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Physical fitness of primary school children differs depending on their timing of school enrollment
(2023)
Previous research has shown that children who were enrolled to school according to the legal key date (i.e., keyage children, between eight and nine years in third grade) exhibited a linear physical fitness development in the ninth year of life. In contrast, children who were enrolled with a delay (i.e., older-than-keyage children [OTK], between nine and ten years in third grade) exhibited a lower physical fitness compared to what would be expected for their age. In these studies, cross-sectional age differences within third grade and timing of school enrollment were confounded. The present study investigated the longitudinal development of keyage and OTK children from third to fifth grade. This design also afforded a comparison of the two groups at the same average chronological age, that is a dissociation of the effects of timing of school enrollment and age. We tested six physical fitness components: cardiorespiratory endurance, coordination, speed, power of lower and upper limbs, and static balance. 1502 children (i.e., 1206 keyage and 296 OTK children) from 35 schools were tested in third, fourth, and fifth grade. Except for cardiorespiratory endurance, both groups developed from third to fourth and from fourth to fifth grade and keyage children outperformed OTK children at the average ages of 9.5 or 10.5 years. For cardiorespiratory endurance, there was no significant gain from fourth to fifth grade and keyage and OTK children did not differ significantly at 10.5 years of age. One reason for a delayed school enrollment could be that a child is (or is perceived as) biologically younger than their chronological age at the school entry examination, implying a negative correlation between chronological and biological age for OTK children. Indeed, a simple reflection of chronological age brought the developmental rate of the chronologically youngest OTK children in line with the developmental rate observed for keyage children, but did not eliminate all differences. The mapping of chronological and biological age of OTK children and other possible reasons for lower physical fitness of OTK children remain a task for future research.
Sensorimotor control can be impaired by slacked muscle spindles. This was shown for reflex responses and, recently, also for muscular stability in the sense of Adaptive Force (AF). The slack in muscle spindles was generated by contracting the lengthened muscle followed by passive shortening. AF was suggested to specifically reflect sensorimotor control since it requires tension-length control in adaptation to an increasing load. This study investigated AF parameters in reaction to another, manually performed slack procedure in a preselected sample (n = 13). The AF of 11 elbow and 12 hip flexors was assessed by an objectified manual muscle test (MMT) using a handheld device. Maximal isometric AF was significantly reduced after manual spindle technique vs. regular MMT. Muscle lengthening started at 64.93 & PLUSMN; 12.46% of maximal voluntary isometric contraction (MVIC). During regular MMT, muscle length could be maintained stable until 92.53 & PLUSMN; 10.12% of MVIC. Hence, muscular stability measured by AF was impaired after spindle manipulation. Force oscillations arose at a significantly lower level for regular vs. spindle. This supports the assumption that they are a prerequisite for stable adaptation. Reduced muscular stability in reaction to slack procedures is considered physiological since sensory information is misled. It is proposed to use slack procedures to test the functionality of the neuromuscular system, which is relevant for clinical practice.
Introduction
Balance is vital for human health and experiments have been conducted to measure the mechanisms of postural control, for example studying reflex responses to simulated perturbations. Such studies are frequent in walking but less common in running, and an understanding of reflex responses to trip-like disturbances could enhance our understanding of human gait and improve approaches to training and rehabilitation. Therefore, the primary aim of this study was to investigate the technical validity and reliability of a treadmill running protocol with perturbations. A further exploratory aim was to evaluate the associated neuromuscular reflex responses to the perturbations, in the lower limbs.
Methods
Twelve healthy participants completed a running protocol (9 km/h) test-retest (2 weeks apart), whereby 30 unilateral perturbations were executed via the treadmill belts (presets:2.0 m/s amplitude;150 ms delay (post-heel contact);100ms duration). Validity of the perturbations was assessed via mean +/- SD comparison, percentage error calculation between the preset and recorded perturbation characteristics (PE%), and coefficient of variation (CV%). Test-retest reliability (TRV%) and Bland-Altman analysis (BLA; bias +/- 1.96 * SD) was calculated for reliability. To measure reflex activity, electromyography (EMG) was applied in both legs. EMG amplitudes (root mean square normalized to unperturbed strides) and latencies [ms] were analysed descriptively.
Results
Left-side perturbation amplitude was 1.9 +/- 0.1 m/s, delay 105 +/- 2 ms, and duration 78 +/- 1 ms. Right-side perturbation amplitude was 1.9 +/- 0.1 m/s, delay 118 +/- 2 ms, duration 78 +/- 1 ms. PE% ranged from 5-30% for the recorded perturbations. CV% of the perturbations ranged from 19.5-76.8%. TRV% for the perturbations was 6.4-16.6%. BLA for the left was amplitude: 0.0 +/- 0.3m/s, delay: 0 +/- 17 ms, duration: 2 +/- 13 ms, and for the right was amplitude: 0.1 +/- 0.7, delay: 4 +/- 40 ms, duration: 1 +/- 35 ms. EMG amplitudes ranged from 175 +/- 141%-454 +/- 359% in both limbs. Latencies were 109 +/- 12-116 +/- 23 ms in the tibialis anterior, and 128 +/- 49-157 +/- 20 ms in the biceps femoris.
Discussion
Generally, this study indicated sufficient validity and reliability of the current setup considering the technical challenges and limitations, although the reliability of the right-sided perturbations could be questioned. The protocol provoked reflex responses in the lower extremities, especially in the leading leg. Acute neuromusculoskeletal adjustments to the perturbations could be studied and compared in clinical and healthy running populations, and the protocol could be utilised to monitor chronic adaptations to interventions over time.
How to confuse motor control
(2023)
Adaptation to external forces relies on a well-functioning proprioceptive system including muscle spindle afferents. Muscle length and tension control in reaction to external forces is most important regarding the Adaptive Force (AF). This study investigated the effect of different procedures, which are assumed to influence the function of muscle spindles, on the AF. Elbow flexors of 12 healthy participants (n = 19 limbs) were assessed by an objectified manual muscle test (MMT) with different procedures: regular MMT, MMT after precontraction (self-estimated 20% MVIC) in lengthened position with passive return to test position (CL), and MMT after CL with a second precontraction in test position (CL-CT). During regular MMTs, muscles maintained their length up to 99.7% +/- 1.0% of the maximal AF (AF(max)). After CL, muscles started to lengthen at 53.0% +/- 22.5% of AF(max). For CL-CT, muscles were again able to maintain the static position up to 98.3% +/- 5.5% of AF(max). AFiso(max) differed highly significantly between CL vs. CL-CT and regular MMT. CL was assumed to generate a slack of muscle spindles, which led to a substantial reduction of the holding capacity. This was immediately erased by a precontraction in the test position. The results substantiate that muscle spindle sensitivity seems to play an important role for neuromuscular functioning and musculoskeletal stability.
Effects of exercise treatment on functional outcome parameters in mid-portion achilles tendinopathy
(2023)
Exercise interventions are evident in the treatment of mid-portion Achilles tendinopathy (AT). However, there is still a lack of knowledge concerning the effect of different exercise treatments on improving a specific function (e.g., strength) in this population. Thus, this study aimed to systematically review the effect of exercise treatments on different functional outcomes in mid-portion AT. An electronic database of Pubmed, Web of Science, and Cochrane Central Register of Controlled Trials were searched from inception to 21 February 2023. Studies that investigated changes in plantar flexor function with exercise treatments were considered in mid-portion AT. Only randomized controlled trials (RCTs) and clinical controlled trials (CCTs) were included. Functional outcomes were classified by kinetic (e.g., strength), kinematic [e.g., ankle range of motion (ROM)], and sensorimotor (e.g., balance index) parameters. The types of exercise treatments were classified into eccentric, concentric, and combined (eccentric plus concentric) training modes. Quality assessment was appraised using the Physiotherapy Evidence Database scale for RCTs, and the Joanna Briggs Institute scale for CCTs. The search yielded 2,260 records, and a total of ten studies were included. Due to the heterogeneity of the included studies, a qualitative synthesis was performed. Eccentric training led to improvements in power outcomes (e.g., height of countermovement jump), and in strength outcomes (e.g., peak torque). Concentric training regimens showed moderate enhanced power outcomes. Moreover, one high-quality study showed an improvement in the balance index by eccentric training, whereas the application of concentric training did not. Combined training modalities did not lead to improvements in strength and power outcomes. Plantarflexion and dorsiflexion ROM measures did not show relevant changes by the exercise treatments. In conclusion, eccentric training is evident in improving strength outcomes in AT patients. Moreover, it shows moderate evidence improvements in power and the sensorimotor parameter "balance index". Concentric training presents moderate evidence in the power outcomes and can therefore be considered as an alternative to improve this function. Kinematic analysis of plantarflexion and dorsiflexion ROM might not be useful in AT people. This study expands the knowledge what types of exercise regimes should be considered to improve the functional outcomes in AT.
IntroductionThe COVID-19 pandemic has huge influences on daily life and is not only associated with physical but also with major psychological impacts. Mental health problems and disorders are frequently present in elite paralympic athletes. Due to the pandemic situation, new stressors (e.g., loss of routine, financial insecurity) might act upon the athletes. Therefore, the assessment of mental health in athletes during the COVID-19 pandemic is important to identify prevalence of psychological problems and propose countermeasures. MethodsThe mental health of German paralympic athletes was longitudinally monitored (starting in May 2019). The athletes completed the Patient Health Questionnaire 4 (PHQ-4) on a weekly basis and reported a stress level, training hours, and training load. During the pandemic, 8 measurement time points (March 2020 to April 2021) were used to reflect the psychological health course of the athletes. In parallel, a convenience sample of the general population was questioned about their psychological distress, including the PHQ-4. To be included in the analysis, participants of both groups had to complete at least 4 measurement time points. Matching of the para-athletes and the general population sample was prioritized upon completion of the same measurement time points, gender, and age. ResultsSeventy-eight paralympic athletes (40 women, 38 men, age: 29.8 +/- 11.4 years) met the inclusion criteria. Seventy-eight matched pairs of the general population (40 women; 38 men; age: 30.5 +/- 10.9 years) were identified. The para-athletes had a significantly (p r <0.48) lower PHQ-4 value at each measurement time point compared to the matched control group. No significant age or sex differences were evident regarding the symptom burden. In para-athletes, no significant and a weak positive correlation was found between decreased training load and PHQ-4 values and a stress level, respectively. Reduced physical activity was significantly (p <0.0001) associated with higher PHQ-4 values in the general population sample. DiscussionLower PHQ-4 values were reported by the para-athletes compared to the general population sample. However, small sample sizes must be considered while interpreting the data. Nevertheless, adequate support for individuals suffering from severe psychopathological symptoms should be provided for para-athletes as well as for the general population.
ObjectiveA 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. MethodsEighteen 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. ResultsBoth exercise interventions (HIIT and MICT) decreased blood glucose levels and improved cardiac performance, with greater changes in the HIIT group (p < 0.001, eta(2): 0.909). While the expressions of miR-206 and apoptotic markers decreased in both training protocols (p < 0.001, eta(2): 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, eta(2): 0.976), with a nearly 50% greater increase in the HIIT group compared with MICT. ConclusionsOur 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.
Brain activation during active balancing and its behavioral relevance in younger and older adults
(2022)
Age-related deterioration of balance control is widely regarded as an important phenomenon influencing quality of life and longevity, such that a more comprehensive understanding of the neural mechanisms underlying this process is warranted.
Specifically, previous studies have reported that older adults typically show higher neural activity during balancing as compared to younger counterparts, but the implications of this finding on balance performance remain largely unclear.
Using functional near-infrared spectroscopy (fNIRS), differences in the cortical control of balance between healthy younger (n = 27) and older (n = 35) adults were explored.
More specifically, the association between cortical functional activity and balance performance across and within age groups was investigated. To this end, we measured hemodynamic responses (i.e., changes in oxygenated and deoxygenated hemoglobin) while participants balanced on an unstable device.
As criterion variables for brain-behavior-correlations, we also assessed postural sway while standing on a free-swinging platform and while balancing on wobble boards with different levels of difficulty.
We found that older compared to younger participants had higher activity in prefrontal and lower activity in postcentral regions.
Subsequent robust regression analyses revealed that lower prefrontal brain activity was related to improved balance performance across age groups, indicating that higher activity of the prefrontal cortex during balancing reflects neural inefficiency.
We also present evidence supporting that age serves as a moderator in the relationship between brain activity and balance, i.e., cortical hemodynamics generally appears to be a more important predictor of balance performance in the older than in the younger. Strikingly, we found that age differences in balance performance are mediated by balancing-induced activation of the superior frontal gyrus, thus suggesting that differential activation of this region reflects a mechanism involved in the aging process of the neural control of balance.
Our study suggests that differences in functional brain activity between age groups are not a mere by-product of aging, but instead of direct behavioral relevance for balance performance.
Potential implications of these findings in terms of early detection of fall-prone individuals and intervention strategies targeting balance and healthy aging are discussed.
Reference values and validation of the 1-minute sit-to-stand test in healthy 5-16-year-old youth
(2021)
Objectives:
It is essential to have simple, reliable and valid tests to measure children's functional capacity in schools or medical practice. The 1-minute sit-to-stand (STS) test is a quick fitness test requiring little equipment or space that is increasingly used in both healthy populations and those with chronic disease. We aimed to provide age-specific and sex-specific reference values of STS test in healthy children and adolescents and to evaluate its short-term reliability and construct validity.
Design setting and participants:
Cross-sectional convenience sample from six public schools and one science fair in central Europe. Overall, 587 healthy participants aged 5-16 years were recruited and divided into age groups of 3 years each.
Outcomes:
1-minute STS. To evaluate short-term reliability, some children performed the STS test twice. To evaluate construct validity, some children also performed a standing long jump (SLJ) and a maximal incremental exercise test.
Results:
Data from 547 youth aged 5-16 years were finally included in the analyses. The median number of repetitions in 1 min in males (females) ranged from 55 [95% CI: 38 to 72] (53 [95% CI: 35 to 76]) in 14-16-year olds to 59 [95% CI: 41 to 77] (60 [95% CI: 38 to 77]) in 8-10-year olds. Children who repeated STS showed a learning effect of on average 4.8 repetitions more than the first test (95% limits of agreement: -6.7 to 16.4). Moderate correlations were observed between the STS and the SLJ (r=0.48) tests and the maximal exercise test (r=0.43).
Conclusions:
The reported STS reference values can be used to interpret STS test performance in children and adolescents. The STS appears to have good test- retest reliability, but a learning effect of about 10%. The association of STS with other measures of physical fitness should be further explored in a larger study and technical standards for its conduct are needed.
Restrictive means to reduce the spread of the COVID-19 pandemic have not only imposed broad challenges on mental health but might also affect cognitive health. Here we asked how restriction-related changes influence cognitive performance and how age, perceived loneliness, depressiveness and affectedness by restrictions contribute to these effects. 51 Germans completed three assessments of an online based study during the first lockdown in Germany (April 2020), a month later, and during the beginning of the second lockdown (November 2020). Participants completed nine online cognitive tasks of the MyBrainTraining and online questionnaires about their perceived strain and impact on lifestyle factors by the situation (affectedness), perceived loneliness, depressiveness as well as subjective cognitive performance. The results suggested a possible negative impact of depressiveness and affectedness on objective cognitive performance within the course of the lockdown. The younger the participants, the more pronounced these effects were. Loneliness and depressiveness moreover contributed to a worse evaluation of subjective cognition. In addition, especially younger individuals reported increased distress. As important educational and social input has partly been scarce during this pandemic and mental health problems have increased, future research should also assess cognitive long-term consequences.