Test Sessions Research Articles

β-Alanine supplementation improves fractional anisotropy scores in the hippocampus and amygdala in 60–80-year-old men and women

Recently, β-alanine (BA) supplementation was shown to improve cognitive function in older adults with decreased cognitive function. Mechanisms supporting these improvements have not been well defined. This study examined the effects of 10-weeks of BA supplementation on changes in circulating brain inflammatory markers, brain derived neurotrophic factor (BDNF), and brain morphology. Twenty participants were initially randomized into BA (2.4 g·d−1) or placebo (PL) groups. At each testing session, participants provided a resting blood sample and completed the Montreal cognitive assessment (MoCA) test and magnetic resonance imaging, which included diffusion tensor imaging to assess brain tissue integrity. Only participants that scored at or below normal for the MoCA assessment were analyzed (6 BA and 4 PL). The Mann-Whitney U test was used to examine Δ (POST–PRE) differences between the groups. No differences in Δ scores were noted in any blood marker (BDNF, CRP, TNF-α and GFAP). Changes in fractional anisotropy scores were significantly greater for BA than PL in the right hippocampus (p = 0.033) and the left amygdala (p = 0.05). No other differences were noted. The results provide a potential mechanism of how BA supplementation may improve cognitive function as reflected by improved tissue integrity within the hippocampus and amygdala.

The effect of post-match fatigue on physical performance in adolescent soccer players.

Soccer involves many physically challenging actions and engaging in such activities can induce a decline in performance due to physical fatigue which predisposes players to develop injuries. The present study aimed to examine the impact of post-match fatigue on functional performance and Inter-Limb Asymmetry Index (LSI) in adolescent soccer players. Thirty-eight adolescent male soccer players (15-18 years) completed a battery of functional performance measures (Rate of Perceived Exertion (RPE) scale, 10 m sprint, agility T-test, and Single leg hop for distance (SLHD) test). The data collection started prior to a soccer match and consisted of two testing sessions; two hours before the match, while the subsequent testing session was performed within two hours immediately following the match. The study results revealed a significant effect of post-match fatigue on change of direction abilities and SLHD (moderate effect size). However, no significant differences were observed in the 10 m sprint test and LSI (P>0.05). Functional performance measures such as agility test and SLHD test can detect physical ability changes due to post-match fatigue in adolescent soccer players. The study findings offer insightful and practical information on the importance of employing field-based functional performance measures in monitoring players' recovery following a game.

Pool-Based Surfboard Elicits Activation of Posterior Shoulder Muscles During a Surfing Stroke.

Pexa, BS, Johnston, CD, Elder, EE, Ford, KR, Patterson, MQ, and Myers, JB. Pool-based surfboard elicits activation of posterior shoulder muscles during a surfing stroke. J Strength Cond Res 38(7): 1300-1304, 2024-Surfboard paddling may activate posterior shoulder muscles, which are critical to baseball pitchers' injury risk and performance. The purpose of this study was to measure posterior shoulder muscle activation during different phases of the surf stroke (propulsion vs. recovery) on a pool-based surfboard. Twenty healthy active adult subjects completed a familiarization and testing session with the pool-based surfboard. During the testing session, electromyography (EMG) sensors were placed on 6 posterior shoulder muscles: latissimus dorsi, infraspinatus, posterior deltoid, upper trapezius, middle trapezius, and lower trapezius. Subjects completed 4 laps in a pool at 3 separate resistances (low, moderate, and heavy) in a randomized order. The peak EMG signal during each phase (propulsion and recovery) was recorded. A 2-way within subject ANOVA (resistance-by-phase) with post hoc Bonferroni's corrections was used to identify differences in EMG activation. There was a significant main effect of phase for the latissimus dorsi (F = 91.3, p < 0.001), upper trapezius (F = 36.5, p < 0.001), middle trapezius (F = 33.8, p < 0.001), and lower trapezius (F = 21.6, p < 0.001). The latissimus dorsi demonstrated higher activation during the propulsion phase (p < 0.001), and all trapezius muscles demonstrated higher activation during the recovery phase (p < 0.001). There was a significant main effect of resistance for the posterior deltoid (F = 3.4, p = 0.043), with higher muscle activation in the low resistance trials compared with the heavy resistance trials (p = 0.036). Recreationally active individuals demonstrate activation of the posterior shoulder when using a pool-based surfboard. This pool-based surfboard may be beneficial to activate the posterior musculature and may be more accessible than standard surfing to baseball athletes.

Can the Velocity of a 1RM Hang Power Clean Be Used to Estimate a 1RM Hang High Pull?

Suchomel, TJ, Techmanski, BS, Kissick, CR, and Comfort, P. Can the velocity of a 1RM hang power clean be used to estimate a 1RM hang high pull? J Strength Cond Res 38(7): 1321-1325, 2024-The purpose of this study was to estimate the 1-repetition maximum hang high pull (1RM HHP) using the peak barbell velocity of a 1RM hang power clean (HPC). Fifteen resistance-trained men (age = 25.5 ± 4.5 years, body mass = 88.3 ± 15.4 kg, height = 176.1 ± 8.5 cm, relative 1RM HPC = 1.3 ± 0.2 kg·kg-1) with previous HPC experience participated in 2 testing sessions that included performing a 1RM HPC and HHP repetitions with 20, 40, 60, and 80% of their 1RM HPC. Peak barbell velocity was measured using a linear position transducer during the 1RM HPC and HHP repetitions performed at each load. The peak barbell velocity achieved during the 1RM HPC was determined as the criterion value for a 1RM performance. Subject-specific linear regression analyses were completed using slope-intercept equations created from the peak velocity of the 1RM HPC and the peak barbell velocities produced at each load during the HHP repetitions. The peak barbell velocity during the 1RM HPC was 1.74 ± 0.30 m·s-1. The average load-velocity profile showed that the estimated 1RM HHP of the subjects was 98.0 ± 19.3% of the 1RM HPC. Although a 1RM HHP value may be estimated using the peak barbell velocity during the HPC, strength and conditioning practitioners should avoid this method because of the considerable variation within the measurement. Additional research examining different methods of load prescription for weightlifting pulling derivatives is needed.

Reliability of lower limb strength assessment in female team sport athletes

BackgroundLower limb injury rates have increased dramatically in line with increased female sport participation levels. Muscle strength is a modifiable lower limb injury risk factor, guiding performance monitoring and rehabilitation. ObjectivesThe aim of this study was to investigate the test-retest reliability of isokinetic and isometric lower limb peak torque to body mass of muscles acting on the hip, knee, and ankle in female team sport athletes. It was hypothesised the test-retest reliability would be good (intraclass correlation coefficients (ICC) ≥ 0.75). MethodsThirty-eight female athletes (Australian Rules Football = 18, netball = 12, soccer = 8) aged 16–35 years participated in this study. Participants performed isokinetic (60°/s and 120°/s) and isometric testing on a Biodex Isokinetic Dynamometer on three separate days. ResultsPoor to good reliability was demonstrated for all joint movements (ICC = 0.38–0.88) with small to moderate effect sizes (0.00–0.43) and typical errors (5.65–24.49). ConclusionDifferences in peak torque to body mass were observed between sessions one and two and/or one and three, demonstrating a learning effect. Therefore, three testing sessions, and/or the inclusion of a familiarisation session, is recommended for future assessments in populations unfamiliar with dynamometry.

Acute and Acclimated Effects of Wearing Compression Garments on Balance Control in Community-Dwelling Older Adults.

Falls are very serious health concerns among older adults. Providing additional cutaneous and proprioceptive feedback to older adults may enhance their balance control and therefore reduce the incidents of falls. This study aimed to investigate the acute and acclimated effect of wearing waist-to-above-ankle compression garments (CGs) on balance control in community-dwelling older adults. Thirty-one older adults participated in the study. The Timed Up and Go, Berg Balance Scale, and the Fall Risk Test of the Biodex Balance System were used in a random order to examine balance control in three testing sessions 1week apart. Results indicated wearing CGs had a significant impact on the Timed Up and Go test (p < .001), Berg Balance Scale (p = .001), and the Fall Risk Test (p = .001). For the Timed Up and Go test, participants exhibited significant improvement in both the acute (8.68 vs. 7.91s) and acclimated effect (7.91 vs. 7.41s) of wearing CGs. For the Berg Balance Scale, participants showed significant improvement after wearing CGs for 1week in comparison to the no CGs condition (55.77 vs. 55.39 points). For the Fall Risk Test, participants showed a significant improvement in the acute effect of wearing CGs in comparison to the no CGs condition (1.55° vs. 1.31°). This exploratory study showed that wearing waist-to-above-ankle CGs provided a positive impact on balance control in healthy community-dwelling older adults. It lays the foundation for future studies with a larger sample size to investigate the potential benefits of wearing CGs in individuals with balance control deficits and/or other comorbidities.

The change in Baroreflex Regulation of Heart Rhythm after “Dry” Immersion Appears during Orthostasis, but not Lower Body Negative Pressure Test

The ratio of low-frequency (LF, ~0.1 Hz) waves of RR interval duration (RRI) and systolic blood pressure (SAP) reflects the cardiac baroreflex sensitivity (BRS). Gravitational unloading (GU) may alter BRS during the passive orthostatic test (HUT) and lower body negative pressure (LBNP) test. Both effects cause blood redistribution to the lower body, but HUT is accompanied by greater unloading of sinocarotid baroreceptors than LBNP and activation of the vestibulosympathetic reflex but GU effects on BRS in these tests have not been directly compared previously. In this study we tested the hypothesis that the effect of “dry” immersion (DI, on-ground model of GU) on BRS in the same subjects will be more pronounced during HUT than during LBNP, which causes a comparable decrease in stroke volume. Nine healthy men participated in two test sessions (before and after 7-day DI) consisting of five 3-min HUT (65°) and five 3-min LBNP (–35 mmHg) with averaging the parameters in each test. Wavelet analysis was used to determine the amplitude of the RRI and SAP waves in the range of 0.05–0.13 Hz. The amplitude of LF waves of SAP increased in both tests, after DI - more significantly in HUT. The amplitude of LF RRI waves decreased in the two tests; the degree of decrease did not differ between tests and did not change under the influence of DI. The α-coefficient (the ratio of the amplitudes of RRI and SAP LF waves) decreased equally in the two tests before DI, but after DI, the degree of α-coefficient reduction increased in HUT test but did not change in LBNP test. Thus, the effect of DI on BRS is evident in HUT, but not in LBNP, which may be explained by the more pronounced influence of HUT on the mechanisms of neural control of heart rhythm.

The dynamic strength index is a reliable and feasible tool to assess neuromuscular performance in male and female handball players

ABSTRACT The aim of this study was to explore the reliability and feasibility of the isometric mid-thigh pull (IMTP) and dynamic strength index (DSI) in semi-professional handball players (seventeen male and eighteen female). A cross-sectional design was used to determine the test-retest reliability of several kinetic metrics registered with a force plates. The peak force, peak relative force, rate of force development (RFD 0–250 ms), and impulse 0–250 ms were selected from the IMTP test, whereas the peak propulsive force was chosen from the countermovement jump test to obtain the DSI. The intraclass correlation coefficient (ICC), coefficient of variation (CV), standard error of the measurement (SEM) and smallest detectable difference (SDD) were calculated. A paired sample t-test was also performed. No significant differences were found between the testing sessions for all variables, except for peak propulsive force for all players (p = 0.036) and DSI for female players (p = 0.037). Reliability for all kinetic metrics was good to excellent (ICC = 0.78–0.97), with low variability (CV ≤ 8.64%), being the SEM scores lower than SDD. In conclusion, the IMTP test and DSI are highly reliable and feasible tools for assessing neuromuscular performance in semi-professional handball players.

Social participation is associated with a habituated blood pressure response to recurrent stress

Lower cardiovascular reactivity is a proposed marker of motivational dysregulation and is related to a range of adverse behavioural and health outcomes. Social participation is a form of motivated behaviour and represents the frequency in which an individual engages in social activities. Low social participation has recently been linked to lower cardiovascular responses to acute psychological stress. With recent work emphasizing the importance of assessing adaptation of the cardiovascular response to recurrent stress, the aim of the current study is to build on previous work by examining the relationship between social participation and cardiovascular stress response adaptation. This study utilised data from the Pittsburgh Cold Study 3 (PCS 3). Two hundred and thirteen participants (M = 30.13; SD = 10.85) completed a social participation measure and had their systolic blood pressure (SBP), diastolic blood pressure (DBP) and heart rate (HR) monitored across two separate standardized stress testing sessions. The testing sessions consisted of a 20-minute baseline and a 15-minute stress task. Results indicated that higher levels of social participation were associated with greater blood pressure habituation to recurrent stress, extending previous work identifying that social participation was associated with higher cardiovascular responses to stress. The present study identifies that those reporting greater levels of social participation may show enhanced stress tolerance when exposed to recurrent stress.

Protocol for the development of a tool to map systemic sclerosis pain sources, patterns, and management experiences: a Scleroderma Patient-centered Intervention Network patient-researcher partnership

IntroductionSystemic sclerosis (SSc) is a rare, complex autoimmune rheumatic disease with multiple factors that contribute to pain. People with SSc emphasize the effect pain has on their quality of life, but no studies have systematically examined the frequency and relative importance of different SSc pain sources, patterns of pain from different sources, and pain management experiences. Our objectives are to (1) develop a tool, jointly with researchers, health care providers, and patients, to map sources of pain in SSc, determine patterns of pain from different sources, and understand pain management experiences; and (2) administer the final tool version to participants in the large multinational Scleroderma Patient-centered Intervention Network (SPIN) Cohort.MethodsFirst, we will use validated pain assessment tools as templates to develop an initial version of our pain assessment tool, and we will obtain input from patient advisors to adapt it for SSc. The tool will include questions on pain sources, pain patterns, pain intensity, pain management techniques, and barriers to pain management in SSc. Second, we will conduct nominal group technique sessions with people living with SSc and health care providers who care for people with SSc to further refine the tool. Third, we will conduct individual usability testing sessions with SPIN Cohort participants. Once the tool has been finalized, we will administer it to individuals in the multinational SPIN Cohort, which currently includes over 1,300 active participants from 54 sites in 7 countries. We will perform unsupervised clustering using the KAy-Means for MIxed LArge data (KAMILA) method to identify participant subgroups with similar profiles of pain sources (present or absent) and to evaluate predictors of subgroup membership. We will use latent profile analysis to identify subgroups of participants with similar profiles based on pain intensity scores for each pain source and evaluate predictors.DiscussionOnce completed, our pain assessment tool will allow our team and other researchers to map sources of pain in SSc and to understand pain management experiences of people living with SSc. This knowledge will provide avenues for studies on the pathophysiology of pain in SSc and studies of interventions to improve pain management.

Equivalence, modality use and patient satisfaction of telepractice administration of the scenario test in persons with primary progressive aphasia

BACKGROUND: The use of telediagnostics for people with primary progressive aphasia (PPA) could improve access to specialised care. There is a gap in research, especially regarding to the evaluation of communicative-pragmatic measurement tools in a digital setting. OBJECTIVE: This study examined the equivalence, modality use, and patient satisfaction of telepractice administration of the Scenario Test (ST) in people with PPA. METHODS: In a cross-over design, the ST was conducted once by videoconferencing and once in person. Fifteen people with PPA participated. Participant satisfaction was assessed after each test session using a short self-designed questionnaire. The total ST scores, the use of the different communicative modalities and the participant satisfaction scores were evaluated using the equivalence and McNemar test. RESULTS: Statistical equivalence was established for the present sample with regard to the total score of the ST. Regarding the use of the different modalities, no significant difference was found. Sample satisfaction was positive for both diagnostic settings, but there was no statistical equivalence of satisfaction. Severe psychiatric and cognitive symptoms affected the test performance. CONCLUSIONS: This study highlights opportunities and limitations of telepractice administration of the ST in people with PPA. There is some evidence that testing with the ST via videoconferencing is feasible. Differences in the use of communication modalities and participant satisfaction should be further investigated. Influencing factors such as psychiatric symptoms and cognitive deficits should be considered in future research projects.

Intrarater and interrater reliability of digital calipers in assessing Achilles tendon thickness in patients with knee osteoarthritis.

This study aimed to evaluate the intrarater and interrater reliability of measuring Achilles tendon (AT) thickness using a digital caliper in patients with knee osteoarthritis. A cross-sectional survey was conducted at the Physiotherapy Department of Rabia Moon Hospital, involving the recruitment of 61 patients with knee osteoarthritis. Measurements were taken in millimeters at a 90-degree angle, approximately 5cm from the attachment to the calcaneus, precisely where the ankle joint joins the medial malleolus. Two physical therapists conducted two testing sessions, separated by 7days, to assess both the intrarater and interrater reliability of the digital caliper. During the second session, two raters simultaneously assessed the patients' responses on the digital caliper. The study analyzed reliability indices, including the Intraclass Correlation Coefficient (ICC) and Bland-Altman plot. The study found high intrarater reliability for the digital caliper, with an ICC of 0.96 (95% confidence interval: 0.22, 0.99). For interrater reliability, the ICC was 0.98 (95% CI: 0.96, 0.98) in patients with knee OA. Additionally, both interrater and intrarater agreement for measuring AT thickness with the digital caliper fell within acceptable limits on 95% of occasions, as indicated by the Limits of Agreement values: 0.32 to -0.53mm for interrater agreement and -0.35 to -0.04mm for intrarater agreement. Digital Calipers have been found to provide excellent intrarater and interrater reliability when used to measure AT thickness in patients with knee osteoarthritis (OA).

Usability Testing of a Web Tool for Dissemination and Implementation Science Models

Dissemination and Implementation science is dedicated to increasing the speed of evidence-based research translated into practice as guided by one or multiple D&I theories, models, and frameworks. The Dissemination and Implementation Models in Health Research and Practice web tool guides users on how to plan, select, combine, adapt, use, and assess theories, models, and frameworks. This paper describes usability testing to update the web tool. Iterative user testing was conducted with implementation science research and clinical participants to facilitate updates and optimize the functionality of the tool. A multi-step protocol involved quantitative and qualitative data collection including a survey, interviews, and a usability testing session. Data from the pre-testing surveys were summarized as frequencies. Data from the usability testing sessions were analyzed using a hybrid adapted deductive rapid matrix qualitative analysis. Data from the interviews were analyzed by deductive a priori coding. Fifteen interviewees represented different research and clinical groups and levels of expertise utilizing D&I TMFs. Participants were purposively selected to represent a range of disciplines and D&I expertise, all invited via one-time email. The 847 total interview comments were reduced by similarity to 259 comments, and 142 were feasible changes fitting the priorities of the web tool. Changes to content, format, and functionality are described in this paper. The iterative usability testing elicited improvements to the web tool including adding more examples, definitions, visuals, and tutorials and simplifying the written content. The web tool remains flexible for additions concerning health equity, de-implementation, and other issues.

Initiating and integrating user-centred design in upgrading the e-learning layout: a case study on FlexLearn (Brightspace) 2.0 template

PurposeThe purpose of this paper is to articulate how the user experience (UX) approach was initiated and integrated into the centre’s scope of operations with the objective of improving the e-learning layout on the D2L learning management system (LMS). One of the most effective ways to collect user feedback has historically been to evaluate user interfaces using strategies from user testing. The integration of a UX approach by the Centre for ODL Experiences (COLE) at Wawasan Open University has led to a more user-oriented design of FlexLearn by conducting user testing on students as the target users of the platform and gathering course leaders’ (CLs) feedback after the presentation of the new template.Design/methodology/approachSince the process of design and development is a looping process, the first user testing methods employed were observation and interviews, which were conducted over the course of numerous sessions. The data collection used a mixed-methods approach, combining quantitative demographic and background data with qualitative feedback from open-ended questions and real-time interview responses. A standardized questionnaire gathered demographic information, while questions for feedback forms and interviews were adjusted based on specific tasks to explore usability and user interactions comprehensively.FindingsThe findings revealed overall positive feedback, with some concerns highlighted by the students who claimed to have trouble navigating the courses during the initial prototype. In addition to the qualitative data from the user testing session, a quantitative method based on an online questionnaire was also utilised for the CLs after the presentation of the final layout. Positive responses were received from the CLs, and constructive suggestions were considered for FlexLearn 3.0.Research limitations/implicationsThis paper is among the first that articulates the process of initiating and integrating user-centred design in an effort to improve the user experience of online and ODL platforms and LMSs. It will contribute to a dialogue on investigating and prioritising learners’ ODL experiences to ensure education equity across all levels or categories of students, which aligns with the United Nations Sustainable Development Goals.Practical implicationsThe integration of UX and user testing allows us to better identify what users like, their concerns and their needs. We gain important input on how easy or difficult it is to use the system, move around it and how much they enjoy using it. This feedback helps us make changes to the design so that the final product is more in line with what users want. It also allows us to discover problems before they become major, saving time and effort later on. Finally, integrating user input improves the LMS, delivering a more fun and successful learning experience for everyone.Social implicationsUser-friendly systems arise as institutions prioritise user-centred design, breaking down barriers for various learners. This develops an innovative culture, improving present learning experiences and setting a precedent for future generations. The emphasis on user demands helps to create a more accessible, adaptive and egalitarian educational landscape by connecting education with current technological trends. As education becomes more inclusive, the broader community benefits, emphasising the beneficial social impact of LMS user testing.Originality/valueBy articulating the process of integrating user testing on an LMS/e-learning prototype, helps us understand what users like, where they face problems and what needs improvement. By involving users in testing, we get valuable feedback on how easy it is to use the system, navigate around and overall, how much they enjoy using it. Case studies like this also offer universities concrete examples of real-world challenges and successes.

Biomarkers of Neurobiologic Recovery in Adults With Sport-Related Concussion

ImportanceSport-related concussion (SRC), a form of mild traumatic brain injury, is a prevalent occurrence in collision sports. There are no well-established approaches for tracking neurobiologic recovery after SRC.ObjectiveTo examine the levels of serum glial fibrillary acidic protein (GFAP) and neurofilament light (NfL) in Australian football athletes who experience SRC.Design, Setting, and ParticipantsA cohort study recruiting from April 10, 2021, to September 17, 2022, was conducted through the Victorian Amateur Football Association, Melbourne, Australia. Participants included adult Australian football players with or without SRC. Data analysis was performed from May 26, 2023, to March 27, 2024.ExposureSport-related concussion, defined as at least 1 observable sign and/or 2 or more symptoms.Main Outcomes and MeasuresPrimary outcomes were serum GFAP and NfL levels at 24 hours, and 1, 2, 4, 6, 8, 12, and 26 weeks. Secondary outcomes were symptoms, cognitive performance, and return to training times.ResultsEighty-one individuals with SRC (median age, 22.8 [IQR, 21.3-26.0] years; 89% male) and 56 control individuals (median age, 24.6 [IQR, 22.4-27.3] years; 96% male) completed a total of 945 of 1057 eligible testing sessions. Compared with control participants, those with SRC exhibited higher GFAP levels at 24 hours (mean difference [MD] in natural log, pg/mL, 0.66 [95% CI, 0.50-0.82]) and 4 weeks (MD, 0.17 [95% CI, 0.02-0.32]), and NfL from 1 to 12 weeks (1-week MD, 0.31 [95% CI, 0.12-0.51]; 2-week MD, 0.38 [95% CI, 0.19-0.58]; 4-week MD, 0.31 [95% CI, 0.12-0.51]; 6-week MD, 0.27 [95% CI, 0.07-0.47]; 8-week MD, 0.36 [95% CI, 0.15-0.56]; and 12-week MD, 0.25 [95% CI, 0.04-0.46]). Growth mixture modeling identified 2 GFAP subgroups: extreme prolonged (16%) and moderate transient (84%). For NfL, 3 subgroups were identified: extreme prolonged (7%), moderate prolonged (15%), and minimal or no change (78%). Individuals with SRC who reported loss of consciousness (LOC) (33% of SRC cases) had higher GFAP at 24 hours (MD, 1.01 [95% CI, 0.77-1.24]), 1 week (MD, 0.27 [95% CI, 0.06-0.49]), 2 weeks (MD, 0.21 [95% CI, 0.004-0.42]) and 4 weeks (MD, 0.34 [95% CI, 0.13-0.55]), and higher NfL from 1 week to 12 weeks (1-week MD, 0.73 [95% CI, 0.42-1.03]; 2-week MD, 0.91 [95% CI, 0.61-1.21]; 4-week MD, 0.90 [95% CI, 0.59-1.20]; 6-week MD, 0.81 [95% CI, 0.50-1.13]; 8-week MD, 0.73 [95% CI, 0.42-1.04]; and 12-week MD, 0.54 [95% CI, 0.22-0.85]) compared with SRC participants without LOC. Return to training times were longer in the GFAP extreme compared with moderate subgroup (incident rate ratio [IRR], 1.99 [95% CI, 1.69-2.34]; NfL extreme (IRR, 3.24 [95% CI, 2.63-3.97]) and moderate (IRR, 1.43 [95% CI, 1.18-1.72]) subgroups compared with the minimal subgroup, and for individuals with LOC compared with those without LOC (IRR, 1.65 [95% CI, 1.41-1.93]).Conclusions and RelevanceIn this cohort study, a subset of SRC cases, particularly those with LOC, showed heightened and prolonged increases in GFAP and NfL levels, that persisted for at least 4 weeks. These findings suggest that serial biomarker measurement could identify such cases, guiding return to play decisions based on neurobiologic recovery. While further investigation is warranted, the association between prolonged biomarker elevations and LOC may support the use of more conservative return to play timelines for athletes with this clinical feature.

Intersession reliability of center of pressure measurement during bipedal standing with different count-back orders

IntroductionDual-task assessments can identify changes in postural control during balance assessments. Static standing with backward counting is frequently used to evaluate postural control while dual-tasking. The most reliable countdown method for standing postural stability has not yet been defined. Research objectiveto investigate postural stability's intra- and inter-day reliability while backward counting in different steps. MethodThirty-nine healthy adults (20 females, 26.94 ± 7.55 years) completed 70 s trials of stability tests with no dual-task, counting backward under five conditions (in ones, tows, threes, fours, and fives) while standing on a force-plate in three sessions: two sessions were on the same day, and the third session was one-week apart. The repeatability of measurements was tested using repeated-measure analysis of variance, interclass correlation, and standard error of measurements. ResultsThe interclass correlation scores ranged from 0.67 to 0.92, and the standard error of measurements ranged from 2.9% to 13.4%. No significant systematic changes (p < 0.05) occurred between the testing sessions for any backward counting. DiscussionThe backward counting showed higher reliability when performed in condition 5 (counting backward in five's). The inter-day reliability scores were greater than intera-day reliability. ConclusionsDual-tasking with most backward counting (in ones to fives) is reliable, and a quantitative assessment of the center of pressure could be used to monitor the changes in postural stability between sessions.

The impact of intermittent fasting during Ramadan on psychomotor and cognitive skills in adolescent athletes.

Intermittent fasting (IF) represents a dietary intervention similar to caloric restriction, characterized by the strategic limitation of food consumption. Among the diverse array of practices for IF, Ramadan IF (RIF), a religious observance in Islam, mandates that healthy adult Muslims abstain from both food and drinks during daylight hours. In sports, researchers have extensively studied IF effects on health, including sleep and physical performance, but its impact on cognitive functions during RIF remains understudied. Therefore, this study was conducted to evaluate the influence of RIF on psychomotor and cognitive performance among young female athletes. To achieve this purpose, a cohort of 23 female handball players, aged 17.2 ± 0.5 years, participated in a series of six testing sessions: one conducted prior to Ramadan (R0), and others during the first (R1), second (R2), third (R3), and fourth (R4) weeks of Ramadan, followed by a session in the week after Ramadan (R5). Each session involved assessments using a Simple Reaction Time Test (SRT), Choice Reaction Time Test (CRT), Vigilance Test (VT), and Mental Rotation Test (MRT). Additionally, dietary intake, body composition, and Pittsburgh Sleep Quality Index (PSQI) scores were evaluated during these periods. The obtained data illustrated that there was a decrease in SRT, CRT, VT, and MRT performances during R1 in comparison to R0 (all p < .001). This reduction was also observed in R2, R3, R4, and R5. Notably, during the fourth week of Ramadan (R4), these cognitive and psychomotor parameters were significantly lower than during the earlier weeks (R1, R2, R3; all p < .001). Furthermore, a gradual decrease in total PSQI scores, sleep quality, and sleep duration was observed throughout the Ramadan period, reaching the lowest levels during R4. These findings illustrate that RIF has a significantly detrimental impact on neuromuscular and cognitive abilities as well as sleep quality in young female athletes. The study also highlights a fluctuating pattern in cognitive function across the four weeks of Ramadan, with the most pronounced decline observed during the final week of fasting illustrating the importance of conducting similar studies on normal individuals from both genders with larger sample size.

Field assessment of active BSE: Trends over test days of subjective indicators and self-reported fatigue for railway construction workers

The research community has conducted several controlled “in -lab” assessments on the effectiveness of industrial exoskeletons, paving the way for their adoption. However, field testing, focusing on ergonomics and the user experience, could serve to enhance both end-users' awareness and address open doubts concerning true effectiveness of industrial exoskeletons. This study presents an analysis of qualitative data regarding the use of back-support exoskeletons during field trials in harsh civil engineering environments. This work evaluates the StreamEXO's (an active back-support exoskeleton) efficacy in reducing fatigue and the evolution of its perceived usefulness. This is achieved using qualitative data collection tools, during real scenarios testing over multiple-day trials. Collected data shows a positive correlation between self-reported fatigue, measured on a four verbal anchors-based Borg CR10 scale, and the use of the exoskeleton during physically demanding movements. Moreover, the evolution of scores throughout the testing sessions (90 minutes of exoskeleton use for three nonconsecutive days) suggests a trend due to the adaptation and learning curve of workers during the exoskeleton experience. The analysis of the open-ended answers highlights that the adaptation to physical interaction has a negative oscillation on day two to rise back during the third day, possibly correlated to a change in muscle pattern. The main critical factors affecting comfort during the exoskeleton experience are weight balance, body pressure, and thermal comfort, which can strongly affect device acceptance.

Validity of the Hawkin Dynamics Wireless Dual Force Platform System Against a Piezoelectric Laboratory Grade System for Vertical Countermovement Jump Variables.

Dos'Santos, T, Evans, DT, and Read, DB. Validity of the Hawkin dynamics wireless dual force platform system against a piezoelectric laboratory grade system for vertical countermovement jump variables. J Strength Cond Res 38(6): 1144-1148, 2024-The aim of this study was to determine the criterion validity of the Hawkin Dynamics (HD) wireless dual force platform system for assessing vertical countermovement jump (CMJ) variables, compared with those derived from a Kistler piezoelectric laboratory grade force platform system. During a single testing session, HD force platforms were placed directly on top of 2 adjacent Kistler force platforms to simultaneously collect vertical ground reaction forces produced by 2 male recreational soccer players (age: 29.0 ± 2.8 years, height: 1.79 ± 0.01 m, mass: 85.6 ± 4.7 kg) that performed 25 vertical CMJs each. Sixteen vertical CMJ variables pertaining to jump height (JH), flight time (FT), time-to-take off (TTT), countermovement depth, body weight (BW), propulsive and braking mean, and peak powers, forces, and impulses were compared between systems. Fixed bias was observed for 6 of 16 variables (peak and mean braking power, mean propulsion force, TTT, FT, and BW), while proportional bias was present for 10 of 16 variables (peak and mean propulsive and braking force, TTT, FT, peak and mean braking power, mean propulsive power, and BW). For all variables regardless of fixed or proportional bias, percentage differences were ≤3.4% between force platform systems, with near perfect to perfect correlations (r or ρ = 0.977-1.000) observed for 15 of 16 variables. The HD dual wireless force platform system can be considered a valid alternative to a piezoelectric laboratory grade force platform system for the collection of vertical CMJ variables, particularly outcome (i.e., JH, reactive strength index modified) and strategy variables (countermovement depth).

Design overview and usability of the codesigned My Surgical Pathway E-health tool for supporting patient self-managed surgical preparation and recovery

IntroductionSurgery plays a critical role in global health, often facing significant quality challenges such as high rates of postoperative complications, variability in patient outcomes, and inconsistencies in care pathways, due to the complex nature of the perioperative journey. The My Surgical Pathway (MSP) app is an e-health intervention designed to address these challenges by supporting self-management and integrated care throughout the entire perioperative journey. This study aims to describe the features and functions of MSP and report on the results of usability testing from both patients and healthcare workers. MethodsThis mixed-methods study evaluated the usability of the My Surgical Pathway (MSP) app using quantitative surveys, qualitative feedback, and observation data from patients and healthcare workers. Structured 2-hour user testing sessions included interaction with the MSP app, completion of the User Version of the Mobile Application Rating Scale (uMARS), and think-aloud activities. Data analysis combined quantitative and qualitative insights to identify usability issues and inform potential improvements. ResultsThe mixed-method user-testing evaluation of the co-designed e-health intervention revealed high overall app quality scores, with an average of 4.50 out of 5. All user-type interfaces received mean scores above the minimum acceptability threshold of 3.0, demonstrating the intervention's efficacy in supporting patient surgery journeys, enhancing healthcare worker coordination, and meeting diverse user needs. Notably, the highest individual item scores were for credibility of source (4.92) and interactivity (4.85), highlighting the application's reliability and engaging nature. ConclusionsThe study evaluated the 'My Surgical Pathway' (MSP) e-health intervention, co-designed with consumers and healthcare workers to support self-management of surgical care. Results indicate high user satisfaction, with an overall app quality score of 4.50 out of 5 on the uMARS tool. Users praised MSP's engagement, education, and responsiveness, highlighting its potential to improve patient experiences and clinician workflows. Recommendations for future research include expanding participant diversity and hospital settings, and employing longitudinal designs for a comprehensive evaluation.