Ratings Of Fatigue Research Articles

Web-based Acceptance and Commitment Therapy (ACT) for adults living with cancer: A Single Case Experimental Design (SCED)

A randomised multiple-baseline design assessed the preliminary efficacy of a low-intensity, minimally-guided, online, self-help Acceptance and Commitment Therapy (ACT) intervention for people affected by cancer on quality of life (QoL), psychological symptoms, psychological flexibility, and level of interference from pain and fatigue. Acceptability and feasibility was also assessed. Adult participants (n = 7) had either completed cancer treatment within the last 18 months or were currently receiving treatment. Participants were randomly assigned to a baseline length of 1-3 weeks prior to completing the six-week ACT intervention, followed by a one-month follow-up. At pre- and post-intervention, and one-month follow-up, cancer-specific QoL, psychological symptoms (anxiety and depression), and psychological flexibility were assessed using standardised questionnaires. Single-item daily ratings of mood, anxiety, psychological flexibility, and bother ratings of pain and fatigue were also assessed. Questionnaire data were analysed using reliable and clinically significant change. Daily measures were analysed using visual and Tau-U analysis. Participants reported less negative impact of cancer on QoL (n = 3: CancerDQoL), fewer depressive symptoms (n=5: HADS depression) and greater psychological flexibility (n=3: MPFI) at follow-up. Daily measures showed improvements in self-reported mood (n=3), anxiety (n=3) and psychological flexibility (n=5) across different phase comparisons. Most participants (n=5) were significantly less bothered by fatigue at follow-up, and two were significantly less bothered by pain. Feedback from participants supported the acceptability of the intervention. The results provide preliminary support for the efficacy of the ACT intervention in reducing the negative impact of cancer on QoL, and improving self-reported psychological outcomes and psychological flexibility. Longitudinal studies utilising a larger sample are warranted.

Examining the Independent and Interactive Carryover Effects of Cognitive and Physical Exertions on Physical Performance.

This study compared the effects of prior cognitive, physical, and concurrent exertion on physical performance. Fatiguing cognitive and physical exertions have been shown to negatively affect subsequent task performance. However, it is not clearly understood if concurrent physical and cognitive effort may exaggerate the negative carryover effects on physical task performance when compared to cognitive or physical exertion alone. Twenty-five participants completed four isometric handgrip endurance trials on different days. The endurance trials were preceded by four, 15-minute experimental manipulations (cognitive, physical, concurrent, control). Electromyography (EMG) and force tracing performance were monitored, with handgrip strength measured pre and post. Subjective ratings of mental and physical fatigue, as well as affect, motivation, and task self-efficacy, were also assessed. Handgrip strength decreased following both physical (-14.4% MVC) and concurrent (-12.3% MVC) exertion manipulations, with no changes being observed for the cognitive and control conditions. No differences were observed across conditions for endurance time, EMG, nor tracing performance. When compared to the control conditions, perceptions of mental and physical fatigue were higher following the experimental manipulation. Endurance trial self-efficacy was lower for the mental, physical and concurrent conditions compared to control. The concurrent condition resulted in similar decreases in strength as the physical fatigue condition, but otherwise resulted in similar carryover effects on endurance performance across all conditions. Further study is required at higher exposure levels, or for longer exposure durations, to further probe the influence of concurrent physical and cognitive effort on task performance. Concurrent cognitive and physical effort resulted in similar physical performance decrements to physical effort alone.

The Impact of Physiological and Psychological Fatigue on Work Efficiency: A Case Study of Parcel Sorting Work.

The popularity of online shopping in China has increased significantly, creating new development opportunities for the express delivery industry. However, the rapid expansion of the express industry has also created challenges in the parcel sorting process. The demanding nature of parcel sorting work, which is characterized by intense and prolonged repetitive tasks, makes individuals particularly vulnerable to the effects of fatigue. Fatigue is a complex condition that encompasses both physiological and psychological exhaustion. It often results in reduced energy levels and diminished functionality, significantly impacting an individual's performance at work and their overall well-being. This study aimed to investigate how physiological and psychological fatigue affects sorting efficiency and to identify appropriate rest periods that will allow employees to maintain their performance levels. The research involved fifteen participants who took part in a 60 min continuous sorting experiment and a similar experiment with scheduled breaks. During both trials, we collected data on participants' electromyography (EMG) and electrodermal activity (EDA), as well as subjective fatigue ratings (RPE). Signal features such as the median frequency (MF) of EMG and the skin conductance level (SCL) were analyzed to assess physiological and psychological fatigue, respectively. The results show that physiological fatigue mainly affects sorting efficiency in the first 30 min, while psychological fatigue becomes more influential in the following half-hour period. In addition, subjective fatigue levels during the first 30 min are primarily determined by psychological factors, while beyond that point, both physiological and psychological fatigue contribute to subjective fatigue. Rest periods of 415-460 s, based on EDA recovery times, effectively support sorting efficiency and participants' recovery. This study highlights the complex ways in which fatigue affects parcel sorting performance and provides valuable theoretical and practical insights for establishing labor quotas and optimizing work schedules in the parcel sorting industry.

Muscle function, exercise capacity, physical activity level and cardiovascular disease risk factor knowledge in patients with prolactinoma.

Prolactinoma can increase the risk of cardiovascular diseases (CVDs), such as arterial stiffness, atherosclerosis, dysrhythmia and heart failure. This study aimed to evaluate and compare muscle function, exercise capacity, physical activity (PA) level, CVD risk factor knowledge level, sleep quality, fatigue and quality of life between prolactinoma patients and healthy controls. Nineteen female patients with prolactinomas and 19 healthy women were included in this study. Quadriceps muscle strength (QMS) was measured using a hand dynamometer, and muscular endurance was evaluated via the squat test. The 6-minute walking test (6MWT) distance was also measured. CVD risk factor knowledge levels were evaluated with the Cardiovascular Diseases Risk Factors Knowledge Level Scale (CARRF-KL), PA levels were assessed with the International Physical Activity Questionnaire-short form (IPAQ), sleep quality was assessed with the Pittsburgh Sleep Quality Index (PSQI), fatigue was assessed with the Multidimensional Fatigue Rating Scale (MAF), and quality of life was assessed with the Short Form-36 questionnaire (SF-36). Patients with prolactinomas had significantly lower 6MWT distances; CARRF-KL total scores; SF-36 general health and physical limitation scores; and higher IPAQ-sitting scores than did healthy controls (p < 0.05). Moreover, there were no significant differences between the groups in terms of QMS score; number of squats; severity of IPAQ score; severity, moderate, or total walking score; total PSQI score; or total MAF score (p > 0.05). Exercise capacity and quality of life are adversely affected, and sedentary behavior is observed in prolactinomas. Patients with prolactinomas have less knowledge about CVD risk factors than healthy individuals. CVD incidence and knowledge and functional capacity should be improved in patients with prolactinomas by the use of a multidisciplinary team for cardiac rehabilitation. This study is part of a larger clinical trial registered on ClinicalTrials.gov prior to participant enrollment (NCT05236829).

Subjective, but not objective, language functions predict fatigue in patients with lower-grade gliomas during longitudinal follow-up

Purpose To investigate the course of fatigue, subjective and objective language functions in patients with lower-grade gliomas during the first year of disease. Further, to examine if subjective and objective language variables predicted ratings of fatigue. Methods Fatigue was assessed with the Fatigue Severity Scale, subjective language with self-reported word-finding, expression of thoughts, reading and writing from the Functional Assessment of Cancer Therapy – Brain, and objective language with standardized tests. Mixed models were used to investigate changes in variables over time and predictors of fatigue. Results Twenty-three patients with gliomas (WHO 1–3) were included. Average ratings of fatigue did not change significantly, but altering patterns were observed. Subjective concerns about word-finding and expression of thoughts increased significantly during follow-up. The regression analyses showed that concerns about abilities to read and write significantly predicted fatigue. The results indicated that less concerns about reading and writing were associated with lower levels of fatigue. Conclusions Patients with lower-grade gliomas report fatigue and language concerns throughout the first year. Concerns about reading and writing call for careful consideration as they seem to provoke fatigue. The findings underline the importance of the patients’ perspective in treatment and follow-up.

Brain endurance training improves soccer-specific technical skills and cognitive performance in fatigued professional soccer players

ObjectivesBrain Endurance Training (BET) — the addition of mentally fatiguing cognitive tasks to standard physical training — could improve performance in soccer. We tested whether BET, with cognitive tasks intermixed with physical training activities, improved players' cognitive and soccer-specific technical performance compared to physical training alone when fresh and fatigued. DesignThe study employed a pre/training/midtest/training/posttest design. Methods31 professional male soccer players were randomly assigned to BET or control groups and completed 18 physical training sessions over 6 weeks. In between the physical training activities, the BET group completed demanding cognitive tasks, whereas the control group rested. Players completed the Loughborough soccer passing (LSPT) and shooting test (LSST) before and after completing a 30-min Stroop task. A brief psychomotor vigilance test (PVT-B), a visual analog rating of mental fatigue (MF-VAS), and rating of perceived exertion (RPE) were measured during testing and training. ResultsDuring testing, the 30-min Stroop task elicited a state of MF, confirmed by higher subjective ratings (P < .01). Compared to pre-testing, at mid- and post-testing, the BET group improved passing (all P < .01), shooting (all P < .01), and PVT-B performance (all P < .01) when tested after (fatigued) but not before (fresh) the Stroop task, whereas the control group did not change performance either way. During training the BET group reported higher MF (P < .01) and exhibited slower PVT-B responses (P < .01) compared to control. ConclusionsIntermixed BET was more effective than physical training alone at improving cognitive and soccer-specific technical performance of professional soccer players when fatigued.

The Autoregulation Rest-Redistribution Training Method Mitigates Sex Differences in Neuromuscular and Perceived Fatigue During Resistance Training.

To examine the sex differences in performance and perceived fatigue during resistance training prescribed using traditional (TRA) and autoregulation rest-redistribution training (ARRT) approaches. Twelve resistance-trained men and 12 women completed 2 sessions including the bench-press exercise matched for load (75% of 1-repetition maximum), volume (24 repetitions), and total rest (240s). Sessions were performed in a counterbalanced randomized design with TRA consisting of 3 sets of 8 repetitions with 120-second interset rest and ARRT employing a personalized combination of clusters, repetitions per cluster, and between-clusters rest regulated with a 20% velocity-loss threshold. The effects of TRA and ARRT on velocity loss, unilateral isometric peak force, and rating of fatigue (ROF) were compared between sexes. The velocity loss was generally lower during ARRT compared with TRA (-0.47% [0.11%]), with velocity loss being mitigated by ARRT to a greater extent among males compared with females (-0.37% [0.15%]). A smaller unilateral isometric peak force decline was observed after ARRT than TRA among males compared with females (-38.4 [8.4]N). Lower ROF after ARRT than TRA was found among males compared to females (-1.97 [0.55]AU). Additionally, males reported greater ROF than females across both conditions (1.92 [0.53]AU), and ARRT resulted in lower ROF than TRA overall (-0.83 [0.39]AU). The ARRT approach resulted in decreased velocity loss, peak force impairment, and ROF compared with TRA in both sexes. However, male subjects exhibited more pronounced acute within-session benefits from the ARRT method.

Towards a more individualised assessment of post-training fatigue in young footballers

Despite improvements in training load and fatigue monitoring, fatigue status may adversely affect intrinsic risk factors, particularly in young footballers. This study aimed to better individualise the fatigue effects of a 75-min football training session in young elite male players.Eighteen players (15.6 ± 1.7 years) completed a test battery before and after a football training session. Assessments included capillary blood samples (HCO3−, lactate, pH), subjective ratings of muscle soreness and fatigue. Functional tests included 30 m field sprint, laboratory drop jump (DJ) and horizontal force-velocity (H-FvP). The k-means method was applied to the first two dimensions of principal component analysis of changes in the H-FvP and DJ tests.Football training resulted in significant physiological changes and functional impairments, in particular an increase in interlimb asymmetry in the DJ test. No significant fatigue effect was found on the H-FvP test data. However, confirming the interest of combining the two tests, cluster analysis revealed two subgroups: In the H-FvP test, Cluster 1 decreased in V‾0 (p < 0.001) and P‾max (p < 0.01), while Cluster 2 decreased in F‾0 (p < 0.001). In the DJ test, Cluster 1 decreased in mean velocity (p < 0.01), relative mean and maximum power (p < 0.01) during push-off, while Cluster 2 decreased in relative mean push-off force (p < 0.01) and increased in interlimb asymmetry during braking (p < 0.01).This study highlights the contribution and complementarity of the H-FvP and DJ tests to improve individual screening for fatigue-related functional changes in footballers. Extrapolated values from the H-FvP test led to the identification of two subgroups with opposite fatigue profiles. One subgroup showed increased interlimb asymmetry in DJ, indicating an increased risk of injury with fatigue. These findings highlight the need for individualised fatigue assessment in young footballers.

The effect of lug parameters on titanium alloy lug’s detail fatigue rating

This article introduces a method to determine the Detail Fatigue Rating (DFR) of lugs through constant amplitude fatigue testing. Fatigue tests of titanium alloy lugs were designed, and the DFR of lugs was calculated based on the test results. A comparative analysis was conducted from two aspects: the relative width (d/b) and the loading direction (θ) of straight lugs, and the effect of lug parameters on the DFR was discussed. The results indicate that the DFR of lugs is positively correlated with the relative width (d/b) and negatively correlated with the loading direction (θ).

Reduced TMS-evoked EEG oscillatory activity in cortical motor regions in patients with post-COVID fatigue

ObjectivePersistent fatigue is a major symptom of the so-called ’long-COVID syndrome’, but the pathophysiological processes that cause it remain unclear.We hypothesized that fatigue after COVID-19 would be associated with altered cortical activity in premotor and motor regions. MethodsWe used transcranial magnetic stimulation combined with EEG (TMS-EEG) to explore the neural oscillatory activity of the left primary motor area (l-M1) and supplementary motor area (SMA) in a group of sixteen post-COVID patients complaining of lingering fatigue as compared to a sample of age-matched healthy controls. Perceived fatigue was assessed with the Fatigue Severity Scale (FSS) and Fatigue Rating Scale (FRS). ResultsPost-COVID patients showed a remarkable reduction of beta frequency in both areas. Correlation analysis exploring linear relation between neurophysiological and clinical measures revealed a significant inverse correlation between the individual level of beta oscillations evoked by TMS of SMA with the individual scores in the FRS (r(15) = -0.596; p = 0.012). ConclusionsPost-COVID fatigue is associated with a reduction of TMS-evoked beta oscillatory activity in SMA. SignificanceTMS-EEG could be used to identify early alterations of cortical oscillatory activity that could be related to the COVID impact in central fatigue.

Mood shapes the impact of reward on perceived fatigue from listening.

Knowledge of the underlying mechanisms of effortful listening could help to reduce cases of social withdrawal and mitigate fatigue, especially in older adults. However, the relationship between transient effort and longer term fatigue is likely to be more complex than originally thought. Here, we manipulated the presence/absence of monetary reward to examine the role of motivation and mood state in governing changes in perceived effort and fatigue from listening. In an online study, 185 participants were randomly assigned to either a "reward" (n = 91) or "no-reward" (n = 94) group and completed a dichotic listening task along with a series of questionnaires assessing changes over time in perceived effort, mood, and fatigue. Effort ratings were higher overall in the reward group, yet fatigue ratings in that group showed a shallower linear increase over time. Mediation analysis revealed an indirect effect of reward on fatigue ratings via perceived mood state; reward induced a more positive mood state which was associated with reduced fatigue. These results suggest that: (1) listening conditions rated as more "effortful" may be less fatiguing if the effort is deemed worthwhile, and (2) alterations to one's mood state represent a potential mechanism by which fatigue may be elicited during unrewarding listening situations.

Fatigue and Performance Rates as Decision-Making Criteria in Pacing Control During CrossFit®.

We investigated fatigue and performance rates as decision-making criteria in pacing control during CrossFit®. Thirteen male regional-level competitors completed conditions of all-out (maximum physical work from beginning to end) and controlled-split (controlled physical work in the first two rounds but maximum work in the third round) pacing throughout the Fight Gone Bad workout separated by one week. We assessed benchmarks, countermovement jumps and ratings of fatigue after each round. Benchmarks were lower in round 1 (99 vs. 114, p < .001) but higher in rounds 2 (98 vs. 80, p < .001) and 3 (97 vs. 80, p < .001) for controlled-split compared with all-out pacing. Reductions in countermovement jumps were higher after rounds 1 (-12.6% vs. 1.6%, p < .001) and 2 (-12.7% vs. -4.0%, p = .014) but similar after round 3 (-13.2% vs. -11.3%, p = .571) for all-out compared with controlled-split pacing. Ratings of fatigue were higher after rounds 1 (7 vs. 5 a.u., p < .001) and 2 (8 vs. 7 a.u, p = .023) but similar after round 3 (9 vs. 9 a.u., p = .737) for all-out compared with controlled-split pacing. During all-out pacing, countermovement jump reductions after round 2 correlated with benchmark drops across rounds 1 and 2 (r = .78, p = .002) and rounds 1 and 3 (r = -.77, p = .002) and with benchmark workout changes between pacing strategies (r = -.58, p = .036), suggesting that the larger the countermovement jump reductions the higher the benchmark drops across rounds and workouts. Therefore, benchmarks, countermovement jumps and ratings of fatigue may assess exercise-induced fatigue as decision-making criteria to improve pacing strategy during workouts performed for as many repetitions as possible.

Decoding visual fatigue in a visual search task selectively manipulated via myopia-correcting lenses.

Visual fatigue resulting from sustained, high-workload visual activities can significantly impact task performance and general wellbeing. So far, however, little is known about the underlying brain networks of visual fatigue. This study aimed to identify such potential networks using a unique paradigm involving myopia-correcting lenses known to directly modulate subjectively-perceived fatigue levels. A sample of N = 31 myopia participants [right eye-SE: -3.77D (SD: 2.46); left eye-SE: -3.75D (SD: 2.45)] performed a demanding visual search task with varying difficulty levels, both with and without the lenses, while undergoing fMRI scanning. There were a total of 20 trials, after each of which participants rated the perceived difficulty and their subjective visual fatigue level. We used representational similarity analysis to decode brain regions associated with fatigue and difficulty, analyzing their individual and joint decoding pattern. Behavioral results showed correlations between fatigue and difficulty ratings and above all a significant reduction in fatigue levels when wearing the lenses. Imaging results implicated the cuneus, lingual gyrus, middle occipital gyrus (MOG), and declive for joint fatigue and difficulty decoding. Parts of the lingual gyrus were able to selectively decode perceived difficulty. Importantly, a broader network of visual and higher-level association areas showed exclusive decodability of fatigue (culmen, middle temporal gyrus (MTG), parahippocampal gyrus, precentral gyrus, and precuneus). Our findings enhance our understanding of processing within the context of visual search, attention, and mental workload and for the first time demonstrate that it is possible to decode subjectively-perceived visual fatigue during a challenging task from imaging data. Furthermore, the study underscores the potential of myopia-correcting lenses in investigating and modulating fatigue.

Performance and perceived fatigability across the intensity spectrum: role of muscle mass during cycling.

The role of muscle mass in modulating performance and perceived fatigability across the entire intensity spectrum during cycling remains unexplored. We hypothesized that at task failure (Tlim), muscle contractile function would decline more following single- (SL) versus double-leg (DL) cycling within severe and extreme intensities, but not moderate and heavy intensities. After DL and SL ramp-incremental tests, on separate days, 11 recreationally active males (V̇o2max: 49.5 ± 7.7 mL·kg-1·min-1) completed SL and DL cycling until Tlim within each intensity domain. Power output for SL trials was set at 60% of the corresponding DL trial. Before and immediately after Tlim, participants performed an isometric maximal voluntary contraction (MVC) coupled with one superimposed and three resting femoral nerve stimulations [100 Hz; 10 Hz; single twitch (Qtw)] to measure performance fatigability. Perceived fatigue, leg pain, dyspnea, and effort were collected during trials. Tlim within each intensity domain was not different between SL and DL (all P > 0.05). MVC declined more for SL versus DL following heavy- (-42 ± 16% vs. -30 ± 18%; P = 0.011) and severe-intensity cycling (-41 ± 12% vs. -31 ± 15%; P = 0.036). Similarly, peak Qtw force declined more for SL following heavy- (-31 ± 12% vs. -22 ± 10%; P = 0.007) and severe-intensity cycling (-49 ± 13% vs. -40 ± 7%; P = 0.048). Except for heavy intensity, voluntary activation reductions were similar between modes. Similarly, except for dyspnea, which was lower for SL versus DL across all domains, ratings of fatigue, pain, and effort were similar at Tlim between exercise modes. Thus, the amount of muscle mass modulates the extent of contractile function impairment in an intensity-dependent manner.NEW & NOTEWORTHY We investigated the modulatory role of muscle mass on performance and perceived fatigability across the entire intensity spectrum. Despite similar time-to-task failure, single-leg cycling resulted in greater impairments in muscle contractile function within the heavy- and severe-intensity domains, but not the moderate- and extreme-intensity domains. Perceived fatigue, pain, and effort were similar between cycling modes. This indicates that the modulatory role of muscle mass on the extent of performance fatigability is intensity domain-dependent.

The Dose-Response in Elite Soccer: Preliminary Insights From Menstrual-Cycle Tracking During the FIFA Women's World Cup 2019.

This preliminary study examined the influence of estimated menstrual-cycle (MC)phase on responses to soccer matches and training sessions in preparation for and during the FIFA (Fédération internationale de football association) Women's World Cup 2019. Twenty outfield players representing a national team were tracked over a 45-day period. External (10-Hz global positioning system; total and distance covered at high-metabolic power [≥20W·kg-1]) and internal load measures (minutes ≥80% heart-rate maximum, sessional ratings of perceived exertion) were collected during all training and matches, with single-item wellness measures (fatigue, soreness, sleep quality, and sleep duration) collected each morning prior to activity. MC phase was estimated individually via an algorithm, informed from pretournament survey responses and ongoing symptom reporting (FitrWoman). Model comparison statistics were used to determine the impact of estimated MC phase in nonhormonal contraceptive users (n = 16). Sessional rating of perceived exertion responses to total distances ≥5km were higher during the luteal phase (+0.6-1.0au; P ≤ .0178) versus menstruation (phase 1), but no other observable dose-response trends were observed. Sleep, fatigue, and soreness ratings were not typically associated with MC phase, with the exception of exacerbated fatigue ratings in luteal versus follicular phase 48 hours postmatch (-0.73au, P = .0275). Preliminary findings suggest that estimated MC phase may contribute to the understanding of the dose-response to soccer training and matches.

Effects of a Physical Training Program on Cognitive and Physical Performance and Health-Related Variables in Professional esports Players: A Pilot Study

The present study focused on the effects of a physical training program on physical- and psychological-related variables in professional esports players. Five professional League of Legends (LOL) players belonging to the highest national category participated in this study. Data were obtained before and after a 5 h virtual training session (acute), as well as before and after an 8-week intervention period, focused on decreasing the impact of fatigue on players’ health and performance. The results showed that a complete virtual training session influences their performance, decreasing jump height and joint mobility (p &lt; 0.01), as well as increasing perceived physical and cognitive exertion by 76.9% (p &lt; 0.01) and 166.67% on the “Rating of Fatigue” scale (p = 0.002). Moreover, the intervention was able to reduce the impact of fatigue (30.8% and 43.3% reduction in cognitive and overall fatigue, respectively, p &lt; 0.05), improving, at the same time, the amount of muscle mass by 2%, jumping ability by 9.8% to 21%, and strength levels in various exercises by 63% to 173% (p &lt; 0.01). The implementation of a physical training program is capable of reducing the players’ fatigue perception, improving their physical conditioning and health status, and decreasing the injury risk.

Effect of computer workstation set-ups on muscle oxygen saturation and perceived fatigue

Multiple literatures show evidences of how office workstation set-ups can influence muscle activities. However, the relationship between the postural adoption due to workstation setup and its effect to muscle oxygen saturation among office workers is unclear. The aim of this study was to investigate trends of muscle oxygen saturation and perceived fatigue ratings between different upper limbs posture variations among representative computer users. A repeated measure experiment was conducted on 15 participants to compare the muscle oxygen saturation and perceived fatigue ratings between four different office work posture variations. Parametric and non-parametric statistical analyses were conducted to analyze significant differences on the dependent parameters. Data analysis showed statistically significant trends (p≤0.050) of lower muscle oxygen saturation in workstation set-ups in which participants were adopting raised shoulder and extended arm positions. In addition, the findings revealed that the perceived fatigue ratings on the shoulder, upper arm and lower arm are the lowest (p≤0.050) in workstation condition where subject can adopt neutral postures. The results highlight the effect of good office workstation setup and work postures to individual muscle oxygen saturation and fatigue levels.

The effect of age of acquisition on listening effort: Pupillometry and subjective measures

Bilinguals typically perform worse on speech-perception-in-noise relative to monolinguals, and bilinguals who learned the language later typically perform worse than those who learned it earlier. This decrement in performance has largely been attributed to the fact that both bilingualism and later acquisition result in comparatively less exposure to a language than monolingualism and earlier acquisition do. Though this effect of age of acquisition has been well-documented for speech recognition accuracy, less is known about how it affects listening effort. This study quantifies listening effort using three measures (pupil dilation, subjective effort ratings, and subjective fatigue ratings) for four listening conditions (quiet, easy, moderate, and hard). We collect these measures from four groups of participants: monolinguals, simultaneous bilinguals, early sequential bilinguals, and late bilinguals. Data collection is ongoing for a target sample size of 128 (32 per group). Based on related work, we expect greater listening effort for listeners with later ages of acquisition (e.g., late bilinguals relative to simultaneous bilinguals), and for that effect to increase with worsening acoustic quality (i.e., the hard relative to the easy condition). Preliminary results (N = 56) support these hypotheses. These data provide foundational insights into the relationship between bilingualism and listening effort.

Listening-Related Fatigue in New and Experienced Adult Cochlear Implant Users.

Active listening in everyday settings is challenging and requires substantial mental effort, particularly in noisy settings. In some cases, effortful listening can lead to significant listening-related fatigue and negatively affect quality of life. However, our understanding of factors that affect the severity of fatigue is limited. Hearing aids and cochlear implants (CIs) can improve speech understanding and thus, potentially, reduce listening effort and fatigue. Some research supports this idea for adult hearing aid users with mild-to-moderate hearing loss, but similar work in CI users is very limited. This study examined (1) longitudinal changes in listening-related fatigue in new and established CI users, and (2) relationships between demographic and audiologic factors and preimplantation and postimplantation listening-related fatigue. Participants included an experimental group of 48 adult CI candidates receiving either a unilateral implant (n = 46) or simultaneous, bilateral implants (n = 2) and a control group of 96 experienced (>12 months experience) adult CI users (50 unilateral, 46 bilateral). Listening-related fatigue was evaluated using the 40-item version of the Vanderbilt Fatigue Scale for Adults. Experimental group ratings were obtained before implantation and again at 0.5-, 1-, 2-, 3-, 6-, and 12-month(s) postactivation. Control group participants completed the scale twice-upon study entry and approximately 3 months later. Additional measures, including a social isolation and disconnectedness questionnaire, hearing handicap inventory, and the Effort Assessment Scale, were also administered at multiple time points. The role of these measures and select demographic and audiologic factors on preimplant and postimplant fatigue ratings were examined. Adult CI candidates reported significantly more fatigue, greater self-perceived hearing handicap, greater listening effort, and more social isolation than experienced adult CI users. However, significant reductions in fatigue and effort were observed within 2 weeks postimplantation. By 3 months, there were no significant differences in fatigue, effort, hearing handicap, or social isolation between new CI recipients and experienced CI users. Secondary analyses revealed that age at onset of hearing loss (before or after 2 years of age) and subjective hearing handicap contributed significantly to the variance of preimplantation fatigue ratings (those with higher handicap reported higher fatigue). In contrast, variance in postimplantation fatigue ratings was not affected by age of hearing loss onset but was affected by gender (females reported more fatigue than males) and subjective ratings of effort, handicap, and isolation (those reporting more effort, handicap, and isolation reported more fatigue). Listening-related fatigue is a significant problem for many CI candidates, as well as for many experienced unilateral and bilateral CI users. Receipt of a CI significantly reduced listening-related fatigue (as well as listening effort, hearing handicap, and social isolation) as soon as 2 weeks post-CI activation. However, the magnitude of fatigue-related issues for both CI candidates and experienced CI users varies widely. Audiologic factors, such as hearing loss severity and aided speech recognition, were not predictive of individual differences in listening-related fatigue. In contrast, strong associations were observed between perceived hearing handicap and listening-related fatigue in all groups suggesting fatigue-related issues may be a component of perceived hearing handicap.

Изменения качества жизни у пациентов с хронической иммунной тромбоцитопенией в процессе терапии ромиплостимом, его эффективность и безопасность в условиях реальной клинической практики: результаты многоцентрового наблюдательного исследования

Aim. To study the quality of life in patients with chronic immune thrombocytopenia (ITP) in the process of romiplostim therapy and to assess the efficacy and safety of this drug in real-world setting.&#x0D; Materials &amp; Methods. The study enrolled adult patients with the confirmed chronic ITP diagnosis and indications for romiplostim therapy. Clinical parameters, RAND SF-36 and FACT-Th6 quality of life as well as FACIT-Fatigue scores were evaluated prior to romiplostim administration vs. 3, 6, and 12 months after the treatment onset. Patient satisfaction checklist was also administered at all study points after the start of therapy. The clinical efficacy of romiplostim was analyzed along with assessing response and time to response. To study the quality of life and fatigue changes, the Generalized Estimating Equation (GEE) method was used during the observation period. Significant fatigue changes were determined and compared in terms of the perception differences from patient’s and physician’s perspective.&#x0D; Results. The study enrolled 60 chronic ITP patients treated with romiplostim in the real-world setting (mean age 51.9 years, 70 % women). The median thrombocyte count prior to romiplostim therapy was 18.5 × 109/L (interquartile range 10.8–22.3 × 109/л). On the enrollment date, 90 % of patients showed hemorrhagic syndrome. Overall response to romiplostim therapy was 98.3 % (complete response was achieved in 93.3 % of patients). After 6 months of therapy, 89.5 % of patients preserved response. After 3 months of therapy, hemorrhagic syndrome was eliminated in 81 % of patients, after 6 months the same was achieved in 93 % of patients. The median time to response was 4.4 weeks (95% confidence interval 3.6–5.3 weeks). Adverse events of grades 1/2 associated with romiplostim were reported in 6.7 % of patients. On romiplostim therapy, pronounced positive changes in quality of life were shown by all scales of the general questionnaire SF-36 and the targeted questionnaire FACT-Th6 (p &lt; 0.001). The clearest improvements were observed in role-physical and role-emotional functioning. Already after 3 months of therapy, a considerable fatigue reduction was observed and sustained for the next 6 and 12 months of romiplostim administration (p &lt; 0.001). During the therapy, the proportion of patients with fatigue impacting various aspects of functioning became considerably smaller. The vast majority of patients (85 %) were satisfied with the treatment. Discrepancies between patients’ and physicians’ evaluations of fatigue were also identified during the treatment.&#x0D; Conclusion. The results of the present multi-center observational study demonstrate high efficacy and safety of romiplostim for chronic ITP patients in the real-world setting. Romiplostim therapy yields considerable quality of life improvement and fatigue reduction. To optimize the patient monitoring system and patient-centered ITP treatment in the real-world setting, it is advisable to use the standardized questionnaires assessing quality of life and fatigue.