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Injuries in professional soccer are a significant concern for teams, and they are caused amongst others by high training load. This cohort study describes the relationship between workload parameters and the occurrence of non-contact injuries, during weeks with high and low workload in professional soccer players throughout the season. Twenty-one professional soccer players aged 28.3 ± 3.9 yrs. who competed in the Iranian Persian Gulf Pro League participated in this 48-week study. The external load was monitored using global positioning system (GPS, GPSPORTS Systems Pty Ltd) and the type of injury was documented daily by the team's medical staff. Odds ratio (OR) and relative risk (RR) were calculated for non-contact injuries for high- and low-load weeks according to acute (AW), chronic (CW), acute to chronic workload ratio (ACWR), and AW variation (Δ-Acute) values. By using Poisson distribution, the interval between previous and new injuries were estimated. Overall, 12 non-contact injuries occurred during high load and 9 during low load weeks. Based on the variables ACWR and Δ-AW, there was a significantly increased risk of sustaining non-contact injuries (p < 0.05) during high-load weeks for ACWR (OR: 4.67), and Δ-AW (OR: 4.07). Finally, the expected time between injuries was significantly shorter in high load weeks for ACWR [1.25 vs. 3.33, rate ratio time (RRT)] and Δ-AW (1.33 vs. 3.45, RRT) respectively, compared to low load weeks. The risk of sustaining injuries was significantly larger during high workload weeks for ACWR, and Δ-AW compared with low workload weeks. The observed high OR in high load weeks indicate that there is a significant relationship between workload and occurrence of non-contact injuries. The predicted time to new injuries is shorter in high load weeks compared to low load weeks. Therefore, the frequency of injuries is higher during high load weeks for ACWR and Δ-AW. ACWR and Δ-AW appear to be good indicators for estimating the injury risk, and the time interval between injuries.
There is a wealth of evidence showing that increasing the distance between an argument and its head leads to more processing effort, namely, locality effects; these are usually associated with constraints in working memory (DLT: Gibson, 2000; activation-based model: Lewis and Vasishth, 2005). In SOV languages, however, the opposite effect has been found: antilocality (see discussion in Levy et al., 2013). Antilocality effects can be explained by the expectation-based approach as proposed by Levy (2008) or by the activation-based model of sentence processing as proposed by Lewis and Vasishth (2005). We report an eye-tracking and a self-paced reading study with sentences in Spanish together with measures of individual differences to examine the distinction between expectation- and memory-based accounts, and within memory-based accounts the further distinction between DLT and the activation-based model. The experiments show that (i) antilocality effects as predicted by the expectation account appear only for high-capacity readers; (ii) increasing dependency length by interposing material that modifies the head of the dependency (the verb) produces stronger facilitation than increasing dependency length with material that does not modify the head; this is in agreement with the activation-based model but not with the expectation account; and (iii) a possible outcome of memory load on low-capacity readers is the increase in regressive saccades (locality effects as predicted by memory-based accounts) or, surprisingly, a speedup in the self-paced reading task; the latter consistent with good-enough parsing (Ferreira et al., 2002). In sum, the study suggests that individual differences in working memory capacity play a role in dependency resolution, and that some of the aspects of dependency resolution can be best explained with the activation-based model together with a prediction component.
This dissertation investigates the working memory mechanism subserving human sentence processing and its relative contribution to processing difficulty as compared to syntactic prediction. Within the last decades, evidence for a content-addressable memory system underlying human cognition in general has accumulated (e.g., Anderson et al., 2004). In sentence processing research, it has been proposed that this general content-addressable architecture is also used for language processing (e.g., McElree, 2000).
Although there is a growing body of evidence from various kinds of linguistic dependencies that is consistent with a general content-addressable memory subserving sentence processing (e.g., McElree et al., 2003; VanDyke2006), the case of reflexive-antecedent dependencies has challenged this view. It has been proposed that in the processing of reflexive-antecedent dependencies, a syntactic-structure based memory access is used rather than cue-based retrieval within a content-addressable framework (e.g., Sturt, 2003).
Two eye-tracking experiments on Chinese reflexives were designed to tease apart accounts assuming a syntactic-structure based memory access mechanism from cue-based retrieval (implemented in ACT-R as proposed by Lewis and Vasishth (2005).
In both experiments, interference effects were observed from noun phrases which syntactically do not qualify as the reflexive's antecedent but match the animacy requirement the reflexive imposes on its antecedent. These results are interpreted as evidence against a purely syntactic-structure based memory access. However, the exact pattern of effects observed in the data is only partially compatible with the Lewis and Vasishth cue-based parsing model.
Therefore, an extension of the Lewis and Vasishth model is proposed. Two principles are added to the original model, namely 'cue confusion' and 'distractor prominence'.
Although interference effects are generally interpreted in favor of a content-addressable memory architecture, an alternative explanation for interference effects in reflexive processing has been proposed which, crucially, might reconcile interference effects with a structure-based account.
It has been argued that interference effects do not necessarily reflect cue-based retrieval interference in a content-addressable memory but might equally well be accounted for by interference effects which have already occurred at the moment of encoding the antecedent in memory (Dillon, 2011).
Three experiments (eye-tracking and self-paced reading) on German reflexives and Swedish possessives were designed to tease apart cue-based retrieval interference from encoding interference. The results of all three experiments suggest that there is no evidence that encoding interference affects the retrieval of a reflexive's antecedent.
Taken together, these findings suggest that the processing of reflexives can be explained with the same cue-based retrieval mechanism that has been invoked to explain syntactic dependency resolution in a range of other structures. This supports the view that the language processing system is located within a general cognitive architecture, with a general-purpose content-addressable working memory system operating on linguistic expressions.
Finally, two experiments (self-paced reading and eye-tracking) using Chinese relative clauses were conducted to determine the relative contribution to sentence processing difficulty of working-memory processes as compared to syntactic prediction during incremental parsing.
Chinese has the cross-linguistically rare property of being a language with subject-verb-object word order and pre-nominal relative clauses. This property leads to opposing predictions of expectation-based
accounts and memory-based accounts with respect to the relative processing difficulty of subject vs. object relatives.
Previous studies showed contradictory results, which has been attributed to different kinds local ambiguities confounding the materials (Lin and Bever, 2011). The two experiments presented are the first to compare Chinese relatives clauses in syntactically unambiguous contexts.
The results of both experiments were consistent with the predictions of the expectation-based account of sentence processing but not with the memory-based account. From these findings, I conclude that any theory of human sentence processing needs to take into account the power of predictive processes unfolding in the human mind.
We examined the effects of argument-head distance in SVO and SOV languages (Spanish and German), while taking into account readers' working memory capacity and controlling for expectation (Levy, 2008) and other factors. We predicted only locality effects, that is, a slowdown produced by increased dependency distance (Gibson, 2000; Lewis and Vasishth, 2005). Furthermore, we expected stronger locality effects for readers with low working memory capacity. Contrary to our predictions, low-capacity readers showed faster reading with increased distance, while high-capacity readers showed locality effects. We suggest that while the locality effects are compatible with memory-based explanations, the speedup of low-capacity readers can be explained by an increased probability of retrieval failure. We present a computational model based on ACT-R built under the previous assumptions, which is able to give a qualitative account for the present data and can be tested in future research. Our results suggest that in some cases, interpreting longer RTs as indexing increased processing difficulty and shorter RTs as facilitation may be too simplistic: The same increase in processing difficulty may lead to slowdowns in high-capacity readers and speedups in low-capacity ones. Ignoring individual level capacity differences when investigating locality effects may lead to misleading conclusions.
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.
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.
Background
Benefit finding, defined as perceiving positive life changes resulting from adversity and negative life stressors, gains growing attention in the context of chronic illness. The study aimed at examining the psychometric properties of the Benefit Finding Scale for Children (BFSC) in a sample of German youth facing chronic conditions.
Methods
A sample of adolescents with various chronic conditions (N = 304; 12 – 21years) completed the 10-item BFSC along with measures of intra- and interpersonal resources, coping strategies, and health-related quality of life (hrQoL). The total sample was randomly divided into two subsamples for conducting exploratory and confirmatory factor analyses (EFA/CFA).
Results
EFA revealed that the BFSC scores had a one-dimensional factor structure. CFA verified the one-dimensional factor structure with an acceptable fit. The BFSC exhibited acceptable internal consistency (α = 0.87 – 0.88) and construct validity. In line with our hypotheses, benefit finding was positively correlated with optimism, self-esteem, self-efficacy, sense of coherence, and support seeking. There were no correlations with avoidance, wishful thinking, emotional reaction, and hrQoL. Sex differences in benefit finding were not consistent across subsamples. Benefit finding was also positively associated with age, disease severity, and social status.
Conclusions
The BFSC is a psychometrically sound instrument to assess benefit finding in adolescents with chronic illness and may facilitate further research on positive adaptation processes in adolescents, irrespective of their specific diagnosis.
Background: The COVID-19 pandemic has highlighted the importance of scientific endeavors. The goal of this systematic review is to evaluate the quality of the research on physical activity (PA) behavior change and its potential to contribute to policy-making processes in the early days of COVID-19 related restrictions.
Methods: We conducted a systematic review of methodological quality of current research according to PRISMA guidelines using Pubmed and Web of Science, of articles on PA behavior change that were published within 365 days after COVID-19 was declared a pandemic by the World Health Organization (WHO). Items from the JBI checklist and the AXIS tool were used for additional risk of bias assessment. Evidence mapping is used for better visualization of the main results. Conclusions about the significance of published articles are based on hypotheses on PA behavior change in the light of the COVID-19 pandemic.
Results: Among the 1,903 identified articles, there were 36% opinion pieces, 53% empirical studies, and 9% reviews. Of the 332 studies included in the systematic review, 213 used self-report measures to recollect prepandemic behavior in often small convenience samples. Most focused changes in PA volume, whereas changes in PA types were rarely measured. The majority had methodological reporting flaws. Few had very large samples with objective measures using repeated measure design (pre and during the pandemic). In addition to the expected decline in PA duration, these studies show that many of those who were active prepandemic, continued to be active during the pandemic.
Conclusions: Research responded quickly at the onset of the pandemic. However, most of the studies lacked robust methodology, and PA behavior change data lacked the accuracy needed to guide policy makers. To improve the field, we propose the implementation of longitudinal cohort studies by larger organizations such as WHO to ease access to data on PA behavior, and suggest those institutions set clear standards for this research. Researchers need to ensure a better fit between the measurement method and the construct being measured, and use both objective and subjective measures where appropriate to complement each other and provide a comprehensive picture of PA behavior.
Recent research has indicated that university students sometimes use caffeine pills for neuroenhancement (NE; non-medical use of psychoactive substances or technology to produce a subjective enhancement in psychological functioning and experience), especially during exam preparation. In our factorial survey experiment, we manipulated the evidence participants were given about the prevalence of NE amongst peers and measured the resulting effects on the psychological predictors included in the Prototype-Willingness Model of risk behavior. Two hundred and thirty-one university students were randomized to a high prevalence condition (read faked research results overstating usage of caffeine pills amongst peers by a factor of 5; 50%), low prevalence condition (half the estimated prevalence; 5%) or control condition (no information about peer prevalence). Structural equation modeling confirmed that our participants’ willingness and intention to use caffeine pills in the next exam period could be explained by their past use of neuroenhancers, attitude to NE and subjective norm about use of caffeine pills whilst image of the typical user was a much less important factor. Provision of inaccurate information about prevalence reduced the predictive power of attitude with respect to willingness by 40-45%. This may be because receiving information about peer prevalence which does not fit with their perception of the social norm causes people to question their attitude. Prevalence information might exert a deterrent effect on NE via the attitude-willingness association. We argue that research into NE and deterrence of associated risk behaviors should be informed by psychological theory.
In the context of back pain, great emphasis has been placed on the importance of trunk stability, especially in situations requiring compensation of repetitive, intense loading induced during high-performance activities, e.g., jumping or landing. This study aims to evaluate trunk muscle activity during drop jump in adolescent athletes with back pain (BP) compared to athletes without back pain (NBP). Eleven adolescent athletes suffering back pain (BP: m/f: n = 4/7; 15.9 ± 1.3 y; 176 ± 11 cm; 68 ± 11 kg; 12.4 ± 10.5 h/we training) and 11 matched athletes without back pain (NBP: m/f: n = 4/7; 15.5 ± 1.3 y; 174 ± 7 cm; 67 ± 8 kg; 14.9 ± 9.5 h/we training) were evaluated. Subjects conducted 3 drop jumps onto a force plate (ground reaction force). Bilateral 12-lead SEMG (surface Electromyography) was applied to assess trunk muscle activity. Ground contact time [ms], maximum vertical jump force [N], jump time [ms] and the jump performance index [m/s] were calculated for drop jumps. SEMG amplitudes (RMS: root mean square [%]) for all 12 single muscles were normalized to MIVC (maximum isometric voluntary contraction) and analyzed in 4 time windows (100 ms pre- and 200 ms post-initial ground contact, 100 ms pre- and 200 ms post-landing) as outcome variables. In addition, muscles were grouped and analyzed in ventral and dorsal muscles, as well as straight and transverse trunk muscles. Drop jump ground reaction force variables did not differ between NBP and BP (p > 0.05). Mm obliquus externus and internus abdominis presented higher SEMG amplitudes (1.3–1.9-fold) for BP (p < 0.05). Mm rectus abdominis, erector spinae thoracic/lumbar and latissimus dorsi did not differ (p > 0.05). The muscle group analysis over the whole jumping cycle showed statistically significantly higher SEMG amplitudes for BP in the ventral (p = 0.031) and transverse muscles (p = 0.020) compared to NBP. Higher activity of transverse, but not straight, trunk muscles might indicate a specific compensation strategy to support trunk stability in athletes with back pain during drop jumps. Therefore, exercises favoring the transverse trunk muscles could be recommended for back pain treatment.
Working memory (WM) performance declines with age. However, several studies have shown that WM training may lead to performance increases not only in the trained task, but also in untrained cognitive transfer tasks. It has been suggested that transfer effects occur if training task and transfer task share specific processing components that are supposedly processed in the same brain areas. In the current study, we investigated whether single-task WM training and training-related alterations in neural activity might support performance in a dual-task setting, thus assessing transfer effects to higher-order control processes in the context of dual-task coordination. A sample of older adults (age 60–72) was assigned to either a training or control group. The training group participated in 12 sessions of an adaptive n-back training. At pre and post-measurement, a multimodal dual-task was performed in all participants to assess transfer effects. This task consisted of two simultaneous delayed match to sample WM tasks using two different stimulus modalities (visual and auditory) that were performed either in isolation (single-task) or in conjunction (dual-task). A subgroup also participated in functional magnetic resonance imaging (fMRI) during the performance of the n-back task before and after training. While no transfer to single-task performance was found, dual-task costs in both the visual modality (p < 0.05) and the auditory modality (p < 0.05) decreased at post-measurement in the training but not in the control group. In the fMRI subgroup of the training participants, neural activity changes in left dorsolateral prefrontal cortex (DLPFC) during one-back predicted post-training auditory dual-task costs, while neural activity changes in right DLPFC during three-back predicted visual dual-task costs. Results might indicate an improvement in central executive processing that could facilitate both WM and dual-task coordination.
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.
There is an ongoing debate about how to test and operationalize self-control. This limited understanding is in large part due to a variety of different tests and measures used to assess self-control, as well as the lack of empirical studies examining the temporal dynamics during the exertion of self-control. In order to track changes that occur over the course of exposure to a self-control task, we investigate and compare behavioral, subjective, and physiological indicators during the exertion of self-control. Participants completed both a task requiring inhibitory control (Go/No-Go task) and a control task (two-choice task). Behavioral performance and pupil size were measured during the tasks. Subjective vitality was measured before and after the tasks. While pupil size and subjective vitality showed similar trajectories in the two tasks, behavioral performance decreased in the inhibitory control-demanding task, but not in the control task. However, behavioral, subjective, and physiological measures were not significantly correlated. These results suggest that there is a disconnect between different measures of self-control with high intra- and interindividual variability. Theoretical and methodological implications for self-control theory and future empirical work are discussed.
As an emerging sub-field of music information retrieval (MIR), music imagery information retrieval (MIIR) aims to retrieve information from brain activity recorded during music cognition–such as listening to or imagining music pieces. This is a highly inter-disciplinary endeavor that requires expertise in MIR as well as cognitive neuroscience and psychology. The OpenMIIR initiative strives to foster collaborations between these fields to advance the state of the art in MIIR. As a first step, electroencephalography (EEG) recordings of music perception and imagination have been made publicly available, enabling MIR researchers to easily test and adapt their existing approaches for music analysis like fingerprinting, beat tracking or tempo estimation on this new kind of data. This paper reports on first results of MIIR experiments using these OpenMIIR datasets and points out how these findings could drive new research in cognitive neuroscience.
Two experiments examined how individuals respond to a restriction presented within an approach versus an avoidance frame. In Study 1, working on a problem-solving task, participants were initially free to choose their strategy, but for a second task were told to change their strategy. The message to change was embedded in either an approach or avoidance frame. When confronted with an avoidance compared to an approach frame, the participants’ reactance toward the request was greater and, in turn, led to impaired performance. The role of reactance as a response to threat to freedom was explicitly examined in Study 2, in which participants evaluated a potential change in policy affecting their program of study herein explicitly varying whether a restriction was present or absent and whether the message was embedded in an approach versus avoidance frame. When communicated with an avoidance frame and as a restriction, participants showed the highest resistance in terms of reactance, message agreement and evaluation of the communicator. The difference in agreement with the change was mediated by reactance only when a restriction was present. Overall, avoidance goal frames were associated with more resistance to change on different levels of experience (reactance, performance, and person perception). Reactance mediated the effect of goal frame on other outcomes only when a restriction was present.
Meaning-making in the brain has become one of the most intensely discussed topics in cognitive science. Traditional theories on cognition that emphasize abstract symbol manipulations often face a dead end: The symbol grounding problem. The embodiment idea tries to overcome this barrier by assuming that the mind is grounded in sensorimotor experiences. A recent surge in behavioral and brain-imaging studies has therefore focused on the role of the motor cortex in language processing. Concrete, action-related words have received convincing evidence to rely on sensorimotor activation. Abstract concepts, however, still pose a distinct challenge for embodied theories on cognition. Fully embodied abstraction mechanisms were formulated but sensorimotor activation alone seems unlikely to close the explanatory gap. In this respect, the idea of integration areas, such as convergence zones or the ‘hub and spoke’ model, do not only appear like the most promising candidates to account for the discrepancies between concrete and abstract concepts but could also help to unite the field of cognitive science again. The current review identifies milestones in cognitive science research and recent achievements that highlight fundamental challenges, key questions and directions for future research.
The Role of Interoceptive Sensibility and Emotional Conceptualization for the Experience of Emotions
(2021)
The theory of constructed emotions suggests that different psychological components, including core affect (mental and neural representations of bodily changes), and conceptualization (meaning-making based on prior experiences and semantic knowledge), are involved in the formation of emotions. However, little is known about their role in experiencing emotions. In the current study, we investigated how individual differences in interoceptive sensibility and emotional conceptualization (as potential correlates of these components) interact to moderate three important aspects of emotional experiences: emotional intensity (strength of emotion felt), arousal (degree of activation), and granularity (ability to differentiate emotions with precision). To this end, participants completed a series of questionnaires assessing interoceptive sensibility and emotional conceptualization and underwent two emotion experience tasks, which included standardized material (emotion differentiation task; ED task) and self-experienced episodes (day reconstruction method; DRM). Correlational analysis showed that individual differences in interoceptive sensibility and emotional conceptualization were related to each other. Principal Component Analysis (PCA) revealed two independent factors that were referred to as sensibility and monitoring. The Sensibility factor, interpreted as beliefs about the accuracy of an individual in detecting internal physiological and emotional states, predicted higher granularity for negative words. The Monitoring factor, interpreted as the tendency to focus on the internal states of an individual, was negatively related to emotional granularity and intensity. Additionally, Sensibility scores were more strongly associated with greater well-being and adaptability measures than Monitoring scores. Our results indicate that independent processes underlying individual differences in interoceptive sensibility and emotional conceptualization contribute to emotion experiencing.
Background
High prevalence rates have been reported for physical inactivity, mobility limitations, and falls in older adults. Home-based exercise might be an adequate means to increase physical activity by improving health- (i.e., muscle strength) and skill-related components of physical fitness (i.e., balance), particularly in times of restricted physical activity due to pandemics.
Objective
The objective of this study was to examine the effects of home-based balance exercises conducted during daily tooth brushing on measures of balance and muscle strength in healthy older adults.
Methods
Fifty-one older adults were randomly assigned to a balance exercise group (n = 27; age: 65.1 ± 1.1 years) or a passive control group (n = 24; age: 66.2 ± 3.3 years). The intervention group conducted balance exercises over a period of eight weeks twice daily for three minutes each during their daily tooth brushing routine. Pre- and post-intervention, tests were included for the assessment of static steady-state balance (i.e., Romberg test), dynamic steady-state balance (i.e., 10-m single and dual-task walk test using a cognitive and motor interference task), proactive balance (i.e., Timed-Up-and-Go Test [TUG], Functional-Reach-Test [FRT]), and muscle strength (i.e., Chair-Rise-Test [CRT]).
Results
Irrespective of group, the statistical analysis revealed significant main effects for time (pre vs. post) for dual-task gait speed (p < .001, 1.12 ≤ d ≤ 2.65), TUG (p < .001, d = 1.17), FRT (p = .002, d = 0.92), and CRT (p = .002, d = 0.94) but not for single-task gait speed and for the Romberg-Test. No significant group × time interactions were found for any of the investigated variables.
Conclusions
The applied lifestyle balance training program conducted twice daily during tooth brushing routines appears not to be sufficient in terms of exercise dosage and difficulty level to enhance balance and muscle strength in healthy adults aged 60–72 years. Consequently, structured balance training programs using higher exercise dosages and/or more difficult balance tasks are recommended for older adults to improve balance and muscle strength.
The predictions of two contrasting approaches to the acquisition of transitive relative clauses were tested within the same groups of German-speaking participants aged from 3 to 5 years old. The input frequency approach predicts that object relative clauses with inanimate heads (e.g., the pullover that the man is scratching) are comprehended earlier and more accurately than those with an animate head (e.g., the man that the boy is scratching). In contrast, the structural intervention approach predicts that object relative clauses with two full NP arguments mismatching in number (e.g., the man that the boys are scratching) are comprehended earlier and more accurately than those with number-matching NPs (e.g., the man that the boy is scratching). These approaches were tested in two steps. First, we ran a corpus analysis to ensure that object relative clauses with number-mismatching NPs are not more frequent than object relative clauses with number-matching NPs in child directed speech. Next, the comprehension of these structures was tested experimentally in 3-, 4-, and 5-year-olds respectively by means of a color naming task. By comparing the predictions of the two approaches within the same participant groups, we were able to uncover that the effects predicted by the input frequency and by the structural intervention approaches co-exist and that they both influence the performance of children on transitive relative clauses, but in a manner that is modulated by age. These results reveal a sensitivity to animacy mismatch already being demonstrated by 3-year-olds and show that animacy is initially deployed more reliably than number to interpret relative clauses correctly. In all age groups, the animacy mismatch appears to explain the performance of children, thus, showing that the comprehension of frequent object relative clauses is enhanced compared to the other conditions. Starting with 4-year-olds but especially in 5-year-olds, the number mismatch supported comprehension—a facilitation that is unlikely to be driven by input frequency. Once children fine-tune their sensitivity to verb agreement information around the age of four, they are also able to deploy number marking to overcome the intervention effects. This study highlights the importance of testing experimentally contrasting theoretical approaches in order to characterize the multifaceted, developmental nature of language acquisition.
Conceptual knowledge about objects, people and events in the world is central to human cognition, underlying core cognitive abilities such as object recognition and use, and word comprehension. Previous research indicates that concepts consist of perceptual and motor features represented in modality-specific perceptual-motor brain regions. In addition, cross-modal convergence zones integrate modality-specific features into more abstract conceptual representations.
However, several questions remain open: First, to what extent does the retrieval of perceptual-motor features depend on the concurrent task? Second, how do modality-specific and cross-modal regions interact during conceptual knowledge retrieval? Third, which brain regions are causally relevant for conceptually-guided behavior? This thesis addresses these three key issues using functional magnetic resonance imaging (fMRI) and transcranial magnetic stimulation (TMS) in the healthy human brain.
Study 1 - an fMRI activation study - tested to what extent the retrieval of sound and action features of concepts, and the resulting engagement of auditory and somatomotor brain regions depend on the concurrent task. 40 healthy human participants performed three different tasks - lexical decision, sound judgment, and action judgment - on words with a high or low association to sounds and actions. We found that modality-specific regions selectively respond to task-relevant features: Auditory regions selectively responded to sound features during sound judgments, and somatomotor regions selectively responded to action features during action judgments. Unexpectedly, several regions (e.g. the left posterior parietal cortex; PPC) exhibited a task-dependent response to both sound and action features. We propose these regions to be "multimodal", and not "amodal", convergence zones which retain modality-specific information.
Study 2 - an fMRI connectivity study - investigated the functional interaction between modality-specific and multimodal areas during conceptual knowledge retrieval. Using the above fMRI data, we asked (1) whether modality-specific and multimodal regions are functionally coupled during sound and action feature retrieval, (2) whether their coupling depends on the task, (3) whether information flows bottom-up, top-down, or bidirectionally, and (4) whether their coupling is behaviorally relevant. We found that functional coupling between multimodal and modality-specific areas is task-dependent, bidirectional, and relevant for conceptually-guided behavior. Left PPC acted as a connectivity "switchboard" that flexibly adapted its coupling to task-relevant modality-specific nodes.
Hence, neuroimaging studies 1 and 2 suggested a key role of left PPC as a multimodal convergence zone for conceptual knowledge. However, as neuroimaging is correlational, it remained unknown whether left PPC plays a causal role as a multimodal conceptual hub. Therefore, study 3 - a TMS study - tested the causal relevance of left PPC for sound and action feature retrieval. We found that TMS over left PPC selectively impaired action judgments on low sound-low action words, as compared to sham stimulation. Computational simulations of the TMS-induced electrical field revealed that stronger stimulation of left PPC was associated with worse performance on action, but not sound, judgments. These results indicate that left PPC causally supports conceptual processing when action knowledge is task-relevant and cannot be compensated by sound knowledge. Our findings suggest that left PPC is specialized for action knowledge, challenging the view of left PPC as a multimodal conceptual hub.
Overall, our studies support "hybrid theories" which posit that conceptual processing involves both modality-specific perceptual-motor regions and cross-modal convergence zones. In our new model of the conceptual system, we propose conceptual processing to rely on a representational hierarchy from modality-specific to multimodal up to amodal brain regions. Crucially, this hierarchical system is flexible, with different regions and connections being engaged in a task-dependent fashion. Our model not only reconciles the seemingly opposing grounded cognition and amodal theories, it also incorporates task dependency of conceptually-related brain activity and connectivity, thereby resolving several current issues on the neural basis of conceptual knowledge retrieval.
Research within the framework of Basic Psychological Need Theory (BPNT) finds strong associations between basic need frustration and depressive symptoms. This study examined the role of rumination as an underlying mechanism in the association between basic psychological need frustration and depressive symptoms. A cross-sectional sample of N = 221 adults (55.2% female, mean age = 27.95, range = 18–62, SD = 10.51) completed measures assessing their level of basic psychological need frustration, rumination, and depressive symptoms. Correlational analyses and multiple mediation models were conducted. Brooding partially mediated the relation between need frustration and depressive symptoms. BPNT and Response Styles Theory are compatible and can further advance knowledge about depression vulnerabilities.
Background
Due to inconclusive evidence on the effects of foot orthoses treatment on lower limb kinematics and kinetics in children, studies are needed that particularly evaluate the long-term use of foot orthoses on lower limb alignment during walking. Thus, the main objective of this study was to evaluate the effects of long-term treatment with arch support foot orthoses versus a sham condition on lower extremity kinematics and kinetics during walking in children with flexible flat feet.
Methods
Thirty boys aged 8–12 years with flexible flat feet participated in this study. While the experimental group (n = 15) used medial arch support foot orthoses during everyday activities over a period of four months, the control group (n = 15) received flat 2-mm-thick insoles (i.e., sham condition) for the same time period. Before and after the intervention period, walking kinematics and ground reaction forces were collected.
Results
Significant group by time interactions were observed during walking at preferred gait speed for maximum ankle eversion, maximum ankle internal rotation angle, minimum knee abduction angle, maximum knee abduction angle, maximum knee external rotation angle, maximum knee internal rotation angle, maximum hip extension angle, and maximum hip external rotation angle in favor of the foot orthoses group. In addition, statistically significant group by time interactions were detected for maximum posterior, and vertical ground reaction forces in favor of the foot orthoses group.
Conclusions
The long-term use of arch support foot orthoses proved to be feasible and effective in boys with flexible flat feet to improve lower limb alignment during walking.
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.
Background: There is evidence that fully recovered COVID-19 patients usually resume physical exercise, but do not perform at the same intensity level performed prior to infection. The aim of this study was to evaluate the impact of COVID-19 infection and recovery as well as muscle fatigue on cardiorespiratory fitness and running biomechanics in female recreational runners.
Methods: Twenty-eight females were divided into a group of hospitalized and recovered COVID-19 patients (COV, n = 14, at least 14 days following recovery) and a group of healthy age-matched controls (CTR, n = 14). Ground reaction forces from stepping on a force plate while barefoot overground running at 3.3 m/s was measured before and after a fatiguing protocol. The fatigue protocol consisted of incrementally increasing running speed until reaching a score of 13 on the 6–20 Borg scale, followed by steady-state running until exhaustion. The effects of group and fatigue were assessed for steady-state running duration, steady-state running speed, ground contact time, vertical instantaneous loading rate and peak propulsion force.
Results: COV runners completed only 56% of the running time achieved by the CTR (p < 0.0001), and at a 26% slower steady-state running speed (p < 0.0001). There were fatigue-related reductions in loading rate (p = 0.004) without group differences. Increased ground contact time (p = 0.002) and reduced peak propulsion force (p = 0.005) were found for COV when compared to CTR.
Conclusion: Our results suggest that female runners who recovered from COVID-19 showed compromised running endurance and altered running kinetics in the form of longer stance periods and weaker propulsion forces. More research is needed in this area using larger sample sizes to confirm our study findings.
The Human Takes It All
(2020)
Background: The increasing involvement of social robots in human lives raises the question as to how humans perceive social robots. Little is known about human perception of synthesized voices.
Aim: To investigate which synthesized voice parameters predict the speaker's eeriness and voice likability; to determine if individual listener characteristics (e.g., personality, attitude toward robots, age) influence synthesized voice evaluations; and to explore which paralinguistic features subjectively distinguish humans from robots/artificial agents.
Methods: 95 adults (62 females) listened to randomly presented audio-clips of three categories: synthesized (Watson, IBM), humanoid (robot Sophia, Hanson Robotics), and human voices (five clips/category). Voices were rated on intelligibility, prosody, trustworthiness, confidence, enthusiasm, pleasantness, human-likeness, likability, and naturalness. Speakers were rated on appeal, credibility, human-likeness, and eeriness. Participants' personality traits, attitudes to robots, and demographics were obtained.
Results: The human voice and human speaker characteristics received reliably higher scores on all dimensions except for eeriness. Synthesized voice ratings were positively related to participants' agreeableness and neuroticism. Females rated synthesized voices more positively on most dimensions. Surprisingly, interest in social robots and attitudes toward robots played almost no role in voice evaluation. Contrary to the expectations of an uncanny valley, when the ratings of human-likeness for both the voice and the speaker characteristics were higher, they seemed less eerie to the participants. Moreover, when the speaker's voice was more humanlike, it was more liked by the participants. This latter point was only applicable to one of the synthesized voices. Finally, pleasantness and trustworthiness of the synthesized voice predicted the likability of the speaker's voice. Qualitative content analysis identified intonation, sound, emotion, and imageability/embodiment as diagnostic features.
Discussion: Humans clearly prefer human voices, but manipulating diagnostic speech features might increase acceptance of synthesized voices and thereby support human-robot interaction. There is limited evidence that human-likeness of a voice is negatively linked to the perceived eeriness of the speaker.
Background/objective
Dry land-training (e.g., plyometric jump training) can be a useful mean to improve swimming performance. This study examined the effects of an 8-week plyometric jump training (PJT) program on jump and sport-specific performances in prepubertal female swimmers.
Methods
Twenty-two girls were randomly assigned to either a plyometric jump training group (PJTG; n = 12, age: 10.01 ± 0.57 years, maturity-offset = -1.50 ± 0.50, body mass = 36.39 ± 6.32 kg, body height = 146.90 ± 7.62 cm, body mass index = 16.50 ± 1.73 kg/m2) or an active control (CG; n = 10, age: 10.50 ± 0.28 years, maturity-offset = -1.34 ± 0.51, body mass = 38.41 ± 9.42 kg, body height = 143.60 ± 5.05 cm, body mass index = 18.48 ± 3.77 kg/m2). Pre- and post-training, tests were conducted for the assessment of muscle power (e.g., countermovement-jump [CMJ], standing-long-jump [SLJ]). Sport-specific-performances were tested using the timed 25 and 50-m front crawl with a diving-start, timed 25-m front crawl without push-off from the wall (25-m WP), and a timed 25-m kick without push-off from the wall (25-m KWP).
Results
Findings showed a significant main effect of time for the CMJ (d = 0.78), the SLJ (d = 0.91), 25-m front crawl test (d = 2.5), and the 25-m-KWP (d = 1.38) test. Significant group × time interactions were found for CMJ, SLJ, 25-m front crawl, 50-m front crawl, 25-m KWP, and 25-m WP test (d = 0.29–1.63) in favor of PJTG (d = 1.34–3.50). No significant pre-post changes were found for CG (p > 0.05).
Conclusion
In sum, PJT is effective in improving muscle power and sport-specific performances in prepubertal swimmers. Therefore, PJT should be included from an early start into the regular training program of swimmers.
Background: The standard method to treat physically active patients with anterior cruciate ligament (ACL) rupture is ligament reconstruction surgery. The rehabilitation training program is very important to improve functional performance in recreational athletes following ACL reconstruction.
Objectives: The aims of this study were to compare the effects of three different training programs, eccentric training (ECC), plyometric training (PLYO), or combined eccentric and plyometric training (COMB), on dynamic balance (Y-BAL), the Lysholm Knee Scale (LKS), the return to sport index (RSI), and the leg symmetry index (LSI) for the single leg hop test for distance in elite female athletes after ACL surgery.
Materials and Methods: Fourteen weeks after rehabilitation from surgery, 40 elite female athletes (20.3 ± 3.2 years), who had undergone an ACL reconstruction, participated in a short-term (6 weeks; two times a week) training study. All participants received the same rehabilitation protocol prior to the training study. Athletes were randomly assigned to three experimental groups, ECC (n = 10), PLYO (n = 10), and COMB (n = 10), and to a control group (CON: n = 10). Testing was conducted before and after the 6-week training programs and included the Y-BAL, LKS, and RSI. LSI was assessed after the 6-week training programs only.
Results: Adherence rate was 100% across all groups and no training or test-related injuries were reported. No significant between-group baseline differences (pre-6-week training) were observed for any of the parameters. Significant group-by-time interactions were found for Y-BAL (p < 0.001, ES = 1.73), LKS (p < 0.001, ES = 0.76), and RSI (p < 0.001, ES = 1.39). Contrast analysis demonstrated that COMB yielded significantly greater improvements in Y-BAL, LKS, and RSI (all p < 0.001), in addition to significantly better performances in LSI (all p < 0.001), than CON, PLYO, and ECC, respectively.
Conclusion: In conclusion, combined (eccentric/plyometric) training seems to represent the most effective training method as it exerts positive effects on both stability and functional performance in the post-ACL-surgical rehabilitation period of elite female athletes.
Background: 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 present study explores the role of the word position-in-text in sentence and paragraph reading. Three eye-movement data sets based on the reading of Dutch and German unrelated sentences reveal a sizeable, replicable increase in reading times over several words in the beginning and the end of sentences. The data from the paragraphbased English-language Dundee corpus replicate the pattern and also indicate that the increase in inspection times is driven by the visual boundaries of the text organized in lines, rather than by syntactic sentence boundaries. We argue that this effect is independent of several established lexical, contextual and oculomotor predictors of eye-movement behavior. We also provide evidence that the effect of word position-intext has two independent components: a start-up effect arguably caused by a strategic oculomotor program of saccade planning over the line of text, and a wrap-up effect originating in cognitive processes of comprehension and semantic integration.
Objective: There is a lack of brief rating scales for the reliable assessment of psychotherapeutic skills, which do not require intensive rater training and/or a high level of expertise. Thus, the objective is to validate a 14-item version of the Clinical Communication Skills Scale (CCSS-S).
Methods: Using a sample of N = 690 video-based ratings of role-plays with simulated patients, we calculated a confirmatory factor analysis and an exploratory structural equation modeling (ESEM), assessed convergent validities, determined inter-rater reliabilities and compared these with those who were either psychology students, advanced psychotherapy trainees, or experts.
Results: Correlations with other competence rating scales were high (rs > 0.86–0.89). The intraclass correlations ranged between moderate and good [ICC(2,2) = 0.65–0.80], with student raters yielding the lowest scores. The one-factor model only marginally replicated the data, but the internal consistencies were excellent (α = 0.91–95). The ESEM yielded a two-factor solution (Collaboration and Structuring and Exploration Skills).
Conclusion: The CCSS-S is a brief and valid rating scale that reliably assesses basic communication skills, which is particularly useful for psychotherapy training using standardized role-plays. To ensure good inter-rater reliabilities, it is still advisable to employ raters with at least some clinical experience. Future studies should further investigate the one- or two-factor structure of the instrument.
Although school climate and self-efficacy have received some attention in the literature, as correlates of students’ willingness to intervene in bullying, to date, very little is known about the potential mediating role of self-efficacy in the relationship between classroom climate and students’ willingness to intervene in bullying. To this end, the present study analyzes whether the relationship between classroom cohesion (as one facet of classroom climate) and students’ willingness to intervene in bullying situations is mediated by self-efficacy in social conflicts. This study is based on a representative stratified random sample of two thousand and seventy-one students (51.3% male), between the ages of twelve and seventeen, from twenty-four schools in Germany. Results showed that between 43% and 48% of students reported that they would not intervene in bullying. A mediation test using the structural equation modeling framework revealed that classroom cohesion and self-efficacy in social conflicts were directly associated with students’ willingness to intervene in bullying situations. Furthermore, classroom cohesion was indirectly associated with higher levels of students’ willingness to intervene in bullying situations, due to self-efficacy in social conflicts. We thus conclude that: (1) It is crucial to increase students’ willingness to intervene in bullying; (2) efforts to increase students’ willingness to intervene in bullying should promote students’ confidence in dealing with social conflicts and interpersonal relationships; and (3) self-efficacy plays an important role in understanding the relationship between classroom cohesion and students’ willingness to intervene in bullying. Recommendations are provided to help increase adolescents’ willingness to intervene in bullying and for future research.
Background: As the number of cardiac diseases continuously increases within the last years in modern society, so does cardiac treatment, especially cardiac catheterization. The procedure of a cardiac catheterization is challenging for both patients and practitioners. Several potential stressors of psychological or physical nature can occur during the procedure. The objective of the study is to develop and implement a stress management intervention for both practitioners and patients that aims to reduce the psychological and physical strain of a cardiac catheterization.
Methods: The clinical study (DRKS00026624) includes two randomized controlled intervention trials with parallel groups, for patients with elective cardiac catheterization and practitioners at the catheterization lab, in two clinic sites of the Ernst-von-Bergmann clinic network in Brandenburg, Germany. Both groups received different interventions for stress management. The intervention for patients comprises a psychoeducational video with different stress management technics and additional a standardized medical information about the cardiac catheterization examination. The control condition includes the in hospitals practiced medical patient education before the examination (usual care). Primary and secondary outcomes are measured by physiological parameters and validated questionnaires, the day before (M1) and after (M2) the cardiac catheterization and at a postal follow-up 6 months later (M3). It is expected that people with standardized information and psychoeducation show reduced complications during cardiac catheterization procedures, better pre- and post-operative wellbeing, regeneration, mood and lower stress levels over time. The intervention for practitioners includes a Mindfulness-based stress reduction program (MBSR) over 8 weeks supervised by an experienced MBSR practitioner directly at the clinic site and an operative guideline. It is expected that practitioners with intervention show improved perceived and chronic stress, occupational health, physical and mental function, higher effort-reward balance, regeneration and quality of life. Primary and secondary outcomes are measured by physiological parameters (heart rate variability, saliva cortisol) and validated questionnaires and will be assessed before (M1) and after (M2) the MBSR intervention and at a postal follow-up 6 months later (M3). Physiological biomarkers in practitioners will be assessed before (M1) and after intervention (M2) on two work days and a two days off. Intervention effects in both groups (practitioners and patients) will be evaluated separately using multivariate variance analysis.
Discussion: This study evaluates the effectiveness of two stress management intervention programs for patients and practitioners within cardiac catheter laboratory. Study will disclose strains during a cardiac catheterization affecting both patients and practitioners. For practitioners it may contribute to improved working conditions and occupational safety, preservation of earning capacity, avoidance of participation restrictions and loss of performance. In both groups less anxiety, stress and complications before and during the procedures can be expected. The study may add knowledge how to eliminate stressful exposures and to contribute to more (psychological) security, less output losses and exhaustion during work. The evolved stress management guidelines, training manuals and the standardized patient education should be transferred into clinical routines
Decades of research have demonstrated that physical stress (PS) stimulates bone remodeling and affects bone structure and function through complex mechanotransduction mechanisms. Recent research has laid ground to the hypothesis that mental stress (MS) also influences bone biology, eventually leading to osteoporosis and increased bone fracture risk. These effects are likely exerted by modulation of hypothalamic–pituitary–adrenal axis activity, resulting in an altered release of growth hormones, glucocorticoids and cytokines, as demonstrated in human and animal studies. Furthermore, molecular cross talk between mental and PS is thought to exist, with either synergistic or preventative effects on bone disease progression depending on the characteristics of the applied stressor. This mini review will explain the emerging concept of MS as an important player in bone adaptation and its potential cross talk with PS by summarizing the current state of knowledge, highlighting newly evolving notions (such as intergenerational transmission of stress and its epigenetic modifications affecting bone) and proposing new research directions.
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.
Sprint and jump performances in highly trained young soccer players of different chronological age
(2020)
Objective
The aim of this study was to examine the effects of two different sprint-training regimes on sprint and jump performances according to age in elite young male soccer players over the course of one soccer season.
Methods
Players were randomly assigned to two training groups. Group 1 performed systematic change-of-direction sprints (CODST, U19 [n = 9], U17 [n = 9], U15 [n = 10]) while group 2 conducted systematic linear sprints (LST, U19 [n = 9], U17 [n = 9], U15 [n = 9]). Training volumes were similar between groups (40 sprints per week x 30 weeks = 1200 sprints per season). Pre and post training, all players performed tests for the assessment of linear and slalom sprint speed (5-m and 10-m), countermovement jump, and maximal aerobic speed performance.
Results
For all physical fitness measures, the baseline-adjusted means data (ANCOVA) across the age groups showed no significant differences between LST and CODST at post (0.061 < p < 0.995; 0.0017 < d < 1.01). The analyses of baseline-adjusted means for all physical fitness measures for U15, U17, and U19 (LST vs. CODST) revealed no significant differences between LST and CODST for U15 (0.213 < p < 0.917; 0.001 < d < 0.087), U17 (0.132 < p < 0.976; 0.001 < d < 0.310), and U19 (0.300 < p < 0.999; 0.001 < d < 0.049) at post.
Conclusions
The results from this study showed that both, LST and CODST induced significant changes in the sprint, lower limbs power, and aerobic performances in young elite soccer players. Since no significant differences were observed between LST and CODST, the observed changes are most likely due to training and/or maturation. Therefore, more research is needed to elucidate whether CODST, LST or a combination of both is beneficial for youth soccer athletes’ performance development.
In numerical processing, the functional role of Spatial-Numerical Associations (SNAs, such as the association of smaller numbers with left space and larger numbers with right space, the Mental Number Line hypothesis) is debated. Most studies demonstrate SNAs with lateralized responses, and there is little evidence that SNAs appear when no response is required. We recorded passive holding grip forces in no-go trials during number processing. In Experiment 1, participants performed a surface numerical decision task (“Is it a number or a letter?”). In Experiment 2, we used a deeper semantic task (“Is this number larger or smaller than five?”). Despite instruction to keep their grip force constant, participants' spontaneous grip force changed in both experiments: Smaller numbers led to larger force increase in the left than in the right hand in the numerical decision task (500–700 ms after stimulus onset). In the semantic task, smaller numbers again led to larger force increase in the left hand, and larger numbers increased the right-hand holding force. This effect appeared earlier (180 ms) and lasted longer (until 580 ms after stimulus onset). This is the first demonstration of SNAs with passive holding force. Our result suggests that (1) explicit motor response is not a prerequisite for SNAs to appear, and (2) the timing and strength of SNAs are task-dependent. (216 words).
Introduction: The body-specificity hypothesis states that in right-handers, positive concepts should be associated with the right side and negative concepts with the left side of the body. Following this hypothesis, our study postulated that negative out-group ethnic stereotypes would be associated with the left side, and positive in-group stereotypes would be associated with the right side.
Methods: The experiment consisted of two parts. First, we measured the spatial mapping of ethnic stereotypes by using a sensibility judgment task, in which participants had to decide whether a sentence was sensible or not by pressing either a left or a right key. The sentences included German vs. Arabic proper names. Second, we measured implicit ethnic stereotypes in the same participants using the Go/No-go Association Task (GNAT), in which Arabic vs. German proper names were presented in combination with positive vs. negative adjectives. Right-handed German native speakers (N = 92) participated in an online study.
Results: As predicted, in the GNAT, participants reacted faster to German names combined with positive adjectives and to Arabic names combined with negative adjectives, which is diagnostic of existing valenced in-and outgroup ethnic stereotypes. However, we failed to find any reliable effects in the sensibility judgment task, i.e., there was no evidence of spatial mapping of positive and negative ethnic stereotypes. There was no correlation between the results of the two tasks at the individual level. Further Bayesian analysis and exploratory analysis in the left-handed subsample (N = 9) corroborated the evidence in favor of null results.
Discussion: Our study suggests that ethnic stereotypes are not automatically mapped in a body-specific manner.
Background: We assessed the effects of gender, in association with a four-week small-sided games (SSGs) training program, during Ramadan intermitting fasting (RIF) on changes in psychometric and physiological markers in professional male and female basketball players.
Methods: Twenty-four professional basketball players from the first Tunisian (Tunisia) division participated in this study. The players were dichotomized by sex (males [GM = 12]; females [GF = 12]). Both groups completed a 4 weeks SSGs training program with 3 sessions per week. Psychometric (e.g., quality of sleep, fatigue, stress, and delayed onset of muscle soreness [DOMS]) and physiological parameters (e.g., heart rate frequency, blood lactate) were measured during the first week (baseline) and at the end of RIF (post-test).
Results: Post hoc tests showed a significant increase in stress levels in both groups (GM [− 81.11%; p < 0.001, d = 0.33, small]; GF [− 36,53%; p = 0.001, d = 0.25, small]). Concerning physiological parameters, ANCOVA revealed significantly lower heart rates in favor of GM at post-test (1.70%, d = 0.38, small, p = 0.002).
Conclusions: Our results showed that SSGs training at the end of the RIF negatively impacted psychometric parameters of male and female basketball players. It can be concluded that there are sex-mediated effects of training during RIF in basketball players, and this should be considered by researchers and practitioners when programing training during RIF.
Objectives: Chronic back pain (CBP) can lead to disability and burden. In addition to its medical causes, its development is influenced by psychosocial risk factors, the so-called flag factors, which are categorized and integrated into many treatment guidelines. Currently, most studies investigate single flag factors, which limit the estimation of individual factor significance in the development of chronic pain. Furthermore, factors concerning patients’ lifestyle, biography and treatment history are often neglected. Therefore, the objectives of the present study are to identify commonly neglected factors of CBP and integrate them into an analysis model comparing their significance with established flag factors.
Methods: A total of 24 patients and therapists were cross-sectionally interviewed to identify commonly neglected factors of CBP. Subsequently, the impact of these factors was surveyed in a longitudinal study. In two rehabilitation clinics, CBP patients (n = 145) were examined before and 6 months after a 3-week inpatient rehabilitation. Outcome variables, chronification factor pain experience (CF-PE) and chronification factor disability (CF-D), were ascertained with confirmatory factor analysis (CFA) of standardized questionnaires. Predictors were evaluated using stepwise calculations of simple and multiple regression models.
Results: Through interviews, medical history, iatrogenic factors, poor compliance, critical life events (LEs), social support (SS) type and effort–reward were identified as commonly neglected factors. However, only the final three held significance in comparison to established factors such as depression and pain-related cognitions. Longitudinally, lifestyle factors found to influence future pain were initial pain, physically demanding work, nicotine consumption, gender and rehabilitation clinic. LEs were unexpectedly found to be a strong predictor of future pain, as were the protective factors, reward at work and perceived SS.
Discussion: These findings shed insight regarding often overlooked factors in the development of CBP, suggesting that more detailed operationalization and superordinate frameworks would be beneficial to further research.
Conclusion: In particular, LEs should be taken into account in future research. Protective factors should be integrated in therapeutic settings.
Midbrain dopamine neurons invigorate responses by signaling opportunity costs (tonic dopamine) and promote associative learning by encoding a reward prediction error signal (phasic dopamine). Recent studies on Bayesian sensorimotor control have implicated midbrain dopamine concentration in the integration of prior knowledge and current sensory information. The present behavioral study addressed the contributions of tonic and phasic dopamine in a Bayesian decision-making task by alternating reward magnitude and inferring reward prediction errors. Twenty-four participants were asked to indicate the position of a hidden target stimulus under varying prior and likelihood uncertainty. Trial-by-trial rewards were allocated based on performance and two different reward maxima. Overall, participants’ behavior agreed with Bayesian decision theory, but indicated excessive reliance on likelihood information. These results thus
oppose accounts of statistically optimal integration in sensorimotor control, and suggest that the sensorimotor system is subject to additional decision heuristics. Moreover, higher reward magnitude was not observed to induce enhanced response vigor, and was associated with less Bayes-like integration. In addition, the weighting of prior knowledge and current sensory information proceeded independently of reward prediction errors.
Taken together, these findings suggest that the process of combining prior and likelihood uncertainties in sensorimotor control is largely robust to variations in reward.
Background
Millions of people in Germany suffer from chronic pain, in which course and intensity are multifactorial. Besides physical injuries, certain psychosocial risk factors are involved in the disease process. The national health care guidelines for the diagnosis and treatment of non-specific low back pain recommend the screening of psychosocial risk factors as early as possible, to be able to adapt the therapy to patient needs (e.g., unimodal or multimodal). However, such a procedure has been difficult to implement in practice and has not yet been integrated into the rehabilitation care structures across the country.
Methods
The aim of this study is to implement an individualized therapy and aftercare program within the rehabilitation offer of the German Pension Insurance in the area of orthopedics and to examine its success and sustainability in comparison to the previous standard aftercare program.
The study is a multicenter randomized controlled trial including 1204 patients from six orthopedic rehabilitation clinics. A 2:1 allocation ratio to intervention (individualized and home-based rehabilitation aftercare) versus the control group (regular outpatient rehabilitation aftercare) is set. Upon admission to the rehabilitation clinic, participants in the intervention group will be screened according to their psychosocial risk profile. They could then receive either unimodal or multimodal, together with an individualized training program. The program is instructed in the clinic (approximately 3 weeks) and will continue independently at home afterwards for 3 months. The success of the program is examined by means of a total of four surveys. The co-primary outcomes are the Characteristic Pain Intensity and Disability Score assessed by the German version of the Chronic Pain Grade questionnaire (CPG).
Discussion
An improvement in terms of pain, work ability, patient compliance, and acceptance in our intervention program compared to the standard aftercare is expected. The study contributes to provide individualized care also to patients living far away from clinical centers.
Trial registration
DRKS, DRKS00020373. Registered on 15 April 2020
The purpose of this study was to examine the test-retest reliability, and convergent and discriminative validity of a new taekwondo-specific change-of-direction (COD) speed test with striking techniques (TST) in elite taekwondo athletes. Twenty (10 males and 10 females) elite (athletes who compete at national level) and top-elite (athletes who compete at national and international level) taekwondo athletes with an average training background of 8.9 ± 1.3 years of systematic taekwondo training participated in this study. During the two-week test-retest period, various generic performance tests measuring COD speed, balance, speed, and jump performance were carried out during the first week and as a retest during the second week. Three TST trials were conducted with each athlete and the best trial was used for further analyses. The relevant performance measure derived from the TST was the time with striking penalty (TST-TSP). TST-TSP performances amounted to 10.57 ± 1.08 s for males and 11.74 ± 1.34 s for females. The reliability analysis of the TST performance was conducted after logarithmic transformation, in order to address the problem of heteroscedasticity. In both groups, the TST demonstrated a high relative test-retest reliability (intraclass correlation coefficients and 90% compatibility limits were 0.80 and 0.47 to 0.93, respectively). For absolute reliability, the TST’s typical error of measurement (TEM), 90% compatibility limits, and magnitudes were 4.6%, 3.4 to 7.7, for males, and 5.4%, 3.9 to 9.0, for females. The homogeneous sample of taekwondo athletes meant that the TST’s TEM exceeded the usual smallest important change (SIC) with 0.2 effect size in the two groups. The new test showed mostly very large correlations with linear sprint speed (r = 0.71 to 0.85) and dynamic balance (r = −0.71 and −0.74), large correlations with COD speed (r = 0.57 to 0.60) and vertical jump performance (r = −0.50 to −0.65), and moderate correlations with horizontal jump performance (r = −0.34 to −0.45) and static balance (r = −0.39 to −0.44). Top-elite athletes showed better TST performances than elite counterparts. Receiver operating characteristic analysis indicated that the TST effectively discriminated between top-elite and elite taekwondo athletes. In conclusion, the TST is a valid, and sensitive test to evaluate the COD speed with taekwondo specific skills, and reliable when considering ICC and TEM. Although the usefulness of the TST is questioned to detect small performance changes in the present population, the TST can detect moderate changes in taekwondo-specific COD speed.
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.
The aim of this review was to describe and summarize the scientific literature on programming parameters related to jump or plyometric training in male and female soccer players of different ages and fitness levels. A literature search was conducted in the electronic databases PubMed, Web of Science and Scopus using keywords related to the main topic of this study (e.g., “ballistic” and “plyometric”). According to the PICOS framework, the population for the review was restricted to soccer players, involved in jump or plyometric training. Among 7556 identified studies, 90 were eligible for inclusion. Only 12 studies were found for females. Most studies (n = 52) were conducted with youth male players. Moreover, only 35 studies determined the effectiveness of a given jump training programming factor. Based on the limited available research, it seems that a dose of 7 weeks (1–2 sessions per week), with ~80 jumps (specific of combined types) per session, using near-maximal or maximal intensity, with adequate recovery between repetitions (<15 s), sets (≥30 s) and sessions (≥24–48 h), using progressive overload and taper strategies, using appropriate surfaces (e.g., grass), and applied in a well-rested state, when combined with other training methods, would increase the outcome of effective and safe plyometric-jump training interventions aimed at improving soccer players physical fitness. In conclusion, jump training is an effective and easy-to-administer training approach for youth, adult, male and female soccer players. However, optimal programming for plyometric-jump training in soccer is yet to be determined in future research.
Purpose: Although subjective knowledge about the prognosis of an advanced disease is extremely important for coping and treatment planning, the concept of prognostic awareness (PA) remains inconsistently defined. The aims of the scoping review were to synthesize a definition of PA from the most recent literature, describe preconditions, correlates and consequences, and suggest a conceptual model.
Methods: By using scoping review methodology, we searched the Web of Science and PubMed databases, and included publications, reviews, meta-analyses or guidelines on all physical diagnoses, as well as publications offering a conceptual or an operational definition of PA. The data were analyzed by means of content analysis techniques.
Results: Of the 24 included publications, 21 referred exclusively to cancer, one to patients with hip fractures and two to palliative care in general. The deduced definition of PA comprised the following facets: adequate estimation of chances for recovery, knowledge of limited time to live, adequate estimation of life expectancy, knowledge of therapy goals, and knowledge of the course of the disease. Further content analysis results were mapped graphically and in a detailed table.
Conclusion: There appears to be a lack of theoretical embedding of PA that in turn influences the methods used for empirical investigation. Drawing on a clear conceptual definition, longitudinal or experimental studies would be desirable.
For life-long learning, an effective learning strategy repertoire is particularly important during acquisition of knowledge in lower secondary school—an educational level characterized with transition into more autonomous learning environments with increased complex academic demands. Using latent profile analysis, we explored the occurrence of different secondary school learner profiles depending on their various combinations of cognitive and metacognitive learning strategy use, as well as their differences in perceived autonomy support, intrinsic motivation, and gender. Data were collected from 576 ninth grade students in Uganda using self-report questionnaires. Four learner profiles were identified: competent strategy user, struggling user, surface-level learner, and deep-level learner profiles. Gender differences were noted in students’ use of elaboration and organization strategies to learn Physics, in favor of girls. In terms of profile memberships, significant differences in gender, intrinsic motivation and perceived autonomy support were also noted. Girls were 2.4–2.7 times more likely than boys to be members of the competent strategy user and surface-level learner profiles. Additionally, higher levels of intrinsic motivation predicted an increased likelihood membership into the deep-level learner profile, while higher levels of perceived teacher autonomy predicted an increased likelihood membership into the competent strategy user profile as compared to other profiles. Further, implications of the findings were discussed.
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.
In a self-paced reading study on German sluicing, Paape (Paape, 2016) found that reading times were shorter at the ellipsis site when the antecedent was a temporarily ambiguous garden-path structure. As a post-hoc explanation of this finding, Paape assumed that the antecedent’s memory representation was reactivated during syntactic reanalysis, making it easier to retrieve. In two eye tracking experiments, we subjected the reactivation hypothesis to further empirical scrutiny. Experiment 1, carried out in French, showed no evidence in favor in the reactivation hypothesis. Instead, results for one out of the three types of garden-path sentences that were tested suggest that subjects sometimes failed to resolve the temporary ambiguity in the antecedent clause, and subsequently failed to resolve the ellipsis. The results of Experiment 2, a conceptual replication of Paape’s (Paape, 2016) original study carried out in German, are compatible with the reactivation hypothesis, but leave open the possibility that the observed speedup for ambiguous antecedents may be due to occasional retrievals of an incorrect structure.
Processing negative imperatives in Bulgarian : evidence from normal, aphasic and child language
(2010)
The incremental nature of sentence processing raises questions about the way the information of incoming functional elements is accessed and subsequently employed in building the syntactic structure which sustains interpretation processes. The present work approaches these questions by investigating the negative particle ne used for sentential negation in Bulgarian and its impact on the overt realisation and the interpretation of imperative inflexion, bound aspectual morphemes and clitic pronouns in child, adult and aphasic language. In contrast to other Slavic languages, Bulgarian negative imperatives (NI) are grammatical only with imperfective verbs. We argue that NI are instantiations of overt aspectual coercion induced by the presence of negation as a temporally sensitive sentential operator. The scope relation between imperative mood, negation, and aspect yields the configuration of the imperfective present which in Bulgarian has to be overtly expressed and prompts the imperfective marking of the predicate. The regular and transparent application of the imperfectivising mechanism relates to the organisation of the TAM categories in Bulgarian which not only promotes the representation of fine perspective shifts but also provides for their distinct morphological expression. Using an elicitation task with NI, we investigated the way 3- and 4-year-old children represent negation in deontic contexts as reflected in their use of aspectually appropriate predicates. Our findings suggest that children are sensitive to the imperfectivity requirement in NI from early on. The imperfectivisation strategies reveal some differences from the target morphological realisation. The relatively low production of target imperfectivised prefixed verbs cannot be explained with morphological processing deficits, but rather indicates that up to the age of five children experience difficulties to apply a progressive view point to accomplishments. Two self-paced reading studies present evidence that neurologically unimpaired Bulgarian speakers profit from the syntactic and prosodic properties of negation during online sentence comprehension. The imperfectivity requirement negation imposes on the predicate speeds up lexical access to imperfective verbs. Similarly, clitic pronouns are more accessible after negation due to the phono-syntactic properties of clitic clusters. As the experimental stimuli do not provide external discourse referents, personal pronouns are parsed as object agreement markers. Without subsequent resolution, personal pronouns appear to be less resource demanding than reflexive clitics. This finding is indicative of the syntax-driven co-reference establishment processes triggered through the lexical specification of reflexive clitics. The results obtained from Bulgarian Broca's aphasics show that they exhibit processing patterns similar to those of the control group. Notwithstanding their slow processing speed, the agrammatic group showed no impairment of negation as reflected by their sensitivity to the aspectual requirements of NI, and to the prosodic constraints on clitic placement. The aphasics were able to parse the structural dependency between mood, negation and aspect as functional categories and to represent it morphologically. The prolonged reaction times (RT) elicited by prefixed verbs indicate increasing processing costs due to the semantic integration of prefixes as perfectivity markers into an overall imperfective construal. This inference is supported by the slower RT to reflexive clitics, which undergo a structurally triggered resolution. Evaluated against cross-linguistic findings, the obtained result strongly suggests that aphasic performance with pronouns depends on the interpretation efforts associated with co-reference establishment and varies due to availability of discourse referents. The investigation of normal and agrammatic processing of Bulgarian NI presents support for the hypothesis that the comprehension deficits in Broca's aphasia result from a slowed-down implementation of syntactic operations. The protracted structure building consumes processing resources and causes temporal mismatches with other processes sustaining sentence comprehension. The investigation of the way Bulgarian children and aphasic speakers process NI reveals that both groups are highly sensitive to the imperfective constraint on the aspectual construal imposed by the presence of negation. The imperfective interpretation requires access to morphologically complex verb forms which contain aspectual morphemes with conflicting semantic information – perfective prefixes and imperfective suffixes. Across modalities, both populations exhibit difficulties in processing prefixed imperfectivised verbs which as predicates of negative imperative sentences reflect the inner perspective the speaker and the addressee need to take towards a potentially bounded situation description.
Proceedings of KogWis 2010 : 10th Biannual Meeting of the German Society for Cognitive Science
(2010)
As the latest biannual meeting of the German Society for Cognitive Science (Gesellschaft für Kognitionswissenschaft, GK), KogWis 2010 at Potsdam University reflects the current trends in a fascinating domain of research concerned with human and artificial cognition and the interaction of mind and brain. The Plenary talks provide a venue for questions of the numerical capacities and human arithmetic (Brian Butterworth), of the theoretical development of cognitive architectures and intelligent virtual agents (Pat Langley), of categorizations induced by linguistic constructions (Claudia Maienborn), and of a cross-level account of the “Self as a complex system“ (Paul Thagard). KogWis 2010 integrates a wealth of experimental research, cognitive modelling, and conceptual analysis in 5 invited symposia, over 150 individual talks, 6 symposia, and more than 40 poster contributions. Some of the invited symposia reflect local and regional strenghts of research in the Berlin-Brandenburg area: the two largests research fields of the university Cognitive Sciences Area of Excellence in Potsdam are represented by an invited symposium on “Information Structure” by the Special Research Area 632 (“Sonderforschungsbereich”, SFB) of the same name, of Potsdam University and Humboldt-University Berlin, and by a satellite conference of the research group “Mind and Brain Dynamics”. The Berlin School of Mind and Brain at Humboldt-University Berlin takes part with an invited symposium on “Decision Making” from a perspective of cognitive neuroscience and philosophy and the DFG Cluster of Excellence “Languages of Emotion” of Free University presents interdisciplinary research results in an invited symposium on “Symbolising Emotions”.
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.
A large body of research now supports the presence of both syntactic and lexical predictions in sentence processing. Lexical predictions, in particular, are considered to indicate a deep level of predictive processing that extends past the structural features of a necessary word (e.g. noun), right down to the phonological features of the lexical identity of a specific word (e.g. /kite/; DeLong et al., 2005). However, evidence for lexical predictions typically focuses on predictions in very local environments, such as the adjacent word or words (DeLong et al., 2005; Van Berkum et al., 2005; Wicha et al., 2004). Predictions in such local environments may be indistinguishable from lexical priming, which is transient and uncontrolled, and as such may prime lexical items that are not compatible with the context (e.g. Kukona et al., 2014). Predictive processing has been argued to be a controlled process, with top-down information guiding preactivation of plausible upcoming lexical items (Kuperberg & Jaeger, 2016). One way to distinguish lexical priming from prediction is to demonstrate that preactivated lexical content can be maintained over longer distances.
In this dissertation, separable German particle verbs are used to demonstrate that preactivation of lexical items can be maintained over multi-word distances. A self-paced reading time and an eye tracking experiment provide some support for the idea that particle preactivation triggered by a verb and its context can be observed by holding the sentence context constant and manipulating the predictabilty of the particle. Although evidence of an effect of particle predictability was only seen in eye tracking, this is consistent with previous evidence suggesting that predictive processing facilitates only some eye tracking measures to which the self-paced reading modality may not be sensitive (Staub, 2015; Rayner1998). Interestingly, manipulating the distance between the verb and the particle did not affect reading times, suggesting that the surprisal-predicted faster reading times at long distance may only occur when the additional distance is created by information that adds information about the lexical identity of a distant element (Levy, 2008; Grodner & Gibson, 2005). Furthermore, the results provide support for models proposing that temporal decay is not major influence on word processing (Lewandowsky et al., 2009; Vasishth et al., 2019).
In the third and fourth experiments, event-related potentials were used as a method for detecting specific lexical predictions. In the initial ERP experiment, we found some support for the presence of lexical predictions when the sentence context constrained the number of plausible particles to a single particle. This was suggested by a frontal post-N400 positivity (PNP) that was elicited when a lexical prediction had been violated, but not to violations when more than one particle had been plausible. The results of this study were highly consistent with previous research suggesting that the PNP might be a much sought-after ERP marker of prediction failure (DeLong et al., 2011; DeLong et al., 2014; Van Petten & Luka, 2012; Thornhill & Van Petten, 2012; Kuperberg et al., 2019). However, a second experiment in a larger sample experiment failed to replicate the effect, but did suggest the relationship of the PNP to predictive processing may not yet be fully understood. Evidence for long-distance lexical predictions was inconclusive.
The conclusion drawn from the four experiments is that preactivation of the lexical entries of plausible upcoming particles did occur and was maintained over long distances. The facilitatory effect of this preactivation at the particle site therefore did not appear to be the result of transient lexical priming. However, the question of whether this preactivation can also lead to lexical predictions of a specific particle remains unanswered. Of particular interest to future research on predictive processing is further characterisation of the PNP. Implications for models of sentence processing may be the inclusion of long-distance lexical predictions, or the possibility that preactivation of lexical material can facilitate reading times and ERP amplitude without commitment to a specific lexical item.
Postural control is important to cope with demands of everyday life. It has been shown that both attentional demand (i.e., cognitive processing) and fatigue affect postural control in young adults. However, their combined effect is still unresolved. Therefore, we investigated the effects of fatigue on single- (ST) and dual-task (DT) postural control. Twenty young subjects (age: 23.7 ± 2.7) performed an all-out incremental treadmill protocol. After each completed stage, one-legged-stance performance on a force platform under ST (i.e., one-legged-stance only) and DT conditions (i.e., one-legged-stance while subtracting serial 3s) was registered. On a second test day, subjects conducted the same balance tasks for the control condition (i.e., non-fatigued). Results showed that heart rate, lactate, and ventilation increased following fatigue (all p < 0.001; d = 4.2–21). Postural sway and sway velocity increased during DT compared to ST (all p < 0.001; d = 1.9–2.0) and fatigued compared to non-fatigued condition (all p < 0.001; d = 3.3–4.2). In addition, postural control deteriorated with each completed stage during the treadmill protocol (all p < 0.01; d = 1.9–3.3). The addition of an attention-demanding interference task did not further impede one-legged-stance performance. Although both additional attentional demand and physical fatigue affected postural control in healthy young adults, there was no evidence for an overadditive effect (i.e., fatigue-related performance decrements in postural control were similar under ST and DT conditions). Thus, attentional resources were sufficient to cope with the DT situations in the fatigue condition of this experiment.
Increased Achilles (AT) and Patellar tendon (PT) thickness in adolescent athletes compared to non-athletes could be shown. However, it is unclear, if changes are of pathological or physiological origin due to training. The aim of this study was to determine physiological AT and PT thickness adaptation in adolescent elite athletes compared to non-athletes, considering sex and sport. In a longitudinal study design with two measurement days (M1/M2) within an interval of 3.2 ± 0.8 years, 131 healthy adolescent elite athletes (m/f: 90/41) out of 13 different sports and 24 recreationally active controls (m/f: 6/18) were included. Both ATs and PTs were measured at standardized reference points. Athletes were divided into 4 sport categories [ball (B), combat (C), endurance (E) and explosive strength sports (S)]. Descriptive analysis (mean ± SD) and statistical testing for group differences was performed (α = 0.05). AT thickness did not differ significantly between measurement days, neither in athletes (5.6 ± 0.7 mm/5.6 ± 0.7 mm) nor in controls (4.8 ± 0.4 mm/4.9 ± 0.5 mm, p > 0.05). For PTs, athletes presented increased thickness at M2 (M1: 3.5 ± 0.5 mm, M2: 3.8 ± 0.5 mm, p < 0.001). In general, males had thicker ATs and PTs than females (p < 0.05). Considering sex and sports, only male athletes from B, C, and S showed significant higher PT-thickness at M2 compared to controls (p ≤ 0.01). Sport-specific adaptation regarding tendon thickness in adolescent elite athletes can be detected in PTs among male athletes participating in certain sports with high repetitive jumping and strength components. Sonographic microstructural analysis might provide an enhanced insight into tendon material properties enabling the differentiation of sex and influence of different sports.
Background
Generating percentile values is helpful for the identification of children with specific fitness characteristics (i.e., low or high fitness level) to set appropriate fitness goals (i.e., fitness/health promotion and/or long-term youth athlete development). Thus, the aim of this longitudinal study was to assess physical fitness development in healthy children aged 9–12 years and to compute sex- and age-specific percentile values.
Methods
Two-hundred and forty children (88 girls, 152 boys) participated in this study and were tested for their physical fitness. Physical fitness was assessed using the 50-m sprint test (i.e., speed), the 1-kg ball push test, the triple hop test (i.e., upper- and lower- extremity muscular power), the stand-and-reach test (i.e., flexibility), the star run test (i.e., agility), and the 9-min run test (i.e., endurance). Age- and sex-specific percentile values (i.e., P10 to P90) were generated using the Lambda, Mu, and Sigma method. Adjusted (for change in body weight, height, and baseline performance) age- and sex-differences as well as the interactions thereof were expressed by calculating effect sizes (Cohen’s d).
Results
Significant main effects of Age were detected for all physical fitness tests (d = 0.40–1.34), whereas significant main effects of Sex were found for upper-extremity muscular power (d = 0.55), flexibility (d = 0.81), agility (d = 0.44), and endurance (d = 0.32) only. Further, significant Sex by Age interactions were observed for upper-extremity muscular power (d = 0.36), flexibility (d = 0.61), and agility (d = 0.27) in favor of girls. Both, linear and curvilinear shaped curves were found for percentile values across the fitness tests. Accelerated (curvilinear) improvements were observed for upper-extremity muscular power (boys: 10–11 yrs; girls: 9–11 yrs), agility (boys: 9–10 yrs; girls: 9–11 yrs), and endurance (boys: 9–10 yrs; girls: 9–10 yrs). Tabulated percentiles for the 9-min run test indicated that running distances between 1,407–1,507 m, 1,479–1,597 m, 1,423–1,654 m, and 1,433–1,666 m in 9- to 12-year-old boys and 1,262–1,362 m, 1,329–1,434 m, 1,392–1,501 m, and 1,415–1,526 m in 9- to 12-year-old girls correspond to a “medium” fitness level (i.e., P40 to P60) in this population.
Conclusions
The observed differences in physical fitness development between boys and girls illustrate that age- and sex-specific maturational processes might have an impact on the fitness status of healthy children. Our statistical analyses revealed linear (e.g., lower-extremity muscular power) and curvilinear (e.g., agility) models of fitness improvement with age which is indicative of timed and capacity-specific fitness development pattern during childhood. Lastly, the provided age- and sex-specific percentile values can be used by coaches for talent identification and by teachers for rating/grading of children’s motor performance.
Physical fitness is an important marker of health that enables people to carry out activities of daily living with vigour and alertness but without undue fatigue and with sufficient reserve to enjoy active leisure pursuits and to meet unforeseen emergencies. Especially, due to scientific findings that the onset of civilization diseases (e.g., obesity, cardiovascular disease) begins in childhood and that physical fitness tracks (at least) into young adulthood, the regular monitoring and promotion of physical fitness in children is risen up to a public health issue. In relation to the evaluation of a child’s physical fitness over time (i.e., development) the use of longitudinally-based percentile values is of particular interest due to their underlined dedication of true physical fitness development within subjects (i.e., individual changes in timing and tempo of growth and maturation). Besides its genetic determination (e.g., sex, body height), physical fitness is influenced by factors that refer to children’s environment and behaviour. For instance, disparities in physical fitness according to children’s living area are frequently reported concerning the fact that living in rural areas as compared to urban areas seems to be more favourable for children’s physical fitness. In addition, cross-sectional studies found higher fitness values in children participating in sports clubs as compared to non-participants. However, up to date, the observed associations between both (i.e., living area and sports club participating) and children’s physical fitness are unresolved concerning a long-term effect. In addition, social inequality as determined by the socioeconomic status (SES) extends through many areas of children’s life. While evidence indicates that the SES is inversely related to various indices of child’s daily life and behaviour like educational success, nutritional habits, and sedentary- and physical activity behaviour, a potential relationship between child’s physical fitness and the SES is hardly investigated and indicated inconsistent results.
The present thesis addressed three objectives: (1) to generate physical fitness percentiles for 9- to 12- year-old boys and girls using a longitudinal approach and to analyse the age- and sex-specific development of physical fitness, (2) to investigate the long-term effect of living area and sports club participation on physical fitness in third- to sixth-grade primary school students, and (3) to examine associations between the SES and physical fitness in a large and representative (i.e., for a German federal state) sample of third grade primary school students.
Methods
(i/ii) Healthy third graders were followed over four consecutive years (up to grade 6), including annually assessment of physical fitness and parental questionnaire (i.e., status of sports club participation and living area). Six tests were conducted to estimate various components of physical fitness: speed (50-m sprint test), upper body muscular power (1-kg ball push test), lower body muscular power (triple hop test), flexibility (stand-and-reach test), agility (star agility run test), and cardiorespiratory fitness (CRF) (9-min run test). (iii) Within a cross-sectional study (i.e., third objective), physical fitness of third graders was assessed by six physical fitness tests including: speed (20-m sprint test), upper body muscular power (1-kg ball push test), lower body muscular power (standing long jump [SLJ] test), flexibility (stand-and-reach test), agility (star agility run test), and CRF (6-min run test). By means of questionnaire, students reported their status of organized sports participation (OSP).
Results
(i) With respect to percentiles of physical fitness development, test performances increased in boys and girls from age 9 to 12, except for males’ flexibility (i.e., stable performance over time). Girls revealed significantly better performance in flexibility, whereas boys scored significantly higher in the remaining physical fitness tests. In girls as compared to boys, physical fitness development was slightly faster for upper body muscular power but substantially faster for flexibility. Generated physical fitness percentile curves indicated a timed and capacity-specific physical fitness development (curvilinear) for upper body muscular power, agility, and CRF. (ii) Concerning the effect of living area and sports club participation on physical fitness development, children living in urban areas showed a significantly faster performance development in physical fitness components of upper and lower body muscular power as compared to peers from rural areas. The same direction was noted as a trend in CRF. Additionally, children that regularly participated in a sports club, when compared to those that not continuously participated in a sports club demonstrated a significantly faster performance development in lower body muscular power. A trend of faster performance development in sports club participants occurred in CRF too. (iii) Regarding the association of SES with physical fitness, the percentage of third graders that achieved a high physical fitness level in lower body muscular power and CRF was significantly higher in students attending schools in communities with high SES as compared to middle and low SES, irrespective of sex. Similar, students from the high SES-group performed significantly better in lower body muscular power and CRF than students from the middle and/or the low SES-group.
Conclusion
(i) The generated percentile values provide an objective tool to estimate childrenʼs physical fitness within the frame of physical education (e.g., age- and sex-specific grading of motor performance) and further to detect children with specific fitness characteristics (low fit or high fit) that may be indicative for the necessity of preventive health promotion or long term athlete development. (ii) It is essential to consider variables of different domains (e.g., environment and behavior) in order to improve knowledge of potential factors which influence physical fitness during childhood. In this regard, the present thesis provide a first input to clarify the causality of living area and sports club participation on physical fitness development in school-aged children. Living in urban areas as well as a regular participation in sports clubs positively affected children´s physical fitness development (i.e., muscular power and CRF). Herein, sports club participation seems to be a key factor within the relationship between living area and physical fitness. (iii) The findings of the present thesis imply that attending schools in communities with high SES refers to better performance in specific physical fitness test items (i.e., muscular power, CRF) in third graders. Extra-curricular physical education classes may represent an important equalizing factor for physical activity opportunities in children of different SES backgrounds. In regard to strong evidence of a positive relationship between physical fitness - in particular muscular fitness/ CRF - and health, more emphasis should be laid on establishing sports clubs and extra-curricular physical education classes as an easy and attractive means to promote fitness-, and hence health- enhancing daily physical activity for all children (i.e. public health approach).
Background
The aim of this study was to analyze the shoulder functional profile (rotation range of motion [ROM] and strength), upper and lower body performance, and throwing speed of U13 versus U15 male handball players, and to establish the relationship between these measures of physical fitness and throwing speed.
Methods
One-hundred and nineteen young male handball players (under (U)-13 (U13) [n = 85]) and U15 [n = 34]) volunteered to participate in this study. The participating athletes had a mean background of sytematic handball training of 5.5 ± 2.8 years and they exercised on average 540 ± 10.1 min per week including sport-specific team handball training and strength and conditioning programs. Players were tested for passive shoulder range-of-motion (ROM) for both internal (IR) and external rotation (ER) and isometric strength (i.e., IR and ER) of the dominant/non-dominant shoulders, overhead medicine ball throw (OMB), hip isometric abductor (ABD) and adductor (ADD) strength, hip ROM, jumps (countermovement jump [CMJ] and triple leg-hop [3H] for distance), linear sprint test, modified 505 change-of-direction (COD) test and handball throwing speed (7 m [HT7] and 9 m [HT9]).
Results
U15 players outperformed U13 in upper (i.e., HT7 and HT9 speed, OMB, absolute IR and ER strength of the dominant and non-dominant sides; Cohen’s d: 0.76–2.13) and lower body (i.e., CMJ, 3H, 20-m sprint and COD, hip ABD and ADD; d: 0.70–2.33) performance measures. Regarding shoulder ROM outcomes, a lower IR ROM was found of the dominant side in the U15 group compared to the U13 and a higher ER ROM on both sides in U15 (d: 0.76–1.04). It seems that primarily anthropometric characteristics (i.e., body height, body mass) and upper body strength/power (OMB distance) are the most important factors that explain the throw speed variance in male handball players, particularly in U13.
Conclusions
Findings from this study imply that regular performance monitoring is important for performance development and for minimizing injury risk of the shoulder in both age categories of young male handball players. Besides measures of physical fitness, anthropometric data should be recorded because handball throwing performance is related to these measures.
Objective: 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.
The present study explores the perceptual span, that is, the physical extent of
the area from which useful visual information is obtained during a single
fixation, during oral reading of Chinese sentences. Characters outside a
window of legible text were replaced by visually similar characters. Results
show that the influence of window size on the perceptual span was consistent
across different fixation and oculomotor measures. To maintain normal
reading behavior when reading aloud, it was necessary to have information
provided from three characters to the right of the fixation. Together with
findings from previous research, our findings suggest that the physical size of
the perceptual span is smaller when reading aloud than in silent reading. This
is in agreement with previous studies in English, suggesting that the mechanisms
causing the reduced span in oral reading have a common base that
generalizes across languages and writing systems.
Importance Alcohol consumption (AC) leads to death and disability worldwide. Ongoing discussions on potential negative effects of the COVID-19 pandemic on AC need to be informed by real-world evidence.
Objective To examine whether lockdown measures are associated with AC and consumption-related temporal and psychological within-person mechanisms.
Design, Setting, and Participants This quantitative, intensive, longitudinal cohort study recruited 1743 participants from 3 sites from February 20, 2020, to February 28, 2021. Data were provided before and within the second lockdown of the COVID-19 pandemic in Germany: before lockdown (October 2 to November 1, 2020); light lockdown (November 2 to December 15, 2020); and hard lockdown (December 16, 2020, to February 28, 2021).
Main Outcomes and Measures Daily ratings of AC (main outcome) captured during 3 lockdown phases (main variable) and temporal (weekends and holidays) and psychological (social isolation and drinking intention) correlates.
Results Of the 1743 screened participants, 189 (119 [63.0%] male; median [IQR] age, 37 [27.5-52.0] years) with at least 2 alcohol use disorder (AUD) criteria according to the Diagnostic and Statistical Manual of Mental Disorders (Fifth Edition) yet without the need for medically supervised alcohol withdrawal were included. These individuals provided 14 694 smartphone ratings from October 2020 through February 2021. Multilevel modeling revealed significantly higher AC (grams of alcohol per day) on weekend days vs weekdays (β = 11.39; 95% CI, 10.00-12.77; P < .001). Alcohol consumption was above the overall average on Christmas (β = 26.82; 95% CI, 21.87-31.77; P < .001) and New Year’s Eve (β = 66.88; 95% CI, 59.22-74.54; P < .001). During the hard lockdown, perceived social isolation was significantly higher (β = 0.12; 95% CI, 0.06-0.15; P < .001), but AC was significantly lower (β = −5.45; 95% CI, −8.00 to −2.90; P = .001). Independent of lockdown, intention to drink less alcohol was associated with lower AC (β = −11.10; 95% CI, −13.63 to −8.58; P < .001). Notably, differences in AC between weekend and weekdays decreased both during the hard lockdown (β = −6.14; 95% CI, −9.96 to −2.31; P = .002) and in participants with severe AUD (β = −6.26; 95% CI, −10.18 to −2.34; P = .002).
Conclusions and Relevance This 5-month cohort study found no immediate negative associations of lockdown measures with overall AC. Rather, weekend-weekday and holiday AC patterns exceeded lockdown effects. Differences in AC between weekend days and weekdays evinced that weekend drinking cycles decreased as a function of AUD severity and lockdown measures, indicating a potential mechanism of losing and regaining control. This finding suggests that temporal patterns and drinking intention constitute promising targets for prevention and intervention, even in high-risk individuals.
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.
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.
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.
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.
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.
In the first years of life, children differ greatly from adults in the temporal organization of their speech gestures in fluent language production. However, dissent remains as to the maturational direction of such organization. The present study sheds new light on this process by tracking the development of anticipatory vowel-to-vowel coarticulation in a cross-sectional investigation of 62 German children (from 3.5 to 7 years of age) and 13 adults. It focuses on gestures of the tongue, a complex organ whose spatiotemporal control is indispensable for speech production. The goal of the study was threefold: 1) investigate whether children as well as adults initiate the articulation for a target vowel in advance of its acoustic onset, 2) test if the identity of the intervocalic consonant matters and finally, 3) describe age-related developments of these lingual coarticulatory patterns. To achieve this goal, ultrasound tongue imaging was used to record lingual movements and quantify changes in coarticulation degree as a function of consonantal context and age. Results from linear mixed effects models indicate that like adults, children initiate vowels' lingual gestures well ahead of their acoustic onset. Second, while the identity of the intervocalic consonant affects the degree of vocalic anticipation in adults, it does not in children at any age. Finally, the degree of vowelto-vowel coarticulation is significantly higher in all cohorts of children than in adults. However, among children, a developmental decrease of vocalic coarticulation is only found for sequences including the alveolar stop /d/ which requires finer spatiotemporal coordination of the tongue's subparts compared to labial and velar stops. Altogether, results suggest greater gestural overlap in child than in adult speech and support the view of a non-uniform and protracted maturation of lingual coarticulation calling for thorough considerations of the articulatory intricacies from which subtle developmental differences may originate.
Walking while concurrently performing cognitive and/or motor interference tasks is the norm rather than the exception during everyday life and there is evidence from behavioral studies that it negatively affects human locomotion. However, there is hardly any information available regarding the underlying neural correlates of single- and dual-task walking. We had 12 young adults (23.8 ± 2.8 years) walk while concurrently performing a cognitive interference (CI) or a motor interference (MI) task. Simultaneously, neural activation in frontal, central, and parietal brain areas was registered using a mobile EEG system. Results showed that the MI task but not the CI task affected walking performance in terms of significantly decreased gait velocity and stride length and significantly increased stride time and tempo-spatial variability. Average activity in alpha and beta frequencies was significantly modulated during both CI and MI walking conditions in frontal and central brain regions, indicating an increased cognitive load during dual-task walking. Our results suggest that impaired motor performance during dual-task walking is mirrored in neural activation patterns of the brain. This finding is in line with established cognitive theories arguing that dual-task situations overstrain cognitive capabilities resulting in motor performance decrements.
Objective: Alexithymia relates to difficulties recognizing and describing emotions. It has been linked to subjectively increased interoceptive awareness (IA) and to psychiatric illnesses such as major depressive disorder (MDD) and somatization. MDD in turn is characterized by aberrant emotion processing and IA on the subjective as well as on the neural level. However, a link between neural activity in response to IA and alexithymic traits in health and depression remains unclear.
Methods: A well-established fMRI task was used to investigate neural activity during IA (heartbeat counting) and exteroceptive awareness (tone counting) in non-psychiatric controls (NC) and MDD. Firstly, comparing MDD and NC, a linear relationship between IA-related activity and scores of the Toronto Alexithymia Scale (TAS) was investigated through whole-brain regression. Secondly, NC were divided by median-split of TAS scores into groups showing low (NC-low) or high (NC-high) alexithymia. MDD and NC-high showed equally high TAS scores. Subsequently, IA-related neural activity was compared on a whole-brain level between the three independent samples (MDD, NC-low, NC-high).
Results: Whole-brain regressions between MDD and NC revealed neural differences during IA as a function of TAS-DD (subscale difficulty describing feelings) in the supragenual anterior cingulate cortex (sACC; BA 24/32), which were due to negative associations between TAS-DD and IA-related activity in NC. Contrasting NC subgroups after median-split on a whole-brain level, high TAS scores were associated with decreased neural activity during IA in the sACC and increased insula activity. Though having equally high alexithymia scores, NC-high showed increased insula activity during IA compared to MDD, whilst both groups showed decreased activity in the sACC.
Conclusions: Within the context of decreased sACC activity during IA in alexithymia (NC-high and MDD), increased insula activity might mirror a compensatory mechanism in NC-high, which is disrupted in MDD.
Background
Doping presents a potential health risk for young athletes. Prevention programs are intended to prevent doping by educating athletes about banned substances. However, such programs have their limitations in practice. This led Germany to introduce the National Doping Prevention Plan (NDPP), in hopes of ameliorating the situation among young elite athletes. Two studies examined 1) the degree to which the NDPP led to improved prevention efforts in elite sport schools, and 2) the extent to which newly developed prevention activities of the national anti-doping agency (NADA) based on the NDPP have improved knowledge among young athletes within elite sports schools.
Methods
The first objective was investigated in a longitudinal study (Study I: t0 = baseline, t1 = follow-up 4 years after NDPP introduction) with N = 22 teachers engaged in doping prevention in elite sports schools. The second objective was evaluated in a cross-sectional comparison study (Study II) in N = 213 elite sports school students (54.5 % male, 45.5 % female, age M = 16.7 ± 1.3 years (all students had received the improved NDDP measure in school; one student group had received additionally NADA anti-doping activities and a control group did not). Descriptive statistics were calculated, followed by McNemar tests, Wilcoxon tests and Analysis of Covariance (ANCOVA).
Results
Results indicate that 4 years after the introduction of the NDPP there have been limited structural changes with regard to the frequency, type, and scope of doping prevention in elite sport schools. On the other hand, in study II, elite sport school students who received further NADA anti-doping activities performed better on an anti-doping knowledge test than students who did not take part (F(1, 207) = 33.99, p <0.001), although this difference was small.
Conclusion
The integration of doping-prevention in elite sport schools as part of the NDPP was only partially successful. The results of the evaluation indicate that the introduction of the NDPP has contributed more to a change in the content of doping prevention activities than to a structural transformation in anti-doping education in elite sport schools. Moreover, while students who did receive additional education in the form of the NDPP“booster sessions” had significantly more knowledge about doping than students who did not receive such education, this difference was only small and may not translate to actual behavior.
Different systems for habitual versus goal-directed control are thought to underlie human decision-making. Working memory is known to shape these decision-making systems and
their interplay, and is known to support goal-directed decision making even under stress. Here, we investigated if and how decision systems are differentially influenced by breaks filled with diverse everyday life activities known to modulate working memory performance. We used a within-subject design where young adults listened to music and played a video game during breaks interleaved with trials of a sequential two-step Markov decision task, designed to assess habitual as well as goal-directed decision making. Based on a neurocomputational model of task performance, we observed that for individuals with a rather limited working memory capacity video gaming as compared to music reduced reliance on the goal-directed decision-making system, while a rather large working memory capacity prevented such a decline. Our findings suggest differential effects of everyday activities on key decision-making processes.
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
Isometric muscle actions can be performed either by initiating the action, e.g., pulling on an immovable resistance (PIMA), or by reacting to an external load, e.g., holding a weight (HIMA). In the present study, it was mainly examined if these modalities could be differentiated by oxygenation variables as well as by time to task failure (TTF). Furthermore, it was analyzed if variables are changed by intermittent voluntary muscle twitches during weight holding (Twitch). It was assumed that twitches during a weight holding task change the character of the isometric muscle action from reacting (≙ HIMA) to acting (≙ PIMA).
Methods
Twelve subjects (two drop outs) randomly performed two tasks (HIMA vs. PIMA or HIMA vs. Twitch, n = 5 each) with the elbow flexors at 60% of maximal torque maintained until muscle failure with each arm. Local capillary venous oxygen saturation (SvO2) and relative hemoglobin amount (rHb) were measured by light spectrometry.
Results
Within subjects, no significant differences were found between tasks regarding the behavior of SvO2 and rHb, the slope and extent of deoxygenation (max. SvO2 decrease), SvO2 level at global rHb minimum, and time to SvO2 steady states. The TTF was significantly longer during Twitch and PIMA (incl. Twitch) compared to HIMA (p = 0.043 and 0.047, respectively). There was no substantial correlation between TTF and maximal deoxygenation independently of the task (r = − 0.13).
Conclusions
HIMA and PIMA seem to have a similar microvascular oxygen and blood supply. The supply might be sufficient, which is expressed by homeostatic steady states of SvO2 in all trials and increases in rHb in most of the trials. Intermittent voluntary muscle twitches might not serve as a further support but extend the TTF. A changed neuromuscular control is discussed as possible explanation.
Childhood compared to adolescence and adulthood is characterized by high neuroplasticity represented by accelerated cognitive maturation and rapid cognitive developmental trajectories. Natural growth, biological maturation and permanent interaction with the physical and social environment fosters motor and cognitive development in children. Of note, the promotion of physical activity, physical fitness, and motor skill learning at an early age is mandatory first, as these aspects are essential for a healthy development and an efficient functioning in everyday life across the life span and second, physical activity behaviors and lifestyle habits tend to track from childhood into adulthood.
The main objective of the present thesis was to optimize and deepen the knowledge of motor and cognitive performance in young children and to develop an effective and age-appropriate exercise program feasible for the implementation in kindergarten and preschool settings. A systematic review with meta-analysis was conducted to examine the effectiveness of fundamental movement skill and exercise interventions in healthy preschool-aged children. Further, the relation between measures of physical fitness (i.e., static balance, muscle strength, power, and coordination) and attention as one domain of cognitive performance in preschool-aged children was analyzed. Subsequently, effects of a strength-dominated kindergarten-based exercise program on physical fitness components (i.e., static balance, muscle strength, power, and coordination) and cognitive performance (i.e., attention) compared to a usual kindergarten curriculum was examined.
The systematic review included trials focusing on healthy young children in kindergarten or preschool settings that applied fundamental movement skill-enhancing intervention programs of at least 4 weeks and further reported standardized motor skill outcome measures for the intervention and the control group. Children aged 4-6 years from three kindergartens participated in the cross-sectional and the longitudinal study. Product-orientated measures were conducted for the assessment of muscle strength (i.e., handgrip strength), muscle power (i.e., standing long jump), balance (i.e., timed single-leg stand), coordination (hopping on right/left leg), and attentional span (i.e., “Konzentrations-Handlungsverfahren für Vorschulkinder” [concentration-action procedure for preschoolers]).
With regards to the scientific literature, exercise and fundamental movement skill interventions are an effective method to promote overall proficiency in motor skills (i.e., object control and locomotor skills) in preschool children particularly when conducted by external experts with a duration of 4 weeks to 5 months. Moreover, significant medium associations were found between the composite score of physical fitness and attention as well as between coordination separately and attention in children aged 4-6 years. A 10-weeks strength-dominated exercise program implemented in kindergarten and preschool settings by educated and trained kindergarten teachers revealed significant improvements for the standing long jump test and the Konzentrations-Handlungsverfahren of intervention children compared to children of the control group.
The findings of the present thesis imply that fundamental movement skill and exercise interventions improve motor skills (i.e., locomotor and object control skills). Nonetheless, more high-quality research is needed. Additionally, physical fitness, particularly high performance in complex fitness components (i.e., coordination measured with the hopping on one leg test), tend to predict attention in preschool age. Furthermore, an exercise program including strength-dominated exercises, fundamental movement skills and elements of gymnastics has a beneficial effect on jumping performance with a concomitant trend toward improvements in attentional capacity in healthy preschool children. Finally, it is recommended to start early with the integration of muscular fitness (i.e., muscle strength, muscle power, muscular endurance) next to coordination, agility, balance, and fundamental movement skill exercises into regular physical activity curriculums in kindergarten settings.
Research on problem solving offers insights into how humans process task-related information and which strategies they use (Newell and Simon, 1972; Öllinger et al., 2014). Problem solving can be defined as the search for possible changes in one's mind (Kahneman, 2003). In a recent study, Adams et al. (2021) assessed whether the predominant problem solving strategy when making changes involves adding or subtracting elements. In order to do this, they used several examples of simple problems, such as editing text or making visual patterns symmetrical, either in naturalistic settings or on-line. The essence of the authors' findings is a strong preference to add rather than subtract elements across a diverse range of problems, including the stabilizing of artifacts, creating symmetrical patterns, or editing texts. More specifically, they succeeded in demonstrating that “participants were less likely to identify advantageous subtractive changes when the task did not (vs. did) cue them to consider subtraction, when they had only one opportunity (vs. several) to recognize the shortcomings of an additive search strategy or when they were under a higher (vs. lower) cognitive load” (Adams et al., 2021, p. 258).
Addition and subtraction are generally defined as de-contextualized mathematical operations using abstract symbols (Russell, 1903/1938). Nevertheless, understanding of both symbols and operations is informed by everyday activities, such as making or breaking objects (Lakoff and Núñez, 2000; Fischer and Shaki, 2018). The universal attribution of “addition bias” or “subtraction neglect” to problem solving activities is perhaps a convenient shorthand but it overlooks influential framing effects beyond those already acknowledged in the report and the accompanying commentary (Meyvis and Yoon, 2021).
Most importantly, while Adams et al.'s study addresses an important issue, their very method of verbally instructing participants, together with lack of control over several known biases, might render their findings less than conclusive. Below, we discuss our concerns that emerged from the identified biases, namely those regarding the instructions and the experimental materials. Moreover, we refer to research from mathematical cognition that provides new insights into Adams et al.'s findings.
The evaluation of process-oriented cognitive theories through time-ordered observations is crucial for the advancement of cognitive science. The findings presented herein integrate insights from research on eye-movement control and sentence comprehension during reading, addressing challenges in modeling time-ordered data, statistical inference, and interindividual variability. Using kernel density estimation and a pseudo-marginal likelihood for fixation durations and locations, a likelihood implementation of the SWIFT model of eye-movement control during reading (Engbert et al., Psychological Review, 112, 2005, pp. 777–813) is proposed. Within the broader framework of data assimilation, Bayesian parameter inference with adaptive Markov Chain Monte Carlo techniques is facilitated for reliable model fitting. Across the different studies, this framework has shown to enable reliable parameter recovery from simulated data and prediction of experimental summary statistics. Despite its complexity, SWIFT can be fitted within a principled Bayesian workflow, capturing interindividual differences and modeling experimental effects on reading across different geometrical alterations of text. Based on these advancements, the integrated dynamical model SEAM is proposed, which combines eye-movement control, a traditionally psychological research area, and post-lexical language processing in the form of cue-based memory retrieval (Lewis & Vasishth, Cognitive Science, 29, 2005, pp. 375–419), typically the purview of psycholinguistics. This proof-of-concept integration marks a significant step forward in natural language comprehension during reading and suggests that the presented methodology can be useful to develop complex cognitive dynamical models that integrate processes at levels of perception, higher cognition, and (oculo-)motor control. These findings collectively advance process-oriented cognitive modeling and highlight the importance of Bayesian inference, individual differences, and interdisciplinary integration for a holistic understanding of reading processes. Implications for theory and methodology, including proposals for model comparison and hierarchical parameter inference, are briefly discussed.
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.
The term Adaptive Force (AF) describes the capability of adaptation of the nerve-muscle-system to externally applied forces during isometric and eccentric muscle action. This ability plays an important role in real life motions as well as in sports. The focus of this paper is on the specific measurement method of this neuromuscular action, which can be seen as innovative. A measuring system based on the use of compressed air was constructed and evaluated for this neuromuscular function. It depends on the physical conditions of the subject, at which force level it deviates from the quasi isometric position and merges into eccentric muscle action. The device enables – in contrast to the isokinetic systems – a measure of strength without forced motion. Evaluation of the scientific quality criteria of the devices was done by measurements regarding the intra- and interrater-, the test-retest-reliability and fatiguing measurements. Comparisons of the pneumatic device with a dynamometer were also done. Looking at the mechanical evaluation, the results show a high level of consistency (r²=0.94 to 0.96). The parallel test reliability delivers a very high and significant correlation (ρ=0.976; p=0.000). Including the biological system, the concordance of three different raters is very high (p=0.001, Cronbachs alpha α=0.987). The test retest with 4 subjects over five weeks speaks for the reliability of the device in showing no statistically significant differences. These evaluations indicate that the scientific evaluation criteria are fulfilled. The specific feature of this system is that an isometric position can be maintained while the externally impacting force rises. Moreover, the device can capture concentric, static and eccentric strength values. Fields of application are performance diagnostics in sports and medicine.
Background
Maximal isokinetic strength ratios of joint flexors and extensors are important parameters to indicate the level of muscular balance at the joint. Further, in combat sports athletes, upper and lower limb muscle strength is affected by the type of sport. Thus, this study aimed to examine the differences in maximal isokinetic strength of the flexors and extensors and the corresponding flexor–extensor strength ratios of the elbows and knees in combat sports athletes.
Method
Forty male participants (age = 22.3 ± 2.5 years) from four different combat sports (amateur boxing, taekwondo, karate, and judo; n = 10 per sport) were tested for eccentric peak torque of the elbow/knee flexors (EF/KF) and concentric peak torque of the elbow/knee extensors (EE/KE) at three different angular velocities (60, 120, and 180°/s) on the dominant and non-dominant side using an isokinetic device.
Results
Analyses revealed significant, large-sized group × velocity × limb interactions for EF, EE, and EF–EE ratio, KF, KE, and KF–KE ratio (p ≤ 0.03; 0.91 ≤ d ≤ 1.75). Post-hoc analyses indicated that amateur boxers displayed the largest EE strength values on the non-dominant side at ≤ 120°/s and the dominant side at ≥ 120°/s (p < 0.03; 1.21 ≤ d ≤ 1.59). The largest EF–EE strength ratios were observed on amateur boxers’ and judokas’ non-dominant side at ≥ 120°/s (p < 0.04; 1.36 ≤ d ≤ 2.44). Further, we found lower KF–KE strength measures in karate (p < 0.04; 1.12 ≤ d ≤ 6.22) and judo athletes (p ≤ 0.03; 1.60 ≤ d ≤ 5.31) particularly on the non-dominant side.
Conclusions
The present findings indicated combat sport-specific differences in maximal isokinetic strength measures of EF, EE, KF, and KE particularly in favor of amateur boxers on the non-dominant side.
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.
Loss to follow-up in a randomized controlled trial study for pediatric weight management (EPOC)
(2016)
Background
Attrition is a serious problem in intervention studies. The current study analyzed the attrition rate during follow-up in a randomized controlled pediatric weight management program (EPOC study) within a tertiary care setting.
Methods
Five hundred twenty-three parents and their 7–13-year-old children with obesity participated in the randomized controlled intervention trial. Follow-up data were assessed 6 and 12 months after the end of treatment. Attrition was defined as providing no objective weight data. Demographic and psychological baseline characteristics were used to predict attrition at 6- and 12-month follow-up using multivariate logistic regression analyses.
Results
Objective weight data were available for 49.6 (67.0) % of the children 6 (12) months after the end of treatment. Completers and non-completers at the 6- and 12-month follow-up differed in the amount of weight loss during their inpatient stay, their initial BMI-SDS, educational level of the parents, and child’s quality of life and well-being. Additionally, completers supported their child more than non-completers, and at the 12-month follow-up, families with a more structured eating environment were less likely to drop out. On a multivariate level, only educational background and structure of the eating environment remained significant.
Conclusions
The minor differences between the completers and the non-completers suggest that our retention strategies were successful. Further research should focus on prevention of attrition in families with a lower educational background.
Previous research has indicated that executive function (EF) is negatively associated with aggressive behavior in childhood. However, there is a lack of longitudinal studies that have examined the effect of deficits in EF on aggression over time and taken into account different forms and functions of aggression at the same time. Furthermore, only few studies have analyzed the role of underlying variables that may explain the association between EF and aggression. The present study examined the prospective paths between EF and different forms (physical and relational) and functions (reactive and proactive) of aggression. The habitual experience of anger was examined as a potential underlying mechanism of the link between EF and aggression, because the tendency to get angry easily has been found to be both a consequence of deficits in EF and a predictor of aggression. The study included 1,652 children (between 6 and 11 years old at the first time point), who were followed over three time points (T1, T2, and T3) covering 3 years. At T1, a latent factor of EF comprised measures of planning, rated via teacher reports, as well as inhibition, set shifting, and working-memory updating, assessed experimentally. Habitual anger experience was assessed via parent reports at T1 and T2. The forms and functions of aggression were measured via teacher reports at all three time points. Structural equation modeling revealed that EF at T1 predicted physical, relational, and reactive aggression at T3, but was unrelated to proactive aggression at T3. Furthermore, EF at T1 was indirectly linked to physical aggression at T3, mediated through habitual anger experience at T2. The results indicate that deficits in EF influence the later occurrence of aggression in middle childhood, and the tendency to get angry easily mediates this relation.
Studies have revealed mixed results on how antidepressant drugs affect lipid profiles of patients with major depression disorder (MDD). Even less is known about how patients respond to a switch of antidepressant medication with respect to their metabolic profile. For this, effects of a switch in antidepressants medication on lipid markers were studied in MDD patients. 15 participants (females = 86.67%; males = 13.33%; age: 49.45 ± 7.45 years) with MDD and a prescribed switch in their antidepressant medication were recruited at a psychosomatic rehabilitation clinic. Participants were characterized (with questionnaires and blood samples) at admission to the rehabilitation clinic (baseline, T0) and followed up with a blood sample two weeks (T1) later. HDL, LDL, total cholesterol, and triglycerides were determined (T0), and their change analyzed (Wilcoxon test) at follow up (T1). Decrements in HDL (p = 0.041), LDL (p < 0.001), and total cholesterol (p < 0.001) were observed two weeks after a switch in antidepressant medication. Triglycerides showed no difference (p = 0.699). Overall, LDL, HDL, and total cholesterol are affected by a change in antidepressant drugs in patients with MDD. These observations are of clinical relevance for medical practitioners in the planning and management of treatment strategies for MDD patients.
Experimental and quantitative research in the field of human language processing and production strongly depends on the quality of the underlying language material: beside its size, representativeness, variety and balance have been discussed as important factors which influence design, analysis and interpretation of experiments and their results. This volume brings together creators and users of both general purpose and specialized lexical resources which are used in psychology, psycholinguistics, neurolinguistics and cognitive research. It aims to be a forum to report experiences and results, review problems and discuss perspectives of any linguistic data used in the field.
Language and Arithmetic
(2018)
We examined cross-domain semantic priming effects between arithmetic and language. We paired subtractions with their linguistic equivalent, exception phrases (EPs) with positive quantifiers (e.g., “everybody except John”) while pairing additions with their own linguistic equivalent, EPs with negative quantifiers (e.g., “nobody except John”; Moltmann, 1995). We hypothesized that EPs with positive quantifiers prime subtractions and inhibit additions while EPs with negative quantifiers prime additions and inhibit subtractions. Furthermore, we expected similar priming and inhibition effects from arithmetic into semantics. Our design allowed for a bidirectional analysis by using one trial's target as the prime for the next trial. Two experiments failed to show significant priming effects in either direction. Implications and possible shortcomings are explored in the general discussion.
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.
Background: Interoceptive awareness (iA), the awareness of stimuli originating inside the body, plays an important role in human emotions and psychopathology. The insula is particularly involved in neural processes underlying iA. However, iA-related neural activity in the insula during the acute state of major depressive disorder (MDD) and in remission from depression has not been explored.
Methods: A well-established fMRI paradigm for studying (iA; heartbeat counting) and exteroceptive awareness (eA; tone counting) was used. Study participants formed three independent groups: patients suffering from MDD, patients in remission from MDD or healthy controls. Task-induced neural activity in three functional subdivisions of the insula was compared between these groups.
Results: Depressed participants showed neural hypo-responses during iA in anterior insula regions, as compared to both healthy and remitted participants. The right dorsal anterior insula showed the strongest response to iA across all participant groups. In depressed participants there was no differentiation between different stimuli types in this region (i.e., between iA, eA and noTask). Healthy and remitted participants in contrast showed clear activity differences.
Conclusions: This is the first study comparing iA and eA-related activity in the insula in depressed participants to that in healthy and remitted individuals. The preliminary results suggest that these groups differ in there being hypo-responses across insula regions in the depressed participants, whilst non-psychiatric participants and patients in remission from MDD show the same neural activity during iA in insula subregions implying a possible state marker for MDD. The lack of activity differences between different stimulus types in the depressed group may account for their symptoms of altered external and internal focus.
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.
This study aimed to compare the training load of a professional under-19 soccer team (U-19) to that of an elite adult team (EAT), from the same club, during the in-season period. Thirty-nine healthy soccer players were involved (EAT [n = 20]; U-19 [n = 19]) in the study which spanned four weeks. Training load (TL) was monitored as external TL, using a global positioning system (GPS), and internal TL, using a rating of perceived exertion (RPE). TL data were recorded after each training session. During soccer matches, players’ RPEs were recorded. The internal TL was quantified daily by means of the session rating of perceived exertion (session-RPE) using Borg’s 0–10 scale. For GPS data, the selected running speed intensities (over 0.5 s time intervals) were 12–15.9 km/h; 16–19.9 km/h; 20–24.9 km/h; >25 km/h (sprint). Distances covered between 16 and 19.9 km/h, > 20 km/h and >25 km/h were significantly higher in U-19 compared to EAT over the course of the study (p = 0.023, d = 0.243, small; p = 0.016, d = 0.298, small; and p = 0.001, d = 0.564, small, respectively). EAT players performed significantly fewer sprints per week compared to U-19 players (p = 0.002, d = 0.526, small). RPE was significantly higher in U-19 compared to EAT (p = 0.001, d = 0.188, trivial). The external and internal measures of TL were significantly higher in the U-19 group compared to the EAT soccer players. In conclusion, the results obtained show that the training load is greater in U19 compared to EAT.
Idioms in the World
(2019)
Emotions are a complex concept and they are present in our everyday life. Persons on the autism spectrum are said to have difficulties in social interactions, showing deficits in emotion recognition in comparison to neurotypically developed persons. But social-emotional skills are believed to be positively augmented by training. A new adaptive social cognition training tool “E.V.A.” is introduced which teaches emotion recognition from face, voice and body language. One cross-sectional and one longitudinal study with adult neurotypical and autistic participants were conducted. The aim of the cross-sectional study was to characterize the two groups and see if differences in their social-emotional skills exist. The longitudinal study, on the other hand, aimed for detecting possible training effects following training with the new training tool. In addition, in both studies usability assessments were conducted to investigate the perceived usability of the new tool for neurotypical as well as autistic participants. Differences were found between autistic and neurotypical participants in their social-emotional and emotion recognition abilities. Training effects for neurotypical participants in an emotion recognition task were found after two weeks of home training. Similar perceived usability was found for the neurotypical and autistic participants. The current findings suggest that persons with ASC do not have a general deficit in emotion recognition, but are in need for more time to correctly recognize emotions. In addition, findings suggest that training emotion recognition abilities is possible. Further studies are needed to verify if the training effects found for neurotypical participants also manifest in a larger ASC sample.
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.
The work elaborates on the question if coaches in non-professional soccer can influence referee decisions. Modeled from a principal-agent perspective, the managing referee boards can be seen as the principal. They aim at facilitating a fair competition which is in accordance with the existing rules and regulations. In doing so, the referees are assigned as impartial agents on the pitch. The coaches take over a non-legitimate principal-like role trying to influence the referees even though they do not have the formal right to do so.
Separate questionnaires were set up for referees and coaches. The coach questionnaire aimed at identifying the extent and the forms of influencing attempts by coaches. The referee questionnaire tried to elaborate on the questions if referees take notice of possible influencing attempts and how they react accordingly.
The results were put into relation with official match data in order to identify significant influences on personal sanctions (yellow cards, second yellow cards, red cards) and the match result.
It is found that there is a slight effect on the referee’s decisions. However, this effect is rather disadvantageous for the influencing coach and there is no evidence for an impact on the match result itself.
Objective: A role for microRNAs is implicated in several biological and pathological processes. We investigated the effects of high-intensity interval training (HIIT) and moderate-intensity continuous training (MICT) on molecular markers of diabetic cardiomyopathy in rats.
Methods: Eighteen male Wistar rats (260 ± 10 g; aged 8 weeks) with streptozotocin (STZ)-induced type 1 diabetes mellitus (55 mg/kg, IP) were randomly allocated to three groups: control, MICT, and HIIT. The two different training protocols were performed 5 days each week for 5 weeks. Cardiac performance (end-systolic and end-diastolic dimensions, ejection fraction), the expression of miR-206, HSP60, and markers of apoptosis (cleaved PARP and cytochrome C) were determined at the end of the exercise interventions.
Results: Both exercise interventions (HIIT and MICT) decreased blood glucose levels and improved cardiac performance, with greater changes in the HIIT group (p < 0.001, η2: 0.909). While the expressions of miR-206 and apoptotic markers decreased in both training protocols (p < 0.001, η2: 0.967), HIIT caused greater reductions in apoptotic markers and produced a 20% greater reduction in miR-206 compared with the MICT protocol (p < 0.001). Furthermore, both training protocols enhanced the expression of HSP60 (p < 0.001, η2: 0.976), with a nearly 50% greater increase in the HIIT group compared with MICT.
Conclusions: Our results indicate that both exercise protocols, HIIT and MICT, have the potential to reduce diabetic cardiomyopathy by modifying the expression of miR-206 and its downstream targets of apoptosis. It seems however that HIIT is even more effective than MICT to modulate these molecular markers.
Introduction: We conducted a case study to examine the feasibility and safety of high-intensity interval training (HIIT) with increased inspired oxygen content in a colon cancer patient undergoing chemotherapy. A secondary purpose was to investigate the effects of such training regimen on physical functioning.
Case presentation: A female patient (51 years; 49.1 kg; 1.65 m; tumor stage: pT3, pN2a (5/29), pM1a (HEP), L0, V0, R0) performed 8 sessions of HIIT (5 × 3 minutes at 90% of Wmax, separated by 2 minutes at 45% Wmax) with an increased inspired oxygen fraction of 30%. Patient safety, training adherence, cardiorespiratory fitness (peak oxygen uptake and maximal power output during an incremental cycle ergometer test), autonomous nervous function (i.e., heart rate variability during an orthostatic test) as well as questionnaire-assessed quality of life (EORTC QLQ-C30) were evaluated before and after the intervention.
No adverse events were reported throughout the training intervention and a 3 months follow-up. While the patient attended all sessions, adherence to total training time was only 51% (102 of 200 minutes; mean training time per session 12:44 min:sec). VO2peak and Wmax increased by 13% (from 23.0 to 26.1 mL min kg−1) and 21% (from 83 to 100 W), respectively. Heart rate variability represented by the root mean squares of successive differences both in supine and upright positions were increased after the training by 143 and 100%, respectively. The EORTC QLQ-C30 score for physical functioning (7.5%) as well as the global health score (10.7%) improved, while social function decreased (17%).
Conclusions: Our results show that a already short period of HIIT with concomitant hyperoxia was safe and feasible for a patient undergoing chemotherapy for colon cancer. Furthermore, the low overall training adherence of only 51% and an overall low training time per session (∼13 minutes) was sufficient to induce clinically meaningful improvements in physical functioning. However, this case also underlines that intensity and/or length of the HIIT-bouts might need further adjustments to increase training compliance.
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
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.