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Symptoms of anxiety and depression in young athletes using the hospital anxiety and depression scale
(2018)
Elite young athletes have to cope with multiple psychological demands such as training volume, mental and physical fatigue, spatial separation of family and friends or time management problems may lead to reduced mental and physical recovery. While normative data regarding symptoms of anxiety and depression for the general population is available (Hinz and Brahler, 2011), hardly any information exists for adolescents in general and young athletes in particular. Therefore, the aim of this study was to assess overall symptoms of anxiety and depression in young athletes as well as possible sex differences. The survey was carried out within the scope of the study "Resistance Training in Young Athletes" (KINGS-Study). Between August 2015 and September 2016, 326 young athletes aged (mean +/- SD) 14.3 +/- 1.6 years completed the Hospital Anxiety and Depression Scale (HAD Scale). Regarding the analysis of age on the anxiety and depression subscales, age groups were classified as follows: late childhood (12-14 years) and late adolescence (15-18 years). The participating young athletes were recruited from Olympic weight lifting, handball, judo, track and field athletics, boxing, soccer, gymnastics, ice speed skating, volleyball, and rowing. Anxiety and depression scores were (mean +/- SD) 4.3 +/- 3.0 and 2.8 +/- 2.9, respectively. In the subscale anxiety, 22 cases (6.7%) showed subclinical scores and 11 cases (3.4%) showed clinical relevant score values. When analyzing the depression subscale, 31 cases (9.5%) showed subclinical score values and 12 cases (3.7%) showed clinically important values. No significant differences were found between male and female athletes (p >= 0.05). No statistically significant differences in the HADS scores were found between male athletes of late childhood and late adolescents (p >= 0.05). To the best of our knowledge, this is the first report describing questionnaire based indicators of symptoms of anxiety and depression in young athletes. Our data implies the need for sports medical as well as sports psychiatric support for young athletes. In addition, our results demonstrated that the chronological classification concerning age did not influence HAD Scale outcomes. Future research should focus on sports medical and sports psychiatric interventional approaches with the goal to prevent anxiety and depression as well as teaching coping strategies to young athletes.
Symptoms of anxiety and depression in young athletes using the Hospital Anxiety and Depression Scale
(2018)
Elite young athletes have to cope with multiple psychological demands such as training volume, mental and physical fatigue, spatial separation of family and friends or time management problems may lead to reduced mental and physical recovery. While normative data regarding symptoms of anxiety and depression for the general population is available (Hinz and Brahler, 2011), hardly any information exists for adolescents in general and young athletes in particular. Therefore, the aim of this study was to assess overall symptoms of anxiety and depression in young athletes as well as possible sex differences. The survey was carried out within the scope of the study "Resistance Training in Young Athletes" (KINGS-Study). Between August 2015 and September 2016, 326 young athletes aged (mean +/- SD) 14.3 +/- 1.6 years completed the Hospital Anxiety and Depression Scale (HAD Scale). Regarding the analysis of age on the anxiety and depression subscales, age groups were classified as follows: late childhood (12-14 years) and late adolescence (15-18 years). The participating young athletes were recruited from Olympic weight lifting, handball, judo, track and field athletics, boxing, soccer, gymnastics, ice speed skating, volleyball, and rowing. Anxiety and depression scores were (mean +/- SD) 4.3 +/- 3.0 and 2.8 +/- 2.9, respectively. In the subscale anxiety, 22 cases (6.7%) showed subclinical scores and 11 cases (3.4%) showed clinical relevant score values. When analyzing the depression subscale, 31 cases (9.5%) showed subclinical score values and 12 cases (3.7%) showed clinically important values. No significant differences were found between male and female athletes (p >= 0.05). No statistically significant differences in the HADS scores were found between male athletes of late childhood and late adolescents (p >= 0.05). To the best of our knowledge, this is the first report describing questionnaire based indicators of symptoms of anxiety and depression in young athletes. Our data implies the need for sports medical as well as sports psychiatric support for young athletes. In addition, our results demonstrated that the chronological classification concerning age did not influence HAD Scale outcomes. Future research should focus on sports medical and sports psychiatric interventional approaches with the goal to prevent anxiety and depression as well as teaching coping strategies to young athletes.
There is evidence for cortical contribution to the regulation of human postural control. Interference from concurrently performed cognitive tasks supports this notion, and the lateral prefrontal cortex (lPFC) has been suggested to play a prominent role in the processing of purely cognitive as well as cognitive-postural dual tasks. The degree of cognitive-motor interference varies greatly between individuals, but it is unresolved whether individual differences in the recruitment of specific lPFC regions during cognitive dual tasking are associated with individual differences in cognitive-motor interference. Here, we investigated inter-individual variability in a cognitive-postural multitasking situation in healthy young adults (n = 29) in order to relate these to inter-individual variability in lPFC recruitment during cognitive multitasking. For this purpose, a oneback working memory task was performed either as single task or as dual task in order to vary cognitive load. Participants performed these cognitive single and dual tasks either during upright stance on a balance pad that was placed on top of a force plate or during fMRI measurement with little to no postural demands. We hypothesized dual one-back task performance to be associated with lPFC recruitment when compared to single one-back task performance. In addition, we expected individual variability in lPFC recruitment to be associated with postural performance costs during concurrent dual one-back performance. As expected, behavioral performance costs in postural sway during dual-one back performance largely varied between individuals and so did lPFC recruitment during dual one-back performance. Most importantly, individuals who recruited the right mid-lPFC to a larger degree during dual one-back performance also showed greater postural sway as measured by larger performance costs in total center of pressure displacements. This effect was selective to the high-load dual one-back task and suggests a crucial role of the right lPFC in allocating resources during cognitivemotor interference. Our study provides further insight into the mechanisms underlying cognitive-motor multitasking and its impairments.
There is evidence for cortical contribution to the regulation of human postural control. Interference from concurrently performed cognitive tasks supports this notion, and the lateral prefrontal cortex (lPFC) has been suggested to play a prominent role in the processing of purely cognitive as well as cognitive-postural dual tasks. The degree of cognitive-motor interference varies greatly between individuals, but it is unresolved whether individual differences in the recruitment of specific lPFC regions during cognitive dual tasking are associated with individual differences in cognitive-motor interference. Here, we investigated inter-individual variability in a cognitive-postural multitasking situation in healthy young adults (n = 29) in order to relate these to inter-individual variability in lPFC recruitment during cognitive multitasking. For this purpose, a oneback working memory task was performed either as single task or as dual task in order to vary cognitive load. Participants performed these cognitive single and dual tasks either during upright stance on a balance pad that was placed on top of a force plate or during fMRI measurement with little to no postural demands. We hypothesized dual one-back task performance to be associated with lPFC recruitment when compared to single one-back task performance. In addition, we expected individual variability in lPFC recruitment to be associated with postural performance costs during concurrent dual one-back performance. As expected, behavioral performance costs in postural sway during dual-one back performance largely varied between individuals and so did lPFC recruitment during dual one-back performance. Most importantly, individuals who recruited the right mid-lPFC to a larger degree during dual one-back performance also showed greater postural sway as measured by larger performance costs in total center of pressure displacements. This effect was selective to the high-load dual one-back task and suggests a crucial role of the right lPFC in allocating resources during cognitivemotor interference. Our study provides further insight into the mechanisms underlying cognitive-motor multitasking and its impairments.
It is well-documented that strength training (ST) improves measures of muscle strength in young athletes. Less is known on transfer effects of ST on proxies of muscle power and the underlying dose-response relationships. The objectives of this meta-analysis were to quantify the effects of ST on lower limb muscle power in young athletes and to provide dose-response relationships for ST modalities such as frequency, intensity, and volume. A systematic literature search of electronic databases identified 895 records. Studies were eligible for inclusion if (i) healthy trained children (girls aged 6–11 y, boys aged 6–13 y) or adolescents (girls aged 12–18 y, boys aged 14–18 y) were examined, (ii) ST was compared with an active control, and (iii) at least one proxy of muscle power [squat jump (SJ) and countermovement jump height (CMJ)] was reported. Weighted mean standardized mean differences (SMDwm) between subjects were calculated. Based on the findings from 15 statistically aggregated studies, ST produced significant but small effects on CMJ height (SMDwm = 0.65; 95% CI 0.34–0.96) and moderate effects on SJ height (SMDwm = 0.80; 95% CI 0.23–1.37). The sub-analyses revealed that the moderating variable expertise level (CMJ height: p = 0.06; SJ height: N/A) did not significantly influence ST-related effects on proxies of muscle power. “Age” and “sex” moderated ST effects on SJ (p = 0.005) and CMJ height (p = 0.03), respectively. With regard to the dose-response relationships, findings from the meta-regression showed that none of the included training modalities predicted ST effects on CMJ height. For SJ height, the meta-regression indicated that the training modality “training duration” significantly predicted the observed gains (p = 0.02), with longer training durations (>8 weeks) showing larger improvements. This meta-analysis clearly proved the general effectiveness of ST on lower-limb muscle power in young athletes, irrespective of the moderating variables. Dose-response analyses revealed that longer training durations (>8 weeks) are more effective to improve SJ height. No such training modalities were found for CMJ height. Thus, there appear to be other training modalities besides the ones that were included in our analyses that may have an effect on SJ and particularly CMJ height. ST monitoring through rating of perceived exertion, movement velocity or force-velocity profile could be promising monitoring tools for lower-limb muscle power development in young athletes.
It is well-documented that strength training (ST) improves measures of muscle strength in young athletes. Less is known on transfer effects of ST on proxies of muscle power and the underlying dose-response relationships. The objectives of this meta-analysis were to quantify the effects of ST on lower limb muscle power in young athletes and to provide dose-response relationships for ST modalities such as frequency, intensity, and volume. A systematic literature search of electronic databases identified 895 records. Studies were eligible for inclusion if (i) healthy trained children (girls aged 6–11 y, boys aged 6–13 y) or adolescents (girls aged 12–18 y, boys aged 14–18 y) were examined, (ii) ST was compared with an active control, and (iii) at least one proxy of muscle power [squat jump (SJ) and countermovement jump height (CMJ)] was reported. Weighted mean standardized mean differences (SMDwm) between subjects were calculated. Based on the findings from 15 statistically aggregated studies, ST produced significant but small effects on CMJ height (SMDwm = 0.65; 95% CI 0.34–0.96) and moderate effects on SJ height (SMDwm = 0.80; 95% CI 0.23–1.37). The sub-analyses revealed that the moderating variable expertise level (CMJ height: p = 0.06; SJ height: N/A) did not significantly influence ST-related effects on proxies of muscle power. “Age” and “sex” moderated ST effects on SJ (p = 0.005) and CMJ height (p = 0.03), respectively. With regard to the dose-response relationships, findings from the meta-regression showed that none of the included training modalities predicted ST effects on CMJ height. For SJ height, the meta-regression indicated that the training modality “training duration” significantly predicted the observed gains (p = 0.02), with longer training durations (>8 weeks) showing larger improvements. This meta-analysis clearly proved the general effectiveness of ST on lower-limb muscle power in young athletes, irrespective of the moderating variables. Dose-response analyses revealed that longer training durations (>8 weeks) are more effective to improve SJ height. No such training modalities were found for CMJ height. Thus, there appear to be other training modalities besides the ones that were included in our analyses that may have an effect on SJ and particularly CMJ height. ST monitoring through rating of perceived exertion, movement velocity or force-velocity profile could be promising monitoring tools for lower-limb muscle power development in young athletes.
Plyometric jump training (PJT) is a frequently used and effective means to improve amateur and elite soccer players' physical fitness. However, it is unresolved how different PJT frequencies per week with equal overall training volume may affect training-induced adaptations. Therefore, the aim of this study was to compare the effects of an in-season 8 week PJT with one session vs. two sessions per week and equal training volume on components of physical fitness in amateur female soccer players. A single-blind randomized controlled trial was conducted. Participants (N = 23; age, 21.4 ± 3.2 years) were randomly assigned to a one session PJT per-week (PJT-1, n = 8), two sessions PJT per-week (PJT-2, n = 8) or an active control group (CON, n = 7). Before and after training, participants performed countermovement jumps (CMJ), drop-jumps from a 20-cm drop-height (DJ20), a maximal kicking velocity test (MKV), the 15-m linear sprint-time test, the Meylan test for the assessment of change of direction ability (CoDA), and the Yo-Yo intermittent recovery endurance test (Yo-YoIR1). Results revealed significant main effects of time for the CMJ, DJ20, MKV, 15-m sprint, CoDA, and the Yo-YoIR1 (all p < 0.001; d = 0.57–0.83). Significant group × time interactions were observed for the CMJ, DJ20, MKV, 15-m sprint, CoDA, and the Yo-YoIR1 (all p < 0.05; d = 0.36–0.51). Post-hoc analyses showed similar improvements for PJT-1 and PJT-2 groups in CMJ (Δ10.6%, d = 0.37; and Δ10.1%, d = 0.51, respectively), DJ20 (Δ12.9%, d = 0.47; and Δ13.1%, d = 0.54, respectively), MKV (Δ8.6%, d = 0.52; and Δ9.1%, d = 0.47, respectively), 15-m sprint (Δ8.3%, d = 2.25; and Δ9.5%, d = 2.67, respectively), CoDA (Δ7.5%, d = 1.68; and Δ7.4%, d = 1.16, respectively), and YoYoIR1 (Δ10.3%, d = 0.22; and Δ9.9%, d = 0.26, respectively). No significant pre-post changes were found for CON (all p > 0.05; Δ0.5–4.2%, d = 0.03–0.2). In conclusion, higher PJT exposure in terms of session frequency has no extra effects on female soccer players' physical fitness development when jump volume is equated during a short-term (i.e., 8 weeks) training program. From this, it follows that one PJT session per week combined with regular soccer-specific training appears to be sufficient to induce physical fitness improvements in amateur female soccer players.
Plyometric jump training (PJT) is a frequently used and effective means to improve amateur and elite soccer players' physical fitness. However, it is unresolved how different PJT frequencies per week with equal overall training volume may affect training-induced adaptations. Therefore, the aim of this study was to compare the effects of an in-season 8 week PJT with one session vs. two sessions per week and equal training volume on components of physical fitness in amateur female soccer players. A single-blind randomized controlled trial was conducted. Participants (N = 23; age, 21.4 ± 3.2 years) were randomly assigned to a one session PJT per-week (PJT-1, n = 8), two sessions PJT per-week (PJT-2, n = 8) or an active control group (CON, n = 7). Before and after training, participants performed countermovement jumps (CMJ), drop-jumps from a 20-cm drop-height (DJ20), a maximal kicking velocity test (MKV), the 15-m linear sprint-time test, the Meylan test for the assessment of change of direction ability (CoDA), and the Yo-Yo intermittent recovery endurance test (Yo-YoIR1). Results revealed significant main effects of time for the CMJ, DJ20, MKV, 15-m sprint, CoDA, and the Yo-YoIR1 (all p < 0.001; d = 0.57–0.83). Significant group × time interactions were observed for the CMJ, DJ20, MKV, 15-m sprint, CoDA, and the Yo-YoIR1 (all p < 0.05; d = 0.36–0.51). Post-hoc analyses showed similar improvements for PJT-1 and PJT-2 groups in CMJ (Δ10.6%, d = 0.37; and Δ10.1%, d = 0.51, respectively), DJ20 (Δ12.9%, d = 0.47; and Δ13.1%, d = 0.54, respectively), MKV (Δ8.6%, d = 0.52; and Δ9.1%, d = 0.47, respectively), 15-m sprint (Δ8.3%, d = 2.25; and Δ9.5%, d = 2.67, respectively), CoDA (Δ7.5%, d = 1.68; and Δ7.4%, d = 1.16, respectively), and YoYoIR1 (Δ10.3%, d = 0.22; and Δ9.9%, d = 0.26, respectively). No significant pre-post changes were found for CON (all p > 0.05; Δ0.5–4.2%, d = 0.03–0.2). In conclusion, higher PJT exposure in terms of session frequency has no extra effects on female soccer players' physical fitness development when jump volume is equated during a short-term (i.e., 8 weeks) training program. From this, it follows that one PJT session per week combined with regular soccer-specific training appears to be sufficient to induce physical fitness improvements in amateur female soccer players.
Recently, there has been a proliferation of published articles on the effect of plyometric jump training, including several review articles and meta-analyses. However, these types of research articles are generally of narrow scope. Furthermore, methodological limitations among studies (e.g., a lack of active/passive control groups) prevent the generalization of results, and these factors need to be addressed by researchers. On that basis, the aims of this scoping review were to (1) characterize the main elements of plyometric jump training studies (e.g., training protocols) and (2) provide future directions for research. From 648 potentially relevant articles, 242 were eligible for inclusion in this review. The main issues identified related to an insufficient number of studies conducted in females, youths, and individual sports (~ 24.0, ~ 37.0, and ~ 12.0% of overall studies, respectively); insufficient reporting of effect size values and training prescription (~ 34.0 and ~ 55.0% of overall studies, respectively); and studies missing an active/passive control group and randomization (~ 40.0 and ~ 20.0% of overall studies, respectively). Furthermore, plyometric jump training was often combined with other training methods and added to participants’ daily training routines (~ 47.0 and ~ 39.0% of overall studies, respectively), thus distorting conclusions on its independent effects. Additionally, most studies lasted no longer than 7 weeks. In future, researchers are advised to conduct plyometric training studies of high methodological quality (e.g., randomized controlled trials). More research is needed in females, youth, and individual sports. Finally, the identification of specific dose-response relationships following plyometric training is needed to specifically tailor intervention programs, particularly in the long term.
From a health and performance-related perspective, it is crucial to evaluate subjective symptoms and objective signs of acute training-induced immunological responses in young athletes. The limited number of available studies focused on immunological adaptations following aerobic training. Hardly any studies have been conducted on resistance-training induced stress responses. Therefore, the aim of this observational study was to investigate subjective symptoms and objective signs of immunological stress responses following resistance training in young athletes. Fourteen (7 females and 7 males) track and field athletes with a mean age of 16.4 years and without any symptoms of upper or lower respiratory tract infections participated in this study. Over a period of 7 days, subjective symptoms using the Acute Recovery and Stress Scale (ARSS) and objective signs of immunological responses using capillary blood markers were taken each morning and after the last training session. Differences between morning and evening sessions and associations between subjective and objective parameters were analyzed using generalized estimating equations (GEE). In post hoc analyses, daily change-scores of the ARSS dimensions were compared between participants and revealed specific changes in objective capillary blood samples. In the GEE models, recovery (ARSS) was characterized by a significant decrease while stress (ARSS) showed a significant increase between morning and evening-training sessions. A concomitant increase in white blood cell count (WBC), granulocytes (GRAN) and percentage shares of granulocytes (GRAN%) was found between morning and evening sessions. Of note, percentage shares of lymphocytes (LYM%) showed a significant decrease. Furthermore, using multivariate regression analyses, we identified that recovery was significantly associated with LYM%, while stress was significantly associated with WBC and GRAN%. Post hoc analyses revealed significantly larger increases in participants’ stress dimensions who showed increases in GRAN%. For recovery, significantly larger decreases were found in participants with decreases in LYM% during recovery. More specifically, daily change-scores of the recovery and stress dimensions of the ARSS were associated with specific changes in objective immunological markers (GRAN%, LYM%) between morning and evening-training sessions. Our results indicate that changes of subjective symptoms of recovery and stress dimensions using the ARSS were associated with specific changes in objectively measured immunological markers.