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Physical activity counseling within the «KiKli Fit»-project: Development and first implementation
No full textIntroduction
Increasing physical activity (PA) levels in children and adolescents with cancer holds promise for enhancing outcomes both during treatment and into survivorship (Stout et al., 2017). Despite this potential, the promotion of PA within Swiss pediatric oncology units remains largely overlooked. To address this gap, the “KiKli Fit” project has been initiated. This program features personalized training sessions during acute care, accompanied by PA counseling during the transition to the post-acute phase. Importantly, it engages not only the patients but also their families, since they play a crucial role in shaping youth’s PA behavior (Cheung et al., 2021). The PA counseling is designed to enhance motivation, volition, enjoyment, family health-climate, and ultimately, foster an active lifestyle (Schorno et al., 2022). This study aims to outline the theoretical development of the counseling approach and present initial findings from its implementation.
Methods
We plan a two-arm multicenter crossover-controlled trial to investigate the effects of the whole PA program. The trial will compare the PA program (intervention group in Bern, n = 40) with standard treatment (control group in Basel, n = 40). Participants will be aged 6-18, newly diagnosed with cancer and undergoing neurotoxic treatment for at least six weeks. The PA counseling comprises four sessions involving the child or adolescent and their parents. These sessions cover various topics, including parental concerns about their child performing PA, individual preferences in exercise and sports, and ways to be physically active as a whole family. Motivational interviewing techniques are applied across all sessions. The study will start in early 2024. Outcomes will be measured three times (once at admission, after twelve weeks of intervention and for follow-up after six months).
Discussion
The “KiKli Fit”-project is a complex program that aims to promote PA in and after acute care by combining personalized training sessions with PA counseling. The scalability of the PA counseling is a key advantage, allowing it to reach a wide demographic, including those who have completed treatment. Fostering PA in young cancer patients seems to particularly important because it can set a foundation for a healthier lifestyle as they transition into adulthood.
References
Cheung, A. T., Li, W. H. C., Ho, L. L. K., Chan, G. C. F., & Chung, J. O. K. (2021). Parental perspectives on promoting physical activity for their children surviving cancer: A qualitative study. Patient Education and Counseling, 104(7), 1719-1725. https://doi.org/10.1016/j.pec.2020.11.009
Schorno, N., Gut, V., Conzelmann, A., & Schmid, J. (2022). Effectiveness of individual exercise and sport counseling based on motives and goals: A randomized controlled trial. Journal of Sport and Exercise Psychology, 44(2), 103-115. https://doi.org/10.1123/jsep.2021-0018
Stout, N. L., Baima, J., Swisher, A. K., Winters-Stone, K. M., & Welsh, J. (2017). A systematic review of exercise systematic reviews in the cancer literature (2005-2017). PM&R, 9, 347-384. https://doi.org/10.1016/j.pmrj.2017.07.07
Effects of pulse width and frequency on evoked responses in electrostimulation: comparison between three muscle groups
No full textIntroduction
Neuromuscular electrical stimulation (NMES) is an innovative and effective (re)training strategy to improve or restore neuromuscular function (Maffiuletti et al., 2018). Contractions induced by NMES differ in many aspects from voluntary contractions, as motor unit (MU) recruitment is random, synchronous and spatially fixed (mostly superficial; Maffiuletti, 2010). Consequently, several limitations, such as higher fatigability (Vanderthommen et al., 1999) and discomfort (Delitto et al., 1992) might restrain its clinical implementation. The use of specific stimulation parameters may partly overcome these limitations. Indeed, the use of wide pulses (≥ 1 ms) delivered at low stimulation intensity leads to a preferential recruitment of Ia sensory axons (Veale et al., 1973) which may promote MU central (reflexive) recruitment. Furthermore, the high stimulation frequencies (> 80 Hz) would facilitate the temporal summation of post-synaptic excitatory potentials and reflexively activate spinal motoneurons through Ia afferents (Dideriksen et al., 2015), which may increase force production. Another potential advantage of wide pulse high frequency (WPHF) NMES is that low stimulation intensities are required to limit antidromic collision, and these lower intensities are associated with less discomfort (Delitto et al., 1992). Therefore, by stimulating at intensities expected to generate ~10% of the maximal voluntary contraction (MVC) force, WPHF NMES induces, in some individuals, a progressive increase in force during the stimulation, called ‘extra force’. It can reach up to 80% of the MVC force in plantar flexors (Neyroud et al., 2018) but the response to WPHF NMES in other muscle groups is less documented. Extra force is usually accompanied by a prolongation of the surface electromyographic (EMG) activity after cessation of the stimulation, also called ‘sustained EMG activity’ which is interpreted as MU recruited through the central pathway (Neyroud et al, 2018). The main aim of the present study was to explore the effect of varying stimulation parameters on the NMES-evoked force and sustained EMG activity in the plantar flexors, knee extensors and elbow flexors. It was hypothesized that the plantar flexors would show higher centrally-mediated responses to NMES than knee extensors and elbow flexors, especially with large pulse duration.
Methods
Sixteen volunteers, 2 women and 14 men (29 ± 6 yr, 177 ± 6 cm, 74 ± 11 kg) participated to three experimental sessions - one for each muscle group - in a randomized order. The experimental protocol was similar for the three muscle groups and included twelve 10-s NMES trains separated by at least 2 min of rest and delivered at an intensity set initially to evoke 10% of the maximal voluntary contraction force. Stimulation trains were randomly delivered with a combination of frequencies (20, 50, 100 and 147 Hz) and pulse durations (0.2, 1 and 2 ms). Force was collected using specific isometric ergometers and EMG activity was recorded with bipolar electrodes on the soleus, vastus lateralis and biceps brachii muscles. Extra force was calculated as the relative force difference between the last second and the 2nd second of stimulation. Sustained EMG activity was identified as the visible activity on the EMG after the end of the stimulation and quantified over 500 ms as the root mean square (RMS) of this signal normalized by the RMS of the EMG activity measured during the MVC.
Results
Stimulation frequency. Extra force was significantly higher for the plantar flexors than for the elbow flexors at 50 Hz (69 ± 68% vs 38 ± 53%, p = 0.025), 100 Hz (84 ± 71% vs 21 ± 72%, p < 0.001) and 147 Hz (75 ± 84% vs 16 ± 82%, p < 0.001), but not at 20 Hz (p = 0.649). For all the tested frequencies, extra force was not significantly different between plantar flexors and knee extensors (p = 0.065 - 0.743). Extra force was significantly higher for the knee extensors than for the elbow flexors at 100 Hz (63 ± 106% vs 21 ± 72%, p = 0.012), but not at the other frequencies (p = 0.156 - 0.388). Sustained EMG activity was significantly higher for the plantar flexors than for the elbow flexors at all frequencies (p < 0.001) as well as compared to the knee extensors at 50 Hz, 100 Hz and 147 Hz (p = 0.010, p = 0.009, p = 0.003 respectively) but not at 20 Hz (p = 0.483). Finally, sustained EMG activity was significantly higher for the knee extensors than for the elbow flexors at for all the tested stimulation frequencies (p < 0.05).
Pulse duration. Extra force was significantly higher for the plantar flexors than for the elbow flexors with pulse durations of 1 ms (76 ± 74% vs 23 ± 48%, p < 0.001) and 2 ms (73 ± 70% vs 29 ± 88%, p < 0.001) but not with 0.2 ms (p = 0.064). Extra force was not significantly different between the plantar flexors and the knee extensors, and the knee extensors showed a higher extra force than elbow flexors with 1 ms (56 ± 99% vs 23 ± 48%, p = 0.002). Sustained EMG activity was significantly higher for the plantar flexors than the elbow flexors with all pulse durations (p < 0.001) and than the knee extensors with 1 and 2 ms (p < 0.001). Knee extensors showed a higher sustained EMG activity than elbow flexors with 0.2 ms and 2 ms (p < 0.001) but not with 1 ms.
Discussion/Conclusion
WPHF NMES is a promising tool for (re)training and the results of the present study suggest that its use to induce centrally-mediated force is more pertinent in lower limb muscles. The difference in responses between muscle groups could be explained by muscle typology and density in neuromuscular spindles. Indeed, muscles involved in precise movements and postural control have a greater number of neuromuscular spindles, which are mainly located in type 1 fibers (Botterman et al., 1978). The greater centrally-mediated responses in the plantar flexors compared with the elbow flexors can be explained by the difference in muscle typology (more type I muscle fibers in the postural lower limb muscles). It may also justify the absence of difference in extra force between plantar flexors and knee extensors as they both contribute to postural maintenance (Jusić et al., 1995). Since the effectiveness of NMES for neuromuscular adaptations depends on the amount of force generated during training (Maffiuletti et al., 2018), these results suggest that the use of WPHF NMES would be efficient on plantar flexors and knee extensors for training and rehabilitation and that wide pulses and high frequencies should be preferentially used when implementing this NMES modality in clinical settings.
References
Botterman, B. R., Binder, M. D., & Stuart, D. G. (1978). Functional anatomy of the association between motor units and muscle teceptors. American Zoologist, 18(1), 135–152. https://doi.org/10.1093/icb/18.1.135
Delitto, A., Strube, M. J., Shulman, A. D., & Minor, S. D. (1992). A study of discomfort with electrical stimulation. Physical Therapy, 72(6), 410–421. https://doi.org/10.1093/ptj/72.6.410
Dideriksen, J. L., Muceli, S., Dosen, S., Laine, C. M., & Farina, D. (2015). Physiological recruitment of motor units by high-frequency electrical stimulation of afferent pathways. Journal of Applied Physiology, 118(3), 365–376. https://doi.org/10.1152/japplphysiol.00327.2014
Jusić, A., Baraba, R., & Bogunović, A. (1995). H-reflex and F-wave potentials in leg and arm muscles. Electromyography and Clinical Neurophysiology, 35(8), 471–478.
Maffiuletti, N. A., Gondin, J., Place, N., Stevens-Lapsley, J., Vivodtzev, I., & Minetto, M. A. (2018). Clinical Use of Neuromuscular Electrical Stimulation for Neuromuscular Rehabilitation: What Are We Overlooking? Archives of Physical Medicine and Rehabilitation, 99(4), 806-812. https://doi.org/10.1016/j.apmr.2017.10.028
Maffiuletti, N. A. (2010). Physiological and methodological considerations for the use of neuromuscular electrical stimulation. European Journal of Applied Physiology, 110(2), 223–234. https://doi.org/10.1007/s00421-010-1502-y
Neyroud, D., Grosprêtre, S., Gondin, J., Kayser, B., & Place, N. (2018). Test–retest reliability of wide-pulse high-frequency neuromuscular electrical stimulation evoked force. Muscle & Nerve, 57(1), E70–E77. https://doi.org/10.1002/mus.25747
Vanderthommen, M., Gilles, R., Carlier, P., Ciancabilla, F., Zahlan, O., Sluse, F., & Crielaard, J. M. (1999). Human muscle energetics during voluntary and electrically induced isometric contractions as measured by 31P NMR spectroscopy. International Journal of Sports Medicine, 20(5), 279–283. https://doi.org/10.1055/s-2007-971131
Veale, J. L., Mark, R. F., & Rees, S. (1973). Differential sensitivity of motor and sensory fibres in human ulnar nerve. Journal of Neurology, Neurosurgery & Psychiatry, 36(1), 75–86
Ventricular arrhythmia burden during different physical activities in patients with arrhythmogenic right ventricular cardiomyopathy: Preliminary analysis
No full textIntroduction
Patients suffering from arrhythmogenic right ventricular cardiomyopathy (ARVC) should avoid intense endurance exercise to reduce the risk of adverse cardiac events and disease progression. On the other hand, an active lifestyle might be preferable to a sedentary one, which also brings a host of complications. Evidence for safe levels of physical activity in ARVC, however, is scarce. This is study aimed to describe the ventricular arrhythmia burden - estimated as the prevalence of premature ventricular contractions (PVC) - of different exercise modalities and intensities on ARVC patients.
Methods
The pilot analysis includes four (1F, 33 ± 12 yrs, BMI 24 ± 4 kg/m2) ARVC patients harboring a pathogenic plakophilin-2 variant and carrying an implantable cardioverter-defibrillator performed different exercises while monitored via 12-lead ECG. The order of modalities was randomized and participants instructed to stop when surpassing perceived exertion of 15 on the Borg 6-20 scale. Resistance exercises included two-legged squats and single arm biceps curls (each with 20 repetitions and 2 min duration) while endurance exercise included 5 min of treadmill walking, 3 min cycling bouts at heart rate (HR) of 80, 100 and 120 bpm as well as cycling at 120 bpm with 2 additional min of active cool down. Blood lactate concentration was assessed at the end of the cycling bouts.
Results
No adverse cardiac event were noted and no exercise was terminated for medical reasons. During walking HR was 76 ± 8 bpm, whereas PVC burden was 11 ± 6% (range 4-18%). Cycling at 82 ± 4 bpm induced a PVC burden of 7 ± 5% (range 3- 14%), which increased to 13 ± 8% (range 3- 21%) at 93 ± 2 bpm and further to 16 ± 16% (range 7-37%) at 105 ± 3 bpm. In all three modalities the PVC burden was higher in the first 3 min of recovery than during the activity itself. Adding a 2 min active cool down increased the PVC burden to 25 ± 16% (range 6-45%). 2-legged squats performed at 101 ± 15 bpm had a PVC burden of 9 ± 12%, which increased to 19 ± 14% at recovery. One arm biceps curls at 75 ± 13 bpm had a PVC burden of 4 ± 3% during the activity and 9 ± 5% during recovery. Perception of effort varied widely when cycling at 80 bpm (range 6-12) or 100 bpm (range 8-14), but less so at 120 bpm (range 13-15). Blood lactate concentration when cycling at 120 bpm ranged between 2.2 and 3.5 mmol/L, typically associated with exercise in the “heavy” intensity domain.
Discussion/Conclusion
ARVC patients present a high, intensity-dependent PVC burden during exercise and short-term recovery. However, we observed widely different PVC burdens and perceived exertion at a given HR during different exercise modalities, which calls for personalized recommendations on physical activity. Exercises with small muscle mass seem to minimize the PVC burden and training the different muscles separately could be an interesting avenue to maintain physical fitness in ARVC patients
Repetitive magnetic stimuli over the motor cortex impair long-term consolidation of a balance task by suppressing up-regulation of intracortical inhibition
No full textIntroduction
Recent findings have demonstrated that low-frequency repetitive magnetic stimulations (rTMS) over the primary motor cortex (M1) impaired short-term consolidation of a balance task, underscoring the causal connection between M1 and the consolidation of balancing skills (Egger et al., 2023). However, the underlying neural mechanisms induced by rTMS and whether these adaptations endure over an extended period, encompassing multiple acquisition sessions, remain insufficiently elucidated (Censor & Cohen, 2011). So far, its is widely acknowledged that GABAergic processes play an important role for consolidation (Sanes & Donoghue, 2000), at the same time, are affected by learning balance skills (Mouthon & Taube, 2019; Taube et al., 2020). Therefore, the present study aimed to investigate the impact of rTMS on GABA-mediated short-interval intracortical inhibition (SICI) and to explore the role of M1 in the long-term consolidation of a balance task (i.e., across multiple acquisition sessions).
Methods
Thirty-one volunteers underwent six balance acquisition sessions on a rocker-board, each followed by either rTMS or sham rTMS based on group affiliation. During the first and last training session, SICI was measured twice; before the balance acquisition and after the application of rTMS or sham-rTMS to investigate potential short- and long-term adaptations in intracortical inhibition. Adaptations were assessed during the execution of the learned balance task and in a non-learning postural control task (i.e., stable upright stance).
Results
Regardless of group affiliation, all participants achieved comparable improvements within the balance acquisition sessions. However, consolidation varied between groups. In particular, between the third and the fourth acquisition session, as Tukey corrected post-hoc tests showed a significant decline in performance for the rTMS group (p = 0.006). Both short- (p = 0.014) and long-term (p = 0.038) adaptations in SICI were affected by rTMS: while the sham rTMS group upregulated SICI, rTMS led to reduced levels of inhibition. No neurophysiological effects were observed in the non-learning control task (upright stance).
Discussion/Conclusion
The interfering effect of rTMS on balance consolidation and on upregulation of SICI indicates that increased intracortical inhibition is an important mechanism to protect and engrave newly acquired motor memory. Importantly, adaptations in SICI were only apparent during the execution of the learned task.
References
Censor, N., & Cohen, L. G. (2011). Using repetitive transcranial magnetic stimulation to study the underlying neural mechanisms of human motor learning and memory. The Journal of Physiology, 589(1), 21-28. https://doi.org/10.1113/jphysiol.2010.198077
Egger, S., Wälchli, M., Rüeger, E., & Taube, W. (2023). Short-term balance consolidation relies on the primary motor cortex: A rTMS study. Scientific Reports, 13, Article 5169. https://doi.org/10.1038/s41598-023-32065-x
Mouthon, A., & Taube, W. (2019). Intracortical inhibition increases during postural task execution in response to balance training. Neuroscience, 401, 35-42. https://doi.org/10.1016/j.neuroscience.2019.01.007
Sanes, J. N., & Donoghue, J. P. (2000). Plasticity and primary motor cortex. Annual Review of Neuroscience, 23, 393-415. https://doi.org/10.1146/annurev.neuro.23.1.393
Taube, W., Gollhofer, A., & Lauber, B. (2020). Training-, muscle- and task-specific up- and downregulation of cortical inhibitory processes. The European Journal of Neuroscience, 51(6), 1428-1440. https://doi.org/10.1111/ejn.1453
Activation of the erythropoietin system in exhaustively exercise muscle relates to ACE gene polymorphism-modulated metabolic signalling and mitochondrial transcript expression
No full textIntroduction
Introduction A fall in muscle oxygen saturation is a potent activator of mitochondrial biogenesis in exercised skeletal muscle which is subject to the training-modulated influence of the insertion/deletion polymorphism of the angiotensin converting enzyme gene (ACE-I/D; Gasser et al 2022) and may involve paracrine erythropoietin (EPO) signaling (Desplanches et al 2014, Nijholt et al 2021). We tested the hypothesis that erythropoietin expression and signaling in fatiguingly exercised muscle would correspond to the expression of hypoxia-regulated mitochondrial genes and altered metabolic signaling and would be subject to a genetic influence by ACE-I/D.
Methods
Methods 22 healthy, male white Caucasian men (27.0 +/- 1.4 years; BMI 23.6 +/- 0.6 kg m-2) completed a session of fatiguing one-legged exercise in the fasted state. Microbiopsies were collected from m. vastus lateralis of the non-exercised leg immediately before exercise, and ½, 3, and 8 hours thereafter from the exercising leg. Levels of the hypoxia-regulated cytochrome c oxidase subunit 4 isoforms 1 and 2 (COX4I1 and COX4I2), ACE and EPO transcript, glycogen concentration in m. vastus lateralis, the ACE-I/D genotype and aerobic fitness state were assessed as described (Desplanches et al 2014; Gasser et al 2022). EPO protein concentration and phosphorylation of intracellular transducers of EPO signaling were quantified in muscle homogenates with validated enzyme-linked immune sorbent and a phospho-kinase assays. Effects and Pearson correlations were assessed with analysis of variance and declared significant at p < 0.05.
Results
One-legged exercise produced metabolic fatigue as indicated by the voluntary cessation of exercise and a reduced glycogen concentration in m. vastus lateralis in all subjects ½ hour after exercise (-0.044 mg mg-1). Concomitantly, EPO protein levels were 4-fold lowered; and subsequently increased 3-8 hours after cessation of exercise alike EPO transcripts levels.
Aerobically fit ACE I-allele carriers demonstrated a sparing of muscle glycogen, exaggerated EPO transcript response, and higher phosphorylation levels of EPO signal transducers [STAT5a-Y694 (+31%), STAT5b-Y699 (+40%)]. The phosphorylation level of the metabolic signal transducer AMPKa2-T172 correlated to EPO transcript levels 3 hours post exercise (r = 0.61). EPO protein levels correlated to ACE and COX4I2 transcript levels (r = -0.79; -0.54).
Discussion
The findings highlight that a paracrine loop of metabolically-regulated EPO signaling exists in exercised human skeletal muscle which variability is associated with the ACE-I/D gene polymorphism in fair correspondence with a mitochondrial marker of local hypoxia.
References
Desplanches, D., Amami, M., Mueller, M., Hoppeler, H., Kreis, R., & Flück, M. (2014). Hypoxia refines plasticity of mitochondrial respiration to repeated muscle work. European Journal of Applied Physiology, 114, 405-417. https://doi.org/10.1007/s00421-013-2783-8
Gasser, B., Franchi, M. V., Ruoss, S., Frei, A., Popp, W. L., Niederseer, D., Catuogno, S., Frey, W. O., & Flück, M. (2022). Accelerated muscle deoxygenation in aerobically fit subjects during exhaustive exercise is associated with the ACE insertion allele. Frontiers in Sports and Active Living, 4, Article 814975. https://doi.org/10.3389/fspor.2022.814975
Nijholt, K. T., Meems, L. M. G., Ruifrok, W. P. T., Maass, A. H., Yurista, S. R., Pavez-Giani, M. G., Mahmoud, B., Wolters, A. H. G., van Veldhuisen, D. J., van Gilst, W. H., Silljé, H. H. W., de Boer, R. A., & Westenbrink, B. D. (2021). The erythropoietin receptor expressed in skeletal muscle is essential for mitochondrial biogenesis and physiological exercise. Pflügers Archiv - European Journal of Physiology, 473, 1301-1313. https://doi.org/10.1007/s00424-021-02577-
Patellar tendon complaints and shear wave velocity patterns in maturing alpine skiers
No full textIntroduction
Patellar tendinopathy is frequent in adolescent athletes and particularly accentuated in competitive alpine skiers (Fröhlich et al., 2020). Tendinopathies are characterized by long disease histories, and whether they can be healed completely is an open question (Kettunen et al., 2002). Three-dimensional (3D) shear wave elastography (SWE) has proven valuable in the early detection of tendinopathies (Götschi et al., 2023). The aims of this study were to (1) describe the longitudinal progression of patellar tendon complaint prevalence in competitive alpine skiers during adolescence, (2) compare the SWV patterns of skiers that were symptomatic four years ago with those with no history of patellar tendon complaints and (3) analyse whether shear wave velocity (SWV) average values correlate with SWV coefficient of variation (CV).
Methods
Forty-seven subjects were analysed in this 4-year follow-up study regarding their patellar tendon complaints and SWV patterns. Symptomatic and asymptomatic skiers were identified by clinical examinations including the criteria of pain sensation under loading and palpation-induced pain. SWV was determined by ultrasound-based 3D SWE. Prevalence differences were assessed using Pearson’s χ2 tests. Group differences in the SWV patterns were analysed using unpaired sample t tests. Correlations between SWV average and CV values were analysed by means of Pearson’s correlation coefficient.
Results
With proceeding adolescence, the prevalence of patellar tendon complaints significantly decreased from 29.8% at baseline assessment (13-16 years) to 12.7% at follow-up assessment (Pearson’s χ2 = 9.429; p = 0.002). Those skiers who were symptomatic at baseline but asymptomatic at the follow-up still had lower average SWV values and higher CVs than asymptomatic skiers with no history of patellar tendon complaints (p = 0.054 and p = 0.011, respectively). Furthermore, there was a significant negative correlation between the tendon SWV average values and their CVs (R = -0.55; p < 0.001).
Discussion/Conclusion
Despite the decreasing prevalence of patellar tendon complaints in youth competitive alpine skiers after their growth spurt, structural abnormalities appear to remain in asymptomatic subjects with a previous history of patellar tendinopathy, indicating potential long-term implications for mechanical tendon proprieties. The SWV average and CV values were negatively correlated, which underlines our hypothesis that a low SWV is associated with a high CV. This altogether may reflect the degenerative processes in patellar tendons affected by complaints in the early stages of a sports career.
References
Fröhlich, S., Peterhans, L., Stern, C., Frey, W. O., Sutter, R., & Spörri, J. (2020). Remarkably high prevalence of overuse-related knee complaints and MRI abnormalities in youth competitive alpine skiers: A descriptive investigation in 108 athletes aged 13-15 years. BMJ Open Sport & Exercice Medicine, 6(1), Aticle e000738. https://doi.org/10.1136/bmjsem-2020-000738
Götschi, T., Franchi, M. V., Schulz, N., Fröhlich, S., Frey, W. O., Snedeker, J. G., & Spörri, J. (2023). Altered regional 3D shear wave velocity patterns in youth competitive alpine skiers suffering from patellar tendon complaints – A prospective case–control study. European Journal of Sport Science, 23(6), 1068-1076. https://doi.org/10.1080/17461391.2022.2088404
Kettunen, J. A., Kvist, M., Alanen, E., & Kujala, U. M. (2002). Long-term prognosis for jumper’s knee in male athletes. A prospective follow-up study. The American Journal of Sports Medicine, 30(5), 689-692. https://doi.org/10.1177/0363546502030005100
Behavioral physical activity counselling to promote an active healthy lifestyle among adolescent psychiatric outpatients. The TRANSPAC-study
No full textIntroduction
Mental health disorders are one of the main reasons for disability in adolescents worldwide (Dahl et al., 2018). Sleep disturbances are an important contributor to a vicious cycle of increased vulnerability during this developmental period. Interventions that improve sleep are suggested to improve psychosocial outcomes. One such intervention may be physical activity (PA), with a beneficial effect on both sleep and mental health. Yet, PA levels are declining during adolescent years, with even higher inactivity levels for individuals with psychiatric disorders. Guidance on how to address PA counselling (PAC) among psychiatric adolescents in routine clinical practice has the potential to improve clinical and psychosocial outcomes.
Methods
During this ongoing randomized waitlist controlled trial, 18 adolescent psychiatric outpatients have been recruited from local clinics and private practices. Those who met inclusion criteria were aged 12 to 18 years, suffered from sleep problems, and had at least one additional mental health diagnosis. Exclusion criteria included organic sleep and brain disorders and changes in medication. At baseline, participants completed questionnaires related to sleep and psychopathology. For the next seven days, participants wore an Actigraph to track PA and sleep patterns. Participants were serially randomized into two groups after baseline: PAC or Treatment as usual (TAU). At 3-month follow-up, all tests were repeated. Additionally, a semi structured interview was conducted with intervention participants. To assess intervention effects, mixed model ANOVAs were conducted for PA, psychopathology, and composite sleep health.
The 6-session intervention builds on previous standardized and theory-based PAC programs (Gerber et al., 2019).
Results
By 2023, follow-up data were available from 12 participants (Mage 15.33 yrs; 75% females). Preliminary data show a significant trend for increased PA on school days, and composite sleep health (p = .07). Yet, compliance of Actigraph wear time was low. No changes were observed for psychopathology. The post-intervention interview revealed positive experiences.
Discussion/Conclusion
The preliminary data show the feasibility of the intervention. It is likely that improvements in PA and sleep patterns must first stabilize before they can have a meaningful impact on psychopathology. However, more data is needed to confirm the results. The interviews revealed that the content and mode of delivery were generally accepted. Considering the many other obligations adolescents face in their everyday lives, including homework and psychotherapy, the combination of online and face-to-face sessions was well received. Because of the low compliance rate of Actigraph wear time, alternative devices should be considered for this population.
References
Dahl, R. E., Allen, N. B., Wilbrecht, L., & Suleiman, A. B. (2018). Importance of investing in adolescence from a developmental science perspective. Nature, 554(7693), 441–450. https://doi.org/10.1038/nature25770
Gerber, M., Beck, J., Brand, S., Cody, R., Donath, L., Eckert, A., Faude, O., Fischer, X., Hatzinger, M., Holsboer-Trachsler, E., Imboden, C., Lang, U., Mans, S., Mikoteit, T., Oswald, A., Pühse, U., Rey, S., Schreiner, A. K., Schweinfurth, N., … Zahner, L. (2019). The impact of lifestyle physical activity counselling in IN-PATients with major depressive disorders on physical activity, cardiorespiratory fitness, depression, and cardiovascular health risk markers: Study protocol for a randomized controlled trial. Trials, 20(1), 1–21. https://doi.org/10.1186/s13063-019-3468-
Increasing habitual walking in mobility-limited older adults through a personalized GIS-based intervention
No full textBackground
Ample evidence supports the health benefits of low-intensity physical activity such as walking, which is universally accessible and impacted by neighbourhood environmental factors like green spaces and availability of local amenities.
Aim
The MOBITEC-Routes project will investigate the effects of an individualized GIS-based walking intervention on physical and psychosocial functioning in mobility-limited older adults.
Methods
A randomized controlled trial to promote habitual walking will take place. The sample will include 130 inactive, chronically ill, mobility-limited older adults. The intervention will combine professional consultations with map-based planning and behaviour change techniques derived from the Health Action Process Approach.
Results
Expected outcomes include increase in participants’ daily step count, physical activity levels, physical function, life space mobility, self-efficacy, social participation, and quality of life.
Conclusion
MOBITEC-Routes is poised to offer new insights into personalized GIS-based interventions’ effectiveness in improving mobility and overall well-being in older adults with mobility impairments
Good governance principles: Snapshot of athletes’ and coaches’ commissions within their National Sports Federations in 2019
No full textIntroduction
Good governance principles of National Sports Federations (NSF) include the representation of athletes and coaches through commissions (PlayTheGame, n. d.). This representation has been an important issue in Switzerland since the “Magglingen Protocols” of October 2020, which outlined the abuses in Swiss women’s gymnastics. In response, Swiss Olympic and the Federal Department of Defence, Civil Protection and Sport have taken measures, including the representation of athletes and coaches within their NSFs. One year before the abuses became public, athletes, coaches and NSFs’ officials were surveyed regarding principles of good governance. The surveys comprised questions on their involvement in policy-making at national level and, in particular, the existence of an athletes’ and coaches’ commission within their NSFs.
Methods
Using the SPLISS model (Sports Policy Factors Leading to International Sporing Success) and respective surveys (De Bosscher et al., 2006), 1,450 athletes with a Swiss Olympic Card Gold, Silver, Bronze or Elite from 54 different sports, 734 coaches with a national coaching position and a professional coaching qualification and 122 officials from NSFs were surveyed via an online survey (Kempf et al., 2021).
Results
Around 990 athletes assessed their involvement in the development and evaluation of policy guidelines, of which 16% (n = 156) reported to be “very/sufficiently involved” in the development within their NSF, followed by 13% (n = 130) for Swiss Olympic and 10% (n = 99) in FOSPO respectively. Overall, 50% (n = 451 – 507) of athletes consider their involvement to be “insufficient/not at all” in all three organisations. The responses for the evaluation of policy guidelines were similar. Regarding the existence of an athlete’s commission within their NSF, 44% (n = 442) of athletes stated that there is one, while 35% (n = 351) did not know; respectively coaches for coaches’ commission: 30% (n = 129) and 25% (n = 108). Finally, 46% (n = 41) of officials stated that there was a coaches’ committee in their NSF and 30% (n = 25) for the athletes’ commissions respectively.
Discussion/Conclusion
The results show that in 2019, an important number of athletes do not feel sufficiently involved in national level policy-making and that a significant number of athletes and coaches are not represented by a commission within their NSF. Meanwhile, the findings confirm the need for improved communication, particularly in relation to the existence of commissions. As posited by PlayTheGame (n. d.), clearly communicating the rights and responsibilities of commission members is needed to improve coaches and athletes’ involvement. Further research could make a comparison with the current situation and analyse the impact of the measures introduced by FOSPO and Swiss Olympic since 2020.
References
De Bosscher, V., De Knop, P., Van Bottenburg, M., & Shibli, S. (2006). A conceptual framework for analysing sports policy factors leading to international sporting success. European Sport Management Quarterly, 6(2), 185-215. https://doi.org/10.1080/16184740600955087
Kempf, H., Weber, A. C., Zurmühle, C., Bosshard, B., Mrkonjic, M., Weber, A., Pillet, F., & Sutter, S. (2021). Leistungssport Schweiz. Momentaufnahme SPLISS-CH 2019 [High performance sport Switzerland. Snapshot SPLISS-CH 2019] (2nd, rev. ed.). Bundesamt für Sport BASPO.
PlayTheGame. (n. d.). Strengthening athlete power in sport. https://www.playthegame.org/projects/strengthening-athlete-power-in-sport-sapis
Preliminary investigation of the effect of artificial sweat on a wearable textile sensing system
No full textIntroduction
Textile wearable systems for human movement monitoring are increasingly popular. However, few examples report on robustness to sweat, which is relevant for use in real life. Some reported the effect of artificial sweat like phosphate buffered saline (PBS; Lin et al., 2022) or simply moisture (Xu et al., 2020) on custom materials. We previously developed an all-textile wireless sensing platform with commercial conductive yarns and fabrics containing silver. There is no study on the effect of sweat on such materials, therefore we performed a preliminary study to account for moisture and potential oxydation of silver.
Methods
The textile sensing system is resonating RLC circuit, where the sensing part is a capacitive parallel plate strain sensor (C) located on a joint (knee). All components are textile based and contain silver. As the capacitive sensor stretches, capacitance increases and the resonance of the circuit fres decreases. This information is transmitted wirelessly via inductive coupling (Galli et al., 2023). We sprayed 1 ml of 0.1 M PBS solution on the textile capacitive sensor to simulate sweating, and applied mechanical strain before (damp state) and after air drying (dry state). The unmodified sensor (before the addition of any PBS) was also used as a baseline measure. First, we applied fixed strain (10%) with a universal testing machine; then, we tested the response of the sensorized pants when bending the knee.
Results The resonance frequency of the textile sensing (RLC) circuit in the damp state was much lower than the baseline (14.85 ± 0.11 MHz vs 22.70 ± 0.12 MHz) as expected from the higher dielectric constant of water that increases the baseline capacitance of the sensor. As for the change in Δfres upon 10% strain (Δfres = fres,baseline - fres,stretch), interestingly a larger change was observed for the damp configuration as compared to the baseline and dried (1.08 ± 0.08 vs 0.79 ± 0.06 vs 0.66 ± 0.03 MHz). A similar behaviour was observed in the test with pants, where the response for flexion was Δfres = 1.58 MHz for the damp sensor and Δfres = 1.28 MHz for the dried sensor.
Discussion/Conclusion
This preliminary investigation showed promising results in terms of robustness of our system to artificial sweat, as there was a measurable response both in the damp and dried configurations. Further tests with different sweat amounts and rate are needed to determine the full functioning range, e.g., how much sweat is tolerated.
References
Galli, V., Sailapu, S. K., Cuthbert, T. J., Ahmadizadeh, C., Hannigan, B. C., & Menon, C. (2023). Passive and wireless all-textile wearable sensor system. Advanced Science 10(22), Article 2206665. https://doi.org/10.1002/advs.202206665
Lin, R., Kim, H.-J., Achavananthadith, S., Xiong, Z., Lee, J. K. W., Kong, Y. L., & Ho, J. S. (2022). Digitally-embroidered liquid metal electronic textiles for wearable wireless systems. Nature Communications, 13, Article 2190. https://doi.org/10.1038/s41467-022-29859-4
Xu, L., Liu, Z., Zhai, H., Chen, X., Sun, R., Lyu, S., Fan, Y., Yi, Y., Chen, Z., Jin, L., Zhang, J., Li, Y., & Ye, T. T. (2020). Moisture-resilient graphene-dyed wool fabric for strain sensing. ACS Applied Materials & Interfaces, 12(11), 13265–13274. https://doi.org/10.1021/acsami.9b2096
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