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Bone pathology is frequent in stressed individuals. A comprehensive examination of mechanisms linking life stress, depression and disturbed bone homeostasis is missing. In this translational study, mice exposed to early life stress (MSUS) were examined for bone microarchitecture (μCT), metabolism (qPCR/ELISA), and neuronal stress mediator expression (qPCR) and compared with a sample of depressive patients with or without early life stress by analyzing bone mineral density (BMD) (DXA) and metabolic changes in serum (osteocalcin, PINP, CTX-I). MSUS mice showed a significant decrease in NGF, NPYR1, VIPR1 and TACR1 expression, higher innervation density in bone, and increased serum levels of CTX-I, suggesting a milieu in favor of catabolic bone turnover. MSUS mice had a significantly lower body weight compared to control mice, and this caused minor effects on bone microarchitecture. Depressive patients with experiences of childhood neglect also showed a catabolic pattern. A significant reduction in BMD was observed in depressive patients with childhood abuse and stressful life events during childhood. Therefore, future studies on prevention and treatment strategies for both mental and bone disease should consider early life stress as a risk factor for bone pathologies.
The present study focuses on an innovative approach in measuring the mechanical oscillations of pre-loaded Achilles tendon by using Mechanotendography (MTG) during application of a short yet powerful mechanical pressure impact. This was applied on the forefoot from the plantar side in direction of dorsiflexion, while the subject stood on the ball of the forefoot on one leg. Participants with Achilles tendinopathy (AT; n = 10) were compared to healthy controls (Con; n = 10). Five trials were performed on each side of the body. For evaluation, two intervals after the impulse began (0-100ms; 30-100ms) were cut from the MTG and pressure raw signals. The intrapersonal variability between the five trials in both intervals were evaluated using the arithmetic mean and coefficient of variation of the mean correlation (Spearman rank correlation) and the normalized averaged mean distances, respectively. The AT-group showed a significantly reduced variability in MTG compared to the Con-group (from p = 0.006 to p = 0.028 for different parameters). The 95% confidence intervals (CI) of MTG results were disjoint, whereas the 95% CIs of the pressure signals were similar (p = 0.192 to p = 0.601). We suggest from this work that the variability of mechanical tendon oscillations could be an indicative parameter of an altered Achilles tendon functionality.
Understanding the development of spoken language in young children has become increasingly important for advancing basic theories of language acquisition and for clinical practice. However, such a goal requires refined measurements of speech articulation (e.g., from the tongue), which are difficult to obtain from young children. In recent years though, technological advances have allowed developmental researchers to make significant steps in that direction. For instance, movements of the tongue, an articulator that is essential for spoken language, can now be tracked and recorded in children with ultrasound imaging. This technique has opened novel research avenues in (a)typical language acquisition, enabling researchers to reliably capture what has long remained invisible in the speech of young children. Within this context, we have designed an experimental platform for the recording and the processing of kinematic data: SOLLAR (Sonographic and Optical Linguo-Labial Articulatory Recording system). The method has been tailored for children, but it is suitable for adults. In the present article, we introduce the recording environment developed to record over 100 children and 30 adults within SOLLAR. We then describe SOLLAR’s data processing framework, providing examples of data visualization and a summary of strengths and limitations.
This study aimed to investigate the relationship between the acute to chronic workload ratio (ACWR), based upon participant session rating of perceived exertion (sRPE), using two models [(1) rolling averages (ACWRRA); and (2) exponentially weighted moving averages (ACWREWMA)] and the injury rate in young male team soccer players aged 17.1 ± 0.7 years during a competitive mesocycle. Twenty-two players were enrolled in this study and performed four training sessions per week with 2 days of recovery and 1 match day per week. During each training session and each weekly match, training time and sRPE were recorded. In addition, training impulse (TRIMP), monotony, and strain were subsequently calculated. The rate of injury was recorded for each soccer player over a period of 4 weeks (i.e., 28 days) using a daily questionnaire. The results showed that over the course of the study, the number of non-contact injuries was significantly higher than that for contact injuries (2.5 vs. 0.5, p = 0.01). There were also significant positive correlations between sRPE and training time (r = 0.411, p = 0.039), ACWRRA (r = 0.47, p = 0.049), and ACWREWMA (r = 0.51, p = 0.038). In addition, small-to-medium correlations were detected between ACWR and non-contact injury occurrence (ACWRRA, r = 0.31, p = 0.05; ACWREWMA, r = 0.53, p = 0.03). Explained variance (r 2) for non-contact injury was significantly greater using the ACWREWMA model (ranging between 21 and 52%) compared with ACWRRA (ranging between 17 and 39%). In conclusion, the results of this study showed that the ACWREWMA model is more sensitive than ACWRRA to identify non-contact injury occurrence in male team soccer players during a short period in the competitive season.
Adolescents growing up in culturally diverse societies need to develop intercultural competence. To better understand how to develop intercultural competence we need measures specifically relating to the everyday intercultural experiences of adolescents. However, few measures of intercultural competence are available for this target group. Based on the cultural intelligence (CQ) model (Earley & Ang, 2003), we developed a measure that combines a self-report questionnaire and situational judgment tests (SJTs). The latter comprise a brief description of intercultural situations, followed by questions asking the adolescents to interpret and provide a reaction to the situations. The reliability, factor structure, measurement equivalence, and validity of the new measure was tested in two samples of adolescents in culturally diverse regions in North Rhine-Westphalia (N = 631, 48% female, M-a(ge) = 13.69 years, SDage = 1.83) and Berlin (N = 1,335, 48% female, M-age = 14.69 years, SDage, = 0.74) in Germany. The self-report CQ scale showed good reliability and a four-dimensional factor structure with a higher-order CQ factor. The responses to the SJTs were coded based on a coding manual and the ratings loaded onto one factor. The measurement models showed metric to scalar measurement equivalence across immigrant background, gender, and grade. The CQ factor and the SJT factor were positively correlated with each other, as well as with related constructs such as openness, perspective-taking, and diversity beliefs. We conclude that the new measure offers a reliable and valid method to assess the intercultural competence of adolescents growing up in culturally diverse societies.
Background
Weight-related stigmatization is a widespread problem. Particularly the internalization of weight-related stereotypes and prejudices (weight bias internalization, WBI) is related to mental and physical health impairments. To date, little is known about the risk factors of WBI. Previous studies are mainly cross-sectional and based on adult samples. As childhood is a sensitive period for the development of a healthy self-concept, we examined predictors of WBI in children.
Methods
The final sample included 1,463 schoolchildren (6–11 years, 51.7% female) who took part in a prospective study consisting of three measurement waves. The first two waves delivered data on objective weight status and self-reported weight-related teasing, body dissatisfaction, relevance of one’s own figure, self-esteem and depressive symptoms; WBI was measured during the third wave. To examine predictors of WBI, we ran hierarchical regression analyses and exploratory mediation analyses.
Results
Lower parental education level, higher child weight status, female gender, experience of teasing, higher body dissatisfaction, higher figure-relevance, and higher depression scores were found to be predictive for higher WBI scores. Body dissatisfaction (only for girls) and the relevance of one’s own figure (both genders) mediated the association between self-esteem and WBI; no weight-related differences were observed.
Conclusions
Our study offers longitudinal evidence for variables that enable the identification of children who are at risk for WBI. Thus, the findings deliver starting points for interventions aimed at the prevention of adverse health developments that come along with WBI.
Strength training is an important means for performance development in young rowers. The purpose of this study was to examine the effects of a 9-week equal volume heavy-resistance strength training (HRST) versus strength endurance training (SET) in addition to regular rowing training on primary (e.g., maximal strength/power) and secondary outcomes (e.g., balance) in young rowers. Twenty-six female elite adolescent rowers were assigned to an HRST (n = 12; age: 13.2 ± 0.5 yrs; maturity-offset: +2.0 ± 0.5 yrs) or a SET group (n = 14; age: 13.1 ± 0.5 yrs; maturity-offset: +2.1 ± 0.5 yrs). HRST and SET comprised lower- (i.e., leg press/knee flexion/extension), upper-limbs (i.e., bench press/pull; lat-pull down), and complex exercises (i.e., rowing ergometer). HRST performed four sets with 12 repetitions per set at an intensity of 75–95% of the one-repetition maximum (1-RM). SET conducted four sets with 30 repetitions per set at 50–60% of the 1-RM. Training volume was matched for overall repetitions × intensity × training per week. Pre-post training, tests were performed for the assessment of primary [i.e., maximal strength (e.g., bench pull/knee flexion/extension 1-RM/isometric handgrip test), muscle power (e.g., medicine-ball push test, triple hop, drop jump, and countermovement jump), anaerobic endurance (400-m run), sport-specific performance (700-m rowing ergometer trial)] and secondary outcomes [dynamic balance (Y-balance test), change-of-direction (CoD) speed (multistage shuttle-run test)]. Adherence rate was >87% and one athlete of each group dropped out. Overall, 24 athletes completed the study and no test or training-related injuries occurred. Significant group × time interactions were observed for maximal strength, muscle power, anaerobic endurance, CoD speed, and sport-specific performance (p ≤ 0.05; 0.45 ≤ d ≤ 1.11). Post hoc analyses indicated larger gains in maximal strength and muscle power following HRST (p ≤ 0.05; 1.81 ≤ d ≤ 3.58) compared with SET (p ≤ 0.05; 1.04 ≤ d ≤ 2.30). Furthermore, SET (p ≤ 0.01; d = 2.08) resulted in larger gains in sport-specific performance compared with HRST (p < 0.05; d = 1.3). Only HRST produced significant pre-post improvements for anaerobic endurance and CoD speed (p ≤ 0.05; 1.84 ≤ d ≤ 4.76). In conclusion, HRST in addition to regular rowing training was more effective than SET to improve selected measures of physical fitness (i.e., maximal strength, muscle power, anaerobic endurance, and CoD speed) and SET was more effective than HRST to enhance sport-specific performance gains in female elite young rowers.
The aim of this study was to establish maturation-, age-, and sex-specific anthropometric and physical fitness percentile reference values of young elite athletes from various sports. Anthropometric (i.e., standing and sitting body height, body mass, body mass index) and physical fitness (i.e., countermovement jump, drop jump, change-of-direction speed [i.e., T-test], trunk muscle endurance [i.e., ventral Bourban test], dynamic lower limbs balance [i.e., Y-balance test], hand grip strength) of 703 male and female elite young athletes aged 8–18 years were collected to aggregate reference values according to maturation, age, and sex. Findings indicate that body height and mass were significantly higher (p<0.001; 0.95≤d≤1.74) in more compared to less mature young athletes as well as with increasing chronological age (p<0.05; 0.66≤d≤3.13). Furthermore, male young athletes were significantly taller and heavier compared to their female counterparts (p<0.001; 0.34≤d≤0.50). In terms of physical fitness, post-pubertal athletes showed better countermovement jump, drop jump, change-of-direction, and handgrip strength performances (p<0.001; 1.57≤d≤8.72) compared to pubertal athletes. Further, countermovement jump, drop jump, change-of-direction, and handgrip strength performances increased with increasing chronological age (p<0.05; 0.29≤d≤4.13). In addition, male athletes outperformed their female counterpart in the countermovement jump, drop jump, change-of-direction, and handgrip strength (p<0.05; 0.17≤d≤0.76). Significant age by sex interactions indicate that sex-specific differences were even more pronounced with increasing age. Conclusively, body height, body mass, and physical fitness increased with increasing maturational status and chronological age. Sex-specific differences appear to be larger as youth grow older. Practitioners can use the percentile values as approximate benchmarks for talent identification and development.
Background: The regular assessment of hormonal and mood state parameters in professional soccer are proposed as good indicators during periods of intense training and/or competition to avoid overtraining.
Objective: The aim of this study was to analyze hormonal, psychological, workload and physical fitness parameters in elite soccer players in relation to changes in training and match exposure during a congested period of match play.
Methods: Sixteen elite soccer players from a team playing in the first Tunisian soccer league were evaluated three times (T1, T2, and T3) over 12 weeks. The non-congested period of match play was from T1 to T2, when the players played 6 games over 6 weeks. The congested period was from T2 to T3, when the players played 10 games over 6 weeks. From T1 to T3, players performed the Yo-Yo intermittent recovery test level 1 (YYIR1), the repeated shuttle sprint ability test (RSSA), the countermovement jump test (CMJ), and the squat jump test (SJ). Plasma Cortisol (C), Testosterone (T), and the T/C ratio were analyzed at T1, T2, and T3. Players had their mood dimensions (tension, depression, anger, vigor, fatigue, confusion, and a Total Mood Disturbance) assessed through the Profile of Mood State questionnaire (POMS). Training session rating of perceived exertion (sRPE) was also recorded on a daily basis in order to quantify internal training load and elements of monotony and strain.
Results: Significant performance declines (T1 < T2 < T3) were found for SJ performance (p = 0.04, effect size [ES] ES₁₋₂ = 0.15−0.06, ES₂₋₃ = 0.24) from T1 to T3. YYIR1 performance improved significantly from T1 to T2 and declined significantly from T2 to T3 (p = 0.001, ES₁₋₂ = 0.24, ES₂₋₃ = −2.54). Mean RSSA performance was significantly higher (p = 0.019, ES₁₋₂ = −0.47, ES₂₋₃ = 1.15) in T3 compared with T2 and T1. Best RSSA performance was significantly higher in T3 when compared with T2 and T1 (p = 0.006, ES₂₋₃ = 0.47, ES₁₋₂ = −0.56), but significantly lower in T2 when compared with to T1. T and T/C were significantly lower in T3 when compared with T2 and T1 (T: p = 0.03, ES₃₋₂ = −0.51, ES₃₋₁ = −0.51, T/C: p = 0.017, ES₃₋₂ = −1.1, ES₃₋₁ = −1.07). Significant decreases were found for the vigor scores in T3 when compared to T2 and T1 (p = 0.002, ES₁₋₂ = 0.31, ES₃₋₂ = −1.25). A significant increase was found in fatigue scores in T3 as compared to T1 and T2 (p = 0.002, ES₁₋₂ = 0.43, ES₂₋₃ = 0.81). A significant increase was found from T1 < T2 < T3 intension score (p = 0.002, ES₁₋₂ = 1.1, ES₂₋₃ = 0.2) and anger score (p = 0.03, ES₁₋₂ = 0.47, ES₂₋₃ = 0.33) over the study period. Total mood disturbance increased significantly (p = 0.02, ES₁₋₂ = 0.91, ES₂₋₃ = 1.1) from T1 to T3. Between T1-T2, significant relationships were observed between workload and changes in T (r = 0.66, p = 0.003), and T/C ratio (r = 0.62, p = 0.01). There were significant relationships between performance in RSSAbest and training load parameters (workload: r = 0.52, p = 0.03; monotony: r = 0.62, p = 0.01; strain: r = 0.62, p = 0.009). Between T2-T3, there was a significant relationship between Δ% of total mood disturbance and Δ% of YYIR1 (r = −0.54; p = 0.04), RSSAbest (r = 0.58, p = 0.01), SJ (r = −0,55, p = 0.01), T (r = 0.53; p = 0.03), and T/C (r = 0.5; p = 0.04).
Conclusion: An intensive period of congested match play significantly compromised elite soccer players’ physical and mental fitness. These changes were related to psychological but not hormonal parameters; even though significant alterations were detected for selected measures. Mood monitoring could be a simple and useful tool to determine the degree of preparedness for match play during a congested period in professional soccer.
Internalizing problems in children belong to the category of special educational needs called emotional and behavioral difficulties. Recent decades have witnessed a critical discussion about whether children and adolescents experiencing internalizing problems are at risk of being sociometrically neglected (neither liked nor disliked by their peers). Previous studies have shown evidence both for and against the association between internalizing problems and neglected sociometric status. These contradictory results may be due to the following methodological aspects: (1) shortcomings of sociometric status classification methods (arbitrariness of the sociometric classification rules) and (2) different operationalizations of internalizing problems (broadband and narrowband dimensions of behavior). The aim of the present study is to investigate empirically whether and to what extent these methodological aspects lead to contradictory results on the internalizing behavior of neglected students. This question is investigated using a sample of students (N = 2334) in German inclusive primary schools. The systematic investigation presented here provides initial indications that the various methodological approaches can lead to conflicting results. The contradictory results are not only due to the application of different sociometric classification methods, but also to different operationalizations of internalizing behavior (narrowband and broadband scales). Earlier contradictory evidence on the internalizing behavior of neglected students must therefore be seen in a different light: the reasons for previously conflicting results may actually be methodological. Based on the results, conclusions are drawn as to how methodological aspects can be given more consideration in sociometric research on internalizing behavior.
Previous clinical research found that invasive vagus nerve stimulation (VNS) enhanced word recognition memory in epileptic patients, an effect assumed to be related to the activation of brainstem arousal systems. In this study, we applied non-invasive transcutaneous auricular VNS (tVNS) to replicate and extend the previous work. Using a single-blind, randomized, between-subject design, 60 healthy volunteers received active or sham stimulation during a lexical decision task, in which emotional and neutral stimuli were classified as words or non-words. In a subsequent recognition memory task (1 day after stimulation), participants' memory performance on these words and their subjective memory confidence were tested. Salivary alpha-amylase (sAA) levels, a putative indirect measure of central noradrenergic activation, were also measured before and after stimulation. During encoding, pleasant words were more accurately detected than neutral and unpleasant words. However, no tVNS effects were observed on task performance or on overall sAA level changes. tVNS also did not modulate overall recognition memory, which was particularly enhanced for pleasant emotional words. However, when hit rates were split based on confidence ratings reflecting familiarity- and recollection-based memory, higher recollection-based memory performance (irrespective of emotional category) was observed during active stimulation than during sham stimulation. To summarize, we replicated prior findings of enhanced processing and memory for emotional (pleasant) words. Whereas tVNS showed no effects on word processing, subtle effects on recollection-based memory performance emerged, which may indicate that tVNS facilitates hippocampus-mediated consolidation processes.
Although a relatively large number of studies on acquired language impairments have tested the case of derivational morphology, none of these have specifically investigated whether there are differences in how prefixed and suffixed derived words are impaired. Based on linguistic and psycholinguistic considerations on prefixed and suffixed derived words, differences in how these two types of derivations are processed, and consequently impaired, are predicted. In the present study, we investigated the errors produced in reading aloud simple, prefixed, and suffixed words by three German individuals with agrammatic aphasia (NN, LG, SA). We found that, while NN and LG produced similar numbers of errors with prefixed and suffixed words, SA showed a selective impairment for prefixed words. Furthermore, NN and SA produced more errors specifically involving the affix with prefixed words than with suffixed words. We discuss our findings in terms of relative position of stem and affix in prefixed and suffixed words, as well as in terms of specific properties of prefixes and suffixes.
Background
Aim of the study was to find predictors of allocating patients after transcatheter aortic valve implantation (TAVI) to geriatric (GR) or cardiac rehabilitation (CR) and describe this new patient group based on a differentiated characterization.
Methods
From 10/2013 to 07/2015, 344 patients with an elective TAVI were consecutively enrolled in this prospective multicentric cohort study. Before intervention, sociodemographic parameters, echocardiographic data, comorbidities, 6-min walk distance (6MWD), quality of life and frailty (score indexing activities of daily living [ADL], cognition, nutrition and mobility) were documented. Out of these, predictors for assignment to CR or GR after TAVI were identified using a multivariable regression model.
Results
After TAVI, 249 patients (80.7 ± 5.1 years, 59.0% female) underwent CR (n = 198) or GR (n = 51). GR patients were older, less physically active and more often had a level of care, peripheral artery disease as well as a lower left ventricular ejection fraction. The groups also varied in 6MWD. Furthermore, individual components of frailty revealed prognostic impact: higher values in instrumental ADL reduced the probability for referral to GR (OR:0.49, p < 0.001), while an impaired mobility was positively associated with referral to GR (OR:3.97, p = 0.046). Clinical parameters like stroke (OR:0.19 of GR, p = 0.038) and the EuroSCORE (OR:1.04 of GR, p = 0.026) were also predictive.
Conclusion
Advanced age patients after TAVI referred to CR or GR differ in several parameters and seem to be different patient groups with specific needs, e.g. regarding activities of daily living and mobility. Thus, our data prove the eligibility of both CR and GR settings.
Objective: To determine immediate performance measures for short-term, multicomponent cardiac rehabilitation (CR) in clinical routine in patients of working age, taking into
account cardiovascular risk factors, physical performance, social medicine, and subjective health parameters and to explore the underlying dimensionality.
Design: Prospective observational multicenter register study in 12 rehabilitation centers throughout Germany.
Setting: Comprehensive 3-week CR.
This study is the first to use kinematic data to assess lingual carryover coarticulation in children. We investigated whether the developmental decrease previously attested in anticipatory coarticulation, as well as the relation between coarticulatory degree and the consonantal context, also characterize carryover coarticulation. Sixty-two children and 13 adults, all native speakers of German, were recruited according to five age cohorts: three-year-olds, four-year-olds, five-year-olds, seven-year-olds, and adults. Tongue movements during the production of ə.CV.Cə utterances (C = /b, d, g/, V = /i, y, e, a, o, u/) were recorded with ultrasound. We measured vowel-induced horizontal displacement of the tongue dorsum within the last syllable and compared the resulting coarticulatory patterns between age cohorts and consonantal contexts. Results indicate that the degree of vocalic carryover coarticulation decreases with age. Vocalic prominence within an utterance as well as its change across childhood depended on the postvocalic consonant’s articulatory demands for the tongue dorsum (i.e., its coarticulatory resistance): Low resistant /b/ and /g/ allowed for more vocalic perseveration and a continuous decrease, while the highly resistant /d/ displayed lower coarticulation degrees and discontinuous effects. These findings parallel those in anticipation suggesting a similar organization of anticipatory and carryover coarticulation. Implications for theories of speech production are discussed.
This study aimed to investigate the relationship between the acute to chronic workload ratio (ACWR), based upon participant session rating of perceived exertion (sRPE), using two models [(1) rolling averages (ACWRRA); and (2) exponentially weighted moving averages (ACWREWMA)] and the injury rate in young male team soccer players aged 17.1 ± 0.7 years during a competitive mesocycle. Twenty-two players were enrolled in this study and performed four training sessions per week with 2 days of recovery and 1 match day per week. During each training session and each weekly match, training time and sRPE were recorded. In addition, training impulse (TRIMP), monotony, and strain were subsequently calculated. The rate of injury was recorded for each soccer player over a period of 4 weeks (i.e., 28 days) using a daily questionnaire. The results showed that over the course of the study, the number of non-contact injuries was significantly higher than that for contact injuries (2.5 vs. 0.5, p = 0.01). There were also significant positive correlations between sRPE and training time (r = 0.411, p = 0.039), ACWRRA (r = 0.47, p = 0.049), and ACWREWMA (r = 0.51, p = 0.038). In addition, small-to-medium correlations were detected between ACWR and non-contact injury occurrence (ACWRRA, r = 0.31, p = 0.05; ACWREWMA, r = 0.53, p = 0.03). Explained variance (r²) for non-contact injury was significantly greater using the ACWREWMA model (ranging between 21 and 52%) compared with ACWRRA (ranging between 17 and 39%). In conclusion, the results of this study showed that the ACWREWMA model is more sensitive than ACWRRA to identify non-contact injury occurrence in male team soccer players during a short period in the competitive season.
Recent studies have suggested that musical rhythm perception ability can affect the phonological system. The most prevalent causal account for developmental dyslexia is the phonological deficit hypothesis. As rhythm is a subpart of phonology, we hypothesized that reading deficits in dyslexia are associated with rhythm processing in speech and in music. In a rhythmic grouping task, adults with diagnosed dyslexia and age-matched controls listened to speech streams with syllables alternating in intensity, duration, or neither, and indicated whether they perceived a strong-weak or weak-strong rhythm pattern. Additionally, their reading and musical rhythm abilities were measured. Results showed that adults with dyslexia had lower musical rhythm abilities than adults without dyslexia. Moreover, lower musical rhythm ability was associated with lower reading ability in dyslexia. However, speech grouping by adults with dyslexia was not impaired when musical rhythm perception ability was controlled: like adults without dyslexia, they showed consistent preferences. However, rhythmic grouping was predicted by musical rhythm perception ability, irrespective of dyslexia. The results suggest associations among musical rhythm perception ability, speech rhythm perception, and reading ability. This highlights the importance of considering individual variability to better understand dyslexia and raises the possibility that musical rhythm perception ability is a key to phonological and reading acquisition.
Background
Psychotherapy is highly effective and widely acknowledged for treating various mental disorders. Nevertheless, in terms of methods for teaching effective psychotherapeutic approaches and competencies, there has been a lack of investigation. Training and supervision are the main strategies for teaching therapist competencies, and standardized role-plays with simulated patients (i.e., trained individuals playing someone with a mental disorder) seem useful for evaluating training approaches. In medical education, this procedure is now internationally established. However, so far, little use has been made of standardized role-playing to evaluate training and supervision in the area of clinical psychology and psychotherapy.
Methods
In this study, standardized role-plays are used to evaluate methods for training and supervision. Central cognitive behavioral approaches for treating depression are taught in the training. The first experiment compares an active training approach (i.e., model learning) with a passive one (i.e., reading manual-based instructions). The second experiment compares a direct supervision technique (i.e., supervision based on video analysis) with an indirect one (i.e., supervision based on verbal reporting). In each experiment, 68 bachelor’s and master’s students of psychology will be randomly assigned to the experimental and control groups. Each student takes part in three role-plays (baseline, post and 3-month follow-up), which are all videotaped. Two independent raters assess therapist competencies in each role-play on the basis of a standardized competence scale.
Discussion
The research project aims to contribute to the development of specific training and supervision methods in order to improve psychotherapy training and patient care.
Commentary
(2020)
The pathophysiology of Parkinson’s disease (PD) is still not understood. There are investigations which show a changed oscillatory behaviour of brain circuits or changes in variability of, e.g., gait parameters in PD. The aim of this study was to investigate whether or not the motor output differs between PD patients and healthy controls. Thereby, patients without tremor are investigated in the medication off state performing a special bilateral isometric motor task. The force and accelerations (ACC) were recorded as well as the Mechanomyography (MMG) of the biceps brachii, the brachioradialis and of the pectoralis major muscles using piezoelectric-sensors during the bilateral motor task at 60% of the maximal isometric contraction. The frequency, a specific power ratio, the amplitude variation and the slope of amplitudes were analysed. The results indicate that the oscillatory behaviour of motor output in PD patients without tremor deviates from controls: thereby, the 95%-confidence-intervals of power ratio and of amplitude variation of all signals are disjoint between PD and controls and show significant differences in group comparisons (power ratio: p = 0.000–0.004, r = 0.441–0.579; amplitude variation: p = 0.000–0.001, r = 0.37–0.67). The mean frequency shows a significant difference for ACC (p = 0.009, r = 0.43), but not for MMG. It remains open, whether this muscular output reflects changes of brain circuits and whether the results are reproducible and specific for PD.
I Can See It in Your Face.
(2019)
The purpose of this study was to illustrate that people’s affective valuation of exercise can be identified in their faces. The study was conducted with a software for automatic facial expression analysis and it involved testing the hypothesis that positive or negative affective valuation occurs spontaneously when people are reminded of exercise. We created a task similar to an emotional Stroop task, in which participants responded to exercise-related and control stimuli with a positive or negative facial expression (smile or frown) depending on whether the photo was presented upright or tilted. We further asked participants how much time they would normally spend for physical exercise, because we assumed that the affective valuation of those who exercise more would be more positive. Based on the data of 86 participants, regression analysis revealed that those who reported less exercise and a more negative reflective evaluation of exercise initiated negative facial expressions on exercise-related stimuli significantly faster than those who reported exercising more often. No significant effect was observed for smile responses. We suspect that responding with a smile to exercise-related stimuli was the congruent response for the majority of our participants, so that for them no Stroop interference occurred in the exercise-related condition. This study suggests that immediate negative affective reactions to exercise-related stimuli result from a postconscious automatic process and can be detected in the study participants’ faces. It furthermore illustrates how methodological paradigms from social–cognition research (here: the emotional Stroop paradigm) can be adapted to collect and analyze biometric data for the investigation of exercisers’ and non-exercisers’ automatic valuations of exercise.
In daily life, we automatically form impressions of other individuals on basis of subtle facial features that convey trustworthiness. Because these face-based judgements influence current and future social interactions, we investigated how perceived trustworthiness of faces affects long-term memory using event-related potentials (ERPs). In the current study, participants incidentally viewed 60 neutral faces differing in trustworthiness, and one week later, performed a surprise recognition memory task, in which the same old faces were presented intermixed with novel ones. We found that after one week untrustworthy faces were better recognized than trustworthy faces and that untrustworthy faces prompted early (350–550 ms) enhanced frontal ERP old/new differences (larger positivity for correctly remembered old faces, compared to novel ones) during recognition. Our findings point toward an enhanced long-lasting, likely familiarity-based, memory for untrustworthy faces. Even when trust judgments about a person do not necessarily need to be accurate, a fast access to memories predicting potential harm may be important to guide social behaviour in daily life.
Background
Sand is an easy-to-access, cost-free resource that can be used to treat pronated feet (PF). Therefore, the aims of this study were to contrast the effects of walking on stable ground versus walking on sand on ground reaction forces (GRFs) and electromyographic (EMG) activity of selected lower limb muscles in PF individuals compared with healthy controls.
Methods
Twenty-nine controls aged 22.2±2.5 years and 30 PF individuals aged 22.2±1.9 years were enrolled in this study. Participants walked at preferred speed and in randomized order over level ground and sand. A force plate was included in the walkway to collect GRFs. Muscle activities were recorded using EMG system.
Results
No statistically significant between-group differences were found in preferred walking speed when walking on stable ground (PF: 1.33±0.12 m/s; controls: 1.35±0.14 m/s; p = 0.575; d = 0.15) and sand (PF: 1.19±0.11 m/s; controls: 1.23±0.18 m/s; p = 0.416; d = 0.27). Irrespective of the group, walking on sand (1.21±0.15 m/s) resulted in significantly lower gait speed compared with stable ground walking (1.34±0.13 m/s) (p<0.001; d = 0.93). Significant main effects of “surface” were found for peak posterior GRFs at heel contact, time to peak for peak lateral GRFs at heel contact, and peak anterior GRFs during push-off (p<0.044; d = 0.27–0.94). Pair-wise comparisons revealed significantly smaller peak posterior GRFs at heel contact (p = 0.005; d = 1.17), smaller peak anterior GRFs during push-off (p = 0.001; d = 1.14), and time to peak for peak lateral GRFs (p = 0.044; d = 0.28) when walking on sand. No significant main effects of “group” were observed for peak GRFs and their time to peak (p>0.05; d = 0.06–1.60). We could not find any significant group by surface interactions for peak GRFs and their time to peak. Significant main effects of “surface” were detected for anterior-posterior impulse and peak positive free moment amplitude (p<0.048; d = 0.54–0.71). Pair-wise comparisons revealed a significantly larger peak positive free moment amplitude (p = 0.010; d = 0.71) and a lower anterior-posterior impulse (p = 0.048; d = 0.38) when walking on sand. We observed significant main effects of “group” for the variable loading rate (p<0.030; d = 0.59). Pair-wise comparisons revealed significantly lower loading rates in PF compared with controls (p = 0.030; d = 0.61). Significant group by surface interactions were observed for the parameter peak positive free moment amplitude (p<0.030; d = 0.59). PF individuals exhibited a significantly lower peak positive free moment amplitude (p = 0.030, d = 0.41) when walking on sand. With regards to EMG, no significant main effects of “surface”, main effects of “group”, and group by surface interactions were observed for the recorded muscles during the loading and push-off phases (p>0.05; d = 0.00–0.53).
Conclusions
The observed lower velocities during walking on sand compared with stable ground were accompanied by lower peak positive free moments during the push-off phase and loading rates during the loading phase. Our findings of similar lower limb muscle activities during walking on sand compared with stable ground in PF together with lower free moment amplitudes, vertical loading rates, and lower walking velocities on sand may indicate more relative muscle activity on sand compared with stable ground. This needs to be verified in future studies.
Background: Telerehabilitation can contribute to the maintenance of successful rehabilitation regardless of location and time. The aim of this study was to investigate a specific three-month interactive telerehabilitation routine regarding its effectiveness in assisting patients with physical functionality and with returning to work compared to typical aftercare.
Objective: The aim of the study was to investigate a specific three-month interactive telerehabilitation with regard to effectiveness in functioning and return to work compared to usual aftercare.
Methods: From August 2016 to December 2017, 111 patients (mean 54.9 years old; SD 6.8; 54.3% female) with hip or knee replacement were enrolled in the randomized controlled trial. At discharge from inpatient rehabilitation and after three months, their distance in the 6-minute walk test was assessed as the primary endpoint. Other functional parameters, including health related quality of life, pain, and time to return to work, were secondary endpoints.
Results: Patients in the intervention group performed telerehabilitation for an average of 55.0 minutes (SD 9.2) per week. Adherence was high, at over 75%, until the 7th week of the three-month intervention phase. Almost all the patients and therapists used the communication options. Both the intervention group (average difference 88.3 m; SD 57.7; P=.95) and the control group (average difference 79.6 m; SD 48.7; P=.95) increased their distance in the 6-minute-walk-test. Improvements in other functional parameters, as well as in quality of life and pain, were achieved in both groups. The higher proportion of working patients in the intervention group (64.6%; P=.01) versus the control group (46.2%) is of note.
Conclusions: The effect of the investigated telerehabilitation therapy in patients following knee or hip replacement was equivalent to the usual aftercare in terms of functional testing, quality of life, and pain. Since a significantly higher return-to-work rate could be achieved, this therapy might be a promising supplement to established aftercare.
The effects of static stretching (StS) on subsequent strength and power activities has been one of the most debated topics in sport science literature over the past decades. The aim of this review is (1) to summarize previous and current findings on the acute effects of StS on muscle strength and power performances; (2) to update readers’ knowledge related to previous caveats; and (3) to discuss the underlying physiological mechanisms of short-duration StS when performed as single-mode treatment or when integrated into a full warm-up routine. Over the last two decades, StS has been considered harmful to subsequent strength and power performances. Accordingly, it has been recommended not to apply StS before strength- and power-related activities. More recent evidence suggests that when performed as a single-mode treatment or when integrated within a full warm-up routine including aerobic activity, dynamic-stretching, and sport-specific activities, short-duration StS (≤60 s per muscle group) trivially impairs subsequent strength and power activities (∆1–2%). Yet, longer StS durations (>60 s per muscle group) appear to induce substantial and practically relevant declines in strength and power performances (∆4.0–7.5%). Moreover, recent evidence suggests that when included in a full warm-up routine, short-duration StS may even contribute to lower the risk of sustaining musculotendinous injuries especially with high-intensity activities (e.g., sprint running and change of direction speed). It seems that during short-duration StS, neuromuscular activation and musculotendinous stiffness appear not to be affected compared with long-duration StS. Among other factors, this could be due to an elevated muscle temperature induced by a dynamic warm-up program. More specifically, elevated muscle temperature leads to increased muscle fiber conduction-velocity and improved binding of contractile proteins (actin, myosin). Therefore, our previous understanding of harmful StS effects on subsequent strength and power activities has to be updated. In fact, short-duration StS should be included as an important warm-up component before the uptake of recreational sports activities due to its potential positive effect on flexibility and musculotendinous injury prevention. However, in high-performance athletes, short-duration StS has to be applied with caution due to its negligible but still prevalent negative effects on subsequent strength and power performances, which could have an impact on performance during competition.
Research on weight-loss interventions in emerging adulthood is warranted. Therefore, a cognitive-behavioral group treatment (CBT), including development-specific topics for adolescents and young adults with obesity (YOUTH), was developed. In a controlled study, we compared the efficacy of this age-specific CBT group intervention to an age-unspecific CBT group delivered across ages in an inpatient setting. The primary outcome was body mass index standard deviation score (BMI-SDS) over the course of one year; secondary outcomes were health-related and disease-specific quality of life (QoL). 266 participants aged 16 to 21 years (65% females) were randomized. Intention-to-treat (ITT) and per-protocol analyses (PPA) were performed. For both group interventions, we observed significant and clinically relevant improvements in BMI-SDS and QoL over the course of time with small to large effect sizes. Contrary to our hypothesis, the age-specific intervention was not superior to the age-unspecific CBT-approach.
Evidence-based prescriptions for balance training in youth have recently been established. However, there is currently no standardized means available to assess and quantify balance task difficulty (BTD). Therefore, the objectives of this study were to examine the effects of graded BTD on postural sway, lower limb muscle activity and coactivation in adolescents. Thirteen healthy high-school students aged 16 to 17 volunteered to participate in this cross-sectional study. Testing involved participants to stand on a commercially available balance board with an adjustable pivot that allowed six levels of increasing task difficulty. Postural sway [i.e., total center of pressure (CoP) displacements] and lower limb muscle activity were recorded simultaneously during each trial. Surface electromyography (EMG) was applied in muscles encompassing the ankle (m. tibialis anterior, medial gastrocnemius, peroneus longus) and knee joint (m. vastus medialis, biceps femoris). The coactivation index (CAI) was calculated for ankle and thigh muscles. Repeated measures analyses of variance revealed a significant main effect of BTD with increasing task difficulty for postural sway (p < 0.001; d = 6.36), muscle activity (p < 0.001; 2.19 < d < 4.88), and CAI (p < 0.001; 1.32 < d < 1.41). Multiple regression analyses showed that m. tibialis anterior activity best explained overall CoP displacements with 32.5% explained variance (p < 0.001). The observed increases in postural sway, lower limb muscle activity, and coactivation indicate increasing postural demands while standing on the balance board. Thus, the examined board can be implemented in balance training to progressively increase BTD in healthy adolescents.
The improvement of power is an objective in training of athletes. In order to detect effective methods of exercise, basic research is required regarding the mechanisms of muscular activity. The purpose of this study is to investigate whether or not a muscular pre-activation prior to an external impulse-like force impact has an effect on the maximal explosive eccentric Adaptive Force (xpAFeccmax). This power capability combines different probable power enhancing mechanisms. To measure the xpAFeccmax an innovative pneumatic device was used. During measuring, the subject tries to hold an isometric position as long as possible. In the moment in which the subjects’ maximal isometric holding strength is exceeded, it merges into eccentric muscle action. This process is very close to motions in sports, where an adaptation of the neuromuscular system is required, e.g., force impacts caused by uneven surfaces during skiing. For investigating the effect of pre-activation on the xpAFeccmax of the quadriceps femoris muscle, n = 20 subjects had to pass three different pre-activation levels in a randomized order (level 1: 0.4 bar, level 2: 0.8 bar, level 3: 1.2 bar). After adjusting the standardized pre-pressure by pushing against the interface, an impulse-like load impacted on the distal tibia of the subject. During this, the xpAFeccmax was detected. The maximal voluntary isometric contraction (MVIC) was also measured. The torque values of the xpAFeccmax were compared with regard to the pre-activation levels. The results show a significant positive relation between the pre-activation of the quadriceps femoris muscle and the xpAFeccmax (male: p = 0.000, η2= 0.683; female: p = 0.000, η2= 0.907). The average percentage increase of torque amounted +28.15 ± 25.4% between MVIC and xpAFeccmax with pre-pressure level 1, +12.09 ± 7.9% for the xpAFeccmax comparing pre-pressure levels 1 vs. 2 and +2.98 ± 4.2% comparing levels 2 and 3. A higher but not maximal muscular activation prior to a fast impacting eccentric load seems to produce an immediate increase of force outcome. Different possible physiological explanatory approaches and the use as a potential training method are discussed.
Background: Although clinical supervision is considered to be a major component of the development and maintenance of psychotherapeutic competencies, and despite an increase in supervision research, the empirical evidence on the topic remains sparse.
Methods: Because most previous reviews lack methodological rigor, we aimed to review the status and quality of the empirical literature on clinical supervision, and to provide suggestions for future research. MEDLINE, PsycInfo and the Web of Science Core Collection were searched and the review was conducted according to current guidelines. From the review results, we derived suggestions for future research on clinical supervision.
Results: The systematic literature search identified 19 publications from 15 empirical studies. Taking into account the review results, the following suggestions for further research emerged: Supervision research would benefit from proper descriptions of how studies are conducted according to current guidelines, more methodologically rigorous empirical studies, the investigation of active supervision interventions, from taking diverse outcome domains into account, and from investigating supervision from a meta-theoretical perspective.
Conclusions: In all, the systematic review supported the notion that supervision research often lags behind psychotherapy research in general. Still, the results offer detailed starting points for further supervision research.
Speech and action sequences are continuous streams of information that can be segmented into sub-units. In both domains, this segmentation can be facilitated by perceptual cues contained within the information stream. In speech, prosodic cues (e.g., a pause, pre-boundary lengthening, and pitch rise) mark boundaries between words and phrases, while boundaries between actions of an action sequence can be marked by kinematic cues (e.g., a pause, pre-boundary deceleration). The processing of prosodic boundary cues evokes an Event-related Potentials (ERP) component known as the Closure Positive Shift (CPS), and it is possible that the CPS reflects domaingeneral cognitive processes involved in segmentation, given that the CPS is also evoked by boundaries between subunits of non-speech auditory stimuli. This study further probed the domain-generality of the CPS and its underlying processes by investigating electrophysiological correlates of the processing of boundary cues in sequences of spoken verbs (auditory stimuli; Experiment 1; N = 23 adults) and actions (visual stimuli; Experiment 2; N = 23 adults). The EEG data from both experiments revealed a CPS-like broadly distributed positivity during the 250 ms prior to the onset of the post-boundary word or action, indicating similar electrophysiological correlates of boundary processing across domains, suggesting that the cognitive processes underlying speech and action segmentation might also be shared.
Background: Agility in general and change-of-direction speed (CoD) in particular represent important performance determinants in elite soccer.
Objectives: The objectives of this study were to determine the effects of a 6-week neuromuscular training program on agility performance, and to determine differences in movement times between the slower and faster turning directions in elite soccer players. Materials and Methods: Twenty male elite soccer players from the Stade Rennais Football Club (Ligue 1, France) participated in this study. The players were randomly assigned to a neuromuscular training group (NTG, n = 10) or an active control (CG, n = 10) according to their playing position. NTG participated in a 6-week, twice per week neuromuscular training program that included CoD, plyometric and dynamic stability exercises. Neuromuscular training replaced the regular warm-up program. Each training session lasted 30 min. CG continued their regular training program. Training volume was similar between groups. Before and after the intervention, the two groups performed a reactive agility test that included 180° left and right body rotations followed by a 5-m linear sprint. The weak side was defined as the left/right turning direction that produced slower overall movement times (MT). Reaction time (RT) was assessed and defined as the time from the first appearance of a visual stimulus until the athlete’s first movement. MT corresponded to the time from the first movement until the athlete reached the arrival gate (5 m distance).
Results: No significant between-group baseline differences were observed for RT or MT. Significant group x time interactions were found for MT (p = 0.012, effect size = 0.332, small) for the slower and faster directions (p = 0.011, effect size = 0.627, moderate). Significant pre-to post improvements in MT were observed for NTG but not CG (p = 0.011, effect size = 0.877, moderate). For NTG, post hoc analyses revealed significant MT improvements for the slower (p = 0.012, effect size = 0.897, moderate) and faster directions (p = 0.017, effect size = 0.968, moderate).
Conclusion: Our results illustrate that 6 weeks of neuromuscular training with two sessions per week included in the warm-up program, significantly enhanced agility performance in elite soccer players. Moreover, improvements were found on both sides during body rotations. Thus, practitioners are advised to focus their training programs on both turning directions.
Objective: We aimed to characterize patients after an acute cardiac event regarding their negative expectations around returning to work and the impact on work capacity upon discharge from cardiac rehabilitation (CR).
Methods: We analyzed routine data of 884 patients (52±7 years, 76% men) who attended 3 weeks of inpatient CR after an acute coronary syndrome (ACS) or cardiac surgery between October 2013 and March 2015. The primary outcome was their status determining their capacity to work (fit vs unfit) at discharge from CR. Further, sociodemographic data (eg, age, sex, and education level), diagnoses, functional data (eg, exercise stress test and 6-min walking test [6MWT]), the Hospital Anxiety and Depression Scale (HADS) and self-assessment of the occupational prognosis (negative expectations and/or unemployment, Würzburger screening) at admission to CR were considered.
Results: A negative occupational prognosis was detected in 384 patients (43%). Out of these, 368 (96%) expected not to return to work after CR and/or were unemployed before CR at 29% (n=113). Affected patients showed a reduced exercise capacity (bicycle stress test: 100 W vs 118 W, P<0.01; 6MWT: 380 m vs 421 m, P<0.01) and were more likely to receive a depression diagnosis (12% vs 3%, P<0.01), as well as higher levels on the HADS. At discharge from CR, 21% of this group (n=81) were fit for work (vs 35% of patients with a normal occupational prognosis (n=175, P<0.01)). Sick leave before the cardiac event (OR 0.4, 95% CI 0.2–0.6, P<0.01), negative occupational expectations (OR 0.4, 95% CI 0.3–0.7, P<0.01) and depression (OR 0.3, 95% CI 0.1–0.8, P=0.01) reduced the likelihood of achieving work capacity upon discharge. In contrast, higher exercise capacity was positively associated.
Conclusion: Patients with a negative occupational prognosis often revealed a reduced physical performance and suffered from a high psychosocial burden. In addition, patients’ occupational expectations were a predictor of work capacity at discharge from CR. Affected patients should be identified at admission to allow for targeted psychosocial care.
Objectives
The aims of this study were to investigate the effects of a six-week in-season period of soccer training and games (congested period) on plasma volume variations (PV), hematological parameters, and physical fitness in elite players. In addition, we analyzed relationships between training load, hematological parameters and players’ physical fitness.
Methods
Eighteen elite players were evaluated before (T1) and after (T2) a six-week in-season period interspersed with 10 soccer matches. At T1 and T2, players performed the Yo-Yo intermittent recovery test level 1 (YYIR1), the repeated shuttle sprint ability test (RSSA), the countermovement jump test (CMJ), and the squat jump test (SJ). In addition, PV and hematological parameters (erythrocytes [M/mm3], hematocrit [%], hemoglobin [g/dl], mean corpuscular volume [fl], mean corpuscular hemoglobin content [pg], and mean hemoglobin concentration [%]) were assessed. Daily ratings of perceived exertion (RPE) were monitored in order to quantify the internal training load.
Results
From T1 to T2, significant performance declines were found for the YYIR1 (p<0.001, effect size [ES] = 0.5), RSSA (p<0.01, ES = 0.6) and SJ tests (p< 0.046, ES = 0.7). However, no significant changes were found for the CMJ (p = 0.86, ES = 0.1). Post-exercise, RSSA blood lactate (p<0.012, ES = 0.2) and PV (p<0.01, ES = 0.7) increased significantly from T1 to T2. A significant decrease was found from T1 to T2 for the erythrocyte value (p<0.002, ES = 0.5) and the hemoglobin concentration (p<0.018, ES = 0.8). The hematocrit percentage rate was also significantly lower (p<0.001, ES = 0.6) at T2. The mean corpuscular volume, mean corpuscular hemoglobin content and the mean hemoglobin content values were not statistically different from T1 to T2. No significant relationships were detected between training load parameters and percentage changes of hematological parameters. However, a significant relationship was observed between training load and changes in RSSA performance (r = -0.60; p<0.003).
Conclusions
An intensive period of “congested match play” over 6 weeks significantly compromised players’ physical fitness. These changes were not related to hematological parameters, even though significant alterations were detected for selected measures.
Alcohol in the Aging Brain
(2019)
As our society grows older new challenges for medicine and healthcare emerge. Agerelated changes of the body have been observed in essential body functions, particularly in the loco-motor system, in the cardiovascular system and in cognitive functions concerning both brain plasticity and changes in behavior. Nutrition and lifestyle, such as nicotine intake and chronic alcohol consumption, also contribute to biological changes in the brain. This review addresses the effect of alcohol consumption on cognitive decline, changes in brain plasticity in the aging brain and on cardiovascular health in aging. Thus, studies on the interplay of chronic alcohol intake and either cognitive decline or cognitive preservation are outlined. Because of the inconsistency in the literature of whether alcohol consumption preserves cognitive functions in the aging brain or whether it accelerates cognitive decline, it is crucial to consider individual contributing factors such as culture, health and lifestyle in future studies.
The concurrent performance of cognitive and postural tasks is particularly impaired in old adults and associated with an increased risk of falls. Biological aging of the cognitive and postural control system appears to be responsible for increased cognitive-motor interference effects. We examined neural and behavioral markers of motor-cognitive dual-task performance in young and old adults performing spatial one-back working memory single and dual tasks during semitandem stance. On the neural level, we used EEG to test for age-related modulations in the frequency domain related to cognitive-postural task load. Twenty-eight healthy young and 30 old adults participated in this study. The tasks included a postural single task, a cognitive-postural dual task, and a cognitive-postural triple task (cognitive dual-task with postural demands). Postural sway (i.e., total center of pressure displacements) was recorded in semistance position on an unstable surface that was placed on top of a force plate while performing cognitive tasks. Neural activation was recorded using a 64-channel mobile EEG system. EEG frequencies were attenuated by the baseline postural single-task condition and demarcated in nine Regions-of-Interest (ROIs), i.e., anterior, central, posterior, over the cortical midline, and both hemispheres. Our findings revealed impaired cognitive dual-task performance in old compared to young participants in the form of significantly lower cognitive performance in the triple-task condition. Furthermore, old adults compared with young adults showed significantly larger postural sway, especially in cognitive-postural task conditions. With respect to EEG frequencies, young compared to old participants showed significantly lower alpha-band activity in cognitive-cognitive-postural triple-task conditions compared with cognitive-postural dual tasks. In addition, with increasing task difficulty, we observed synchronized theta and delta frequencies, irrespective of age. Taskdependent alterations of the alpha frequency band were most pronounced over frontal and central ROIs, while alterations of the theta and delta frequency bands were found in frontal, central, and posterior ROIs. Theta and delta synchronization exhibited a decrease from anterior to posterior regions. For old adults, task difficulty was reflected by theta synchronization in the posterior ROI. For young adults, it was reflected by alpha desynchronization in bilateral anterior ROIs. In addition, we could not identify any effects of task difficulty and age on the beta frequency band. Our results shed light on age-related cognitive and postural declines and how they interact. Modulated alpha frequencies during high cognitive-postural task demands in young but not old adults might be reflective of a constrained neural adaptive potential in old adults. Future studies are needed to elucidate associations between the identified age-related performance decrements with task difficulty and changes in brain activity.
Purpose: To examine the effects of fatiguing isometric contractions on maximal eccentric strength and electromechanical delay (EMD) of the knee flexors in healthy young adults of different training status.
Methods: Seventy-five male participants (27.7 ± 5.0 years) were enrolled in this study and allocated to three experimental groups according to their training status: athletes (ATH, n = 25), physically active adults (ACT, n = 25), and sedentary participants (SED, n = 25). The fatigue protocol comprised intermittent isometric knee flexions (6-s contraction, 4-s rest) at 60% of the maximum voluntary contraction until failure. Pre- and post-fatigue, maximal eccentric knee flexor strength and EMDs of the biceps femoris, semimembranosus, and semitendinosus muscles were assessed during maximal eccentric knee flexor actions at 60, 180, and 300°/s angular velocity. An analysis of covariance was computed with baseline (unfatigued) data included as a covariate.
Results: Significant and large-sized main effects of group (p ≤ 0.017, 0.87 ≤ d ≤ 3.69) and/or angular velocity (p < 0.001, d = 1.81) were observed. Post hoc tests indicated that regardless of angular velocity, maximal eccentric knee flexor strength was lower and EMD was longer in SED compared with ATH and ACT (p ≤ 0.025, 0.76 ≤ d ≤ 1.82) and in ACT compared with ATH (p = ≤0.025, 0.76 ≤ d ≤ 1.82). Additionally, EMD at post-test was significantly longer at 300°/s compared with 60 and 180°/s (p < 0.001, 2.95 ≤ d ≤ 4.64) and at 180°/s compared with 60°/s (p < 0.001, d = 2.56), irrespective of training status.
Conclusion: The main outcomes revealed significantly higher maximal eccentric strength and shorter eccentric EMDs of knee flexors in individuals with higher training status (i.e., athletes) following fatiguing exercises. Therefore, higher training status is associated with better neuromuscular functioning (i.e., strength, EMD) of the hamstring muscles in fatigued condition. Future longitudinal studies are needed to substantiate the clinical relevance of these findings.
Idioms in the World
(2019)
Physical fatigue and pronated feet constitute two risk factors for running-related lower limb injuries. Accordingly, different running shoe companies designed anti-pronation shoes with medial support to limit over pronation in runners. However, there is little evidence on the effectiveness and clinical relevance of anti-pronation shoes. This study examined lower limb kinematics and kinetics in young female runners with pronated feet during running with antipronation versus regular (neutral) running shoes in unfatigued and fatigued condition. Twenty-six female runners aged 24.1±5.6 years with pronated feet volunteered to participate in this study. Kinetic (3D Kistler force plate) and kinematic analyses (Vicon motion analysis system) were conducted to record participants’ ground reaction forces and joint kinematics when running with anti-pronation compared with neutral running shoes. Physical fatigue was induced through an individualized submaximal running protocol on a motorized treadmill using rate of perceived exertion and heart rate monitoring. The statistical analyses indicated significant main effects of “footwear” for peak ankle inversion, peak ankle eversion, and peak hip internal rotation angles (p<0.03; d = 0.46–0.95). Pair-wise comparisons revealed a significantly greater peak ankle inversion angle (p<0.03; d = 0.95; 2.70°) and smaller peak eversion angle (p<0.03; d = 0.46; 2.53°) when running with anti-pronation shoes compared with neutral shoes. For kinetic data, significant main effects of “footwear” were found for peak ankle dorsiflexor moment, peak knee extensor moment, peak hip flexor moment, peak hip extensor moment, peak hip abductor moment, and peak hip internal rotator moment (p<0.02; d = 1.00–1.79). For peak positive hip power in sagittal and frontal planes and peak negative hip power in horizontal plane, we observed significant main effects of “footwear” (p<0.03; d = 0.92–1.06). Pairwise comparisons revealed that peak positive hip power in sagittal plane (p<0.03; d = 0.98; 2.39 w/kg), peak positive hip power in frontal plane (p = 0.014; d = 1.06; 0.54 w/kg), and peak negative hip power in horizontal plane (p<0.03; d = 0.92; 0.43 w/kg) were greater with anti-pronation shoes. Furthermore, the statistical analyses indicated significant main effects of “Fatigue” for peak ankle inversion, peak ankle eversion, and peak knee external rotation angles. Pair-wise comparisons revealed a fatigue-induced decrease in peak ankle inversion angle (p<0.01; d = 1.23; 2.69°) and a fatigue-induced increase in peak knee external rotation angle (p<0.05; d = 0.83; 5.40°). In addition, a fatigue-related increase was found for peak ankle eversion (p<0.01; d = 1.24; 2.67°). For kinetic data, we observed a significant main effect of “Fatigue” for knee flexor moment, knee internal rotator moment, and hip extensor moment (p<0.05; d = 0.83–1.01). The statistical analyses indicated significant a main effect of “Fatigue” for peak negative ankle power in sagittal plane (p<0.01; d = 1.25). Finally, we could not detect any significant footwear by fatigue interaction effects for all measures of joint kinetics and kinematics. Running in anti-pronation compared with neutral running shoes produced lower peak moments and powers in lower limb joints and better control in rear foot eversion. Physical fatigue increased peak moments and powers in lower limb joints irrespective of the type of footwear.
Aim: The aim of the study was to identify common orthopedic sports injury profiles in adolescent elite athletes with respect to age, sex, and anthropometrics.
Methods: A retrospective data analysis of 718 orthopedic presentations among 381 adolescent elite athletes from 16 different sports to a sports medical department was performed. Recorded data of history and clinical examination included area, cause and structure of acute and overuse injuries. Injury-events were analyzed in the whole cohort and stratified by age (11–14/15–17 years) and sex. Group differences were tested by chi-squared-tests. Logistic regression analysis was applied examining the influence of factors age, sex, and body mass index (BMI) on the outcome variables area and structure (a = 0.05).
Results: Higher proportions of injury-events were reported for females (60%) and athletes of the older age group (66%) than males and younger athletes. The most frequently injured area was the lower extremity (47%) followed by the spine (30.5%) and the upper extremity (12.5%). Acute injuries were mainly located at the lower extremity (74.5%), while overuse injuries were predominantly observed at the lower extremity (41%) as well as the spine (36.5%). Joints (34%), muscles (22%), and tendons (21.5%) were found to be the most often affected structures. The injured structures were different between the age groups (p = 0.022), with the older age group presenting three times more frequent with ligament pathology events (5.5%/2%) and less frequent with bony problems (11%/20.5%) than athletes of the younger age group. The injured area differed between the sexes (p = 0.005), with males having fewer spine injury-events (25.5%/34%) but more upper extremity injuries (18%/9%) than females. Regression analysis showed statistically significant influence for BMI (p = 0.002) and age (p = 0.015) on structure, whereas the area was significantly influenced by sex (p = 0.005).
Conclusion: Events of soft-tissue overuse injuries are the most common reasons resulting in orthopedic presentations of adolescent elite athletes. Mostly, the lower extremity and the spine are affected, while sex and age characteristics on affected area and structure must be considered. Therefore, prevention strategies addressing the injury-event profiles should already be implemented in early adolescence taking age, sex as well as injury entity into account.
Presupposition triggers differ with respect to whether their presupposition is easily accommodatable. The presupposition of focus-sensitive additive particles like also or too is often classified as hard to accommodate, i.e., these triggers are infelicitous if their presupposition is not entailed by the immediate linguistic or non-linguistic context. We tested two competing accounts for the German additive particle auch concerning this requirement: First, that it requires a focus alternative to the whole proposition to be salient, and second, that it merely requires an alternative to the focused constituent (e.g., an individual) to be salient. We conducted two experiments involving felicity judgments as well as questions asking for the truth of the presupposition to be accommodated. Our results suggest that the latter account is too weak: mere previous mention of a potential alternative to the focused constituent is not enough to license the use of auch. However, our results also suggest that the former account is too strong: when an alternative of the focused constituent is prementioned and certain other accommodation-enhancing factors are present, the context does not have to entail the presupposed proposition. We tested the following two potentially accommodation-enhancing factors: First, whether the discourse can be construed to be from the perspective of the individual that the presupposition is about, and second, whether the presupposition is needed to establish coherence between the host sentence of the additive particle and the preceding context. The factor coherence was found to play a significant role. Our results thus corroborate the results of other researchers showing that discourse participants go to great lengths in order to identify a potential presupposition to accommodate, and we contribute to these results by showing that coherence is one of the factors that enhance accommodation.
Regulatory focus is a motivational construct that describes humans’ motivational orientation during goal pursuit. It is conceptualized as a chronic, trait-like, as well as a momentary, state-like orientation. Whereas there is a large number of measures to capture chronic regulatory focus, measures for its momentary assessment are only just emerging. This paper presents the development and validation of a measure of Momentary–Chronic Regulatory Focus. Our development incorporates the distinction between self-guide and reference-point definitions of regulatory focus. Ideals and ought striving are the promotion and prevention dimension in the self-guide system; gain and non-loss regulatory focus are the respective dimensions within the reference-point system. Three-survey-based studies test the structure, psychometric properties, and validity of the measure in its version to assess chronic regulatory focus (two samples of working participants, N = 389, N = 672; one student sample [time 1, N = 105; time 2, n = 91]). In two further studies, an experience sampling study with students (N = 84, k = 1649) and a daily-diary study with working individuals (N = 129, k = 1766), the measure was applied to assess momentary regulatory focus. Multilevel analyses test the momentary measure’s factorial structure, provide support for its sensitivity to capture within-person fluctuations, and provide evidence for concurrent construct validity.
We aimed at unveiling the role of executive functions (EFs) and language-related skills in spelling for mono- versus multilingual primary school children. We focused on EF and language-related skills, in particular lexicon size and phonological awareness (PA), because these factors were found to predict spelling in studies predominantly conducted with monolinguals, and because multilingualism can modulate these factors. There is evidence for (a) a bilingual advantage in EF due to constant high cognitive demands through language control, (b) a smaller mental lexicon in German and (c) possibly better PA. Multilinguals in Germany show on average poorer German language proficiency, what can influence performance on language-based tasks negatively. Thus, we included two spelling tasks to tease apart spelling based on lexical knowledge (i.e., word spelling) from spelling based on non-lexical strategies (i.e., non-word spelling). Our sample consisted of heterogeneous third graders from Germany: 69 monolinguals (age: M = 108 months) and 57 multilinguals (age: M = 111 months). On less language-dependent tasks (e.g., non-word spelling, PA, intelligence, short-term memory (STM) and three EF tasks testing switching, inhibition, and working memory) performance of both groups did not differ significantly. However, multilinguals performed significantly more poorly on tasks measuring German lexicon size and word spelling than monolinguals. Regression analyses revealed that for multilinguals, inhibition was related to spelling, whereas switching was the only EF component to influence word spelling in monolinguals and non-word spelling performance in both groups. By adding lexicon size and other language-related factors to the regression models, the influence of switching was reduced to insignificant effects, but inhibition remained significant for multilinguals. Language-related skills best predicted spelling and both language groups shared those variables: PA for word spelling, and STM for non-word spelling. Additionally, multilinguals’ word spelling performance was also predicted by their German lexicon size, and non-word spelling performance by PA. This study offers an in-depth look at spelling acquisition at a certain point of literacy development. Mono- and multilinguals have the predominant factors for spelling in common, but probably due to superior language knowledge, monolinguals were already able to make use of EF during spelling. For multilinguals, German lexicon size was more important for spelling than EF. For multilinguals’ spelling these functions might come into play only at a later stage.
In canoe sprint, the trunk muscles play an important role in stabilizing the body in an unstable environment (boat) and in generating forces that are transmitted through the shoulders and arms to the paddle for propulsion of the boat. Isokinetic training is well suited for sports in which propulsion is generated through water resistance due to similarities in the resistive mode. Thus, the purpose of this study was to determine the effects of isokinetic training in addition to regular sport-specific training on trunk muscular fitness and body composition in world-class canoeists and to evaluate associations between trunk muscular fitness and canoe-specific performance. Nine world-class canoeists (age: 25.6 ± 3.3 years; three females; four world champions; three Olympic gold medalists) participated in an 8-week progressive isokinetic training with a 6-week block “muscle hypertrophy” and a 2-week block “muscle power.” Pre- and post-tests included the assessment of peak isokinetic torque at different velocities in concentric (30 and 140∘s-1) and eccentric (30 and 90∘s-1) mode, trunk muscle endurance, and body composition (e.g., body fat, segmental lean mass). Additionally, peak paddle force was assessed in the flume at a water current of 3.4 m/s. Significant pre-to-post increases were found for peak torque of the trunk rotators at 30∘s-1 (p = 0.047; d = 0.4) and 140∘s-1 (p = 0.014; d = 0.7) in concentric mode. No significant pre-to-post changes were detected for eccentric trunk rotator torque, trunk muscle endurance, and body composition (p > 0.148). Significant medium-to-large correlations were observed between concentric trunk rotator torque but not trunk muscle endurance and peak paddle force, irrespective of the isokinetic movement velocity (all r ≥ 0.886; p ≤ 0.008). Isokinetic trunk rotator training is effective in improving concentric trunk rotator strength in world-class canoe sprinters. It is recommended to progressively increase angular velocity from 30∘s-1 to 140∘s-1 over the course of the training period.
Background
Postoperative delirium is a common disorder in older adults that is associated with higher morbidity and mortality, prolonged cognitive impairment, development of dementia, higher institutionalization rates, and rising healthcare costs. The probability of delirium after surgery increases with patients’ age, with pre-existing cognitive impairment, and with comorbidities, and its diagnosis and treatment is dependent on the knowledge of diagnostic criteria, risk factors, and treatment options of the medical staff. In this study, we will investigate whether a cross-sectoral and multimodal intervention for preventing delirium can reduce the prevalence of delirium and postoperative cognitive decline (POCD) in patients older than 70 years undergoing elective surgery. Additionally, we will analyze whether the intervention is cost-effective.
Methods
The study will be conducted at five medical centers (with two or three surgical departments each) in the southwest of Germany. The study employs a stepped-wedge design with cluster randomization of the medical centers. Measurements are performed at six consecutive points: preadmission, preoperative, and postoperative with daily delirium screening up to day 7 and POCD evaluations at 2, 6, and 12 months after surgery. Recruitment goals are to enroll 1500 patients older than 70 years undergoing elective operative procedures (cardiac, thoracic, vascular, proximal big joints and spine, genitourinary, gastrointestinal, and general elective surgery procedures.
Discussion
Results of the trial should form the basis of future standards for preventing delirium and POCD in surgical wards. Key aims are the improvement of patient safety and quality of life, as well as the reduction of the long-term risk of conversion to dementia. Furthermore, from an economic perspective, we expect benefits and decreased costs for hospitals, patients, and healthcare insurances.
Trial registration
German Clinical Trials Register, DRKS00013311. Registered on 10 November 2017.
Introduction: Studies that combined balance and resistance training induced larger performance improvements compared with single mode training. Agility exercises contain more dynamic and sport-specific movements compared with balance training. Thus, the purpose of this study was to contrast the effects of combined balance and plyometric training with combined agility and plyometric training and an active control on physical fitness in youth.
Methods: Fifty-seven male soccer players aged 10–12 years participated in an 8-week training program (2 × week). They were randomly assigned to a balance-plyometric (BPT: n = 21), agility-plyometric (APT: n = 20) or control group (n = 16). Measures included proxies of muscle power [countermovement jump (CMJ), triple-hop-test (THT)], muscle strength [reactive strength index (RSI), maximum voluntary isometric contraction (MVIC) of handgrip, back extensors, knee extensors], agility [4-m × 9-m shuttle run, Illinois change of direction test (ICODT) with and without the ball], balance (Standing Stork, Y-Balance), and speed (10–30 m sprints).
Results: Significant time × group interactions were found for CMJ, hand grip MVIC force, ICODT without a ball, agility (4 m × 9 m), standing stork balance, Y-balance, 10 and 30-m sprint. The APT pre- to post-test measures displayed large ES improvements for hand grip MVIC force, ICODT without a ball, agility test, CMJ, standing stork balance test, Y-balance test but only moderate ES improvements with the 10 and 30 m sprints. The BPT group showed small (30 m sprint), moderate (hand grip MVIC, ICODTwithout a ball) and large ES [agility (4 m × 9 m) test, CMJ, standing stork balance test, Y-balance] improvements, respectively.
Conclusion: In conclusion, both training groups provided significant improvements in all measures. It is recommended that youth incorporate balance exercises into their training and progress to agility with their strength and power training.
Introduction
Annually, 2 million sports-related injuries are reported in Germany of which athletes contribute to a large proportion. Multiple sport injury prevention programs designed to decrease acute and overuse injuries in athletes have been proven effective. Yet, the programs’ components, general or sports-specific, that led to these positive effects are uncertain. Despite not knowing about the superiority of sports-specific injury prevention programs, coaches and athletes alike prefer more specialized rather than generalized exercise programs. Therefore, this systematic review aimed to present the available evidence on how general and sports-specific prevention programs affect injury rates in athletes.
Methods
PubMed and Web of Science were electronically searched throughout April 2018. The inclusion criteria were publication dates Jan 2006–Dec 2017, athletes (11–45 years), exercise-based injury prevention programs and injury incidence. The methodological quality was assessed with the Cochrane Collaboration assessment tools.
Results
Of the initial 6619 findings, 15 studies met the inclusion criteria. In addition, 13 studies were added from reference lists and external sources making a total of 28 studies. Of which, one used sports-specific, seven general and 20 mixed prevention strategies. Twenty-four studies revealed reduced injury rates. Of the four ineffective programs, one was general and three mixed.
Conclusion
The general and mixed programs positively affect injury rates. Sports-specific programs are uninvestigated and despite wide discussion regarding the definition, no consensus was reached. Defining such terminology and investigating the true effectiveness of such IPPs is a potential avenue for future research.