitness in obese youth remains to be elucidated. Thus, the purpose of this study was to examine the effects of 9-weeks of CT compared to RT or HIIT alone, on body composition and selected physical fitness components in healthy sedentary obese youth. Out of 73 participants, only 37; [14 males and 23 females; age 13.4 ± 0.9 years; body-mass-index (BMI): 31.2 ± 4.8 kg·m-2] were eligible and randomized into three groups: HIIT (n = 12): 3-4 sets×12 runs at 80–110% peak velocity, with 10-s passive recovery between bouts; RT (n = 12): 6 exercises; 3–4 sets × 10 repetition maximum (RM) and CT (n = 13): 50% serial completion of RT and HIIT. CT promoted significant greater gains compared to HIIT and RT on body composition (p < 0.01, d = large), 6-min-walking test distance (6 MWT-distance) and on 6 MWT-VO2max (p < 0.03, d = large). In addition, CT showed substantially greater improvements than HIIT in the medicine ball throw test (20.2 vs. 13.6%, p < 0.04, d = large). On the other hand, RT exhibited significantly greater gains in relative hand grip strength (p < 0.03, d = large) and CMJ (p < 0.01, d = large) than HIIT and CT. CT promoted greater benefits for fat, body mass loss and cardiorespiratory fitness than HIIT or RT modalities. This study provides important information for practitioners and therapists on the application of effective exercise regimes with obese youth to induce significant and beneficial body composition changes. The applied CT program and the respective programming parameters in terms of exercise intensity and volume can be used by practitioners as an effective exercise treatment to fight the pandemic overweight and obesity in youth.
The purpose of this study was to examine the test-retest reliability, and convergent and discriminative validity of a new taekwondo-specific change-of-direction (COD) speed test with striking techniques (TST) in elite taekwondo athletes. Twenty (10 males and 10 females) elite (athletes who compete at national level) and top-elite (athletes who compete at national and international level) taekwondo athletes with an average training background of 8.9 ± 1.3 years of systematic taekwondo training participated in this study. During the two-week test-retest period, various generic performance tests measuring COD speed, balance, speed, and jump performance were carried out during the first week and as a retest during the second week. Three TST trials were conducted with each athlete and the best trial was used for further analyses. The relevant performance measure derived from the TST was the time with striking penalty (TST-TSP). TST-TSP performances amounted to 10.57 ± 1.08 s for males and 11.74 ± 1.34 s for females. The reliability analysis of the TST performance was conducted after logarithmic transformation, in order to address the problem of heteroscedasticity. In both groups, the TST demonstrated a high relative test-retest reliability (intraclass correlation coefficients and 90% compatibility limits were 0.80 and 0.47 to 0.93, respectively). For absolute reliability, the TST’s typical error of measurement (TEM), 90% compatibility limits, and magnitudes were 4.6%, 3.4 to 7.7, for males, and 5.4%, 3.9 to 9.0, for females. The homogeneous sample of taekwondo athletes meant that the TST’s TEM exceeded the usual smallest important change (SIC) with 0.2 effect size in the two groups. The new test showed mostly very large correlations with linear sprint speed (r = 0.71 to 0.85) and dynamic balance (r = −0.71 and −0.74), large correlations with COD speed (r = 0.57 to 0.60) and vertical jump performance (r = −0.50 to −0.65), and moderate correlations with horizontal jump performance (r = −0.34 to −0.45) and static balance (r = −0.39 to −0.44). Top-elite athletes showed better TST performances than elite counterparts. Receiver operating characteristic analysis indicated that the TST effectively discriminated between top-elite and elite taekwondo athletes. In conclusion, the TST is a valid, and sensitive test to evaluate the COD speed with taekwondo specific skills, and reliable when considering ICC and TEM. Although the usefulness of the TST is questioned to detect small performance changes in the present population, the TST can detect moderate changes in taekwondo-specific COD speed.
Physical fatigue (PF) negatively affects postural control, resulting in impaired balance performance in young and older adults. Similar effects on postural control can be observed for mental fatigue (MF) mainly in older adults. Controversial results exist for young adults. There is a void in the literature on the effects of fatigue on balance and cortical activity. Therefore, this study aimed to examine the acute effects of PF and MF on postural sway and cortical activity. Fifteen healthy young adults aged 28 ± 3 years participated in this study. MF and PF protocols comprising of an all-out repeated sit-to-stand task and a computer-based attention network test, respectively, were applied in random order. Pre and post fatigue, cortical activity and postural sway (i.e., center of pressure displacements [CoPd], velocity [CoPv], and CoP variability [CV CoPd, CV CoPv]) were tested during a challenging bipedal balance board task. Absolute spectral power was calculated for theta (4–7.5 Hz), alpha-2 (10.5–12.5 Hz), beta-1 (13–18 Hz), and beta-2 (18.5–25 Hz) in frontal, central, and parietal regions of interest (ROI) and baseline-normalized. Inference statistics revealed a significant time-by-fatigue interaction for CoPd (p = 0.009, d = 0.39, Δ 9.2%) and CoPv (p = 0.009, d = 0.36, Δ 9.2%), and a significant main effect of time for CoP variability (CV CoPd: p = 0.001, d = 0.84; CV CoPv: p = 0.05, d = 0.62). Post hoc analyses showed a significant increase in CoPd (p = 0.002, d = 1.03) and CoPv (p = 0.003, d = 1.03) following PF but not MF. For cortical activity, a significant time-by-fatigue interaction was found for relative alpha-2 power in parietal (p < 0.001, d = 0.06) areas. Post hoc tests indicated larger alpha-2 power increases after PF (p < 0.001, d = 1.69, Δ 3.9%) compared to MF (p = 0.001, d = 1.03, Δ 2.5%). In addition, changes in parietal alpha-2 power and measures of postural sway did not correlate significantly, irrespective of the applied fatigue protocol. No significant changes were found for the other frequency bands, irrespective of the fatigue protocol and ROI under investigation. Thus, the applied PF protocol resulted in increased postural sway (CoPd and CoPv) and CoP variability accompanied by enhanced alpha-2 power in the parietal ROI while MF led to increased CoP variability and alpha-2 power in our sample of young adults. Potential underlying cortical mechanisms responsible for the greater increase in parietal alpha-2 power after PF were discussed but could not be clearly identified as cause. Therefore, further future research is needed to decipher alternative interpretations.
Injuries in professional soccer are a significant concern for teams, and they are caused amongst others by high training load. This cohort study describes the relationship between workload parameters and the occurrence of non-contact injuries, during weeks with high and low workload in professional soccer players throughout the season. Twenty-one professional soccer players aged 28.3 ± 3.9 yrs. who competed in the Iranian Persian Gulf Pro League participated in this 48-week study. The external load was monitored using global positioning system (GPS, GPSPORTS Systems Pty Ltd) and the type of injury was documented daily by the team's medical staff. Odds ratio (OR) and relative risk (RR) were calculated for non-contact injuries for high- and low-load weeks according to acute (AW), chronic (CW), acute to chronic workload ratio (ACWR), and AW variation (Δ-Acute) values. By using Poisson distribution, the interval between previous and new injuries were estimated. Overall, 12 non-contact injuries occurred during high load and 9 during low load weeks. Based on the variables ACWR and Δ-AW, there was a significantly increased risk of sustaining non-contact injuries (p < 0.05) during high-load weeks for ACWR (OR: 4.67), and Δ-AW (OR: 4.07). Finally, the expected time between injuries was significantly shorter in high load weeks for ACWR [1.25 vs. 3.33, rate ratio time (RRT)] and Δ-AW (1.33 vs. 3.45, RRT) respectively, compared to low load weeks. The risk of sustaining injuries was significantly larger during high workload weeks for ACWR, and Δ-AW compared with low workload weeks. The observed high OR in high load weeks indicate that there is a significant relationship between workload and occurrence of non-contact injuries. The predicted time to new injuries is shorter in high load weeks compared to low load weeks. Therefore, the frequency of injuries is higher during high load weeks for ACWR and Δ-AW. ACWR and Δ-AW appear to be good indicators for estimating the injury risk, and the time interval between injuries.
The purpose of this study was to examine the test-retest reliability, and convergent and discriminative validity of a new taekwondo-specific change-of-direction (COD) speed test with striking techniques (TST) in elite taekwondo athletes. Twenty (10 males and 10 females) elite (athletes who compete at national level) and top-elite (athletes who compete at national and international level) taekwondo athletes with an average training background of 8.9 ± 1.3 years of systematic taekwondo training participated in this study. During the two-week test-retest period, various generic performance tests measuring COD speed, balance, speed, and jump performance were carried out during the first week and as a retest during the second week. Three TST trials were conducted with each athlete and the best trial was used for further analyses. The relevant performance measure derived from the TST was the time with striking penalty (TST-TSP). TST-TSP performances amounted to 10.57 ± 1.08 s for males and 11.74 ± 1.34 s for females. The reliability analysis of the TST performance was conducted after logarithmic transformation, in order to address the problem of heteroscedasticity. In both groups, the TST demonstrated a high relative test-retest reliability (intraclass correlation coefficients and 90% compatibility limits were 0.80 and 0.47 to 0.93, respectively). For absolute reliability, the TST’s typical error of measurement (TEM), 90% compatibility limits, and magnitudes were 4.6%, 3.4 to 7.7, for males, and 5.4%, 3.9 to 9.0, for females. The homogeneous sample of taekwondo athletes meant that the TST’s TEM exceeded the usual smallest important change (SIC) with 0.2 effect size in the two groups. The new test showed mostly very large correlations with linear sprint speed (r = 0.71 to 0.85) and dynamic balance (r = −0.71 and −0.74), large correlations with COD speed (r = 0.57 to 0.60) and vertical jump performance (r = −0.50 to −0.65), and moderate correlations with horizontal jump performance (r = −0.34 to −0.45) and static balance (r = −0.39 to −0.44). Top-elite athletes showed better TST performances than elite counterparts. Receiver operating characteristic analysis indicated that the TST effectively discriminated between top-elite and elite taekwondo athletes. In conclusion, the TST is a valid, and sensitive test to evaluate the COD speed with taekwondo specific skills, and reliable when considering ICC and TEM. Although the usefulness of the TST is questioned to detect small performance changes in the present population, the TST can detect moderate changes in taekwondo-specific COD speed.
The prevalence of obesity in the pediatric population has become a major public health issue. Indeed, the dramatic increase of this epidemic causes multiple and harmful consequences, Physical activity, particularly physical exercise, remains to be the cornerstone of interventions against childhood obesity. Given the conflicting findings with reference to the relevant literature addressing the effects of exercise on adiposity and physical fitness outcomes in obese children and adolescents, the effect of duration-matched concurrent training (CT) [50% resistance (RT) and 50% high-intensity-interval-training (HIIT)] on body composition and physical fitness in obese youth remains to be elucidated. Thus, the purpose of this study was to examine the effects of 9-weeks of CT compared to RT or HIIT alone, on body composition and selected physical fitness components in healthy sedentary obese youth. Out of 73 participants, only 37; [14 males and 23 females; age 13.4 ± 0.9 years; body-mass-index (BMI): 31.2 ± 4.8 kg·m-2] were eligible and randomized into three groups: HIIT (n = 12): 3-4 sets×12 runs at 80–110% peak velocity, with 10-s passive recovery between bouts; RT (n = 12): 6 exercises; 3–4 sets × 10 repetition maximum (RM) and CT (n = 13): 50% serial completion of RT and HIIT. CT promoted significant greater gains compared to HIIT and RT on body composition (p < 0.01, d = large), 6-min-walking test distance (6 MWT-distance) and on 6 MWT-VO2max (p < 0.03, d = large). In addition, CT showed substantially greater improvements than HIIT in the medicine ball throw test (20.2 vs. 13.6%, p < 0.04, d = large). On the other hand, RT exhibited significantly greater gains in relative hand grip strength (p < 0.03, d = large) and CMJ (p < 0.01, d = large) than HIIT and CT. CT promoted greater benefits for fat, body mass loss and cardiorespiratory fitness than HIIT or RT modalities. This study provides important information for practitioners and therapists on the application of effective exercise regimes with obese youth to induce significant and beneficial body composition changes. The applied CT program and the respective programming parameters in terms of exercise intensity and volume can be used by practitioners as an effective exercise treatment to fight the pandemic overweight and obesity in youth.
Physical fatigue (PF) negatively affects postural control, resulting in impaired balance performance in young and older adults. Similar effects on postural control can be observed for mental fatigue (MF) mainly in older adults. Controversial results exist for young adults. There is a void in the literature on the effects of fatigue on balance and cortical activity. Therefore, this study aimed to examine the acute effects of PF and MF on postural sway and cortical activity. Fifteen healthy young adults aged 28 ± 3 years participated in this study. MF and PF protocols comprising of an all-out repeated sit-to-stand task and a computer-based attention network test, respectively, were applied in random order. Pre and post fatigue, cortical activity and postural sway (i.e., center of pressure displacements [CoPd], velocity [CoPv], and CoP variability [CV CoPd, CV CoPv]) were tested during a challenging bipedal balance board task. Absolute spectral power was calculated for theta (4–7.5 Hz), alpha-2 (10.5–12.5 Hz), beta-1 (13–18 Hz), and beta-2 (18.5–25 Hz) in frontal, central, and parietal regions of interest (ROI) and baseline-normalized. Inference statistics revealed a significant time-by-fatigue interaction for CoPd (p = 0.009, d = 0.39, Δ 9.2%) and CoPv (p = 0.009, d = 0.36, Δ 9.2%), and a significant main effect of time for CoP variability (CV CoPd: p = 0.001, d = 0.84; CV CoPv: p = 0.05, d = 0.62). Post hoc analyses showed a significant increase in CoPd (p = 0.002, d = 1.03) and CoPv (p = 0.003, d = 1.03) following PF but not MF. For cortical activity, a significant time-by-fatigue interaction was found for relative alpha-2 power in parietal (p < 0.001, d = 0.06) areas. Post hoc tests indicated larger alpha-2 power increases after PF (p < 0.001, d = 1.69, Δ 3.9%) compared to MF (p = 0.001, d = 1.03, Δ 2.5%). In addition, changes in parietal alpha-2 power and measures of postural sway did not correlate significantly, irrespective of the applied fatigue protocol. No significant changes were found for the other frequency bands, irrespective of the fatigue protocol and ROI under investigation. Thus, the applied PF protocol resulted in increased postural sway (CoPd and CoPv) and CoP variability accompanied by enhanced alpha-2 power in the parietal ROI while MF led to increased CoP variability and alpha-2 power in our sample of young adults. Potential underlying cortical mechanisms responsible for the greater increase in parietal alpha-2 power after PF were discussed but could not be clearly identified as cause. Therefore, further future research is needed to decipher alternative interpretations.
Aims: High intensity interval training (HIIT) improves mitochondrial characteristics. This study compared the impact of two workload-matched high intensity interval training (HIIT) protocols with different work:recovery ratios on regulatory factors related to mitochondrial biogenesis in the soleus muscle of diabetic rats.
Materials and methods: Twenty-four Wistar rats were randomly divided into four equal-sized groups: non-diabetic control, diabetic control (DC), diabetic with long recovery exercise [4–5 × 2-min running at 80%–90% of the maximum speed reached with 2-min of recovery at 40% of the maximum speed reached (DHIIT1:1)], and diabetic with short recovery exercise (5–6 × 2-min running at 80%–90% of the maximum speed reached with 1-min of recovery at 30% of the maximum speed reached [DHIIT2:1]). Both HIIT protocols were completed five times/week for 4 weeks while maintaining equal running distances in each session.
Results: Gene and protein expressions of PGC-1α, p53, and citrate synthase of the muscles increased significantly following DHIIT1:1 and DHIIT2:1 compared to DC (p ˂ 0.05). Most parameters, except for PGC-1α protein (p = 0.597), were significantly higher in DHIIT2:1 than in DHIIT1:1 (p ˂ 0.05). Both DHIIT groups showed significant increases in maximum speed with larger increases in DHIIT2:1 compared with DHIIT1:1.
Conclusion: Our findings indicate that both HIIT protocols can potently up-regulate gene and protein expression of PGC-1α, p53, and CS. However, DHIIT2:1 has superior effects compared with DHIIT1:1 in improving mitochondrial adaptive responses in diabetic rats.
Injuries in professional soccer are a significant concern for teams, and they are caused amongst others by high training load. This cohort study describes the relationship between workload parameters and the occurrence of non-contact injuries, during weeks with high and low workload in professional soccer players throughout the season. Twenty-one professional soccer players aged 28.3 ± 3.9 yrs. who competed in the Iranian Persian Gulf Pro League participated in this 48-week study. The external load was monitored using global positioning system (GPS, GPSPORTS Systems Pty Ltd) and the type of injury was documented daily by the team's medical staff. Odds ratio (OR) and relative risk (RR) were calculated for non-contact injuries for high- and low-load weeks according to acute (AW), chronic (CW), acute to chronic workload ratio (ACWR), and AW variation (Δ-Acute) values. By using Poisson distribution, the interval between previous and new injuries were estimated. Overall, 12 non-contact injuries occurred during high load and 9 during low load weeks. Based on the variables ACWR and Δ-AW, there was a significantly increased risk of sustaining non-contact injuries (p < 0.05) during high-load weeks for ACWR (OR: 4.67), and Δ-AW (OR: 4.07). Finally, the expected time between injuries was significantly shorter in high load weeks for ACWR [1.25 vs. 3.33, rate ratio time (RRT)] and Δ-AW (1.33 vs. 3.45, RRT) respectively, compared to low load weeks. The risk of sustaining injuries was significantly larger during high workload weeks for ACWR, and Δ-AW compared with low workload weeks. The observed high OR in high load weeks indicate that there is a significant relationship between workload and occurrence of non-contact injuries. The predicted time to new injuries is shorter in high load weeks compared to low load weeks. Therefore, the frequency of injuries is higher during high load weeks for ACWR and Δ-AW. ACWR and Δ-AW appear to be good indicators for estimating the injury risk, and the time interval between injuries.
Background:
There is evidence that fully recovered COVID-19 patients usually resume physical exercise, but do not perform at the same intensity level performed prior to infection. The aim of this study was to evaluate the impact of COVID-19 infection and recovery as well as muscle fatigue on cardiorespiratory fitness and running biomechanics in female recreational runners.
Methods:
Twenty-eight females were divided into a group of hospitalized and recovered COVID-19 patients (COV, n = 14, at least 14 days following recovery) and a group of healthy age-matched controls (CTR, n = 14). Ground reaction forces from stepping on a force plate while barefoot overground running at 3.3 m/s was measured before and after a fatiguing protocol. The fatigue protocol consisted of incrementally increasing running speed until reaching a score of 13 on the 6-20 Borg scale, followed by steady-state running until exhaustion. The effects of group and fatigue were assessed for steady-state running duration, steady-state running speed, ground contact time, vertical instantaneous loading rate and peak propulsion force.
Results:
COV runners completed only 56% of the running time achieved by the CTR (p < 0.0001), and at a 26% slower steady-state running speed (p < 0.0001). There were fatigue-related reductions in loading rate (p = 0.004) without group differences. Increased ground contact time (p = 0.002) and reduced peak propulsion force (p = 0.005) were found for COV when compared to CTR.
Conclusion:
Our results suggest that female runners who recovered from COVID-19 showed compromised running endurance and altered running kinetics in the form of longer stance periods and weaker propulsion forces. More research is needed in this area using larger sample sizes to confirm our study findings.
The aim of this review was to describe and summarize the scientific literature on programming parameters related to jump or plyometric training in male and female soccer players of different ages and fitness levels. A literature search was conducted in the electronic databases PubMed, Web of Science and Scopus using keywords related to the main topic of this study (e.g., “ballistic” and “plyometric”). According to the PICOS framework, the population for the review was restricted to soccer players, involved in jump or plyometric training. Among 7556 identified studies, 90 were eligible for inclusion. Only 12 studies were found for females. Most studies (n = 52) were conducted with youth male players. Moreover, only 35 studies determined the effectiveness of a given jump training programming factor. Based on the limited available research, it seems that a dose of 7 weeks (1–2 sessions per week), with ~80 jumps (specific of combined types) per session, using near-maximal or maximal intensity, with adequate recovery between repetitions (<15 s), sets (≥30 s) and sessions (≥24–48 h), using progressive overload and taper strategies, using appropriate surfaces (e.g., grass), and applied in a well-rested state, when combined with other training methods, would increase the outcome of effective and safe plyometric-jump training interventions aimed at improving soccer players physical fitness. In conclusion, jump training is an effective and easy-to-administer training approach for youth, adult, male and female soccer players. However, optimal programming for plyometric-jump training in soccer is yet to be determined in future research.
The aim of this review was to describe and summarize the scientific literature on programming parameters related to jump or plyometric training in male and female soccer players of different ages and fitness levels. A literature search was conducted in the electronic databases PubMed, Web of Science and Scopus using keywords related to the main topic of this study (e.g., “ballistic” and “plyometric”). According to the PICOS framework, the population for the review was restricted to soccer players, involved in jump or plyometric training. Among 7556 identified studies, 90 were eligible for inclusion. Only 12 studies were found for females. Most studies (n = 52) were conducted with youth male players. Moreover, only 35 studies determined the effectiveness of a given jump training programming factor. Based on the limited available research, it seems that a dose of 7 weeks (1–2 sessions per week), with ~80 jumps (specific of combined types) per session, using near-maximal or maximal intensity, with adequate recovery between repetitions (<15 s), sets (≥30 s) and sessions (≥24–48 h), using progressive overload and taper strategies, using appropriate surfaces (e.g., grass), and applied in a well-rested state, when combined with other training methods, would increase the outcome of effective and safe plyometric-jump training interventions aimed at improving soccer players physical fitness. In conclusion, jump training is an effective and easy-to-administer training approach for youth, adult, male and female soccer players. However, optimal programming for plyometric-jump training in soccer is yet to be determined in future research.
Objective: To determine the effects of low- vs. high-intensity aerobic and resistance training on motor and cognitive function, brain activation, brain structure, and neurochemical markers of neuroplasticity and the association thereof in healthy young and older adults and in patients with multiple sclerosis, Parkinson's disease, and stroke. Design: Systematic review and robust variance estimation meta-analysis with meta-regression. Data sources: Systematic search of MEDLINE, Web of Science, and CINAHL databases. Results: Fifty studies with 60 intervention arms and 2283 in-analyses participants were included. Due to the low number of studies, the three patient groups were combined and analyzed as a single group. Overall, low- (g=0.19, p = 0.024) and high-intensity exercise (g=0.40, p = 0.001) improved neuroplasticity. Exercise intensity scaled with neuroplasticity only in healthy young adults but not in healthy older adults or patient groups. Exercise-induced improvements in neuroplasticity were associated with changes in motor but not cognitive outcomes. Conclusion: Exercise intensity is an important variable to dose and individualize the exercise stimulus for healthy young individuals but not necessarily for healthy older adults and neurological patients. This conclusion warrants caution because studies are needed that directly compare the effects of low- vs. high-intensity exercise on neuroplasticity to determine if such changes are mechanistically and incrementally linked to improved cognition and motor function.
Background
Non-invasive transcutaneous auricular vagus nerve stimulation (taVNS) has received tremendous attention as a potential neuromodulator of cognitive and affective functions, which likely exerts its effects via activation of the locus coeruleus-noradrenaline (LC-NA) system. Reliable effects of taVNS on markers of LC-NA system activity, however, have not been demonstrated yet.
Methods
The aim of the present study was to overcome previous limitations by pooling raw data from a large sample of ten taVNS studies (371 healthy participants) that collected salivary alpha-amylase (sAA) as a potential marker of central NA release.
Results
While a meta-analytic approach using summary statistics did not yield any significant effects, linear mixed model analyses showed that afferent stimulation of the vagus nerve via taVNS increased sAA levels compared to sham stimulation (b = 0.16, SE = 0.05, p = 0.001). When considering potential confounders of sAA, we further replicated previous findings on the diurnal trajectory of sAA activity.
Conclusion(s)
Vagal activation via taVNS increases sAA release compared to sham stimulation, which likely substantiates the assumption that taVNS triggers NA release. Moreover, our results highlight the benefits of data pooling and data sharing in order to allow stronger conclusions in research.
Background
Non-invasive transcutaneous auricular vagus nerve stimulation (taVNS) has received tremendous attention as a potential neuromodulator of cognitive and affective functions, which likely exerts its effects via activation of the locus coeruleus-noradrenaline (LC-NA) system. Reliable effects of taVNS on markers of LC-NA system activity, however, have not been demonstrated yet.
Methods
The aim of the present study was to overcome previous limitations by pooling raw data from a large sample of ten taVNS studies (371 healthy participants) that collected salivary alpha-amylase (sAA) as a potential marker of central NA release.
Results
While a meta-analytic approach using summary statistics did not yield any significant effects, linear mixed model analyses showed that afferent stimulation of the vagus nerve via taVNS increased sAA levels compared to sham stimulation (b = 0.16, SE = 0.05, p = 0.001). When considering potential confounders of sAA, we further replicated previous findings on the diurnal trajectory of sAA activity.
Conclusion(s)
Vagal activation via taVNS increases sAA release compared to sham stimulation, which likely substantiates the assumption that taVNS triggers NA release. Moreover, our results highlight the benefits of data pooling and data sharing in order to allow stronger conclusions in research.
Timing of initial school enrollment may vary considerably for various reasons such as early or delayed enrollment, skipped or repeated school classes. Accordingly, the age range within school grades includes older-(OTK) and younger-than-keyage (YTK) children. Hardly any information is available on the impact of timing of school enrollment on physical fitness. There is evidence from a related research topic showing large differences in academic performance between OTK and YTK children versus keyage children. Thus, the aim of this study was to compare physical fitness of OTK (N = 26,540) and YTK (N = 2586) children versus keyage children (N = 108,295) in a representative sample of German third graders. Physical fitness tests comprised cardiorespiratory endurance, coordination, speed, lower, and upper limbs muscle power. Predictions of physical fitness performance for YTK and OTK children were estimated using data from keyage children by taking age, sex, school, and assessment year into account. Data were annually recorded between 2011 and 2019. The difference between observed and predicted z-scores yielded a delta z-score that was used as a dependent variable in the linear mixed models. Findings indicate that OTK children showed poorer performance compared to keyage children, especially in coordination, and that YTK children outperformed keyage children, especially in coordination. Teachers should be aware that OTK children show poorer physical fitness performance compared to keyage children.
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.
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.
Background
Communicating a diagnosis is highly important, yet complex, especially in the context of cancer and mental disorders. The aim was to explore the communication style of an oncologist vs. psychotherapist in an online study.
Methods
Patients (N = 136: 65 cancer, 71 depression) were randomly assigned to watch a standardized video vignette with one of two communication styles (empathic vs. unempathic). Outcome measures of affectivity, information recall, communication skills, empathy and trust were applied.
Results
Regardless of diagnosis, empathic communication was associated with the perception of a significantly more empathic (p < 0.001, η2partial = 0.08) and trustworthy practitioner (p = 0.014, η2partial = 0.04) with better communication skills (p = 0.013, η2partial = 0.05). Cancer patients reported a larger decrease in positive affect (p < 0.001, η2partial = 0.15) and a larger increase in negative affect (p < 0.001, η2partial = 0.14) from pre- to post-video than depressive patients. Highly relevant information was recalled better in both groups (p < 0.001, d = 0.61–1.06).
Conclusions
The results highlight the importance of empathy while communicating both a diagnosis of cancer and a mental disorder. Further research should focus on the communication of a mental disorder in association with cancer.
Purpose: Although subjective knowledge about the prognosis of an advanced disease is extremely important for coping and treatment planning, the concept of prognostic awareness (PA) remains inconsistently defined. The aims of the scoping review were to synthesize a definition of PA from the most recent literature, describe preconditions, correlates and consequences, and suggest a conceptual model.
Methods: By using scoping review methodology, we searched the Web of Science and PubMed databases, and included publications, reviews, meta-analyses or guidelines on all physical diagnoses, as well as publications offering a conceptual or an operational definition of PA. The data were analyzed by means of content analysis techniques.
Results: Of the 24 included publications, 21 referred exclusively to cancer, one to patients with hip fractures and two to palliative care in general. The deduced definition of PA comprised the following facets: adequate estimation of chances for recovery, knowledge of limited time to live, adequate estimation of life expectancy, knowledge of therapy goals, and knowledge of the course of the disease. Further content analysis results were mapped graphically and in a detailed table.
Conclusion: There appears to be a lack of theoretical embedding of PA that in turn influences the methods used for empirical investigation. Drawing on a clear conceptual definition, longitudinal or experimental studies would be desirable.
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.
Background
Millions of people in Germany suffer from chronic pain, in which course and intensity are multifactorial. Besides physical injuries, certain psychosocial risk factors are involved in the disease process. The national health care guidelines for the diagnosis and treatment of non-specific low back pain recommend the screening of psychosocial risk factors as early as possible, to be able to adapt the therapy to patient needs (e.g., unimodal or multimodal). However, such a procedure has been difficult to implement in practice and has not yet been integrated into the rehabilitation care structures across the country.
Methods
The aim of this study is to implement an individualized therapy and aftercare program within the rehabilitation offer of the German Pension Insurance in the area of orthopedics and to examine its success and sustainability in comparison to the previous standard aftercare program.
The study is a multicenter randomized controlled trial including 1204 patients from six orthopedic rehabilitation clinics. A 2:1 allocation ratio to intervention (individualized and home-based rehabilitation aftercare) versus the control group (regular outpatient rehabilitation aftercare) is set. Upon admission to the rehabilitation clinic, participants in the intervention group will be screened according to their psychosocial risk profile. They could then receive either unimodal or multimodal, together with an individualized training program. The program is instructed in the clinic (approximately 3 weeks) and will continue independently at home afterwards for 3 months. The success of the program is examined by means of a total of four surveys. The co-primary outcomes are the Characteristic Pain Intensity and Disability Score assessed by the German version of the Chronic Pain Grade questionnaire (CPG).
Discussion
An improvement in terms of pain, work ability, patient compliance, and acceptance in our intervention program compared to the standard aftercare is expected. The study contributes to provide individualized care also to patients living far away from clinical centers.
Trial registration
DRKS, DRKS00020373. Registered on 15 April 2020
Conceptual knowledge about objects, people and events in the world is central to human cognition, underlying core cognitive abilities such as object recognition and use, and word comprehension. Previous research indicates that concepts consist of perceptual and motor features represented in modality-specific perceptual-motor brain regions. In addition, cross-modal convergence zones integrate modality-specific features into more abstract conceptual representations.
However, several questions remain open: First, to what extent does the retrieval of perceptual-motor features depend on the concurrent task? Second, how do modality-specific and cross-modal regions interact during conceptual knowledge retrieval? Third, which brain regions are causally relevant for conceptually-guided behavior? This thesis addresses these three key issues using functional magnetic resonance imaging (fMRI) and transcranial magnetic stimulation (TMS) in the healthy human brain.
Study 1 - an fMRI activation study - tested to what extent the retrieval of sound and action features of concepts, and the resulting engagement of auditory and somatomotor brain regions depend on the concurrent task. 40 healthy human participants performed three different tasks - lexical decision, sound judgment, and action judgment - on words with a high or low association to sounds and actions. We found that modality-specific regions selectively respond to task-relevant features: Auditory regions selectively responded to sound features during sound judgments, and somatomotor regions selectively responded to action features during action judgments. Unexpectedly, several regions (e.g. the left posterior parietal cortex; PPC) exhibited a task-dependent response to both sound and action features. We propose these regions to be "multimodal", and not "amodal", convergence zones which retain modality-specific information.
Study 2 - an fMRI connectivity study - investigated the functional interaction between modality-specific and multimodal areas during conceptual knowledge retrieval. Using the above fMRI data, we asked (1) whether modality-specific and multimodal regions are functionally coupled during sound and action feature retrieval, (2) whether their coupling depends on the task, (3) whether information flows bottom-up, top-down, or bidirectionally, and (4) whether their coupling is behaviorally relevant. We found that functional coupling between multimodal and modality-specific areas is task-dependent, bidirectional, and relevant for conceptually-guided behavior. Left PPC acted as a connectivity "switchboard" that flexibly adapted its coupling to task-relevant modality-specific nodes.
Hence, neuroimaging studies 1 and 2 suggested a key role of left PPC as a multimodal convergence zone for conceptual knowledge. However, as neuroimaging is correlational, it remained unknown whether left PPC plays a causal role as a multimodal conceptual hub. Therefore, study 3 - a TMS study - tested the causal relevance of left PPC for sound and action feature retrieval. We found that TMS over left PPC selectively impaired action judgments on low sound-low action words, as compared to sham stimulation. Computational simulations of the TMS-induced electrical field revealed that stronger stimulation of left PPC was associated with worse performance on action, but not sound, judgments. These results indicate that left PPC causally supports conceptual processing when action knowledge is task-relevant and cannot be compensated by sound knowledge. Our findings suggest that left PPC is specialized for action knowledge, challenging the view of left PPC as a multimodal conceptual hub.
Overall, our studies support "hybrid theories" which posit that conceptual processing involves both modality-specific perceptual-motor regions and cross-modal convergence zones. In our new model of the conceptual system, we propose conceptual processing to rely on a representational hierarchy from modality-specific to multimodal up to amodal brain regions. Crucially, this hierarchical system is flexible, with different regions and connections being engaged in a task-dependent fashion. Our model not only reconciles the seemingly opposing grounded cognition and amodal theories, it also incorporates task dependency of conceptually-related brain activity and connectivity, thereby resolving several current issues on the neural basis of conceptual knowledge retrieval.
Adaptive Force (AF) reflects the capability of the neuromuscular system to adapt adequately to external forces with the intention of maintaining a position or motion. One specific approach to assessing AF is to measure force and limb position during a pneumatically applied increasing external force. Through this method, the highest (AFmax), the maximal isometric (AFisomax) and the maximal eccentric Adaptive Force (AFeccmax) can be determined. The main question of the study was whether the AFisomax is a specific and independent parameter of muscle function compared to other maximal forces. In 13 healthy subjects (9 male and 4 female), the maximal voluntary isometric contraction (pre- and post-MVIC), the three AF parameters and the MVIC with a prior concentric contraction (MVICpri-con) of the elbow extensors were measured 4 times on two days. Arithmetic mean (M) and maximal (Max) torques of all force types were analyzed. Regarding the reliability of the AF parameters between days, the mean changes were 0.31–1.98 Nm (0.61%–5.47%, p = 0.175–0.552), the standard errors of measurements (SEM) were 1.29–5.68 Nm (2.53%–15.70%) and the ICCs(3,1) = 0.896–0.996. M and Max of AFisomax, AFmax and pre-MVIC correlated highly (r = 0.85–0.98). The M and Max of AFisomax were significantly lower (6.12–14.93 Nm; p ≤ 0.001–0.009) and more variable between trials (coefficient of variation (CVs) ≥ 21.95%) compared to those of pre-MVIC and AFmax (CVs ≤ 5.4%). The results suggest the novel measuring procedure is suitable to reliably quantify the AF, whereby the presented measurement errors should be taken into consideration. The AFisomax seems to reflect its own strength capacity and should be detected separately. It is suggested its normalization to the MVIC or AFmax could serve as an indicator of a neuromuscular function.
Background
Millions of people in Germany suffer from chronic pain, in which course and intensity are multifactorial. Besides physical injuries, certain psychosocial risk factors are involved in the disease process. The national health care guidelines for the diagnosis and treatment of non-specific low back pain recommend the screening of psychosocial risk factors as early as possible, to be able to adapt the therapy to patient needs (e.g., unimodal or multimodal). However, such a procedure has been difficult to implement in practice and has not yet been integrated into the rehabilitation care structures across the country.
Methods
The aim of this study is to implement an individualized therapy and aftercare program within the rehabilitation offer of the German Pension Insurance in the area of orthopedics and to examine its success and sustainability in comparison to the previous standard aftercare program.
The study is a multicenter randomized controlled trial including 1204 patients from six orthopedic rehabilitation clinics. A 2:1 allocation ratio to intervention (individualized and home-based rehabilitation aftercare) versus the control group (regular outpatient rehabilitation aftercare) is set. Upon admission to the rehabilitation clinic, participants in the intervention group will be screened according to their psychosocial risk profile. They could then receive either unimodal or multimodal, together with an individualized training program. The program is instructed in the clinic (approximately 3 weeks) and will continue independently at home afterwards for 3 months. The success of the program is examined by means of a total of four surveys. The co-primary outcomes are the Characteristic Pain Intensity and Disability Score assessed by the German version of the Chronic Pain Grade questionnaire (CPG).
Discussion
An improvement in terms of pain, work ability, patient compliance, and acceptance in our intervention program compared to the standard aftercare is expected. The study contributes to provide individualized care also to patients living far away from clinical centers.
Trial registration
DRKS, DRKS00020373. Registered on 15 April 2020
Background
Communicating a diagnosis is highly important, yet complex, especially in the context of cancer and mental disorders. The aim was to explore the communication style of an oncologist vs. psychotherapist in an online study.
Methods
Patients (N = 136: 65 cancer, 71 depression) were randomly assigned to watch a standardized video vignette with one of two communication styles (empathic vs. unempathic). Outcome measures of affectivity, information recall, communication skills, empathy and trust were applied.
Results
Regardless of diagnosis, empathic communication was associated with the perception of a significantly more empathic (p < 0.001, η2partial = 0.08) and trustworthy practitioner (p = 0.014, η2partial = 0.04) with better communication skills (p = 0.013, η2partial = 0.05). Cancer patients reported a larger decrease in positive affect (p < 0.001, η2partial = 0.15) and a larger increase in negative affect (p < 0.001, η2partial = 0.14) from pre- to post-video than depressive patients. Highly relevant information was recalled better in both groups (p < 0.001, d = 0.61–1.06).
Conclusions
The results highlight the importance of empathy while communicating both a diagnosis of cancer and a mental disorder. Further research should focus on the communication of a mental disorder in association with cancer.
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.
Purpose: Although subjective knowledge about the prognosis of an advanced disease is extremely important for coping and treatment planning, the concept of prognostic awareness (PA) remains inconsistently defined. The aims of the scoping review were to synthesize a definition of PA from the most recent literature, describe preconditions, correlates and consequences, and suggest a conceptual model.
Methods: By using scoping review methodology, we searched the Web of Science and PubMed databases, and included publications, reviews, meta-analyses or guidelines on all physical diagnoses, as well as publications offering a conceptual or an operational definition of PA. The data were analyzed by means of content analysis techniques.
Results: Of the 24 included publications, 21 referred exclusively to cancer, one to patients with hip fractures and two to palliative care in general. The deduced definition of PA comprised the following facets: adequate estimation of chances for recovery, knowledge of limited time to live, adequate estimation of life expectancy, knowledge of therapy goals, and knowledge of the course of the disease. Further content analysis results were mapped graphically and in a detailed table.
Conclusion: There appears to be a lack of theoretical embedding of PA that in turn influences the methods used for empirical investigation. Drawing on a clear conceptual definition, longitudinal or experimental studies would be desirable.
Infants show impressive speech decoding abilities and detect acoustic regularities that highlight the syntactic relations of a language, often coded via non-adjacent dependencies (NADs, e.g., is singing). It has been claimed that infants learn NADs implicitly and associatively through passive listening and that there is a shift from effortless associative learning to a more controlled learning of NADs after the age of 2 years, potentially driven by the maturation of the prefrontal cortex. To investigate if older children are able to learn NADs, Lammertink et al. (2019) recently developed a word-monitoring serial reaction time (SRT) task and could show that 6–11-year-old children learned the NADs, as their reaction times (RTs) increased then they were presented with violated NADs. In the current study we adapted their experimental paradigm and tested NAD learning in a younger group of 52 children between the age of 4–8 years in a remote, web-based, game-like setting (whack-a-mole). Children were exposed to Italian phrases containing NADs and had to monitor the occurrence of a target syllable, which was the second element of the NAD. After exposure, children did a “Stem Completion” task in which they were presented with the first element of the NAD and had to choose the second element of the NAD to complete the stimuli. Our findings show that, despite large variability in the data, children aged 4–8 years are sensitive to NADs; they show the expected differences in r RTs in the SRT task and could transfer the NAD-rule in the Stem Completion task. We discuss these results with respect to the development of NAD dependency learning in childhood and the practical impact and limitations of collecting these data in a web-based setting.
Emotions are a complex concept and they are present in our everyday life. Persons on the autism spectrum are said to have difficulties in social interactions, showing deficits in emotion recognition in comparison to neurotypically developed persons. But social-emotional skills are believed to be positively augmented by training. A new adaptive social cognition training tool “E.V.A.” is introduced which teaches emotion recognition from face, voice and body language. One cross-sectional and one longitudinal study with adult neurotypical and autistic participants were conducted. The aim of the cross-sectional study was to characterize the two groups and see if differences in their social-emotional skills exist. The longitudinal study, on the other hand, aimed for detecting possible training effects following training with the new training tool. In addition, in both studies usability assessments were conducted to investigate the perceived usability of the new tool for neurotypical as well as autistic participants. Differences were found between autistic and neurotypical participants in their social-emotional and emotion recognition abilities. Training effects for neurotypical participants in an emotion recognition task were found after two weeks of home training. Similar perceived usability was found for the neurotypical and autistic participants. The current findings suggest that persons with ASC do not have a general deficit in emotion recognition, but are in need for more time to correctly recognize emotions. In addition, findings suggest that training emotion recognition abilities is possible. Further studies are needed to verify if the training effects found for neurotypical participants also manifest in a larger ASC sample.
The Role of Interoceptive Sensibility and Emotional Conceptualization for the Experience of Emotions
(2021)
The theory of constructed emotions suggests that different psychological components, including core affect (mental and neural representations of bodily changes), and conceptualization (meaning-making based on prior experiences and semantic knowledge), are involved in the formation of emotions. However, little is known about their role in experiencing emotions. In the current study, we investigated how individual differences in interoceptive sensibility and emotional conceptualization (as potential correlates of these components) interact to moderate three important aspects of emotional experiences: emotional intensity (strength of emotion felt), arousal (degree of activation), and granularity (ability to differentiate emotions with precision). To this end, participants completed a series of questionnaires assessing interoceptive sensibility and emotional conceptualization and underwent two emotion experience tasks, which included standardized material (emotion differentiation task; ED task) and self-experienced episodes (day reconstruction method; DRM). Correlational analysis showed that individual differences in interoceptive sensibility and emotional conceptualization were related to each other. Principal Component Analysis (PCA) revealed two independent factors that were referred to as sensibility and monitoring. The Sensibility factor, interpreted as beliefs about the accuracy of an individual in detecting internal physiological and emotional states, predicted higher granularity for negative words. The Monitoring factor, interpreted as the tendency to focus on the internal states of an individual, was negatively related to emotional granularity and intensity. Additionally, Sensibility scores were more strongly associated with greater well-being and adaptability measures than Monitoring scores. Our results indicate that independent processes underlying individual differences in interoceptive sensibility and emotional conceptualization contribute to emotion experiencing.
The Role of Interoceptive Sensibility and Emotional Conceptualization for the Experience of Emotions
(2021)
The theory of constructed emotions suggests that different psychological components, including core affect (mental and neural representations of bodily changes), and conceptualization (meaning-making based on prior experiences and semantic knowledge), are involved in the formation of emotions. However, little is known about their role in experiencing emotions. In the current study, we investigated how individual differences in interoceptive sensibility and emotional conceptualization (as potential correlates of these components) interact to moderate three important aspects of emotional experiences: emotional intensity (strength of emotion felt), arousal (degree of activation), and granularity (ability to differentiate emotions with precision). To this end, participants completed a series of questionnaires assessing interoceptive sensibility and emotional conceptualization and underwent two emotion experience tasks, which included standardized material (emotion differentiation task; ED task) and self-experienced episodes (day reconstruction method; DRM). Correlational analysis showed that individual differences in interoceptive sensibility and emotional conceptualization were related to each other. Principal Component Analysis (PCA) revealed two independent factors that were referred to as sensibility and monitoring. The Sensibility factor, interpreted as beliefs about the accuracy of an individual in detecting internal physiological and emotional states, predicted higher granularity for negative words. The Monitoring factor, interpreted as the tendency to focus on the internal states of an individual, was negatively related to emotional granularity and intensity. Additionally, Sensibility scores were more strongly associated with greater well-being and adaptability measures than Monitoring scores. Our results indicate that independent processes underlying individual differences in interoceptive sensibility and emotional conceptualization contribute to emotion experiencing.
Infants show impressive speech decoding abilities and detect acoustic regularities that highlight the syntactic relations of a language, often coded via non-adjacent dependencies (NADs, e.g., is singing). It has been claimed that infants learn NADs implicitly and associatively through passive listening and that there is a shift from effortless associative learning to a more controlled learning of NADs after the age of 2 years, potentially driven by the maturation of the prefrontal cortex. To investigate if older children are able to learn NADs, Lammertink et al. (2019) recently developed a word-monitoring serial reaction time (SRT) task and could show that 6–11-year-old children learned the NADs, as their reaction times (RTs) increased then they were presented with violated NADs. In the current study we adapted their experimental paradigm and tested NAD learning in a younger group of 52 children between the age of 4–8 years in a remote, web-based, game-like setting (whack-a-mole). Children were exposed to Italian phrases containing NADs and had to monitor the occurrence of a target syllable, which was the second element of the NAD. After exposure, children did a “Stem Completion” task in which they were presented with the first element of the NAD and had to choose the second element of the NAD to complete the stimuli. Our findings show that, despite large variability in the data, children aged 4–8 years are sensitive to NADs; they show the expected differences in r RTs in the SRT task and could transfer the NAD-rule in the Stem Completion task. We discuss these results with respect to the development of NAD dependency learning in childhood and the practical impact and limitations of collecting these data in a web-based setting.
Background: The standard method to treat physically active patients with anterior cruciate ligament (ACL) rupture is ligament reconstruction surgery. The rehabilitation training program is very important to improve functional performance in recreational athletes following ACL reconstruction.
Objectives: The aims of this study were to compare the effects of three different training programs, eccentric training (ECC), plyometric training (PLYO), or combined eccentric and plyometric training (COMB), on dynamic balance (Y-BAL), the Lysholm Knee Scale (LKS), the return to sport index (RSI), and the leg symmetry index (LSI) for the single leg hop test for distance in elite female athletes after ACL surgery.
Materials and Methods: Fourteen weeks after rehabilitation from surgery, 40 elite female athletes (20.3 ± 3.2 years), who had undergone an ACL reconstruction, participated in a short-term (6 weeks; two times a week) training study. All participants received the same rehabilitation protocol prior to the training study. Athletes were randomly assigned to three experimental groups, ECC (n = 10), PLYO (n = 10), and COMB (n = 10), and to a control group (CON: n = 10). Testing was conducted before and after the 6-week training programs and included the Y-BAL, LKS, and RSI. LSI was assessed after the 6-week training programs only.
Results: Adherence rate was 100% across all groups and no training or test-related injuries were reported. No significant between-group baseline differences (pre-6-week training) were observed for any of the parameters. Significant group-by-time interactions were found for Y-BAL (p < 0.001, ES = 1.73), LKS (p < 0.001, ES = 0.76), and RSI (p < 0.001, ES = 1.39). Contrast analysis demonstrated that COMB yielded significantly greater improvements in Y-BAL, LKS, and RSI (all p < 0.001), in addition to significantly better performances in LSI (all p < 0.001), than CON, PLYO, and ECC, respectively.
Conclusion: In conclusion, combined (eccentric/plyometric) training seems to represent the most effective training method as it exerts positive effects on both stability and functional performance in the post-ACL-surgical rehabilitation period of elite female athletes.
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.
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.
Background: The standard method to treat physically active patients with anterior cruciate ligament (ACL) rupture is ligament reconstruction surgery. The rehabilitation training program is very important to improve functional performance in recreational athletes following ACL reconstruction.
Objectives: The aims of this study were to compare the effects of three different training programs, eccentric training (ECC), plyometric training (PLYO), or combined eccentric and plyometric training (COMB), on dynamic balance (Y-BAL), the Lysholm Knee Scale (LKS), the return to sport index (RSI), and the leg symmetry index (LSI) for the single leg hop test for distance in elite female athletes after ACL surgery.
Materials and Methods: Fourteen weeks after rehabilitation from surgery, 40 elite female athletes (20.3 ± 3.2 years), who had undergone an ACL reconstruction, participated in a short-term (6 weeks; two times a week) training study. All participants received the same rehabilitation protocol prior to the training study. Athletes were randomly assigned to three experimental groups, ECC (n = 10), PLYO (n = 10), and COMB (n = 10), and to a control group (CON: n = 10). Testing was conducted before and after the 6-week training programs and included the Y-BAL, LKS, and RSI. LSI was assessed after the 6-week training programs only.
Results: Adherence rate was 100% across all groups and no training or test-related injuries were reported. No significant between-group baseline differences (pre-6-week training) were observed for any of the parameters. Significant group-by-time interactions were found for Y-BAL (p < 0.001, ES = 1.73), LKS (p < 0.001, ES = 0.76), and RSI (p < 0.001, ES = 1.39). Contrast analysis demonstrated that COMB yielded significantly greater improvements in Y-BAL, LKS, and RSI (all p < 0.001), in addition to significantly better performances in LSI (all p < 0.001), than CON, PLYO, and ECC, respectively.
Conclusion: In conclusion, combined (eccentric/plyometric) training seems to represent the most effective training method as it exerts positive effects on both stability and functional performance in the post-ACL-surgical rehabilitation period of elite female athletes.
Research on problem solving offers insights into how humans process task-related information and which strategies they use (Newell and Simon, 1972; Öllinger et al., 2014). Problem solving can be defined as the search for possible changes in one's mind (Kahneman, 2003). In a recent study, Adams et al. (2021) assessed whether the predominant problem solving strategy when making changes involves adding or subtracting elements. In order to do this, they used several examples of simple problems, such as editing text or making visual patterns symmetrical, either in naturalistic settings or on-line. The essence of the authors' findings is a strong preference to add rather than subtract elements across a diverse range of problems, including the stabilizing of artifacts, creating symmetrical patterns, or editing texts. More specifically, they succeeded in demonstrating that “participants were less likely to identify advantageous subtractive changes when the task did not (vs. did) cue them to consider subtraction, when they had only one opportunity (vs. several) to recognize the shortcomings of an additive search strategy or when they were under a higher (vs. lower) cognitive load” (Adams et al., 2021, p. 258).
Addition and subtraction are generally defined as de-contextualized mathematical operations using abstract symbols (Russell, 1903/1938). Nevertheless, understanding of both symbols and operations is informed by everyday activities, such as making or breaking objects (Lakoff and Núñez, 2000; Fischer and Shaki, 2018). The universal attribution of “addition bias” or “subtraction neglect” to problem solving activities is perhaps a convenient shorthand but it overlooks influential framing effects beyond those already acknowledged in the report and the accompanying commentary (Meyvis and Yoon, 2021).
Most importantly, while Adams et al.'s study addresses an important issue, their very method of verbally instructing participants, together with lack of control over several known biases, might render their findings less than conclusive. Below, we discuss our concerns that emerged from the identified biases, namely those regarding the instructions and the experimental materials. Moreover, we refer to research from mathematical cognition that provides new insights into Adams et al.'s findings.