Test-retest, intra- and inter-rater reliability of the reactive balance test in patients with chronic ankle instability

IntroductionThe Reactive Balance Test (RBT) could be a valuable addition to research on chronic ankle instability (CAI) and clinical practice, but before it can be used in clinical practice it needs to be reliable. It has already been proven reliable in healthy recreational athletes, but not yet in patients with CAI who have shown persistent deficits in dynamic balance. The study aimed to determine the test-retest, intra-, and inter-rater reliability of the RBT in patients with CAI, and the test-retest and inter-rater reliability of the newly developed RBT score sheet.MethodsWe used a repeated-measures, single-group design to administer the RBT to CAI patients on three occasions, scored by multiple raters. We included 27 participants with CAI. The study used multiple reliability measures, including Pearson r, intra-class correlations (ICC), standard error of measurement (SEM), standard error of prediction (SEP), minimal detectable change (MDC), and Bland–Altman plots, to evaluate the reliability of the RBT’s outcome measures (visuomotor response time and accuracy). It also assessed the test-retest and inter-rater reliability of the RBT score sheet using the same measures.ResultsThe ICC measures for test-retest reliability were similar for accuracy (0.609) and VMRT (0.594). Intra-rater reliability had high correlations and ICCs for accuracy (r = 0.816, ICC = 0.815) and VMRT (r = 0.802, ICC = 0.800). Inter-rater reliability had a higher ICC for VMRT (0.868) than for accuracy (0.690).ConclusionTest-retest reliability was moderate, intra-rater reliability was good, and inter-rater reliability showed moderate reliability for accuracy and good reliability for VMRT. Additionally, the RBT shows robust SEM and mean difference measures. The score sheet method also demonstrated moderate test-retest reliability, while inter-rater reliability was good to excellent. This suggests that the RBT can be a valuable tool in assessing and monitoring balance in patients with CAI

Treadmill Training in Multiple Sclerosis: Can Body Weight Support or Robot Assistance Provide Added Value? A Systematic Review

Purpose. This systematic review critically analyzes the literature on the effectiveness of treadmill training (TT), body-weight-supported TT (BWSTT), and robot-assisted TT (RATT) in persons with multiple sclerosis (MS), with focus on gait-related outcome measurements. Method. Electronic databases (Pubmed, Pedro, Web of Science, and Cochrane Library) and reference lists of articles and narrative reviews were searched. Pre-, quasi- and true-experimental studies were included if adult persons with MS were involved in TT, BWSTT, or RATT intervention studies published before 2012. Descriptive analysis was performed and two researchers scored the methodological quality of the studies. Results. 5 true- and 3 preexperimental studies (mean quality score: 66%) have been included. In total 161 persons with MS were involved (TT, BWSTT, or RATT, 6–42 sessions; 2–5x/week; 3–21 weeks). Significant improvements in walking speed and endurance were reported. Furthermore, improvements of step length, double-support time, and Expanded Disability Status Scale were found. Conclusions. There is a limited number of published papers related to TT in persons with MS, concluding that TT, BWSTT, and RATT improve the walking speed and endurance. However, it is not clear what type of TT is most effective. RCTs with larger but more homogeneous populations are needed

Cycling on a bike desk positively influences cognitive performance

Purpose: cycling desks as a means to reduce sedentary time in the office has gained interest as excessive sitting has been associated with several health risks. However, the question rises if people will still be as efficient in performing their desk-based office work when combining this with stationary cycling. Therefore, the effect of cycling at 30% Wmax on typing, cognitive performance and brain activity was investigated. Methods: After two familiarisation sessions, 23 participants performed a test battery [typing test, Rey auditory verbal learning test (RAVLT), Stroop test and Rosvold continuous performance test (RCPT)] with electroencephalography recording while cycling and sitting on a conventional chair. Results: Typing performance, performance on the RAVLT and accuracy on the Stroop test and the RCPT did not differ between conditions. Reaction times on the Stroop test and the RCPT were shorter while cycling relative to sitting (p < 0.05). N200, P300, N450 and conflict SP latency and amplitude on the Stroop test and N200 and P300 on the RCPT did not differ between conditions. Conclusions: This study showed that typing performance and short-term memory are not deteriorated when people cycle at 30% Wmax. Furthermore, cycling had a positive effect on response speed across tasks requiring variable amounts of attention and inhibition

Aging effects on prefrontal cortex oxygenation in a posture-cognition dual-task: an fNIRS pilot study

The aging process alters upright posture and locomotion control from an automatically processed to a more cortically controlled one. The present study investigated a postural-cognitive dual-task paradigm in young and older adults using functional Near- Infrared Spectroscopy (fNIRS).Methods: Twenty healthy participants (10 older adults 72 ± 3 y, 10 young adults 23 ± 3 y) performed a cognitive (serial subtractions) and a postural task (tandem stance) as single-tasks (ST) and concurrently as a dual-task (DT) while the oxygenation levels of the dorsolateral prefrontal cortex (DLPFC) were measured.Results: In the cognitive task, young adults performed better than older adults in both conditions (ST and DT) and could further increase the number of correct answers from ST to DT (all ps ≤ 0.027) while no change was found for older adults. No significant effects were found for the postural performance. Cerebral oxygenation values (O2Hb) increased significantly from baseline to the postural ST (p = 0.033), and from baseline to the DT (p = 0.031) whereas no changes were found in deoxygenated hemoglobin (HHb). Finally, the perceived exertion differed between all conditions (p ≤  0.003) except for the postural ST and the DT (p = 0.204).Conclusions: There was a general lack of age-related changes except the better cognitive performance under motor-cognitive conditions in young compared to older adults. However, the current results point out that DLPFC is influenced more strongly by postural than cognitive load. Future studies should assess the different modalities of cognitive as well as postural load

A data-driven machine learning approach for brain-computer interfaces targeting lower limb neuroprosthetics

Prosthetic devices that replace a lost limb have become increasingly performant in recent years. Recent advances in both software and hardware allow for the decoding of electroencephalogram (EEG) signals to improve the control of active prostheses with brain-computer interfaces (BCI). Most BCI research is focused on the upper body. Although BCI research for the lower extremities has increased in recent years, there are still gaps in our knowledge of the neural patterns associated with lower limb movement. Therefore, the main objective of this study is to show the feasibility of decoding lower limb movements from EEG data recordings. The second aim is to investigate whether well-known neuroplastic adaptations in individuals with an amputation have an influence on decoding performance. To address this, we collected data from multiple individuals with lower limb amputation and a matched able-bodied control group. Using these data, we trained and evaluated common BCI methods that have already been proven effective for upper limb BCI. With an average test decoding accuracy of 84% for both groups, our results show that it is possible to discriminate different lower extremity movements using EEG data with good accuracy. There are no significant differences (p = 0.99) in the decoding performance of these movements between healthy subjects and subjects with lower extremity amputation. These results show the feasibility of using BCI for lower limb prosthesis control and indicate that decoding performance is not influenced by neuroplasticity-induced differences between the two groups

A caffeine-maltodextrin mouth rinse counters mental fatigue

Introduction: Mental fatigue is a psychobiological state caused by prolonged periods of demanding cognitive activity that has negative implications on many aspects in daily life. Caffeine and carbohydrate ingestion have been shown to be able to reduce these negative effects of mental fatigue. Intake of these substances might however be less desirable in some situations (e.g., restricted caloric intake, Ramadan). Rinsing caffeine or glucose within the mouth has already been shown to improve exercise performance. Therefore, we sought to evaluate the effect of frequent caffeine-maltodextrin (CAF-MALT) mouth rinsing on mental fatigue induced by a prolonged cognitive task. Methods: Ten males (age 23?±?2 years, physical activity 7.3?±?4.3 h/week, low CAF users) performed two trials. Participants first completed a Flanker task (3 min), then performed a 90-min mentally fatiguing task (Stroop task), followed by another Flanker task. Before the start and after each 12.5% of the Stroop task (eight blocks), subjects received a CAF-MALT mouth rinse (MR: 0.3 g/25 ml CAF: 1.6g/25 ml MALT) or placebo (PLAC: 25 ml artificial saliva). Results: Self-reported mental fatigue was lower in MR (p?=?0.017) compared to PLAC. Normalized accuracy (accuracy first block?=?100%) was higher in the last block of the Stroop in MR (p?=?0.032) compared to PLAC. P2 amplitude in the dorsolateral prefrontal cortex (DLPFC) decreased over time only in PLAC (p?=?0.017). Conclusion: Frequent mouth rinsing during a prolonged and demanding cognitive task reduces mental fatigue compared to mouth rinsing with artificial saliva

The effects of acute dopamine reuptake inhibition on performance

Introduction: Acute bupropion (BUP; dopamine/noradrenaline reuptake inhibitor) administration significantly improved time trial performance and increased core temperature in the heat (30°C). Purpose: The present study was performed to examine the effect of a dopaminergic reuptake inhibitor on exercise capacity and thermoregulation during prolonged exercise in temperate and warm conditons. Methods: Eight healthy well-trained male cyclists participated in this study. Subjects ingested either a placebo (PLAC; lactose; 20mg) or Ritalin (RIT; methylphenidate (MPH); 20mg) one hour before the start of exercise in temperate (18°C) or warm (30°C) conditions and cycled for 60 min at 55% Wmax, immediately followed by a time trial (TT; pla18 and rit18; pla30 and rit30) to measure exercise performance. Results: Ritalin did not influence TT performance at 18oC (P=0.397). TT was completed 16% faster in rit30 (38.1±6.4min) than in pla30 (45.4±7.3min; p=0.049). Power output was higher in rit30, compared to pla30 (p<0.05). In the heat Tcore was significantly higher at rest (p=0.009), at the start of exercise and throughout rit30 (p<0.05). Throughout rit30 heart rates were significantly higher (p<0.05). Prolactin concentrations decreased after one hour cycling in 18°C (p=0,036) and at rest in 30°C (p=0,007) after RIT administration. Conclusions: These results show that RIT has a clear ergogenic effect that was not apparent in 18°C. The combination of a dopamine reuptake inhibitor and exercise in the heat clearly improved performance and appeared to increase metabolic heat production, suggesting an important role for dopamine in the fatigue process