Repeated Testing Sessions Research Articles

Reproducibility of Maximum Respiratory Pressure Assessment: A Systematic Review and Meta-analysis

Accurate assessment of maximum respiratory pressure is vital when tracking disease progression and devising treatment strategies. Previous studies indicate a learning effect when undertaking maximum respiratory pressure measurements. The extent of this learning effect and methodologies undertaken to mitigate this learning effect have not been investigated systematically. What is the magnitude of improvements in maximum respiratory pressure in response to respiratory muscle warm-up protocols and repeated measures of maximum respiratory pressure in healthy individuals and clinical populations? A comprehensive search of electronic databases was undertaken during August 2021 for studies examining the intrarater reliability of maximum inspiratory or expiratory pressure, or both, studies developing a protocol or an intervention to obtain maximum values, and studies analyzing the reliability of repeated maneuvers in a single testing session in healthy individuals and clinical populations. Included articles were analyzed critically using two appraisal tools. Standardized mean differences with 95%CIs were calculated and corrected for the sample size as a measure of the magnitude of change in maximum respiratory pressure outcomes. Of the 1,969 articles retrieved, 32 were included in the meta-analysis. Eighteen studies included healthy individuals and 14 studies included individuals with chronic medical conditions. The overall effect of inspiratory muscle warm-up protocols was higher (effects size [ES], 0.40; 95%CI, 0.17-0.63) in comparison with single testing session studies (ES, 0.20; 95%CI, 0.05-0.35) and studies performing repeated testing sessions of maximum respiratory pressure (ES, 0.14; 95%CI, 0.07-022). Inspiratory muscles warm-up procedures induce higher increases in maximum inspiratory pressure in comparison with single and repeated testing sessions of maximum respiratory pressure in healthy individuals. Warm-up protocols are more effective to obtain the maximum performance of inspiratory muscles in one testing session in comparison with other methods. PROSPERO; No.: CRD42022304591; URL: https://www.crd.york.ac.uk/prospero/.

Developing a feasible and sensitive judgement bias task in dairy cows

Judgement bias tasks (JBTs) are used to assess the influence of farm practices on livestock affective states. The tasks must be adjusted to the species and age group of focus. In cattle, most JBTs were designed for calves instead of adult cows. This study aimed to develop a JBT suitable for adult dairy cows, combining feasibility, validity, sensitivity and repeatability. Three JBTs were developed in which cows were trained to reach or avoid reaching a feeder, the location of which signalled a reward or punisher. The tasks differed in terms of punisher—cows being allocated either to “no-reward”, an air puff or an electric shock. Cows were then exposed twice to three ambiguous positions of the feeder, on two separate occasions. Speed of learning and proportions of correct responses to the conditioned locations were used to assess the feasibility of the task. Adjusted latencies to reach the ambiguous feeder positions were used to examine whether response patterns matched the linear and monotonic graded pattern expected in a valid and sensitive JBT at baseline. Latencies to reach the feeders in the two repeated testing sessions were compared to assess ambiguity loss over tasks’ repetitions. The validity of using spatial JBTs for dairy cows was demonstrated. While the effect on JBT feasibility was nuanced, the punisher did influence JBT sensitivity. None of the JBTs’ repeatability could be supported. We conclude that using an air puf as punisher led to the most sensitive, yet non-repeatable, JBT for dairy cows.

Characterization of Differences in the Time Course of Reflex and Voluntary Responses Following Botulinum Toxin Injections in Chronic Stroke Survivors.

Spasticity is a major impairment that can occur following a hemispheric stroke and is often treated with injections of botulinum toxin, a neurotoxin that impairs transmission at the neuromuscular junction. Hyperreflexia is a defining feature of spasticity. Our main objective here was to quantify the time course of changes in the deep tendon reflex (DTR) responses and voluntary activation capacity following BT injection as well as to track changes in a clinical assessment of spasticity. Four chronic stroke survivors, scheduled to receive BT in their Biceps Brachii(BB) as part of their clinical care plan, were recruited for repeated testing sessions over the course of 4 months post injection. Both surface BB EMG reflex response to bicipital tendon taps as well as signals of applied tendon tap forces were recorded before and up to 18 weeks post-BT. Voluntary force and biceps EMG signals were also recorded during maximum voluntary (isometric) contractions (MVC) at each testing session. Our results show major reductions (up to 75%) in voluntary sEMG and force arising between 11 to 35 days post-BT-injection. The stretch reflex gain declined two weeks after the maximal reductions in voluntary EMG and force. Paradoxically, there was a short-term increase in stretch reflex gain, in three out of four participants, approximately 11-35 days post BT. The time course of recovery of voluntary MVC and reflex responses varied considerably with a longer recovery time for the reflex responses.

Challenging the Myth of Non-Response to the Ergogenic Effects of Caffeine Ingestion on Exercise Performance.

The ergogenicity of caffeine on several exercise and sport situations is well-established. However, the extent of the ergogenic response to acute caffeine ingestion might greatly vary among individuals despite using the same dosage and timing. The existence of one or several individuals that obtained minimal ergogenic effects or even slightly ergolytic effects after caffeine intake (i.e., non-responders) has been reported in several previous investigations. Nevertheless, the concept non-responding to caffeine, in terms of physical performance, relies on investigations based on the measurement of one performance variable obtained once. Recently it has been suggested that correct identification of the individual ergogenic effect induced by caffeine intake requires the repeated measurement of physical performance in identical caffeine–placebo comparisons. In this communication, we present data from an investigation where the ergogenic effect of acute caffeine intake (3 mg/kg) was measured eight times over a placebo in the same individuals and under the same conditions by an incremental cycling test to volitional fatigue and an adapted version of the Wingate cycling test. The ergogenic response to caffeine varied from 9% to 1% among individuals, but all participants increased both cycling power in the incremental test and Wingate mean power at least three to eight times out of eight the caffeine–placebo comparisons. These data expand the suggestion of a minimal occurrence of caffeine non-responders because it shows that all individuals responded to caffeine when caffeine is compared to a placebo on multiple and repeated testing sessions.

The Reliability and Validity of the PowerTap P1 Power Pedals Before and After 100Hours of Use.

To (1)evaluate agreement between the PowerTap P1 (P1) pedals and the Lode Excalibur Sport cycle ergometer, (2)investigate the reliability of the P1 pedals between repeated testing sessions, and (3)compare the reliability and validity of the P1 pedals before (P10) and after (P1100) ∼100h of use. Ten participants completed four 5-min submaximal cycling bouts (100, 150, 200, and 250W), a 2-min time trial, and two 10-s all-out sprints on 2 occasions. This protocol was repeated after 15mo and ∼100h of use. Significant differences were seen between the P10 pedals and the Lode Excalibur Sport at 100W (P = .006), 150W (P = .006), 200W (P = .001), and 250W (P = .006) and during the all-out sprints (P = .020). After ∼100h of use, the P1100 pedals did not significantly differ from the Lode Excalibur Sport at 100W (P = .799), 150W (P = .183), 200W (P = .289), and 250W (P = .183), during the 2-min time trial (P = .583), or during the all-out sprints (P = .412). The coefficients of variation for the P10 and P1100 ranged from 0.6% to 1.3% and 0.5% to 2.0%, respectively, during the submaximal cycling bouts. The P1 pedals provide valid data after ∼100h of laboratory use. Furthermore, the pedals provide reliable data during submaximal cycling, even after prolonged use.

Improvements in Obstacle Clearance Parameters and Reaction Time Over a Series of Obstacles Revealed After Five Repeated Testing Sessions in Older Adults.

The purpose of this study was to investigate obstacle clearance and reaction time parameters when crossing a series of six obstacles in older adults. A second aim was to examine the repeated exposure of this testing protocol once per week for 5 weeks. In total, 10 older adults (five females; age: 67.0 ± 6.9years) walked onto and over six obstacles of varying heights (range: 100-200mm) while completing no reaction time, simple reaction time, and choice reaction time tasks once per week for 5 weeks. The highest obstacles elicited the lowest toe clearance, and the first three obstacles revealed smaller heel clearance compared with the last three obstacles. Dual tasking negatively impacted obstacle clearance parameters when information processing demands were high. Longer and less consistent time to completion was observed in Session 1 compared with Sessions 2-5. Finally, improvements in simple reaction time were displayed after Session 2, but choice reaction time gradually improved and did not reach a plateau after repeated testing.

Intra-Subject Consistency and Reliability of Response Following 2 mA Transcranial Direct Current Stimulation.

Transcranial direct current stimulation (tDCS) is a popular non-invasive brain stimulation technique that has been shown to influence cortical excitability. While polarity specific effects have often been reported, this is not always the case, and variability in both the magnitude and direction of the effects have been observed. We aimed to explore the consistency and reliability of the effects of tDCS by investigating changes in cortical excitability across multiple testing sessions in the same individuals. A within subjects design was used to investigate the effects of anodal and cathodal tDCS applied to the motor cortex. Four experimental sessions were tested for each polarity in addition to two sham sessions. Transcranial magnetic stimulation (TMS) was used to measure cortical excitability (TMS recruitment curves). Changes in excitability were measured by comparing baseline measures and those taken immediately following 20 minutes of 2 mA stimulation or sham stimulation. Anodal tDCS significantly increased cortical excitability at a group level, whereas cathodal tDCS failed to have any significant effects. The sham condition also failed to show any significant changes. Analysis of intra-subject responses to anodal stimulation across four sessions suggest that the amount of change in excitability across sessions was only weakly associated, and was found to have poor reliability across sessions (ICC = 0.276). The effects of cathodal stimulation show even poorer reliability across sessions (ICC = 0.137). In contrast ICC analysis for the two sessions of sham stimulation reflect a moderate level of reliability (ICC = .424). Our findings indicate that although 2 mA anodal tDCS is effective at increasing cortical excitability at group level, the effects are unreliable across repeated testing sessions within individual participants. Our results suggest that 2 mA cathodal tDCS does not significantly alter cortical excitability immediately following stimulation and that there is poor reliability of the effect within the same individual across different testing sessions.

How reproducible are psychoacoustic listening tests on spatial impression in auditoria?

In three psychoacoustic experiments, it was shown that changes in frequency (pitch) and level (loudness) of stimuli lead to significant differences in the perception of apparent source width (ASW). Due to partially identical test conditions in two of the experiments, it is possible to analyze the collected data in regard to stability of ASW perception over repeated testing sessions and to study inter-individual differences. This analysis shows that intra-individual effects of stimulus loudness and pitch are consistent across participants, whereas the absolute level of ASW perception varies between individuals and between experimental sessions. Using this data, possible influences such as listener training effect over repetition of test sessions are discussed. The presented results provide insights into possible improvements of investigating ASW in future studies.

Quantifying thigh muscle co-activation during isometric knee extension contractions: Within- and between-session reliability

Muscle co-activation around the knee is important during ambulation and balance. The wide range of methodological approaches for the quantification of co-activation index (CI) makes comparisons across studies and populations difficult. The present study determined within- and between-session reliability of different methodological approaches for the quantification of the CI of the knee extensor and flexor muscles during maximum voluntary isometric contractions (MVICs). Eight healthy volunteers participated in two repeated testing sessions. A series of knee extension MVICs of the dominant leg with concomitant torque and electromyographic (EMG) recordings were captured. CI was calculated utilizing different analytical approaches. Intraclass correlation coefficient (ICC) showed that within-session measures displayed higher reliability (ICC>0.861) and lower variability (Coefficient of variation; CV<21.8%) than between-session measures (ICC<0.645; CV>24.2%). A selection of a 500ms or larger window of RMS EMG activity around the PT delivered more reliable and less variable results than other approaches. Our findings suggest that the CI can provide a reliable measure for comparisons among conditions and is best utilized for within-session experimental designs.

Effect of Repeated Testing to the Development of Vocabulary, Nominal Structures and Verbal Morphology

The repeating testing has shown to increase the general proficiency level of the students. Metsamuuronen (2013) showed with an experimental study that the overall achievement level in a secondary language enhanced statistically significantly whit repeated testing design. Previously, Tuvling (1967) and Karpicke & Roediger (2008) showed with a laboratory experiment that remembering the material studied is the most efficient with repeated testing sessions rather than with repeated studying sessions. An explanation for this, given by Lasry, Levy and Tremblay (2008), is that the repeated testing leads to multiple traces to the memory, which optimizes recall. This study concentrates on the increase in the proficiency level in Vocabulary, Nominal structures and Verbal Morphology after the set of exhaustive testing sessions. It also reviles change in the proficiency levels of the students in these areas during the study process. The experimental group gained more than the control group in all areas though the difference is statistically significant only in the content of Vocabulary. The effect sizes are high (Cohen’s d > 1.0). In all areas of interest, the learning curve was of wide U-shape after the elementary period of studies.

Modified Taylor Complex Figure: Normative data from 290 adults

Data for copying and delayed recall (after a 15-min delay) of the Modified Taylor Complex Figure (MTCF), an alternative form of the Rey-Osterrieth Complex Figure (ROCF), were collected from 290 healthy participants. Normative data are provided. Age and education were significantly correlated with MTCF scores and must be corrected for to interpret results accurately. More specifically, increasing age adversely affected performance, whereas a higher education resulted in a better performance. Twenty-five participants were tested with both complex figures (MTCF and ROCF) in two separate sessions to assess correlation, which proved to be high. The collected data allow using the MTCF as a valid alternative material for testing visual long-term memory avoiding implicit learning that can occur when the same version of the ROCF is used for repeated testing sessions.

Effect of Repeated Testing on the Development of Secondary Language Proficiency

Karpicke & Roediger (2008) showed that delayed recall is optimized, not with repeated studying sessions, butwith repeated testing sessions. The result was very soon re-interpreted by Lasry, Levy and Tremblay (2008), whohypothesized that repeated testing may lead to multiple traces in one’s memory, which facilitates recall. The aimof the study was, first, to test whether the results of the Karpicke & Roediger study of repeating similar tests areapplicable in real life with dissimilar, though equated, tests of a gradually increasing level of difficulty inBiblical Hebrew language with no connection to the use of the spoken language in everyday life. Second, theaim was also to reveal the profiles of the students’ proficiency levels of during the study process. Randomized,matched-pairs (N = 7 + 7) of students with the same teacher, the same lessons and the same routines participatedin the experiment. The intervention for the experimental group consisted of a set of short, ten-minute tests duringeach three-hour study session held twice weekly. IRT modeling with linking items served to equate the testscores. ANOVA was used to analyze the gain score between the pre-test and post-test. The experimental groupimproved statistically significantly more than did the control group. The learning curve was a nonlinear, wide Uor J shape after the first elementary period of learning the letters and basic vocabulary. The repeated testingsessions helped the students raise their language proficiency level more than without the repeated testingsessions. Although the groups were small, the effect was high (Cohen’s d > 1.0 or d > 1.5 depending on theindicator). The result supports the idea that Karpicke & Roediker’s results may also be applicable when the testsmeasure different topics with the different in each test.

Cortisol Response to Repeated Psychosocial Stress

Psychosocial stress plays a major role in the etiology and the course of mental disorders that often show an altered activation of the hypothalamus-pituitary-adrenal (HPA) axis. The Trier Social Stress Test (TSST) reliably activates the HPA axis and reflects real life stress exposure. However, habituation may confound the results of clinical trials that apply TSST. The present study investigates the cortisol response after repeated psychosocial stress induction with short-term and long-term intervals between repeated testing sessions. Forty-one healthy subjects were exposed to the TSST four times with an interval of 24 h between the first and the second testing session (t1 and t2). The 3rd and the 4th testing session (t3 and t4) were also separated by a 24-hour interval whereas there were 10 weeks between t2 and t3. A significant decrease in the salivary cortisol responses was noticed from testing session t1 to t2 as well as from testing session t3 to t4. By contrast, there were no differences in the HPA axis reactivity between testing session t2 and t3. Our results demonstrated the habituation of the HPA axis to a standardized psychosocial stress test when testing was repeated after 24 h. By contrast, a renewed challenge with a ten-week-interval in-between activated the HPA axis in a similar manner as before. It is suggested that studies designed to investigate the HPA axis activity under repeated psychosocial stress conditions should apply the TSST three times in order to separate habituation from intervention effects.

A cable-driven locomotor training system for restoration of gait in human SCI

A novel cable-driven robotic locomotor training system was developed to provide compliant assistance/resistance forces to the legs during treadmill training in patients with incomplete spinal cord injury (SCI). Eleven subjects with incomplete SCI were recruited to participate in two experiments to test the feasibility of the robotic gait training system. Specifically, 10 subjects participated in one experimental session to test the characteristics of the robotic gait training system and one subject participated in repeated testing sessions over 8 weeks with the robotic device to test improvements in locomotor function. Limb kinematics were recorded in one experiment to evaluate the system characteristics of the cable-driven locomotor trainer and the overground gait speed and 6min walking distance were evaluated at pre, 4 and 8 weeks post treadmill training of a single subject as well. The results indicated that the cable driven robotic gait training system improved the kinematic performance of the leg during treadmill walking and had no significant impact on the variability of lower leg trajectory, suggesting a high backdrivability of the cable system. In addition, results from a patient with incomplete SCI indicated that prolonged robotic gait training using the cable robot improved overground gait speed. Results from this study suggested that a cable driven robotic gait training system is effective in improving leg kinematic performance, yet allows variability of gait kinematics. Thus, it seems feasible to improve the locomotor function in human SCI using this cable driven robotic system, warranting testing with a larger group of patients.

Reproducibility of a simplified Q-angle measurement technique

Background The Q-angle test is routinely used by clinicians specializing in orthopaedics to assess the line of pull of the quadriceps muscle at the patellofemoral joint. Research has found that this tests' reliability is influenced by a host of procedural and anthropometric variables. As a result, the diagnostic relevance of using the Q-angle measurement in the clinical assessment of patellofemoral joint alignment has been called into question. Our hypothesis was that a “simplified” Q angle (SQA) technique is clinically reliable. Methods Participants (n=54) were between the ages of 18 and 45 years, with no history of acute trauma. The SQA technique was adapted from the “traditional” Q angle (TQA) test protocol. It uses the same superior (ASIS) and inferior (TT) landmarks as the TQA protocol, but instead of using the mid-point of the patella as the location of intersection between the superior and inferior vectors, the SQA technique uses the mid-point of the quadriceps tendon, immediately superior to the base of the patella. Board certified therapists assessed SQA in supine participants. A re-test session was completed 7 to 10 days later. Results The intraclass correlation (ICC) values illustrated moderate to high levels of intra-rater (ICC: 0.69, 95%CI: 0.58-0.78) and inter-rater (ICC: 0.77, 95%CI: 0.71-0.82) reliability. Measurement error values illustrated the reliability limits (CV: 2°, ME: 2°, CV: 17%) of the technique, as well as the minimum difference (MD: 5°) required between repeated testing sessions to conclude that a “real” change has occurred in measurements. Conclusions Results demonstrated that the SQA technique had higher levels of reliability than have been reported in the literature for the TQA measurement. This knowledge has important implications for clinicians who routinely use Q angle measurements as part of their decision-making paradigm when dealing with patellofemoral joint-related pathologies.

Adaptive Allocation of Attentional Gain

Humans are adept at distinguishing between stimuli that are very similar, an ability that is particularly crucial when the outcome is of serious consequence (e.g., for a surgeon or air-traffic controller). Traditionally, selective attention was thought to facilitate perception by increasing the gain of sensory neurons tuned to the defining features of a behaviorally relevant object (e.g., color, orientation, etc.). In contrast, recent mathematical models counterintuitively suggest that, in many cases, attentional gain should be applied to neurons that are tuned away from relevant features, especially when discriminating highly similar stimuli. Here we used psychophysical methods to critically evaluate these "ideal observer" models. The data demonstrate that attention enhances the gain of the most informative sensory neurons, even when these neurons are tuned away from the behaviorally relevant target feature. Moreover, the degree to which an individual adopted optimal attentional gain settings by the end of testing predicted success rates on a difficult visual discrimination task, as well as the amount of task improvement that occurred across repeated testing sessions (learning). Contrary to most traditional accounts, these observations suggest that the primary function of attentional gain is not to enhance the representation of target features per se, but instead to optimize performance on the current perceptual task. Additionally, individual differences in gain suggest that the operating characteristics of low-level attentional phenomena are not stable trait-like attributes and that variability in how attention is deployed may play an important role in determining perceptual abilities.

Making Memories, Again

In their Report, “The critical importance of retrieval for learning” (15 February, p. [966][1]), J. D. Karpicke and H. L. Roediger III show that delayed recall is optimized, not with repeated studying sessions, but with repeated testing sessions. The authors conclude that “retrieval during

Repeated testing sessions and scholastic aptitude in college students’ metacognitive accuracy

We performed three experiments to examine the effects of repeated study–judgement–test sessions on metacognitive monitoring, and to see if better students (those with higher Scholastic Aptitude Test or SAT scores) outperform low SAT students. In all experiments, mean metacognitive accuracy (bias scores and Gamma correlations) did improve with practice. Most improvement involved students’ ability to predict which items would not be recalled later. In addition, students with high SAT scores recalled more items, were less overconfident, and adjusted their predictions more effectively. Thus, high SAT students may be able to adjust their metacognitive monitoring effectively without feedback, but low SAT students appear unlikely to do so. Educators may need to devise more explicit techniques to help low SAT students improve their metacognitive monitoring during the course of a semester.

Spatial learning and psychomotor performance of C57BL/6 mice: age sensitivity and reliability of individual differences

Two tests often used in aging research, the elevated path test and the Morris water maze test, were examined for their application to the study of brain aging in a large sample of C57BL/6JNia mice. Specifically, these studies assessed: (1) sensitivity to age and the degree of interrelatedness among different behavioral measures derived from these tests, (2) the effect of age on variation in the measurements, and (3) the reliability of individual differences in performance on the tests. Both tests detected age-related deficits in group performance that occurred independently of each other. However, analysis of data obtained on the Morris water maze test revealed three relatively independent components of cognitive performance. Performance in initial acquisition of spatial learning in the Morris maze was not highly correlated with performance during reversal learning (when mice were required to learn a new spatial location), whereas performance in both of those phases was independent of spatial performance assessed during a single probe trial administered at the end of acquisition training. Moreover, impaired performance during initial acquisition could be detected at an earlier age than impairments in reversal learning. There were modest but significant age-related increases in the variance of both elevated path test scores and in several measures of learning in the Morris maze test. Analysis of test scores of mice across repeated testing sessions confirmed reliability of the measurements obtained for cognitive and psychomotor function. Power calculations confirmed that there are sufficiently large age-related differences in elevated path test performance, relative to within age variability, to render this test useful for studies into the ability of an intervention to prevent or reverse age-related deficits in psychomotor performance. Power calculations indicated a need for larger sample sizes for detection of intervention effects on cognitive components of the Morris water maze test, at least when implemented at the ages tested in this study. Variability among old mice in both tests, including each of the various independent measures in the Morris maze, may be useful for elucidating the biological bases of different aspects of dysfunctional brain aging.

Modulation of Fear-Potentiated Startle and Vocalizations in Juvenile Rhesus Monkeys by Morphine, Diazepam, and Buspirone

Modulation of the acoustic startle response by aversive sensory stimulation is a simple and objective indicator of emotionality in rodents and human beings that has been extremely valuable for the analysis of neural systems associated with fear and anxiety. We have described a paradigm for measuring fear-potentiated, whole-body acoustic startle in nonhuman primates and have developed a protocol for maintaining fear-potentiated startle over repeated sessions with minimal extinction to allow measurement of pharmacological effects on fear-potentiated startle by using within-subjects designs in relatively small groups of monkeys. A novel, within-subjects testing protocol was used to examine the effects of three compounds in rhesus monkeys that have anxiolytic effects in rodents on fear-potentiated startle but that differ in their mechanism of action. Spontaneous vocalizations during testing also were recorded. Juvenile monkeys that were trained to associate a visual stimulus with a fear-inducing air blast to the face were tested after acute administration of different doses of buspirone diazepam, morphine, or vehicle. Monkeys rapidly developed a robust and persistent elevation of startle response in the presence of the CS during repeated testing sessions. Diazepam and morphine produced dose-related reductions of fear-potentiated startle. Buspirone did not significantly reduce fear-potentiated startle at the doses tested, although a trend was evident at the highest dose. All drugs reduced rates of coo vocalizations during startle testing. These fear-potentiated startle results suggest that rhesus monkeys have a pharmacological profile with respect to these compounds that is closer to humans than to rats. This demonstrates the value of examining the effects of drugs on fear-potentiated startle in nonhuman primates.