Single Training Session Research Articles

Feasibility of a real-time pattern-based kinematic feedback system for gait retraining in pediatric cerebral palsy.

IntroductionVisual biofeedback of lower extremity kinematics has the potential to enhance retraining of pathological gait patterns. We describe a system that uses wearable inertial measurement units to provide kinematic feedback on error measures generated during periods of gait in which the knee is predominantly extended (‘extension period’) and flexed (‘flexion period’).MethodsWe describe the principles of operation of the system, a validation study on the inertial measurement unit derived knee flexion angle on which the system is based, and a feasibility study to assess the ability of a child with cerebral palsy to modify a gait deviation (decreased swing phase knee flexion) in response to the feedback.ResultsThe validation study demonstrated strong convergent validity with an independent measurement of knee flexion angle. The gait pattern observed during training with the system exhibited increased flexion in the flexion period with maintenance of appropriate extension in the extension period.ConclusionsInertial measurement units can provide robust feedback during gait training. A child with cerebral palsy was able to interpret the novel two phase visual feedback and respond with rapid gait adaptation in a single training session. With further development, the system has the potential to support clinical retraining of deviated gait patterns.

The influence of lower limb plyometric and resistance training on the stiffness of Achilles and patellar tendons in recreational athletes

Abstract Study aim: This study aimed to investigate the influence of combined plyometric and resistance training of lower limbs when administered for a shorter duration of six weeks on the stiffness of Achilles and patellar tendons as well as the jump height. Materials and methods: Twenty recreational athletes were administered six weeks of a single session of lower limb resistance training and one session of plyometric training every week for a total duration of six weeks. Tendon stiffness was measured using MyotonPro, and vertical jump height was derived from the force plate at baseline and six weeks after the intervention. Results: There was a statistically significant difference (p < 0.01) between the baseline and post-training measures of patellar and Achilles tendons stiffness as well as the squat jump (SJ) and countermovement jump (CMJ) height. Conclusion: Both resistance and plyometric training may be incorporated into the training session as combined training showed significant improvements in jump height and tendon stiffness after six weeks of combined RT and PT.

Acute effect of high-intensity interval training exercise on redox status in the ovaries of rats fed a high-fat diet.

This study demonstrates the effect of a single high-intensity interval training (HIIT) session on the redox status of rat ovaries with excess adiposity. Forty Wistar female rats (mean (±s.e.m.) weight 94.40 ± 13.40 g) were divided into two groups and fed either a standard diet (SD) or a high-fat diet (HFD) for 62 days. At the end of this period, the rats were subjected to a single HIIT session and were killed 24 h after exercise. Both groups subjected to exercise (SDex and HFDex) generated a significantly higher antioxidant environment by presenting a higher thiol content, which represents a lower oxidation rate of GSH than their respective controls (SD and HFD). The percentage of morphologically normal primary follicles decreased, whereas that of antral follicles increased, in the SDex group. In addition, the HFD group had a higher percentage of degenerated antral follicles than the SD and SDex groups. Cells immunoreactive for α-smooth muscle actin were seen in the cortical stroma and thecal layer enclosing late secondary and tertiary follicles in all groups. Moreover, heme oxygenase and cytochrome P450 family 19 subfamily A member 1 (Cyp19A1) labelling was seen in all antral follicles. Progesterone concentrations were significantly higher in the HFDex than SDex group. In conclusion, this study indicates that a single session of HIIT may result in an improvement in ovary redox status because of metabolic muscle activity by inducing physiological adaptation after exercise in a paracrine manner.

The effects of acute moderate intensity training on hematological parameters in elite para-badminton athletes

Background and objective: The knowledge on the effects of para-badminton sport on physiological parameters is relatively limited in the literature. This study aims to examine the effects of moderate-intensity badminton training on the hematological parameters of elite para-badminton athletes. Methods: A total of 12 para-badminton athletes, 6 female and 6 male, with international competitive experience in the Turkish Para-Badminton National Team, participated in the study. A 90-minute badminton training was applied to the athletes for their technical and tactical development. A 4 mL blood sample was taken before and after the training. Hematological parameters were analyzed from these blood samples. White blood cells, red blood cells, platelets count, and their particular subgroups such as hemoglobin, hematocrit, granulocytes, and lymphocytes were examined as the hematological parameters in this study. Results: The findings revealed that the female para-badminton athletes exhibited a significant increase in white blood cells, granulocytes percentage, red blood cells, hemoglobin, hematocrit, platelets values after training compared to pre-training. It was determined that there were significant increases in white blood cells, granulocytes, granulocytes percentage, red blood cells, and hematocrit values for male para-badminton athletes after training compared to pre-training, and significant decreases in lymphocytes percentage values. Conclusion: In conclusion, the present study showed that a single 90-minute moderate-intensity badminton training session leads to physiological changes on the blood parameters of elite para-badminton athletes. These changes, which differ by gender, can affect the health and performance of the athlete.

Effects of Training on the Execution of Complete-Arch Scans. Part 1: Scanning Time.

To investigate the effect of training on scanning times of complete-arch scans (CAS) performed by first-time users, with a distinction made between specific training (repeated practice of CAS) and nonspecific training (simple use of an intraoral scanner for a sextant scan in the context of a student CAD/CAM course). Thirty-six students with no experience in intraoral scanning were randomized into three groups (n = 12 per group) according to the number of specific CAS training sessions: three sessions (3S), two sessions (2S), and one session (1S). Each student performed 10 CAS per scanning session. These sessions were scheduled at baseline (T0), T1 (2 weeks after T0), and T2 (4 weeks after T0) for group 3S; at T0 and T2 for group 2S; and at T2 for group 1S. Before the final scanning session in each group (ie, the first scanning session in group 1S), the students participated in a CAD/CAM course (3 weeks after T0) in which a monolithic crown was fabricated in a fully digital chairside workflow. The scanning time was measured as the time between the activation and termination of the scanning mode of the intraoral device. Data were analyzed using SPSS Statistics 25 (IBM). The level of significance was set to α = .05. A continual decrease in scanning time was observed for all groups as experience in intraoral scanning increased. The mean scanning times were as follows: for group 3S, 305 seconds at T0, 246 seconds at T1, and 233 seconds at T2; for group 2S, 380 seconds at T0 and 303 seconds at T2; and for group 1S, 355 seconds at T2. When compared to group 1S after it had received nonspecific training only, the effect of a single specific training session in groups 3S and 2S was not significant (P = .4428). However, two specific training sessions had a significant effect on scanning time compared to nonspecific training only (P = .0005). Training does affect the scanning time required for CAS. To perform such scans in a time-efficient manner, dental practitioners should undertake training that comprises at least 12 CAS.

The Effects of Kinect-Enhanced Lymphatic Exercise Intervention on Lymphatic Pain, Swelling, and Lymph Fluid Level.

Background:The-Optimal-Lymph-Flow (TOLF) intervention aims to promote lymph flow through therapeutic lymphatic exercises to relieve lymphatic pain, swelling, lymphedema symptoms, and to decrease lymph fluid levels among breast cancer survivors. To enhance the efficacy of the TOLF intervention, an innovative, intelligent, Kinect-enhanced lymphatic exercise intervention (Kinect-TOLF) was developed to teach patients to perform the lymphatic exercises correctly.Objectives:This feasibility trial aimed to determine the feasibility, usability, and effects of the Kinect-TOLF on lymphatic pain, swelling, lymphedema symptoms, and lymph fluid levels.Methods:A single-arm feasibility trial with a pre- and post-test design was employed to recruit 30 breast cancer survivors with persistent lymphatic pain or swelling. Patients received a single training session to learn how to perform the lymphatic exercises using the Kinect-TOLF program. Descriptive statistics, Wilcoxon signed-rank tests, t-test, Spearman’s rank correlation coefficients, linear regressions, and Cohen’s d were performed for data analysis. Qualitative data were assessed for common themes.Results:The Kinect-TOLF was effective in training patients to perform the lymphatic exercises correctly with high user satisfaction. Significant reductions were found in scores of lymphatic pain (MedΔ = −1.00, CI = [−1.5, −0.1], P = .004), arm/hand swelling (MedΔ = −1.00, CI = [−1.5, −0.5], P = .004), total swelling (MedΔ = −1.5, CI = [−2.0, −1.0], P = .003), number of lymphedema symptoms (MΔ = −3.8, CI = [−5.5, −2.1], P < .001), and lymphedema symptom severity (MΔ = −5.3, CI = [−9.5, −1.1], P = .016). A significant reduction in lymph fluid levels was found in mean L-Dex scores (MΔ = −2.68, CI = [−4.67, −0.69], P = .010). Greater decrease in mean L-Dex scores were found in patients with abnormal lymph fluid levels (L-Dex ≥ 7.1) (MΔ = −5.19, CI = [−1.75, −8.63], P = .008). Patients’ qualitative feedback supported the results of the study.Conclusions:The Kinect-TOLF is safe, feasible, and effective in reducing lymphatic pain, swelling, lymphedema symptoms, and in decreasing lymph fluid levels. Future research should focus on a randomized clinical trial to confirm the unique or synergistic efficacy of the Kinect-TOLF in comparison with current lymphedema treatment and other forms of exercises or movement therapy. This study was registered in ClinicalTrials.gov with US ClinicalTrials.gov Identifier: NCT03999177.

Post-Adaptation Effects in a Motor Imagery Brain-Computer Interface Online Coadaptive Paradigm

Online coadaptive training has been successfully employed to enable people to control motor imagery (MI)-based brain-computer interfaces (BCIs), allowing to completely skip the lengthy and demotivating open-loop calibration stage traditionally applied before closed-loop control. However, practical reasons may often dictate to eventually switch off decoder adaptation and proceed with BCI control under a fixed BCI model, a situation that remains rather unexplored. This work studies the existence and magnitude of potential post-adaptation effects on system performance, subject learning and brain signal modulation stability in a state-of-the-art, coadaptive training regime inspired by a game-like design. The results extracted in a cohort of 20 able-bodied individuals reveal that ceasing classifier adaptation after three runs (approx. 30 min) of a single-session training protocol had no significant impact on any of the examined BCI control and learning aspects in the remaining two runs (about 20 min) with a fixed classifier. Fifteen individuals achieved accuracies that are better than chance level and allowed them to successfully execute the given task. These findings alleviate a major concern regarding the applicability of coadaptive MI BCI training, thus helping to further establish this training approach and allow full exploitation of its benefits.

A mathematical model-based approach to optimize loading schemes of isometric resistance training sessions

Individualized resistance training is necessary to optimize training results. A model-based optimization of loading schemes could provide valuable impulses for practitioners and complement the predominant manual program design by customizing the loading schemes to the trainee and the training goals. We compile a literature overview of model-based approaches used to simulate or optimize the response to single resistance training sessions or to long-term resistance training plans in terms of strength, power, muscle mass, or local muscular endurance by varying the loading scheme. To the best of our knowledge, contributions employing a predictive model to algorithmically optimize loading schemes for different training goals are nonexistent in the literature. Thus, we propose to set up optimal control problems as follows. For the underlying dynamics, we use a phenomenological model of the time course of maximum voluntary isometric contraction force. Then, we provide mathematical formulations of key performance indicators for loading schemes identified in sport science and use those as objective functionals or constraints. We then solve those optimal control problems using previously obtained parameter estimates for the elbow flexors. We discuss our choice of training goals, analyze the structure of the computed solutions, and give evidence of their real-life feasibility. The proposed optimization methodology is independent from the underlying model and can be transferred to more elaborate physiological models once suitable ones become available.

Feasibility to Train Older Adults in India to Use Smart-Phone to Increase Participation in Daily Activities

Though 60% of 104 million older adults own a smart phone in India, up to 85% of these individuals find challenging to use smart-phone during daily activities. This is problematic because inability to use smart-phone limits their ability to participate in daily activities such as, managing their health, paying bills, shopping and communicating with their loved ones, resulting in social isolation and dependence on others. The purpose of this study was to examine the feasibility of training older adults to use smart-phone to increase participation in daily activities. This preliminary study was conducted over two phases. In phase-I, we used the principles of stakeholder engagement to interview 12 older adults to identify the barriers associated with the use of technology using a brief survey. Based on the results of Phase I, we implemented a single education and training session for 42 participant (> 60 years) in using smart-phone based applications in Phase II. Older adults were trained to use smart-phone based applications to manage money using banking apps, pay bills, shop, manage health to monitor vitals and medications and communicate with their loved ones. All participants rated their satisfaction with the program, 70% participants showed the ability to use the applications independently. Seventy five percent rated the program extremely useful, and 70% rated it extremely relevant to them. It is feasible to train older adults in using smart-phone based applications. Future studies need to focus on providing follow-up sessions to increase retention and carry-over to increase participation in daily activities.

The Influence of Lower-Body Training, Upper-Body Training and a Combination of Both on Pain, Functionality and Quality of Life in Knee Osteoarthritis Patients

Purpose: Regular physical activities are a keystone in the nonmedical and nonsurgical treatment of knee-osteoarthritis. However, the underlying mechanisms are still regarded as a black-box and a matter of debate. As potential candidates, two groups can be distinguished: First, joint-specific influences such as better biomechanical functioning and improvements in the quality of cartilage. Secondly, more unspecific effectors like anti-inflammatory cytokines and a central modulation of pain perception. In order to distinguish between these two groups the present study compared the training effects of knee-joint surrounding muscles (LBT), upper body muscles (UBT), and the combination of both (WBT). &#x0D; Methods: 372 physically inactive, adult knee-osteoarthritic patients of both sexes were enrolled in the multi-centered, controlled, and randomized training intervention. All three exercise groups fulfilled an 8-week circle-training intervention two times per week with a subjective intensity of 4 - 5 for the first five sessions (on a 0 = no effort to 10 = extreme effort scale). From the 6th to the 10th session, intensity was adjusted to 6 – 7 and thereafter to 7 – 8. The single training sessions were as follows. LBT: 4 devices, exercise net time (ENT) 20 min., UBT: 4 devices, ENT12 min., WBT 8 devices, ENT 28 min. Anthropometric data, comorbidities, regular physical activities, actual and former medical treatments, knee specific functionality, pain, stiffness, and health related physical and mental quality of life was evaluated at the beginning, after 4 weeks, and finally after 8 weeks by means of online-questionnaires.&#x0D; Main Results: Initially, pain and physical function correlated well with the Kellgren-Lawrence grades (p &lt; 0,01). All three training interventions led to significantly increased functionalities (p &lt; 0,0001) and physical qualities of life (p &lt; 0,02). The pain-subscore of the Western Ontario and McMaster Universities Osteoarthritis Index was significantly reduced (p &lt; 0,004). None of these improvements showed significant differences between groups, although there was a tendency of WBT to be superior to UBT and LBT.&#x0D; Conclusion: The positive effects of physical training regimens cannot be exclusively attributed to a knee-specific training effect since significant improvements also occurred in the UBT group.

The effect of a single training session on cognition and mood in young adults – is there added value of a dual-task over a single-task paradigm?

ABSTRACT The combination of simultaneous physical and cognitive training has rarely been assessed in young adults. Here we consider whether one dual-task cognitive and physical session was more effective than a single – cognitive or physical session in enhancing mood and cognitive functioning. In addition, we assessed whether habitual physical activity (PA) is a moderator of these training regimens. Individuals (N = 116) aged 19–35 were randomly divided into four groups: physical exercise, cognitive exercise, combined physical-cognitive exercise, and control. Cognitive functioning was assessed by two tests of verbal fluency – phonemic fluency (PF) and semantic fluency (SF), and mood by the Profiles of Mood States (POMS). Level of PA was assessed by the International Physical Activity Questionnaire (IPAQ), and based on Metabolic Equivalents (METs) calculations, participants were divided into moderate- and high-level of PA. Three-way ANOVAs with repeated measures for the intervention groups and level of PA were conducted for each of the outcome measures – PF, SF, and POMS, followed by post-hoc comparisons. Results indicated that for those who engage in moderate-level PA, a session of combined physical and cognitive exercise is preferable over only physical or only cognitive, as the combined exercise may benefit both PF and mood. For high-level PA, combined exercise is not a stimulator for verbal fluency or for mood. Physical exercise as a single task is efficient in enhancing mood in those who engage in both moderate and high-level habitual PA. Further studies are recommended to explore the effect of simultaneously performed physical and cognitive exercise in young adults.

Evaluating Healthcare Worker Competence in the Correct Use of Personal Protective Equipment in the COVID Era: A Quality Improvement Project.

Introduction: Throughout the coronavirus disease 2019 pandemic, personal protective equipment (PPE) guidance has rapidly evolved. Healthcare workers (HCWs) should use PPE correctly to reduce the risk of nosocomial transmission of the coronavirus. We predict a lack of training regarding correct PPE usage amongst HCWs and introduce a low-resource method of training.Methods: HCWs from various disciplines at a District General Hospital self-rated their ability in utilising PPE using uncontrolled pre- and post-session 16-item questionnaires following a single PPE training session. Participant responses were analysed using Student's t-test for independent (unpaired) samples.Results: Of 64 participants, 37 participants (59%) received any prior PPE training. Six participants (9%) previously received specific severe acute respiratory syndrome coronavirus 2 PPE training. Survey scores were higher in the post-test than the pre-test group.Conclusion: This study highlights the lack of formal PPE training amongst HCWs and the need for establishing PPE training as part of the mandatory training of HCWs.

ACUTE EFFECT OF AEROBIC EXERCISE OF DIFFERENT INTENSITIES IN CYTOKINES OF UNIVERSITY STUDENTS

ABSTRACT Introduction: A single exercise training session promotes stimuli for changes in the immune system that are cumulatively considered adaptations to the exercise. Objective: This paper explores the acute effect of different intensities of aerobic exercise on anti-inflammatory and proinflammatory markers in apparently healthy university students. Methods: Eighteen volunteers underwent two sessions of aerobic exercise, the first at 65-70% estimated heart rate (HR), and after seven days, a second session at 80-85% HR. Before and after each session, venous blood was drawn, in order to analyze interleukin (IL) 6 and 10 in a Milliplex Kit. The participants’ level of physical activity was determined using a questionnaire. For statistical comparisons, two-way ANOVA was used for the variables hemodynamics and perceived exertion. The cytokine results were compared through the Student's t-test for repeated measurements. The exclusion criteria were the practice of physical exercise and having drunk alcohol on the day before the intervention sessions, the presence of osteomioarticular conditions, and missing one of the sessions. Results: This study showed that IL-6 was not significantly decreased when comparing the two sessions. IL-10 was significantly decreased (p=0.033) in the 65-70% HR session but not in the 80-85% HR session. The delta variation for IL-10 showed a tendency (p=0.053) towards a greater decrease in the 65-70% HR session when compared to the 80-85% HR session. There were no differences in the acute effect of exercise when comparing the levels of physical activity. Conclusion: This study highlights that two different zones of high intensity exercise can induce different inflammatory responses, as demonstrated by the significant decrease in IL-10 in the 65-70%HR zone. The study also shows that there was no difference in physical exercise response in individuals with moderate and high physical activity levels. Level of evidence III; Comparative study.

Echocardiography does not prolong peri-shock pause in cardiopulmonary resuscitation using the COACH-RED protocol with non-expert sonographers in simulated cardiac arrest

ObjectiveFocused echocardiography during peri-shock pause (PSP) can prognosticate and detect reversible causes in cardiac arrest but minimising interruptions to chest compressions improves outcome. The COACH-RED protocol was adapted from the COACHED protocol to systematically incorporate echocardiography into rhythm check without prolonging PSP beyond the recommended 10s. The primary objective of this study was to test the feasibility of emergency nurses learning to perform all roles in the COACH-RED protocol. PSP duration and change in participant confidence were secondary outcomes. MethodsAfter an initial two-hour workshop, five ALS-trained nurses were assessed for the correct use of COACH-RED protocol, without critical error, in three simulated cardiac arrest scenarios of four cycles each. Assessments were repeated on days 7 and 35. On day 35, three COACHED scenarios were also assessed for comparison. Participant roles per scenario and cardiac rhythm per cycle were randomised. Participants completed questionnaires on their confidence levels. Sessions were videotaped for accurate measurement of PSP duration and results tabulated for simple comparison. Statistical analysis was not performed due to small sample size. ResultsThere were no critical errors, two minor team-leading errors and two minor echosonography errors. Minor errors occurred in separate scenarios resulting in a 100% pass rate overall by predetermined criteria. Echocardiographic recordings were 100% adequate. Overall median PSP was 9.35s for COACH-RED and 6.94s for COACHED. Sub-group analysis of COACH-RED revealed median PSP 10.80s in shockable rhythms and 8.74s (∼2s less) in non-shockable rhythms. Mean participant confidence in performing COACH-RED improved from 1.6 to 4.6, on a 5-point scale. ConclusionThe COACH-RED protocol can be effectively performed by ALS-trained nurses, in all roles of this protocol, including echocardiography, in a simulated environment, after a single training session. Using this protocol, focused echocardiography does not prolong PSP beyond 10s.

Sleep facilitates anticipation training of a handball goalkeeping task in novices

Sleep facilitates perceptual, cognitive and motor learning; however, the role of sleep for perceptual learning in sports is yet unclear. Here, we tested the impact of sleep on novices' visual anticipation training using a handball goalkeeping task. To this end, 30 novices were divided randomly in two groups and asked to predict the directional outcome of handball penalties presented as videos. One group did the pre-test and a single session of training in the morning, post-test in the evening on the same day, and the retention test in the next morning again. Conversely, the second group started and finished in the evening. Analyses of prediction accuracy revealed that the group starting in the evening improved largest between pre- and post-test (sleep in-between), while the greatest improvement for the group starting in the morning was found between post- and retention-test (sleep in-between). Overall, our results provide first insight into the potential relevance of sleep for effective anticipation training in sports.

Training general practitioners in the ABC versus 5As method of delivering stop-smoking advice: a pragmatic, two-arm cluster randomised controlled trial.

This study assessed the effectiveness of a 3.5-h training session for general practitioners (GPs) in providing brief stop-smoking advice and compared two methods of giving advice – ABC versus 5As – on the rates of delivery of such advice and of recommendations of evidence-based smoking cessation treatment during routine consultations.A pragmatic, two-arm cluster randomised controlled trial was carried out including a pre-/post-design for the analyses of the primary outcome in 52 GP practices in Germany. Practices were randomised (1:1) to receive a 3.5-h training session (ABC or 5As). In total, 1937 tobacco-smoking patients, who consulted trained GPs in these practices in the 6 weeks prior to or following the training, were included. The primary outcome was patient-reported rates of GP-delivered stop-smoking advice prior to and following the training, irrespective of the training method. Secondary outcomes were patient-reported receipt of recommendation/prescription of behavioural therapy, pharmacotherapy or combination therapy for smoking cessation, and the effectiveness of ABC versus 5As regarding all outcomes.GP-delivered stop-smoking advice increased from 13.1% (n=136 out of 1039) to 33.1% (n=297 out of 898) following the training (adjusted odds ratio (aOR) 3.25, 95% CI 2.34–4.51). Recommendation/prescription rates of evidence-based treatments were low (<2%) pre-training, but had all increased after training (e.g. behavioural support: aOR 7.15, 95% CI 4.02–12.74). Delivery of stop-smoking advice increased non-significantly (p=0.08) stronger in the ABC versus 5As group (aOR 1.71, 95% CI 0.94–3.12).A single training session in stop-smoking advice was associated with a three-fold increase in rates of advice giving and a seven-fold increase in offer of support. The ABC method may lead to higher rates of GP-delivered advice during routine consultations.

Practice Makes Transfer Imperfect: Evidence From Auditory Learning.

Evidence from motor and visual studies suggests that the ability to generalize learning gains to untrained conditions decreases as the training progresses. This decrease in generalization was suggested to reflect a shift from higher to lower levels of neuronal representations of the task following prolonged training. In the auditory modality, however, the few studies that tested the influence of prolonging training on generalization ability showed no decrease and sometimes even an increase in generalization. To test the impact of extending training in a basic psychoacoustic task on the ability to generalize the gains attained in training to untrained conditions. Eighty-two young adults participated in two experiments that differed in the specific training regimen. In both experiments, training was conducted using a difference limen for frequency (DLF) task with an adaptive forced-choice procedure, for either a single- or nine-session training. Following training, generalization to the untrained ear and to an untrained frequency was assessed. (a) Training induced significant learning (i.e., smaller DLF thresholds) following a single session of training, and more so following nine training sessions; (b) results from the combined data from both experiments showed that the ability to generalize the learning gains to the untrained ear and frequency was limited after the extended DLF training; (c) larger improvements under the trained condition resulted in smaller generalization to the untrained conditions. The findings of increased specificity with training in the auditory modality support the notion that gradual changes, both quantitative and qualitative, occur in the neural representations of an auditory task during its acquisition. These findings suggest common underlying mechanisms in basic skill learning across different modalities.

Psychogenic non-epileptic seizures in children – psychophysiology & dissociative characteristics

The purpose of this study was to determine psychophysiology and dissociative characteristics of psychogenic non-epileptic seizures (PNES) in a clinical pediatric setting. A retrospective chart review was conducted over a 5-year period that included children meeting criteria for probable, clinically established or documented PNES. Of these, 33 patients (81%) underwent psychophysiology assessment as part of standardized care and were selected for study inclusion. Ages ranged from 10 to 17 years inclusive (70% female). The majority of patients were found to have some form of autonomic decompensation at baseline (82%) and lack of autonomic recovery from a cognitive stressor (58%). Inhibition of electrodermal skin response to laboratory stressor was associated with significantly longer duration of PNES illness (t=2.65, p=.013), while elevated heart rate (above 90th percentile) was associated with significantly higher frequency of PNES events in the month preceding diagnosis (t=3.1, p=.004). High levels of dissociation and hyperventilation symptoms were self-reported by adolescent patients (n=19) with a moderate degree of positive association (r=0.35, p=.038). The majority of patients (n= 25, 89%) were taught to correct respiratory CO2 levels during a single biofeedback training session. Conclusions: Child PNES populations appear to be characterized by chronic autonomic hyperarousal reflecting severity of their symptoms, which can feasibly be targeted for behavioral treatment.

Effects of a single mental chronometry training session in subacute stroke patients \u2013 a randomized controlled trial

BackgroundMotor imagery training might be helpful in stroke rehabilitation. This study explored if a single session of motor imagery (MI) training induces performance changes in mental chronometry (MC), motor execution, or changes of motor excitability.MethodsSubacute stroke patients (n = 33) participated in two training sessions. The order was randomized. One training consisted of a mental chronometry task, the other training was a hand identification task, each lasting 30 min. Before and after the training session, the Box and Block Test (BBT) was fully executed and also performed as a mental version which served as a measure of MC. A subgroup analysis based on the presence of sensory deficits was performed. Patients were allocated to three groups (no sensory deficits, moderate sensory deficits, severe sensory deficits). Motor excitability was measured by transcranial magnetic stimulation (TMS) pre and post training. Amplitudes of motor evoked potentials at rest and during pre-innervation as well as the duration of cortical silent period were measured in the affected and the non-affected hand.ResultsPre-post differences of MC showed an improved MC after the MI training, whereas MC was worse after the hand identification training. Motor execution of the BBT was significantly improved after mental chronometry training but not after hand identification task training. Patients with severe sensory deficits performed significantly inferior in BBT execution and MC abilities prior to the training session compared to patients without sensory deficits or with moderate sensory deficits. However, pre-post differences of MC were similar in the 3 groups. TMS results were not different between pre and post training but showed significant differences between affected and unaffected side.ConclusionEven a single training session can modulate MC abilities and BBT motor execution in a task-specific way. Severe sensory deficits are associated with poorer motor performance and poorer MC ability, but do not have a negative impact on training-associated changes of mental chronometry. Studies with longer treatment periods should explore if the observed changes can further be expanded.Trial registrationDRKS, DRKS00020355, registered March 9th, 2020, retrospectively registered

A novel attention bias modification single session training improves eye gaze behaviour in social anxiety disorder: a pilot study

Background Attention bias modification (ABM) can reduce anxiety and attentional bias towards threatening stimuli, but evidence of its usefulness as a potential intervention for socially anxious individuals has been mixed. Eye contact avoidance, a maladaptive attentional strategy in social anxiety disorder (SAD), has yet to be targeted by ABM research. Aims This study sought to establish whether a new ABM training paradigm could increase attentional deployment towards eyes and what effect this would have on social and gaze-related anxiety. Method Participants (n = 23) recruited through adverts calling for people who felt anxious in social situations completed either a novel ABM training task designed to induce attentional bias towards images of eyes over images of noses, or control training. Data on response times (RTs), accuracy of responses, gaze behaviour (using an eye tracker) and scores on clinical measures of social and gaze-related anxiety were collected before and after both training tasks. Results ABM training produced a greater number of initial saccades towards eye images than did the control task, indicating an induced shift in early attentional deployment. ABM training was also associated with a marginal increase in fixation durations on eye images. No effect was observed on RTs or social and gaze-related anxiety. Conclusions Our results indicate that ABM can alter the gaze behaviour of socially anxious individuals. They also highlight the importance of eye tracking to ABM research, because it was more sensitive than analyses of RTs to changes in early attentional deployment.