Adolescent Training Research Articles

At Home Progressive Resistance Training For Adolescents And Adults With Down Syndrome

At Home Progressive Resistance Training For Adolescents And Adults With Down Syndrome

Development and Effectiveness of Dialectical Behavioral Therapy-Based Emotion Regulation Skills Training for Adolescents

Development and Effectiveness of Dialectical Behavioral Therapy-Based Emotion Regulation Skills Training for Adolescents

Group-based progressive functional, high-intensity training in adolescents and young adults with unilateral cerebral palsy – a tool to improve gross motor function, endurance and gait? – a pilot study

ABSTRACT Purpose This pilot study assessed the safety and effects of progressive functional high-intensity training in a group setting for adolescents with unilateral cerebral palsy (CP) on daily function indicators. Methods Nine adolescents (mean age 16.9 years, GMFCS levels I–II) participated in 12 weeks of training (2x/week). Evaluations included 3D gait analysis, the 6-min walking test (6MWT), clinical exams, and the Gross Motor Function Measure-66 (GMFM-66). Results No adverse events occurred, and GMFM-66 scores significantly improved (p = .031, Δ = 2.19%). Although increases in 6MWT (p = .09, Δ = 29.8 m) performance and propulsion ratio (p = .067, Δ = 5.4%) for the affected leg were observed, they were not statistically significant. Discussion The study suggests that this training is safe and may enhance gross motor function, endurance, and gait asymmetry in unilateral CP. Future research should include upper limb evaluations and out-of-clinic motion analysis with wearable inertial measurement units (IMUs) to provide a more comprehensive assessment of functional movements.

Acceptance and commitment coaching for music performance anxiety in adolescent singers.

Most of the anxiety disorders, particularly social anxiety, seem to develop either during childhood or adolescence. Adolescent singers who experience physical, mental and emotional changes along with voice change are particularly prone to the development of MPA. However, adolescence also seems to be an opportune time to instil healthy behaviours in singing students as they are more likely to remember these coping strategies, owing to the release of dopamine and the 'reminiscence bump'. As this period of a singer's life is wrought with inevitable anxiety development, the additional aim of the study was to develop a coaching framework which can be used by singing teachers in their practice. Mindset training for adolescents seems crucial to help them continue singing through puberty so they do not drop out of singing lessons or choir during voice change and identity development. The study aimed to determine if Acceptance and Commitment coaching could be used with adolescent singers with MPA and to record and analyse rich qualitative data in the form of semi-structured participant interviews and questionnaires. When their perception of MPA symptoms and physiological and psychological arousal before a performance changed, their behaviour and reactions changed accordingly. The change took place over a period of time, which was characterised by discoveries about themselves, confusion in understanding new concepts and letting go of old habits. Interestingly, by the end of the coaching sessions, their preoccupation with pleasing the audience and appearing perfect on stage was replaced by a new-found delight in pursuing values and goals related to their singing. Along with this came the acceptance of themselves and others as individuals with the potential for growth and change and the capacity to learn from mistakes. This study marks the first investigation into the effectiveness of using of ACC as an intervention for MPA in adolescent singers undergoing puberty by a singing teacher. The results are promising and suggest that ACC is an effective MPA intervention for adolescent singers to cope with inevitable development-related anxieties and keep them engaged in the activity of singing during their pubertal years.

A randomized clinical trial to evaluate feasibility, tolerability, and preliminary target engagement for a novel executive working memory training in adolescents with ADHD

ObjectiveWorking memory training for Attention-Deficit/Hyperactivity Disorder (ADHD) has focused on increasing working memory capacity, with inconclusive evidence for its effectiveness. Alternative training targets are executive working memory (EWM) processes that promote flexibility or bolster stability of working memory contents to guide behavior via selective attention. This randomized, placebo-controlled study was designed to assess feasibility, tolerability, and behavioral target engagement of a novel EWM training for ADHD. Method62 ADHD-diagnosed adolescents (12–18 years) were randomized to EWM training or placebo arms for 20 remotely coached sessions conducted over 4–5 weeks. Primary outcome measures were behavioral changes on EWM tasks. Secondary outcomes were intervention tolerability, trial retention, and responsiveness to adaptive training difficulty manipulations. ResultsLinear regression analyses found intervention participants showed medium effect size improvements, many of which were statistically significant, on Shifting and Filtering EWM task accuracy and Shifting and Updating reaction time measures. Intervention participants maintained strong self-rated motivation, mood, and engagement and progressed through the adaptive difficulty measures, which was further reflected in high trial retention. ConclusionsThe results suggest that these EWM processes show promise as training targets for ADHD. The subsequent NIMH R33-funded extension clinical trial will seek to replicate and extend these findings.

Effects of virtual reality-based cognitive training for adolescents with depressive episodes: A pilot randomized controlled study

Cognitive impairment is a common symptom in depression, yet few intervention strategies target adolescents. This study investigated the effects of an attention and working memory cognitive training system based on virtual reality (VRCT) in adolescents with mild to moderate depressive episodes. Adolescents with depression were randomized into a VR training group (VRG, n = 47) or a waitlist control group (WT, n = 46). The VR training consisted of three 10-min tasks per session, conducted three sessions per week for 20 sessions over 7 weeks. Forty-four healthy adolescents participated as a comparison group for baseline cognitive assessment. Cognitive functions and depressive symptoms were assessed using the Das-Naglieri cognitive assessment system, driven by the Planning, Attention, Simultaneous, and Successive (PASS) processing theory, and the Hamilton Depression Rating Scale-24 at pre- and post-intervention. Baseline results indicated significantly lower cognitive scores in patients compared to healthy adolescents. Post-intervention, the VRG demonstrated significant improvements in all four cognitive scales (effect sizes 0.56 to 0.76) and a significant reduction in depressive symptoms compared to the WT. These findings suggest that VRCT holds potential for improving cognitive impairments and alleviating depressive symptoms in adolescents with depression. Further large-scale and follow-up studies are necessary to confirm long-term benefits.

Effects of 9 Weeks of High- or Moderate-Intensity Training on Cardiorespiratory Fitness, Inhibitory Control, and Plasma Brain-Derived Neurotrophic Factor in Danish Adolescents-A Randomized Controlled Trial.

The primary aims of this study were to examine the effects of 9 weeks of aerobic training, comprising three 30-min sessions per week, on V̇O2max, inhibitory control, and plasma brain-derived neurotrophic factor (BDNF) levels among adolescents aged 16-19 years. One hundred twenty-one untrained or recreationally active adolescents from a Danish high school were enrolled in the study, with 58 females (17.8 ± 0.8 years) and 27 males (18.0 ± 0.9 years) completing it. Participants were randomly divided into three groups performing aerobic training at either moderate-intensity (MIT: 60%-70% heart rate reserve [HRR]) or high-intensity (HIT: 80%-100% HRR) or a passive control group (CON) continuing their habitual lifestyle. Both the training groups exercised for 3×30 min per week for 9 weeks using a combination of cycling and running. Before and after the intervention period maximal oxygen uptake (V̇O2max) and the primary outcomes (inhibitory control measured by a modified flanker task, and resting plasma levels of BDNF) were evaluated. After the intervention period, the HIT group demonstrated a larger increase in V̇O2max compared to both the CON and MIT groups, while no significant effects were observed on inhibitory control or plasma BDNF levels in any training group. However, compared to the CON group, the HIT group exhibited a tendency for greater improvement in the flanker interference score (accuracy), attributable to enhanced accuracy on the incongruent stimuli from pre to post. Aerobic training in adolescents increased cardiorespiratory fitness in an intensity-dependent manner, but no clear effects were observed on neither inhibitory control nor resting plasma BDNF levels. ClinicalTrials.gov: NCT02075944.

Longitudinal changes in executive function in autism spectrum disorder: A systematic review and meta-analyses.

Individuals with an autism spectrum disorder (ASD) diagnosis show impairment in executive function (EF). However, findings are mixed regarding differences in the age effect on EF between autistic individuals and persons with typical development (TD). Questions remain regarding whether the age-related trajectories of EF in ASD are the same as or different from those in TD. To bridge this knowledge gap, we conducted a systematic review and meta-analyses of longitudinal studies that compared age-related changes in EF between ASD and TD groups (preregistration: osf.io/j5764). A literature search was conducted using PubMed, PsycINFO, and Web of Science on January 29, 2024. After screening by two independent reviewers, 14 longitudinal studies were included. Random-effects meta-analyses of studies involving a maximum total of 518 autistic and 3558 TD children and adolescents (mean baseline ages: 5.7-12.0 years) showed that ASD had significantly poorer EF than TD at both baseline and follow-up. However, there was no significant group difference in the age-related change in EF across domains, including working memory, inhibition, shifting, and planning. Robust Bayesian meta-analyses also provided substantial evidence in favor of the null hypothesis that ASD and TD groups showed similar changes over time for most EF processes. Limitations of the literature included the limited number of longitudinal studies and a narrow range of developmental stages and EF constructs analyzed across studies. Altogether, these findings suggest that autistic children and adolescents generally can improve in EF over time similarly to their neurotypical peers. This has important implications for parents and educators, encouraging appropriate EF training and intervention for autistic children and adolescents at an early stage.

Creating a digital approach for promoting physical activity in pediatric pulmonary hypertension: A framework for future interventions.

Children with pulmonary hypertension (PH) often demonstrate limited exercise capacity. Data support exercise as an effective nonpharmacologic intervention among adults with PH. However, data on exercise training in children and adolescents are limited, and characteristics of the optimal exercise program in pediatric PH have not been identified. Exercise programs may have multiple targets, including muscle deficits which are associated with exercise limitations in both adult and pediatric PH. Wearable accelerometer sensors measure physical activity volume and intensity in the naturalistic setting and can facilitate near continuous data transfer and bidirectional communication between patients and the study team when paired with informatics tools during exercise interventions. To address the knowledge gaps in exercise training in pediatric PH, we designed a prospective, single arm, nonrandomized pilot study to determine feasibility and preliminary estimates of efficacy of a 16-week home exercise intervention, targeting lower extremity muscle mass and enriched by wearable mobile health technology. The exercIse Training in pulmONary hypertEnsion (iTONE) trial includes (1) semistructured exercise prescriptions tailored to the participant's baseline level of activity and access to resources; (2) interval goal setting fostering self-efficacy; (3) real time monitoring of activity via wearable devices; (4) a digital platform enabling communication and feedback between participant and study team; (5) multiple avenues to assess participant safety. This pilot intervention will provide information on the digital infrastructure needed to conduct home-based exercise interventions in PH and will generate important preliminary data on the effect of exercise interventions in youth with chronic cardiorespiratory conditions to power larger studies in the future.

Exergames as an Effective Alternative to Real Environmental Tennis Training for Adolescents.

(1) Background: The popularity of motion-sensing computer-based games, like virtual reality (VR) exergames, is increasing among adolescents. However, their efficacy compared to conventional physical training methods remains unclear. This study investigated whether VR exergames produce effects on reaction time (RT) comparable to traditional tennis training in school-aged adolescents. (2) Methods: In total, 130 adolescents (mean age: 15.6 ± 2.0 years; 67 boys: 15.5 ± 2.2 years; 63 girls: 15.7 ± 1.8 years) were recruited in schools and assigned to one of three groups: VR exergame (G1, n = 39), tennis training (G2, n = 25), or control (G3, n = 66). Participants' RTs were evaluated before and after the interventions. G1 engaged in VR exergames for 8 min, G2 underwent traditional tennis training for 30 min, and G3 did not participate in any physical activity. (3) Results: Our results indicated that in G3, girls exhibited slower RTs compared to boys (p < 0.0). No differences were observed in RTs when comparing G1 and G2. (4) Conclusions: Sex appeared to influence RT, with girls showing slower RTs than boys in G3. The findings suggest that VR exergames and traditional tennis training have similar impacts on RT. This indicates the potential of VR exergames as an alternative to conventional physical training for improving RT in adolescents.

Assessing adherence and clinical utility of modified goal management training for adolescents with ADHD: A pilot study

Many adolescents with attention-deficit hyperactivity disorder (ADHD) have executive functioning (EF) difficulties that contribute to academic and social-emotional challenges. This pilot explored adherence to and effectiveness of modified Goal Management Training (GMT), an EF intervention, with ADHD youth. Six adolescents with ADHD (14–17 years, 2 female) participated in a 6-session online group. Adherence was tracked via attendance and homework. Reliable change scores gaged pre-post differences on measures before and after training (primary: everyday EF and goal attainment; secondary: EF task performance, functional impairment, emotional adjustment, and self-concept). All youth attended at least 4 sessions, though homework completion was mixed. Four youth achieved their goal, some demonstrated reliable change on outcome measures, and all evidenced a reduction in impairment. Results support the feasibility of modified GMT in adolescents with ADHD and suggest that youth may benefit from this more personalized and holistic approach to EF intervention.

Social Skills Interventions for Adolescents with Level 1 Autism Spectrum Disorder: A Systematic Review with Meta-Analysis of Randomized Controlled Trials.

Evidence on the efficacy of social skills training for adolescents with Level 1 Autism Spectrum Disorder (ASD) is unclear. We searched Pubmed, Scopus, and Web of Science until July 27th, 2023, for randomized controlled trials (RCTs) of social skills training for pre-adolescents and adolescents (aged 9-18) with Level 1 ASD. We then pooled data on efficacy from individual RCTs by conducting multivariate mixed-effects meta-analyses in R. We estimated possible bias in the retained RCTs using the RoB2 tool. We retained 36 RCTs (encompassing 2796 participants), including 18 RCTs comparing an experimental treatment to a waiting list, and 18 RCTs comparing it to standard care/control treatment. Meta-analyses showed that experimental treatments were significantly more efficacious than waiting list or standard care/ control treatments in improving social skills (SMD = 0.3745; 95%CI = [0.2396; 0.5093]), as well as reducing behavioral symptoms (0.3154;0.1783, 0.4525) and anxious/depressive symptoms (0.2780; 0.0432, 0.5128). However, for some outcomes there was significant heterogeneity across studies and evidence of publication bias. Subgroup analyses and meta-regressions did not identify any specific clinical or demographic factors as significant predictors of outcome. The most common risk of bias across studies was related to deviations from intended interventions and measurement of the outcomes. At the group level, social skills training for adolescents with Level 1 ASD is efficacious, with small-to-moderate effect size. Future research should focus on personalized medicine approaches, aimed at tailoring interventions to specific characteristics of adolescents with Level 1 ASD.

Emotion regulation training for adolescents with major depression: Results from a randomized controlled trial.

Difficulties in emotion regulation (ER) are thought to contribute to the development and maintenance of major depression (MD) in adolescents. In healthy adults, a task-based training of ER has previously proven effective to reduce stress, but no such studies are available for MD. It is also unclear whether findings can be generalized onto adolescent populations. The final sample consisted of n = 70 adolescents with MD, who were randomized to a task-based ER training (n = 36) or a control training (n = 34). Across four sessions, the ER group was trained to downregulate negative affect to negative images via reappraisal, while the control group was instructed to attend the images. Rumination, stress-, and affect-related measures were assessed as primary outcomes, behavioral and neurophysiological responses (late positive potential, LPP), as secondary outcomes. The trial was preregistered at clinicaltrials.gov (NCT03957850). While there was no significant differential effect of the ER training on primary outcomes, we found small to moderate effects on rumination in the ER group, but not the control group. During reappraisal (compared to attend), the ER group showed an unexpected increase of the LPP during the first, but not during later training sessions. Although replication in large, multicenter trials is needed, our findings on effect sizes suggest that ER training might be promising to decrease rumination in adolescent MD. The LPP increase at the first session may represent cognitive effort, which was successfully reduced over the sessions. Future studies should research whether training effects transfer to daily life and are durable over a longer time period. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Risk of not being in employment, education or training (NEET) in late adolescence is signalled by school readiness measures at 4-5 years.

Not being in employment, education, or training (NEET) is associated with poor health (physical and mental) and social exclusion. We investigated whether England's statutory school readiness measure conducted at 4-5 years provides a risk signal for NEET in late adolescence. We identified 8,118 individuals with school readiness measures at 4-5 years and NEET records at 16-17 years using Connected Bradford, a bank of linked routinely collected datasets. Children were categorised as 'school ready' if they reached a 'Good Level of Development' on the Early Years Foundation Stage Profile. We used probit regression and structural equation modelling to investigate the relationship between school readiness and NEET status and whether it primarily relates to academic attainment. School readiness was significantly associated with NEET status. A larger proportion of young people who were not school ready were later NEET (11%) compared to those who were school ready (4%). Most of this effect was attributable to shared relationships with academic attainment, but there was also a direct effect. Measures of deprivation and Special Educational Needs were also strong predictors of NEET status. NEET risk factors occur early in life. School readiness measures could be used as early indicators of risk, with interventions targeted to prevent the long-term physical and mental health problems associated with NEET, especially in disadvantaged areas. Primary schools are therefore well placed to be public health partners in early intervention strategies.

A Randomized Trial of Inspiratory Training in Children and Adolescents With Obesity.

Introduction: Children with obesity suffer excess dyspnea that contributes to sedentariness. Developing innovative strategies to increase exercise tolerance and participation in children with obesity is a high priority. Because inspiratory training (IT) has reduced dyspnea, we sought to assess IT in children with obesity. Methods: We conducted a 6-week randomized IT trial involving 8- to 17-year-olds with obesity. Participants were randomized 1:1 to either high [75% of maximal inspiratory pressure (MIP)] or low resistance control (15% of MIP) three times weekly. Assessments included adherence, patient satisfaction, and changes in inspiratory strength and endurance, dyspnea scores and total activity level. Results: Among 27 randomized, 24 (89%) completed the intervention. Total session adherence was 72% which did not differ between treatment groups. IT was safe, and more than 90% felt IT benefitted breathing and general health. IT led to a mean improvement (95% CI) in inspiratory strength measured by MIP of 10.0 cm H2O (-3.5, 23.6; paired t-test, p = 0.139) and inspiratory endurance of 8.9 (1.0, 16.8; paired t-test, p = 0.028); however, there was no significant difference between high- and low-treatment groups. IT led to significant reductions in dyspnea with daily activity (p < 0.001) and in prospectively reported dyspnea during exercise (p = 0.024). Among the high- versus low-treatment group, we noted a trend for reduced dyspnea with daily activity (p = 0.071) and increased daily steps (865 vs. -51, p = 0.079). Discussion: IT is safe and feasible for children with obesity and holds promise for reducing dyspnea and improving healthy activity in children with obesity. Breathe-Fit trial NCT05412134.

74. Functional Connectivity Changes as a Result of a Novel Executive Working Memory Training in Adolescents With ADHD

74. Functional Connectivity Changes as a Result of a Novel Executive Working Memory Training in Adolescents With ADHD

Smartphone App-Delivered Mindfulness-Based Intervention for Mild Traumatic Brain Injury in Adolescents: Protocol for a Feasibility Randomized Controlled Trial.

Concussion in children and adolescents is a significant public health concern, with 30% to 35% of patients at risk for prolonged emotional, cognitive, sleep, or physical symptoms. These symptoms negatively impact a child's quality of life while interfering with their participation in important neurodevelopmental activities such as schoolwork, socializing, and sports. Early psychological intervention following a concussion may improve the ability to regulate emotions and adapt to postinjury symptoms, resulting in the greater acceptance of change; reduced stress; and recovery of somatic, emotional, and cognitive symptoms. The primary objective of this study is to assess the feasibility of conducting a parallel-group (1:1) randomized controlled trial (RCT) to evaluate a digital therapeutics (DTx) mindfulness-based intervention (MBI) in adolescents aged 12 to <18 years. The attention-matched comparator intervention (a math game also used in previous RCTs) will be delivered on the same DTx platform. Both groups will be provided with the standard of care guidelines. The secondary objective is to examine intervention trends for quality of life; resilience; self-efficacy; cognition such as attention, working memory, and executive functioning; symptom burden; and anxiety and depression scores at 4 weeks after concussion, which will inform a more definitive RCT. A subsample will be used to examine whether those randomized to the experimental intervention group have different brain-based imaging patterns compared with those randomized to the control group. This study is a double-blind Health Canada-regulated trial. A total of 70 participants will be enrolled within 7 days of concussion and randomly assigned to receive the 4-week DTx MBI (experimental group) or comparator intervention. Feasibility will be assessed based on the recruitment rate, treatment adherence to both interventions, and retention. All outcome measures will be evaluated before the intervention (within 7 days after injury) and at 1, 2, and 4 weeks after the injury. A subset of 60 participants will undergo magnetic resonance imaging within 72 hours and at 4 weeks after recruitment to identify the neurophysiological mechanisms underlying the potential benefits from MBI training in adolescents following a concussion. The recruitment began in October 2022, and the data collection is expected to be completed by September 2024. Data collection and management is still in progress; therefore, data analysis is yet to be conducted. This trial will confirm the feasibility and resolve uncertainties to inform a future definitive multicenter efficacy RCT. If proven effective, a smartphone-based MBI has the potential to be an accessible and low-risk preventive treatment for youth at risk of experiencing prolonged postconcussion symptoms and complications. ClinicalTrials.gov NCT05105802; https://classic.clinicaltrials.gov/ct2/show/NCT05105802. DERR1-10.2196/57226.

Study on the Application of Functional Movement Screen in the Design of Individualized Physical Training Programs for Adolescents

This article aims to explore the application and effects of Functional Movement Screen (FMS) in the design of individualized physical training programs for adolescents. The introduction section introduces FMS as a tool to assess the quality of movement patterns, its current application status in various sports fields, and points out that its application in physical training for adolescents is still an under explored zone. The research method section adopts a quantitative research method to analyze the application of FMS in designing individualized physical training programs and its impact on physical training effects and sports injuries through FMS testing and physical training of 100 adolescent athletes aged between 12-16 years. The results show that the application of FMS testing can effectively improve the movement patterns of adolescent athletes, enhance their physical performance, and reduce the risk of sports injuries. However, there are also some limitations in the study, such as the relatively small sample size and short training duration, which may affect the stability and generalization of the results. The conclusion summarizes that the application of FMS testing in the design of individualized physical training programs for adolescents has positive effects, providing new theoretical and practical guidance for adolescent physical training. However, more research is still needed to further validate these results.

Implication of Social Rejection in Cognitive Bias Modification Interpretation Training in Adolescents With Eating Disorders.

Difficulties in interpersonal relationships intensify negative emotions and act as risk and maintenance factors for eating pathology in eating disorders. Rejection sensitivity refers to the tendency to react sensitively to a rejection. Patients with eating disorders experience difficulties in interpersonal relationships because of their high sensitivity to rejection. Cognitive bias modification interpretation (CBM-I) is a treatment developed to correct interpretation bias for social and emotional stimuli. In this review, we searched for research characteristics and trends through a systematic literature analysis of CBM-I for eating disorders. Five papers that met the selection and exclusion criteria were included in the final literature review and analyzed according to detailed topics (participant characteristics, design, and results). The literature supports the efficacy of the CBM-I in reducing negative interpretation bias and eating disorder psychopathology in patients with eating disorders. CBM-I targets emotional dysregulation in adolescent patients with eating disorders and serves as an additional strengthening psychotherapy to alleviate eating disorder symptoms. The current findings highlight the potential of CBM-I as an individualized adjunctive treatment for adolescents with eating disorders and social functioning problems.

Effect of Training of Adolescents on Household Environmental Safety from Childhood Injuries in a Rural Area of Delhi.

The environment poses an important risk in the causation of injuries in children. Simple measures in improving the safety of the domestic and peri-domestic environment can go a long way in preventing injuries. This study was conducted to assess the effect of training of the adolescents in the families, on the household environmental safety regarding childhood injuries. A pre- and post-intervention study was conducted over 16 months, on 116 families of two villages of Delhi. Data were collected regarding domestic and peri-domestic environments along with danger points with respect to injuries, of the enrolled houses, during the pre- and post-intervention phases of 4 months each. The intervention comprised training of the eldest adolescent of the family, on causes of common injuries and role of environment in injury causation. Scores were assigned to all relevant aspects, and the total environmental safety scores were calculated. The comparison was made between pre- and post-intervention scores of the two areas. Environmental safety scores were more than 70% in both areas at the baseline with no difference between the two areas. In the intervention area, there was statistically significant improvement of scores after the intervention, in the domestic environment and danger signs within the houses. Training adolescents about the prevention of injuries and motivating them to remain vigilant over domestic environment are effective in bringing about significant change in the household environment with regard to safety from injuries in children. Repeated visits by health workers also increase awareness and change the household environment making it safer for children.