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Introduction
Varus knee alignment has been identified as a risk factor for the progression of medial knee osteoarthritis. However, the underlying mechanisms have not been elucidated yet in children. Thus, the aims of the present study were to examine differences in ground reaction forces, loading rate, impulses, and free moment values during running in children with and without genu varus.
Methods
Thirty-six boys aged 9–14 volunteered to participate in this study. They were divided in two age-matched groups (genu varus versus healthy controls). Body weight adjusted three dimensional kinetic data (Fx, Fy, Fz) were collected during running at preferred speed using two Kistler force plates for the dominant and non-dominant limb.
Results
Individuals with knee genu varus produced significantly higher (p = .01; d = 1.09; 95%) body weight adjusted ground reaction forces in the lateral direction (Fx) of the dominant limb compared to controls. On the non-dominant limb, genu varus patients showed significantly higher body weight adjusted ground reaction forces values in the lateral (p = .01; d = 1.08; 86%) and medial (p < .001; d = 1.55; 102%) directions (Fx). Further, genu varus patients demonstrated 55% and 36% greater body weight adjusted loading rates in the dominant (p < .001; d = 2.09) and non-dominant (p < .001; d = 1.02) leg, respectively. No significant between-group differences were observed for adjusted free moment values (p>.05). Discussion Higher mediolateral ground reaction forces and vertical loading rate amplitudes in boys with genu varus during running at preferred running speed may accelerate the development of progressive joint degeneration in terms of the age at knee osteoarthritis onset. Therefore, practitioners and therapists are advised to conduct balance and strength training programs to improve lower limb alignment and mediolateral control during dynamic movements.
It is well-documented that strength training (ST) improves measures of muscle strength in young athletes. Less is known on transfer effects of ST on proxies of muscle power and the underlying dose-response relationships. The objectives of this meta-analysis were to quantify the effects of ST on lower limb muscle power in young athletes and to provide dose-response relationships for ST modalities such as frequency, intensity, and volume. A systematic literature search of electronic databases identified 895 records. Studies were eligible for inclusion if (i) healthy trained children (girls aged 6–11 y, boys aged 6–13 y) or adolescents (girls aged 12–18 y, boys aged 14–18 y) were examined, (ii) ST was compared with an active control, and (iii) at least one proxy of muscle power [squat jump (SJ) and countermovement jump height (CMJ)] was reported. Weighted mean standardized mean differences (SMDwm) between subjects were calculated. Based on the findings from 15 statistically aggregated studies, ST produced significant but small effects on CMJ height (SMDwm = 0.65; 95% CI 0.34–0.96) and moderate effects on SJ height (SMDwm = 0.80; 95% CI 0.23–1.37). The sub-analyses revealed that the moderating variable expertise level (CMJ height: p = 0.06; SJ height: N/A) did not significantly influence ST-related effects on proxies of muscle power. “Age” and “sex” moderated ST effects on SJ (p = 0.005) and CMJ height (p = 0.03), respectively. With regard to the dose-response relationships, findings from the meta-regression showed that none of the included training modalities predicted ST effects on CMJ height. For SJ height, the meta-regression indicated that the training modality “training duration” significantly predicted the observed gains (p = 0.02), with longer training durations (>8 weeks) showing larger improvements. This meta-analysis clearly proved the general effectiveness of ST on lower-limb muscle power in young athletes, irrespective of the moderating variables. Dose-response analyses revealed that longer training durations (>8 weeks) are more effective to improve SJ height. No such training modalities were found for CMJ height. Thus, there appear to be other training modalities besides the ones that were included in our analyses that may have an effect on SJ and particularly CMJ height. ST monitoring through rating of perceived exertion, movement velocity or force-velocity profile could be promising monitoring tools for lower-limb muscle power development in young athletes.
Background
Relatively little is known about protective factors and the emergence and maintenance of positive outcomes in the field of adolescents with chronic conditions. Therefore, the primary aim of the study is to acquire a deeper understanding of the dynamic process of resilience factors, coping strategies and psychosocial adjustment of adolescents living with chronic conditions.
Methods/design
We plan to consecutively recruit N = 450 adolescents (12–21 years) from three German patient registries for chronic conditions (type 1 diabetes, cystic fibrosis, or juvenile idiopathic arthritis). Based on screening for anxiety and depression, adolescents are assigned to two parallel groups – “inconspicuous” (PHQ-9 and GAD-7 < 7) vs. “conspicuous” (PHQ-9 or GAD-7 ≥ 7) – participating in a prospective online survey at baseline and 12-month follow-up. At two time points (T1, T2), we assess (1) intra- and interpersonal resiliency factors, (2) coping strategies, and (3) health-related quality of life, well-being, satisfaction with life, anxiety and depression. Using a cross-lagged panel design, we will examine the bidirectional longitudinal relations between resiliency factors and coping strategies, psychological adaptation, and psychosocial adjustment. To monitor Covid-19 pandemic effects, participants are also invited to take part in an intermediate online survey.
Discussion
The study will provide a deeper understanding of adaptive, potentially modifiable processes and will therefore help to develop novel, tailored interventions supporting a positive adaptation in youths with a chronic condition. These strategies should not only support those at risk but also promote the maintenance of a successful adaptation.
Trial registration
German Clinical Trials Register (DRKS), no. DRKS00025125. Registered on May 17, 2021.
About the relation between implicit Theory of Mind & the comprehension of complement sentences
(2010)
Previous studies on the relation between language and social cognition have shown that children’s mastery of embedded sentential complements plays a causal role for the development of a Theory of Mind (ToM). Children start to succeed on complementation tasks in which they are required to report the content of an embedded clause in the second half of the fourth year. Traditional ToM tasks test the child’s ability to predict that a person who is holding a false belief (FB) about a situation will act "falsely". In these task, children do not represent FBs until the age of 4 years. According the linguistic determinism hypothesis, only the unique syntax of complement sentences provides the format for representing FBs. However, experiments measuring children’s looking behavior instead of their explicit predictions provided evidence that already 2-year olds possess an implicit ToM. This dissertation examined the question of whether there is an interrelation also between implicit ToM and the comprehension of complement sentences in typically developing German preschoolers. Two studies were conducted. In a correlational study (Study 1 ), 3-year-old children’s performance on a traditional (explicit) FB task, on an implicit FB task and on language tasks measuring children’s comprehension of tensed sentential complements were collected and tested for their interdependence. Eye-tracking methodology was used to assess implicit ToM by measuring participants’ spontaneous anticipatory eye movements while they were watching FB movies. Two central findings emerged. First, predictive looking (implicit ToM) was not correlated with complement mastery, although both measures were associated with explicit FB task performance. This pattern of results suggests that explicit, but not implicit ToM is language dependent. Second, as a group, 3-year-olds did not display implicit FB understanding. That is, previous findings on a precocious reasoning ability could not be replicated. This indicates that the characteristics of predictive looking tasks play a role for the elicitation of implicit FB understanding as the current task was completely nonverbal and as complex as traditional FB tasks. Study 2 took a methodological approach by investigating whether children display an earlier comprehension of sentential complements when using the same means of measurement as used in experimental tasks tapping implicit ToM, namely anticipatory looking. Two experiments were conducted. 3-year-olds were confronted either with a complement sentence expressing the protagonist’s FB (Exp. 1) or with a complex sentence expressing the protagonist’s belief without giving any information about the truth/ falsity of the belief (Exp. 2). Afterwards, their expectations about the protagonist’s future behavior were measured. Overall, implicit measures reveal no considerably earlier understanding of sentential complementation. Whereas 3-year-olds did not display a comprehension of complex sentences if these embedded a false proposition, children from 3;9 years on were proficient in processing complement sentences if the truth value of the embedded proposition could not be evaluated. This pattern of results suggests that (1) the linguistic expression of a person’s FB does not elicit implicit FB understanding and that (2) the assessment of the purely syntactic understanding of complement sentences is affected by competing reality information. In conclusion, this dissertation found no evidence that the implicit ToM is related to the comprehension of sentential complementation. The findings suggest that implicit ToM might be based on nonlinguistic processes. Results are discussed in the light of recently proposed dual-process models that assume two cognitive mechanisms that account for different levels of ToM task performance.
This study examines the access to healthcare for children and adolescents with three common chronic diseases (type-1 diabetes (T1D), obesity, or juvenile idiopathic arthritis (JIA)) within the 4th (Delta), 5th (Omicron), and beginning of the 6th (Omicron) wave (June 2021 until July 2022) of the COVID-19 pandemic in Germany in a cross-sectional study using three national patient registries. A paper-and-pencil questionnaire was given to parents of pediatric patients (<21 years) during the routine check-ups. The questionnaire contains self-constructed items assessing the frequency of healthcare appointments and cancellations, remote healthcare, and satisfaction with healthcare. In total, 905 parents participated in the T1D-sample, 175 in the obesity-sample, and 786 in the JIA-sample. In general, satisfaction with healthcare (scale: 0–10; 10 reflecting the highest satisfaction) was quite high (median values: T1D 10, JIA 10, obesity 8.5). The proportion of children and adolescents with canceled appointments was relatively small (T1D 14.1%, JIA 11.1%, obesity 20%), with a median of 1 missed appointment, respectively. Only a few parents (T1D 8.6%; obesity 13.1%; JIA 5%) reported obstacles regarding health services during the pandemic. To conclude, it seems that access to healthcare was largely preserved for children and adolescents with chronic health conditions during the COVID-19 pandemic in Germany.
Background: High-intensity muscle actions have the potential to temporarily improve the performance which has been denoted as postactivation performance enhancement.
Objectives: This study determined the acute effects of different stretch-shortening (fast vs. low) and strength (dynamic vs. isometric) exercises executed during one training session on subsequent balance performance in youth weightlifters.
Materials and Methods: Sixteen male and female young weightlifters, aged 11.3±0.6years, performed four strength exercise conditions in randomized order, including dynamic strength (DYN; 3 sets of 3 repetitions of 10 RM) and isometric strength exercises (ISOM; 3 sets of maintaining 3s of 10 RM of back-squat), as well as fast (FSSC; 3 sets of 3 repetitions of 20-cm drop-jumps) and slow (SSSC; 3 sets of 3 hurdle jumps over a 20-cm obstacle) stretch-shortening cycle protocols. Balance performance was tested before and after each of the four exercise conditions in bipedal stance on an unstable surface (i.e., BOSU ball with flat side facing up) using two dependent variables, i.e., center of pressure surface area (CoP SA) and velocity (CoP V).
Results: There was a significant effect of time on CoP SA and CoP V [F(1,60)=54.37, d=1.88, p<0.0001; F(1,60)=9.07, d=0.77, p=0.003]. In addition, a statistically significant effect of condition on CoP SA and CoP V [F(3,60)=11.81, d=1.53, p<0.0001; F(3,60)=7.36, d=1.21, p=0.0003] was observed. Statistically significant condition-by-time interactions were found for the balance parameters CoP SA (p<0.003, d=0.54) and CoP V (p<0.002, d=0.70). Specific to contrast analysis, all specified hypotheses were tested and demonstrated that FSSC yielded significantly greater improvements than all other conditions in CoP SA and CoP V [p<0.0001 (d=1.55); p=0.0004 (d=1.19), respectively]. In addition, FSSC yielded significantly greater improvements compared with the two conditions for both balance parameters [p<0.0001 (d=2.03); p<0.0001 (d=1.45)].
Conclusion: Fast stretch-shortening cycle exercises appear to be more effective to improve short-term balance performance in young weightlifters. Due to the importance of balance for overall competitive achievement in weightlifting, it is recommended that young weightlifters implement dynamic plyometric exercises in the fast stretch-shortening cycle during the warm-up to improve their balance performance.
The effects of static stretching (StS) on subsequent strength and power activities has been one of the most debated topics in sport science literature over the past decades. The aim of this review is (1) to summarize previous and current findings on the acute effects of StS on muscle strength and power performances; (2) to update readers’ knowledge related to previous caveats; and (3) to discuss the underlying physiological mechanisms of short-duration StS when performed as single-mode treatment or when integrated into a full warm-up routine. Over the last two decades, StS has been considered harmful to subsequent strength and power performances. Accordingly, it has been recommended not to apply StS before strength- and power-related activities. More recent evidence suggests that when performed as a single-mode treatment or when integrated within a full warm-up routine including aerobic activity, dynamic-stretching, and sport-specific activities, short-duration StS (≤60 s per muscle group) trivially impairs subsequent strength and power activities (∆1–2%). Yet, longer StS durations (>60 s per muscle group) appear to induce substantial and practically relevant declines in strength and power performances (∆4.0–7.5%). Moreover, recent evidence suggests that when included in a full warm-up routine, short-duration StS may even contribute to lower the risk of sustaining musculotendinous injuries especially with high-intensity activities (e.g., sprint running and change of direction speed). It seems that during short-duration StS, neuromuscular activation and musculotendinous stiffness appear not to be affected compared with long-duration StS. Among other factors, this could be due to an elevated muscle temperature induced by a dynamic warm-up program. More specifically, elevated muscle temperature leads to increased muscle fiber conduction-velocity and improved binding of contractile proteins (actin, myosin). Therefore, our previous understanding of harmful StS effects on subsequent strength and power activities has to be updated. In fact, short-duration StS should be included as an important warm-up component before the uptake of recreational sports activities due to its potential positive effect on flexibility and musculotendinous injury prevention. However, in high-performance athletes, short-duration StS has to be applied with caution due to its negligible but still prevalent negative effects on subsequent strength and power performances, which could have an impact on performance during competition.
NutzerInnen von gewalthaltigen Medien geben einerseits oftmals zu, dass sie fiktionale, gewalthaltige Medien konsumieren, behaupten jedoch gleichzeitig, dass dies nicht ihr Verhalten außerhalb des Medienkontexts beeinflusst. Sie argumentieren, dass sie leicht zwischen Dingen, die im fiktionalen Kontext und Dingen, die in der Realität gelernt wurden, unterscheiden können. Im Kontrast zu diesen Aussagen zeigen Metanalysen Effektstärken im mittleren Bereich für den Zusammenhang zwischen Gewaltmedienkonsum und aggressivem Verhalten. Diese Ergebnisse können nur erklärt werden, wenn MediennutzerInnen gewalthaltige Lernerfahrungen auch außerhalb des Medienkontexts anwenden. Ein Prozess, der Lernerfahrungen innerhalb des Medienkontexts mit dem Verhalten in der realen Welt verknüpft, ist Desensibilisierung, die oftmals eine Reduktion des negativen Affektes gegenüber Gewalt definiert ist. Zur Untersuchung des Desensibilisierungsprozesses wurden vier Experimente durchgeführt. Die erste in dieser Arbeit untersuchte Hypothese war, dass je häufiger Personen Gewaltmedien konsumieren, desto weniger negativen Affekt zeigen sie gegenüber Bildern mit realer Gewalt. Jedoch wurde angenommen, dass diese Bewertung auf Darstellungen von realer Gewalt beschränkt ist und nicht bei Bildern ohne Gewaltbezug, die einen negativen Affekt auslösen, zu finden ist. Die zweite Hypothese bezog sich auf den Affekt während des Konsums von Mediengewalt. Hier wurde angenommen, dass besonders Personen, die Freude an Gewalt in den Medien empfinden weniger negativen Affekt gegenüber realen Gewaltdarstellungen zeigen. Die letzte Hypothese beschäftigte sich mit kognitiver Desensibilisierung und sagte vorher, dass Gewaltmedienkonsum zu einem Transfer von Reaktionen, die normalerweise gegenüber gewalthaltigen Reizen gezeigt werden, auf ursprünglich neutrale Reize führt. Das erste Experiment (N = 57) untersuchte, ob die habituelle Nutzung von gewalthaltigen Medien den selbstberichteten Affekt (Valenz und Aktivierung) gegenüber Darstellungen von realer Gewalt und nichtgewalthaltigen Darstellungen, die negativen Affekt auslösen, vorhersagt. Die habituelle Nutzung von gewalthaltigen Medien sagte weniger negative Valenz und weniger allgemeine Aktivierung gegenüber gewalthalten und nichtgewalthaltigen Bildern vorher. Das zweite Experiment (N = 103) untersuchte auch die Beziehung zwischen habituellem Gewaltmedienkonsum und den affektiven Reaktionen gegenüber Bildern realer Gewalt und negativen affektauslösenden Bildern. Als weiterer Prädiktor wurde der Affekt beim Betrachten von gewalthaltigen Medien hinzugefügt. Der Affekt gegenüber den Bildern wurde zusätzlich durch psychophysiologische Maße (Valenz: C: Supercilii; Aktivierung: Hautleitreaktion) erhoben. Wie zuvor sagte habitueller Gewaltmedienkonsum weniger selbstberichte Erregung und weniger negative Valenz für die gewalthaltigen und die negativen, gewalthaltfreien Bilder vorher. Die physiologischen Maßen replizierten dieses Ergebnis. Jedoch zeigte sich ein anderes Muster für den Affekt beim Konsum von Gewalt in den Medien. Personen, die Gewalt in den Medien stärker erfreut, zeigen eine Reduktion der Responsivität gegenüber Gewalt auf allen vier Maßen. Weiterhin war bei drei dieser vier Maße (selbstberichte Valenz, Aktivität des C. Supercilii und Hautleitreaktion) dieser Zusammenhang auf die gewalthaltigen Bilder beschränkt, mit keinem oder nur einem kleinen Effekt auf die negativen, aber nichtgewalthaltigen Bilder. Das dritte Experiment (N = 73) untersuchte den Affekt während die Teilnehmer ein Computerspiel spielten. Das Spiel wurde eigens für dieses Experiment programmiert, sodass einzelne Handlungen im Spiel mit der Aktivität des C. Supercilii, dem Indikator für negativen Affekt, in Bezug gesetzt werden konnten. Die Analyse des C. Supercilii zeigte, dass wiederholtes Durchführen von aggressiven Spielzügen zu einem Rückgang von negativen Affekt führte, der die aggressiven Spielhandlungen begleitete. Der negative Affekt während gewalthaltiger Spielzüge wiederum sagte die affektive Reaktion gegenüber Darstellungen von gewalthaltigen Bildern vorher, nicht jedoch gegenüber den negativen Bildern. Das vierte Experiment (N = 77) untersuchte kognitive Desensibilisierung, die die Entwicklung von Verknüpfungen zwischen neutralen und aggressiven Kognitionen beinhaltete. Die Teilnehmer spielten einen Ego-Shooter entweder auf einem Schiff- oder einem Stadtlevel. Die Beziehung zwischen den neutralen Konstrukten (Schiff/Stadt) und den aggressiven Kognitionen wurde mit einer lexikalischen Entscheidungsaufgabe gemessen. Das Spielen im Schiff-/Stadt-Level führte zu einer kürzen Reaktionszeit für aggressive Wörter, wenn sie einem Schiff- bzw. Stadtprime folgten. Dies zeigte, dass die im Spiel enthaltenen neutralen Konzepte mit aggressiven Knoten verknüpft werden. Die Ergebnisse dieser vier Experimente wurden diskutiert im Rahmen eines lerntheoretischen Ansatzes um Desensibilisierung zu konzeptualisieren.
Children’s physical fitness development and related moderating effects of age and sex are well documented, especially boys’ and girls’ divergence during puberty. The situation might be different during prepuberty. As girls mature approximately two years earlier than boys, we tested a possible convergence of performance with five tests representing four components of physical fitness in a large sample of 108,295 eight-year old third-graders. Within this single prepubertal year of life and irrespective of the test, performance increased linearly with chronological age, and boys outperformed girls to a larger extent in tests requiring muscle mass for successful performance. Tests differed in the magnitude of age effects (gains), but there was no evidence for an interaction between age and sex. Moreover, “physical fitness” of schools correlated at r = 0.48 with their age effect which might imply that "fit schools” promote larger gains; expected secular trends from 2011 to 2019 were replicated.
Age-related decline in executive functions and postural control due to degenerative processes in the central nervous system have been related to increased fall-risk in old age. Many studies have shown cognitive-postural dual-task interference in old adults, but research on the role of specific executive functions in this context has just begun. In this study, we addressed the question whether postural control is impaired depending on the coordination of concurrent response-selection processes related to the compatibility of input and output modality mappings as compared to impairments related to working-memory load in the comparison of cognitive dual and single tasks. Specifically, we measured total center of pressure (CoP) displacements in healthy female participants aged 19–30 and 66–84 years while they performed different versions of a spatial one-back working memory task during semi-tandem stance on an unstable surface (i.e., balance pad) while standing on a force plate. The specific working-memory tasks comprised: (i) modality compatible single tasks (i.e., visual-manual or auditory-vocal tasks), (ii) modality compatible dual tasks (i.e., visual-manual and auditory-vocal tasks), (iii) modality incompatible single tasks (i.e., visual-vocal or auditory-manual tasks), and (iv) modality incompatible dual tasks (i.e., visual-vocal and auditory-manual tasks). In addition, participants performed the same tasks while sitting. As expected from previous research, old adults showed generally impaired performance under high working-memory load (i.e., dual vs. single one-back task). In addition, modality compatibility affected one-back performance in dual-task but not in single-task conditions with strikingly pronounced impairments in old adults. Notably, the modality incompatible dual task also resulted in a selective increase in total CoP displacements compared to the modality compatible dual task in the old but not in the young participants. These results suggest that in addition to effects of working-memory load, processes related to simultaneously overcoming special linkages between input- and output modalities interfere with postural control in old but not in young female adults. Our preliminary data provide further evidence for the involvement of cognitive control processes in postural tasks.