Tom Citherlet, Gustavo R. Mota, Marco Carletta, Kevin Hayoz, Daniel Pereira Silva, Grégoire P. Millet
Introduction The global rise in the elderly population is accompanied by an increased incidence of non-communicable diseases, including cancers, cardiovascular conditions, or sarcopenia. Therefore, it becomes crucial to find effective strategies to delay the onset or slow down the progression of these diseases. Hypoxic (HYP), blood flow restriction (BFR), and eccentric (ECC) training are promising modalities to mitigate the effects of aging. However, these training strategies have never been compared. Thus, this study aimed to evaluate whether moderate-intensity intermittent training (MIIT) combined with HYP, BFR, or ECC can induce similar or greater effects in strength and muscle mass in the elderly, compared to traditional cycling training (CON). Methods Fifty-five elderly participants completed a four-week MIIT protocol on cycle ergometers, divided into HYP, BFR, ECC, and CON groups. The HYP group trained under hypoxic conditions (inspired oxygen fraction ~14%), BFR group used occlusion cuffs applied proximally on thighs (~350 mmHg occlusion pressure), ECC group trained with an eccentric cycle-ergometer, and the CON group underwent standard cycling training. The first week consisted of 3 sets of 5 min exercise followed by 5 min rest and an additional set was added each week. All groups maintained a 60-rpm cadence, with intensity set at a 14-perceived exertion level on the 6-20 Borg scale. Strength parameters were assessed via isokinetic tests at angular velocities of 30°/s, 90°/s, and 180°/s, as well as isometric and endurance tests. Endurance strength was calculated as a percentage decrement score during 30 repetitions at 180°/s and the rate of force development was calculated on the isometric test. Muscle-bone cross-sectional area (CSA) was measured by integrating thigh circumference measured using a measuring tape, and anterior and posterior adipose tissue thickness assessed with a B-mode ultrasound. Results Post-training, all groups showed increased isometric quadriceps strength (14 ± 15%, p < 0.001) and strength at all angular velocities: 18 ± 17% and 15 ± 21% (30°/s), 17 ± 20% and 20 ± 26% (90°/s), 10 ± 14% and 10 ± 16% (180°/s) for quadriceps and hamstrings respectively, all P < 0.001. No significant group interaction effects were noted, except for hamstring strength at 30°/s (P = 0.038), with no improvements in the ECC group. No changes in the rate of force development or dynamic endurance post-training were noted. Thigh circumference increased (1 ± 2%, p = 0.008), without difference between training modalities. No significant variations in adipose tissue thickness or muscle-bone CSA occurred. The ECC group had higher training intensity (173.2 ± 7.5 W) than HYP (169.6 ± 9.8 W), BFR (169.9 ± 11.6 W), and CON (169.6 ± 8.4 W) groups (p < 0.001). Training heart rate was lower in ECC (104.5 ± 6.6 bpm) compared to BFR (117.5 ± 10.5 bpm; p = 0.007) and CON (122.2 ± 12.3 bpm; p = 0.001), but similar to HYP (112.2 ± 9.4 bpm). Discussio
{"title":"Hypoxic, blood flow restriction, or eccentric cycling: Which training intervention is the most effective in elderly individuals?","authors":"Tom Citherlet, Gustavo R. Mota, Marco Carletta, Kevin Hayoz, Daniel Pereira Silva, Grégoire P. Millet","doi":"10.36950/2024.2ciss036","DOIUrl":"https://doi.org/10.36950/2024.2ciss036","url":null,"abstract":"Introduction \u0000The global rise in the elderly population is accompanied by an increased incidence of non-communicable diseases, including cancers, cardiovascular conditions, or sarcopenia. Therefore, it becomes crucial to find effective strategies to delay the onset or slow down the progression of these diseases. Hypoxic (HYP), blood flow restriction (BFR), and eccentric (ECC) training are promising modalities to mitigate the effects of aging. However, these training strategies have never been compared. Thus, this study aimed to evaluate whether moderate-intensity intermittent training (MIIT) combined with HYP, BFR, or ECC can induce similar or greater effects in strength and muscle mass in the elderly, compared to traditional cycling training (CON). \u0000Methods \u0000Fifty-five elderly participants completed a four-week MIIT protocol on cycle ergometers, divided into HYP, BFR, ECC, and CON groups. The HYP group trained under hypoxic conditions (inspired oxygen fraction ~14%), BFR group used occlusion cuffs applied proximally on thighs (~350 mmHg occlusion pressure), ECC group trained with an eccentric cycle-ergometer, and the CON group underwent standard cycling training. The first week consisted of 3 sets of 5 min exercise followed by 5 min rest and an additional set was added each week. All groups maintained a 60-rpm cadence, with intensity set at a 14-perceived exertion level on the 6-20 Borg scale. \u0000Strength parameters were assessed via isokinetic tests at angular velocities of 30°/s, 90°/s, and 180°/s, as well as isometric and endurance tests. Endurance strength was calculated as a percentage decrement score during 30 repetitions at 180°/s and the rate of force development was calculated on the isometric test. \u0000Muscle-bone cross-sectional area (CSA) was measured by integrating thigh circumference measured using a measuring tape, and anterior and posterior adipose tissue thickness assessed with a B-mode ultrasound. \u0000Results \u0000Post-training, all groups showed increased isometric quadriceps strength (14 ± 15%, p < 0.001) and strength at all angular velocities: 18 ± 17% and 15 ± 21% (30°/s), 17 ± 20% and 20 ± 26% (90°/s), 10 ± 14% and 10 ± 16% (180°/s) for quadriceps and hamstrings respectively, all P < 0.001. No significant group interaction effects were noted, except for hamstring strength at 30°/s (P = 0.038), with no improvements in the ECC group. No changes in the rate of force development or dynamic endurance post-training were noted. Thigh circumference increased (1 ± 2%, p = 0.008), without difference between training modalities. \u0000No significant variations in adipose tissue thickness or muscle-bone CSA occurred. The ECC group had higher training intensity (173.2 ± 7.5 W) than HYP (169.6 ± 9.8 W), BFR (169.9 ± 11.6 W), and CON (169.6 ± 8.4 W) groups (p < 0.001). Training heart rate was lower in ECC (104.5 ± 6.6 bpm) compared to BFR (117.5 ± 10.5 bpm; p = 0.007) and CON (122.2 ± 12.3 bpm; p = 0.001), but similar to HYP (112.2 ± 9.4 bpm). \u0000Discussio","PeriodicalId":415194,"journal":{"name":"Current Issues in Sport Science (CISS)","volume":"137 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139800911","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Kyle G. P. J. M. Bolye, Patrick Schön, F. Beltrami, Matthias Greutmann, Christina M. Spengler
Introduction Congenital heart defects may require surgical intervention such as the Fontan procedure that connects the systemic venous return to the pulmonary arteries. Although this procedure has increased survival, it results in reduced exercise capacity; which is reduced not only due to cardiovascular factors, but respiratory limitations as well. However, there is a lack of evidence outlining ventilatory limitations during constant-load exercise, which better represents exercise in cardiac rehabilitation programs and non-laboratory based exercise. Therefore, the aim of the present study was to compare responses to constant-load exercise in adult Fontan patients with those of healthy well-matched controls. Methods 14 adult Fontan patients (5F, 27 ± 6yrs) were recruited with 14 healthy matched controls. Participants performed forced vital capacity (FVC), as well as maximal inspiratory and and expiratory pressure assessments (MIP and MEP, respectively). Patients performed an incremental cycling test (ICT) to exhaustion to determine peak work rate. Following a period of recovery, patients performed a constant-load cycling test (CLCT) at 70% of peak ICT work rate until exhaustion. Healthy subjects reproduced the exercise of their matched patient. Cardiorespiratory variables and heart rate (HR) were measured using a metabolic cart and a 12-lead electrocardiogram, respectively. Participants were asked to rate their perception of breathlessness and respiratory exertion via a visual analogue scale every 2 min and at peak exercise. Patients without cardiac pacemakers underwent involuntary assessments of respiratory muscle contractility via phrenic (n = 8) nerve magnetic stimulation before and following exercise to quantify respiratory muscle fatigue. Results Patients showed significantly reduced FVC, MIP and MEP compared to controls (all p < 0.025). Patients’ time-to-exhaustion during the CLCT was 7.1 ± 3.3 min. During CLCT vs. the ICT, patients reached maximal HR, respiratory rate (fR), breathlessness, respiratory exertion, and leg exertion. End-exercise V̇O2 during the CLCT did not reach ICT values, with a mean difference of 1.5 ml/kg/min (p = 0.017). Controls did not reach peak ICT responses during the CLCT. During the CLCT, patients displayed significantly elevated minute ventilation (V̇E; mean difference = 21.5 L/min), fR (mean difference = 13.8 breaths-per-minute), breathlessness (mean difference = 3.4 points), and respiratory exertion (mean difference = 2.3 points), along with significantly decreased ventilatory reserve (V̇E/maximal voluntary ventilation; mean difference = 27.5%; all p < 0.002). Following the CLCT, Fontan patients showed a larger decrease in involuntary respiratory muscle contractility (15 ± 12% vs. 2 ± 11%). Finally, a decreased ventilatory reserve was significantly correlated with decreased MIP (r = 0.723, p = 0.003) and MEP (r = 0.623, p = 0.042). Discussion/Conclusion Fontan patients had a lower-than-expected time-to-exhaus
{"title":"It’s not just the heart: respiratory limitations to constant-load exercise in adult Fontan patients and potential implications for rehabilitation","authors":"Kyle G. P. J. M. Bolye, Patrick Schön, F. Beltrami, Matthias Greutmann, Christina M. Spengler","doi":"10.36950/2024.2ciss030","DOIUrl":"https://doi.org/10.36950/2024.2ciss030","url":null,"abstract":"Introduction\u0000Congenital heart defects may require surgical intervention such as the Fontan procedure that connects the systemic venous return to the pulmonary arteries. Although this procedure has increased survival, it results in reduced exercise capacity; which is reduced not only due to cardiovascular factors, but respiratory limitations as well. However, there is a lack of evidence outlining ventilatory limitations during constant-load exercise, which better represents exercise in cardiac rehabilitation programs and non-laboratory based exercise. Therefore, the aim of the present study was to compare responses to constant-load exercise in adult Fontan patients with those of healthy well-matched controls.\u0000Methods\u000014 adult Fontan patients (5F, 27 ± 6yrs) were recruited with 14 healthy matched controls. Participants performed forced vital capacity (FVC), as well as maximal inspiratory and and expiratory pressure assessments (MIP and MEP, respectively). Patients performed an incremental cycling test (ICT) to exhaustion to determine peak work rate. Following a period of recovery, patients performed a constant-load cycling test (CLCT) at 70% of peak ICT work rate until exhaustion. Healthy subjects reproduced the exercise of their matched patient. Cardiorespiratory variables and heart rate (HR) were measured using a metabolic cart and a 12-lead electrocardiogram, respectively. Participants were asked to rate their perception of breathlessness and respiratory exertion via a visual analogue scale every 2 min and at peak exercise. Patients without cardiac pacemakers underwent involuntary assessments of respiratory muscle contractility via phrenic (n = 8) nerve magnetic stimulation before and following exercise to quantify respiratory muscle fatigue.\u0000Results\u0000Patients showed significantly reduced FVC, MIP and MEP compared to controls (all p < 0.025). Patients’ time-to-exhaustion during the CLCT was 7.1 ± 3.3 min. During CLCT vs. the ICT, patients reached maximal HR, respiratory rate (fR), breathlessness, respiratory exertion, and leg exertion. End-exercise V̇O2 during the CLCT did not reach ICT values, with a mean difference of 1.5 ml/kg/min (p = 0.017). Controls did not reach peak ICT responses during the CLCT. During the CLCT, patients displayed significantly elevated minute ventilation (V̇E; mean difference = 21.5 L/min), fR (mean difference = 13.8 breaths-per-minute), breathlessness (mean difference = 3.4 points), and respiratory exertion (mean difference = 2.3 points), along with significantly decreased ventilatory reserve (V̇E/maximal voluntary ventilation; mean difference = 27.5%; all p < 0.002). Following the CLCT, Fontan patients showed a larger decrease in involuntary respiratory muscle contractility (15 ± 12% vs. 2 ± 11%). Finally, a decreased ventilatory reserve was significantly correlated with decreased MIP (r = 0.723, p = 0.003) and MEP (r = 0.623, p = 0.042).\u0000Discussion/Conclusion\u0000Fontan patients had a lower-than-expected time-to-exhaus","PeriodicalId":415194,"journal":{"name":"Current Issues in Sport Science (CISS)","volume":"7 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139801745","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Introduction Priming effect has been shown to accelerate the oxygen consumption (V̇O2) kinetics. This phenomenon could be explained by muscle oxygen (O2) enhanced delivery, motor unit recruitment or intracellular O2 enhanced utilization (Goulding et al. 2023). Catecholamines such as epinephrine (E) and norepinephrine (NE) are known to impact the cardiovascular system as well as the respiratory system and metabolic effects (Zouhal et al. 2008). The aim of this study is two folds. Observing the effect of increased E and NE induced by cold-water hand immersion on V̇O2 kinetic during heavy intensity exercise bout (HCWR). Compare the effect of cold-water hand immersion and previous HCWR on V̇O2 kinetic to see if the sympathetic system could partially explain the priming effects. Methods Ten healthy active males (mean ± SD, age 23 ± 5 years, body mass 71 ± 6.5 kg) participated in this study. An incremental test was performed on ergometer to prescribe the intensity for the HCWR exercise (∆ 25%). Participants did an 8 min HCWR normal bout (NO), followed by 8 min rest and a second bout (SB) and hand cooling bout (HC) at heavy intensity in a randomized order. For the HC condition, participants put hands in cold water (0°C) for 2 min then directly did the HCWR. Blood samples has been taken at rest, before and directly after the HCWR. Results Just before exercise, all conditions were different, but HC E (1.095 ± 0.64 nmol/ml) increased by 347% while HC NE (6.98 ± 1.89 nmol/ml) matched values from SB NE (6.89 ± 2.22 nmol/ml). At the end of exercise, no significant difference has been found between NO E (1.44 ± 1.06) and HC E (1.54 ± 1.38 nmol/ml) while SB E (2.35 ± 1.55 nmol/ml) was significantly higher than both conditions but no differences have been found between HC (20.15 ± 8.76 nmol/ml) and SB (20.41 ± 9.74 nmol/ml) NE. V̇O2 kinetic has been sped up for both HC and SB by increasing the absolute primary prime amplitude of HC (33.88 ± 0.96 ml/min/kg),SB (34.60 ± 0.86ml/min/kg) compared to NO (32.75 ± 0.65 ml/min/kg) and reducing the prime amplitude of HC (3.22 ± 0.51 ml/min/kg), SB (2.90 ± 0.64 ml/min/kg) vs NO (3.87 ±0 .56 ml/min/kg) of the slow component of V̇O2. Discussion/Conclusion Catecholamines stimulation via hand cooling accelerated the V̇O2 kinetics enhancing the primary phase and reducing the slow component. This effect seemed to follow the priming effect but with less intensity. Increased O2 delivery appeared to be a common feature of both conditions, Motor neuron excitability due to increased NE was also a likely hypothesis, as both HC and SB had the same values just before exercise. Finally, intra-muscular enhancement illustrated by improved intracellular partial pressure kinetics and mitochondrial O2 utilization might explain the effects of catecholamines and part of the priming effect. Mitochondrial “warm-up” could be influenced by both catecholamines and priming effect resulting in a better production of adenosine triphosphate. Ref
引言 引力效应已被证明可加速氧消耗（VO2）动力学。这一现象可解释为肌肉氧（O2）输送增强、运动单位募集或细胞内 O2 利用增强（Goulding 等人，2023 年）。众所周知，儿茶酚胺（如肾上腺素（E）和去甲肾上腺素（NE））会影响心血管系统、呼吸系统和代谢作用（Zouhal 等人，2008 年）。本研究的目的有两个方面。观察在大强度运动（HCWR）期间，冷水浸泡手引起的 E 和 NE 增加对 V̇O2 动力学的影响。比较冷水浸手和之前的高强度运动对 V̇O2 运动的影响，以了解交感系统是否可以部分解释引物效应。方法 10 名健康活跃的男性（平均值± SD，年龄 23 ± 5 岁，体重 71 ± 6.5 千克）参加了本研究。他们在测力计上进行了增量测试，以确定 HCWR 运动的强度（∆ 25%）。参与者先进行 8 分钟的高负荷负重正常运动（NO），然后休息 8 分钟，再按随机顺序进行第二次运动（SB）和高强度手部冷却运动（HC）。在 HC 条件下，参与者将手放入冷水（0°C）中 2 分钟，然后直接进行 HCWR。血液样本分别在休息时、进行 HCWR 之前和之后采集。结果 就在运动前，所有条件都不同，但 HC E（1.095 ± 0.64 nmol/ml）增加了 347%，而 HC NE（6.98 ± 1.89 nmol/ml）与 SB NE（6.89 ± 2.22 nmol/ml）的值一致。运动结束时，NO E（1.44 ± 1.06）和 HC E（1.54 ± 1.38 nmol/ml）之间没有发现明显差异，而 SB E（2.35 ± 1.55 nmol/ml）明显高于两种情况，但 HC NE（20.15 ± 8.76 nmol/ml）和 SB NE（20.41 ± 9.74 nmol/ml）之间没有发现差异。通过增加 HC（33.88 ± 0.96 毫升/分钟/千克）和 SB（34.60 ± 0.86 毫升/分钟/千克）的绝对初级振幅，HC 和 SB 的 V̇O2 动力学均比 NO（32.75±0.65ml/min/kg）相比，HC（3.22±0.51ml/min/kg）、SB（2.90±0.64ml/min/kg）与 NO（3.87±0.56ml/min/kg）的 VO2 慢速成分的初级振幅降低。讨论/结论 通过手部冷却刺激儿茶酚胺可加速 VO2 的动力学，增强初级阶段，减少慢速部分。这种效应似乎与启动效应相同，但强度较小。增加氧气输送量似乎是这两种情况的共同特征，由于 NE 增加而导致的运动神经元兴奋性也是一个可能的假设，因为 HC 和 SB 在运动前都具有相同的值。最后，细胞内分压动力学和线粒体氧气利用率的提高所显示的肌肉内增强可能解释了儿茶酚胺的作用和部分启动效应。线粒体的 "热身 "可能同时受到儿茶酚胺和启动效应的影响，从而产生更好的三磷酸腺苷。参考文献 Goulding, R. P., Burnley, M., & Wüst, R. C. I. (2023).引体运动如何影响摄氧动力学：从基础机制到耐力表现。https://doi.org/10.1007/s40279-023-01832-1 Zouhal, H., Jacob, C., Delamarche, P., & Gratas-Delamarche, A. (2008).儿茶酚胺与运动、训练和性别的影响。运动医学》38，401-423。https://doi.org/10.2165/00007256-200838050-00004。
{"title":"Effect of catecholamines stimulation via hand cooling and the priming effect on the oxygen consumption kinetics","authors":"Louis Finiel, Fabio Borrani","doi":"10.36950/2024.2ciss041","DOIUrl":"https://doi.org/10.36950/2024.2ciss041","url":null,"abstract":"Introduction \u0000Priming effect has been shown to accelerate the oxygen consumption (V̇O2) kinetics. This phenomenon could be explained by muscle oxygen (O2) enhanced delivery, motor unit recruitment or intracellular O2 enhanced utilization (Goulding et al. 2023). Catecholamines such as epinephrine (E) and norepinephrine (NE) are known to impact the cardiovascular system as well as the respiratory system and metabolic effects (Zouhal et al. 2008). The aim of this study is two folds. Observing the effect of increased E and NE induced by cold-water hand immersion on V̇O2 kinetic during heavy intensity exercise bout (HCWR). Compare the effect of cold-water hand immersion and previous HCWR on V̇O2 kinetic to see if the sympathetic system could partially explain the priming effects. \u0000Methods \u0000Ten healthy active males (mean ± SD, age 23 ± 5 years, body mass 71 ± 6.5 kg) participated in this study. An incremental test was performed on ergometer to prescribe the intensity for the HCWR exercise (∆ 25%). Participants did an 8 min HCWR normal bout (NO), followed by 8 min rest and a second bout (SB) and hand cooling bout (HC) at heavy intensity in a randomized order. For the HC condition, participants put hands in cold water (0°C) for 2 min then directly did the HCWR. Blood samples has been taken at rest, before and directly after the HCWR. \u0000Results \u0000Just before exercise, all conditions were different, but HC E (1.095 ± 0.64 nmol/ml) increased by 347% while HC NE (6.98 ± 1.89 nmol/ml) matched values from SB NE (6.89 ± 2.22 nmol/ml). At the end of exercise, no significant difference has been found between NO E (1.44 ± 1.06) and HC E (1.54 ± 1.38 nmol/ml) while SB E (2.35 ± 1.55 nmol/ml) was significantly higher than both conditions but no differences have been found between HC (20.15 ± 8.76 nmol/ml) and SB (20.41 ± 9.74 nmol/ml) NE. V̇O2 kinetic has been sped up for both HC and SB by increasing the absolute primary prime amplitude of HC (33.88 ± 0.96 ml/min/kg),SB (34.60 ± 0.86ml/min/kg) compared to NO (32.75 ± 0.65 ml/min/kg) and reducing the prime amplitude of HC (3.22 ± 0.51 ml/min/kg), SB (2.90 ± 0.64 ml/min/kg) vs NO (3.87 ±0 .56 ml/min/kg) of the slow component of V̇O2. \u0000Discussion/Conclusion \u0000Catecholamines stimulation via hand cooling accelerated the V̇O2 kinetics enhancing the primary phase and reducing the slow component. This effect seemed to follow the priming effect but with less intensity. Increased O2 delivery appeared to be a common feature of both conditions, Motor neuron excitability due to increased NE was also a likely hypothesis, as both HC and SB had the same values just before exercise. Finally, intra-muscular enhancement illustrated by improved intracellular partial pressure kinetics and mitochondrial O2 utilization might explain the effects of catecholamines and part of the priming effect. Mitochondrial “warm-up” could be influenced by both catecholamines and priming effect resulting in a better production of adenosine triphosphate. \u0000Ref","PeriodicalId":415194,"journal":{"name":"Current Issues in Sport Science (CISS)","volume":"116 15","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139801974","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
M. Haas, A. Martin-Niedecken, Larissa Wild, Leander Schneeberger, Eveline S. Graf
Introduction Exergaming - physically active gaming - offers great potential for rehabilitation after knee injuries in sports, as it combines physical and cognitive challenges. However, before its use in sports rehabilitation can be recommended as safe and reliable, it is necessary to assess the biomechanics associated with knee injuries - an abducted, internally rotated knee at 10-30° of flexion (Koga et al., 2010). The aim of this study was to compare knee valgus (KV) during 10-30° knee flexion between healthy individuals without previous knee injuries and patients undergoing rehabilitation after knee injuries in three exercises of a high-intensive, immersive exergame (ExerCube). Methods The kinematics of 18 healthy subjects (25.2 ± 3.3 years, 9 female) and 6 patients (25.0 ± 5.9 years, 2 female) were recorded using marker-based movement analysis (Vicon) during 25 minutes of exergame training (Sphery Racer, ExerCube). The average maximum KV angle during 10-30° knee flexion was compared between healthy subjects and patients in the squat, jump, and burpee for the right leg using a linear mixed model. Results The average maximal KV in the squat was 4.3° for healthy subjects and 4.8° for patients. In the jump, an average maximal KV of 5.9° (healthy subjects) and 6.8° (patients) was found. With an average of 6.9° in the maximal KV of healthy subjects and 8.6° in patients, the burpee showed the highest KV of all exercises. A significant main effect was found for exercise (F(2, 45) = 57.03, p < .001), but not for the difference between groups (F(1, 22) = 0.45, p = 0.51). Discussion/Conclusion There are no significant differences in KV between healthy participants and patients undergoing rehabilitation after knee injuries. This indicates that the pre-injury movement pattern was restored in the patients, and it can be assumed that the studied exercises during exergaming are safe for use in this stage of rehabilitation. References Koga, H., Nakamae, A., Shima, Y., Iwasa, J., Myklebust, G., Engebretsen, L., Bahr, R., & Krosshaug, T. (2010). Mechanisms for noncontact anterior cruciate ligament injuries: Knee joint kinematics in 10 injury situations from female team handball and basketball. The American Journal of Sports Medicine, 38(11), 2218–2225. https://doi.org/10.1177/0363546510373570
{"title":"Comparison of biomechanical risk factors for ACL injury between patients and healthy subjects during exergaming","authors":"M. Haas, A. Martin-Niedecken, Larissa Wild, Leander Schneeberger, Eveline S. Graf","doi":"10.36950/2024.2ciss045","DOIUrl":"https://doi.org/10.36950/2024.2ciss045","url":null,"abstract":"Introduction \u0000Exergaming - physically active gaming - offers great potential for rehabilitation after knee injuries in sports, as it combines physical and cognitive challenges. However, before its use in sports rehabilitation can be recommended as safe and reliable, it is necessary to assess the biomechanics associated with knee injuries - an abducted, internally rotated knee at 10-30° of flexion (Koga et al., 2010). The aim of this study was to compare knee valgus (KV) during 10-30° knee flexion between healthy individuals without previous knee injuries and patients undergoing rehabilitation after knee injuries in three exercises of a high-intensive, immersive exergame (ExerCube). \u0000Methods \u0000The kinematics of 18 healthy subjects (25.2 ± 3.3 years, 9 female) and 6 patients (25.0 ± 5.9 years, 2 female) were recorded using marker-based movement analysis (Vicon) during 25 minutes of exergame training (Sphery Racer, ExerCube). The average maximum KV angle during 10-30° knee flexion was compared between healthy subjects and patients in the squat, jump, and burpee for the right leg using a linear mixed model. \u0000Results \u0000The average maximal KV in the squat was 4.3° for healthy subjects and 4.8° for patients. In the jump, an average maximal KV of 5.9° (healthy subjects) and 6.8° (patients) was found. With an average of 6.9° in the maximal KV of healthy subjects and 8.6° in patients, the burpee showed the highest KV of all exercises. A significant main effect was found for exercise (F(2, 45) = 57.03, p < .001), but not for the difference between groups (F(1, 22) = 0.45, p = 0.51). \u0000Discussion/Conclusion \u0000There are no significant differences in KV between healthy participants and patients undergoing rehabilitation after knee injuries. This indicates that the pre-injury movement pattern was restored in the patients, and it can be assumed that the studied exercises during exergaming are safe for use in this stage of rehabilitation. \u0000References \u0000Koga, H., Nakamae, A., Shima, Y., Iwasa, J., Myklebust, G., Engebretsen, L., Bahr, R., & Krosshaug, T. (2010). Mechanisms for noncontact anterior cruciate ligament injuries: Knee joint kinematics in 10 injury situations from female team handball and basketball. The American Journal of Sports Medicine, 38(11), 2218–2225. https://doi.org/10.1177/0363546510373570","PeriodicalId":415194,"journal":{"name":"Current Issues in Sport Science (CISS)","volume":"116 S4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139801980","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Martin Buehrer, S. Rosenstiel, Gorden Sudeck, Julia Schmid
Introduction Interventions targeting physical inactive individuals have not yielded sufficient impact yet. This may be attributed to two reasons: Firstly, affective processes during physical activity (PA) are often inadequately acknowledged (e. g. shame, feeling bad; Hohberg et al. 2022). Secondly, individuals are often not empowered to PA that positively influences affective wellbeing and mental health (Sudeck & Pfeifer, 2016). The FEEL project addresses these two deficiencies by developing a program promoting pleasant experiences, affect regulation competence, wellbeing and consequently PA. The program is grounded in Ekkekakis et al.’s (2021) conceptual framework on affective exercise experiences and their antecedent appraisals. It consists of [a] an instructor workshop focused on creating an inclusive, socially supportive atmosphere. Additionally, the program features [b] group exercise sessions covering topics such as attentional focus, preferred intensity, and flexible goal setting. Experiential learning is employed during these sessions, encouraging participants to engage not only physically but also to reflect on and in action. Finally, the program incorporates [c] a PA counseling session, during which participants individual motives for exercise are assessed, and suitable activities are discussed (Schorno et al., 2022). Methods We plan a multicenter randomized controlled trial to investigate the impact of the 6-8 week FEEL program. Inactive individuals (meeting less than 75% of recommended PA guidelines) in the age of 16 to 35 will take part in the study. Participants will be recruited via schools, universities, companies, and social work institutions. Around 300 people will be assigned to either the intervention or control group. The control group will undergo a standard fitness program (usual care). The primary outcomes positive affective exercise experiences, affect regulation competence, wellbeing and PA will be measured pre- (0 weeks), post-intervention (6 weeks) and at follow-up (12 weeks). After piloting the FEEL program in April 2024, the main study will start in fall 2024. Discussion This study explores the impact of a multifaceted intervention in a primary care context. It may provide valuable insights for effective considerations of affective processes and related competencies in PA programs. Should the FEEL program showcase positive effects, there may be interest in extending its implementation in diverse settings (e.g., rehabilitation). References Ekkekakis, P., Zenko, Z., & Vazou, S. (2021). Do you find exercise pleasant or unpleasant? The Affective Exercise Experiences (AFFEXX) questionnaire. Psychology of Sport and Exercise, 55, Article 101930. https://doi.org/10.1016/j.psychsport.2021.101930 Hohberg, V., Kreppke, J.‑N., Cody, R., Guthold, R., Woods, C., Brand, R., Dunton, G., Rothman, A., Ketelhut, S., & Nigg, C. (2022). What is needed to promote physical activity? Current Issues in Sport Science, 7, Article 005
导言 针对不爱运动者的干预措施尚未产生足够的效果。这可能有两个原因：首先，体育锻炼（PA）过程中的情感过程往往没有得到充分认识（如羞愧、感觉不好；Hohberg 等人，2022 年）。其次，个人往往没有能力进行对情感幸福和心理健康有积极影响的体育锻炼（Sudeck & Pfeifer, 2016）。FEEL 项目通过开发一项促进愉快体验、情感调节能力、幸福感并进而促进 PA 的计划，解决了这两方面的不足。该项目以 Ekkekakis 等人（2021 年）关于情感运动体验及其前因评估的概念框架为基础。该计划包括[a]一个侧重于营造包容、社会支持氛围的指导员工作坊。此外，该计划还包括[b]小组锻炼课程，涵盖注意力集中、偏好强度和灵活的目标设定等主题。在这些课程中采用了体验式学习，鼓励参与者不仅身体力行，而且在行动中进行反思。最后，该计划还包括[c]一个运动疗法咨询环节，在该环节中，将对参与者的个人运动动机进行评估，并讨论适合的活动（Schorno 等人，2022 年）。方法 我们计划开展一项多中心随机对照试验，调查为期 6-8 周的 FEEL 计划的影响。16 至 35 岁的非活跃人群（满足建议运动量准则的 75% 以下）将参与研究。参与者将通过学校、大学、公司和社会工作机构招募。约 300 人将被分配到干预组或对照组。对照组将接受标准的健身计划（常规护理）。主要结果将在干预前（0 周）、干预后（6 周）和后续（12 周）进行测量。在 2024 年 4 月试行 FEEL 计划后，主要研究将于 2024 年秋季开始。讨论 本研究探讨了在初级保健背景下进行多方面干预的影响。它可能会为在 PA 课程中有效考虑情感过程和相关能力提供有价值的见解。如果 FEEL 计划显示出积极的效果，可能会有兴趣将其推广到不同的环境中（如康复）。参考文献 Ekkekakis, P., Zenko, Z., & Vazou, S. (2021)。您觉得运动愉快还是不愉快？运动情感体验 (AFFEXX) 问卷。https://doi.org/10.1016/j.psychsport.2021.101930 Hohberg, V., Kreppke, J.-N., Cody, R., Guthold, R., Woods, C., Brand, R., Dunton, G., Rothman, A., Ketelhut, S., & Nigg, C. (2022)。促进体育锻炼需要什么？当前体育科学问题》，7，第 005 条 https://doi.org/10.36950/2022ciss005 Schorno, N., Gut, V., Conzelmann, A., & Schmid, J. (2022)。基于动机和目标的个人运动和体育咨询的有效性：随机对照试验。https://doi.org/10.1123/jsep.2021-0018 Sudeck, G., & Pfeifer, K. (2016)。体育活动相关健康能力作为运动疗法和健康运动的综合目标--简短问卷的构思与验证。Sportwissenschaft, 46, 74-87. https://doi.org/10.1007/s12662-016-0405-4
{"title":"Fostering positive affective exercise experiences and affect-related competencies for a physically active lifestyle: The FEEL project","authors":"Martin Buehrer, S. Rosenstiel, Gorden Sudeck, Julia Schmid","doi":"10.36950/2024.2ciss033","DOIUrl":"https://doi.org/10.36950/2024.2ciss033","url":null,"abstract":"Introduction \u0000Interventions targeting physical inactive individuals have not yielded sufficient impact yet. This may be attributed to two reasons: Firstly, affective processes during physical activity (PA) are often inadequately acknowledged (e. g. shame, feeling bad; Hohberg et al. 2022). Secondly, individuals are often not empowered to PA that positively influences affective wellbeing and mental health (Sudeck & Pfeifer, 2016). The FEEL project addresses these two deficiencies by developing a program promoting pleasant experiences, affect regulation competence, wellbeing and consequently PA. \u0000The program is grounded in Ekkekakis et al.’s (2021) conceptual framework on affective exercise experiences and their antecedent appraisals. It consists of [a] an instructor workshop focused on creating an inclusive, socially supportive atmosphere. Additionally, the program features [b] group exercise sessions covering topics such as attentional focus, preferred intensity, and flexible goal setting. Experiential learning is employed during these sessions, encouraging participants to engage not only physically but also to reflect on and in action. Finally, the program incorporates [c] a PA counseling session, during which participants individual motives for exercise are assessed, and suitable activities are discussed (Schorno et al., 2022). \u0000Methods \u0000We plan a multicenter randomized controlled trial to investigate the impact of the 6-8 week FEEL program. Inactive individuals (meeting less than 75% of recommended PA guidelines) in the age of 16 to 35 will take part in the study. Participants will be recruited via schools, universities, companies, and social work institutions. Around 300 people will be assigned to either the intervention or control group. The control group will undergo a standard fitness program (usual care). The primary outcomes positive affective exercise experiences, affect regulation competence, wellbeing and PA will be measured pre- (0 weeks), post-intervention (6 weeks) and at follow-up (12 weeks). After piloting the FEEL program in April 2024, the main study will start in fall 2024. \u0000Discussion \u0000This study explores the impact of a multifaceted intervention in a primary care context. It may provide valuable insights for effective considerations of affective processes and related competencies in PA programs. Should the FEEL program showcase positive effects, there may be interest in extending its implementation in diverse settings (e.g., rehabilitation). \u0000References \u0000Ekkekakis, P., Zenko, Z., & Vazou, S. (2021). Do you find exercise pleasant or unpleasant? The Affective Exercise Experiences (AFFEXX) questionnaire. Psychology of Sport and Exercise, 55, Article 101930. https://doi.org/10.1016/j.psychsport.2021.101930 \u0000Hohberg, V., Kreppke, J.‑N., Cody, R., Guthold, R., Woods, C., Brand, R., Dunton, G., Rothman, A., Ketelhut, S., & Nigg, C. (2022). What is needed to promote physical activity? Current Issues in Sport Science, 7, Article 005 ","PeriodicalId":415194,"journal":{"name":"Current Issues in Sport Science (CISS)","volume":"363 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139858281","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Introduction In Europe, more than 60 million people practice sport in a club. Through the consumption behaviour of this large number of sport club members, organised sport not only has positive impacts, but can be deleterious to the environment, for example through travel behaviour or the destruction of natural habitats caused by sport activities and required infrastructure (McCullough et al., 2020). National sport federations, which represent sport clubs and engage in sport policy issues, could be crucial when it comes to taking measures concerning the environmental sustainability of and through organised sport. However, sport federations are traditionally committed to the interests of their members and sport as their core business (Thiel & Mayer, 2009). Therefore, this study addresses the extent to which environmental policies are set on agendas in national sport federations and which drivers are relevant for the agenda setting of such policies. Methods To gain a comprehensive and in-depth understanding of these questions, we conducted an explorative qualitative multiple case study with eight Swiss sport federations. To investigate the agenda-setting process in sport organisations, we employed the multiple streams approach by Kingdon (1984). Results The developed conceptual framework shows that whereas nature conservation policies were primarily driven by national regulations, climate protection policies were pushed by engaged functionaries of the federations. Functional issues (as opposed to normative arguments), sponsor and member interests, practices of other federations and societal developments could further facilitate or impede the agenda setting of all types of environmental policies. Discussion/Conclusion This study provides valuable insights into the drivers of the agenda setting of environmental policies in national sport federations. Furthermore, it outlines the fit and limitations of the multiple streams approach according to Kingdon (1984) to explain agenda setting processes in national sport federations and extends it by external factors to gain a more holistic perspective of the phenomenon. Understanding drivers in the agenda setting of environmental policies in national sport federations is especially important because it is a prerequisite for the subsequent decision making and implementation of such policies and can help to shape the response of the organised sport to environmental challenges. References Kingdon, J. W. (1984). Agendas, alternatives, and public policies. Little Brown and Co. McCullough, B. P., Orr, M., & Watanabe, N. M. (2020). Measuring externalities: The imperative next step to sustainability assessment in sport. Journal of Sport Management, 34(5), 393–402. https://doi.org/10.1123/jsm.2019-0254 Thiel, A., & Mayer, J. (2009). Characteristics of voluntary sports clubs management: A sociological perspective. European Sport Management Quarterly, 9(1), 81–98. https://doi.org/10.1080/16184740802461744
引言 在欧洲，有 6000 多万人在俱乐部从事体育运动。通过大量体育俱乐部成员的消费行为，有组织的体育运动不仅会对环境产生积极影响，还可能对环境造成危害，例如，体育活动和所需基础设施造成的旅行行为或对自然栖息地的破坏（McCullough 等人，2020 年）。国家体育联合会代表体育俱乐部并参与体育政策问题，在采取措施实现有组织体育的环境可持续发展方面至关重要。然而，体育联合会历来致力于维护其成员的利益，并将体育作为其核心业务（Thiel 和 Mayer，2009 年）。因此，本研究探讨了各国体育联合会在多大程度上将环境政策列入议程，以及哪些驱动因素与此类政策的议程设置相关。研究方法 为了全面深入地了解这些问题，我们对瑞士八个体育联合会进行了多案例定性探索性研究。为了研究体育组织的议程设置过程，我们采用了 Kingdon（1984 年）的多流方法。结果 所制定的概念框架表明，自然保护政策主要是由国家法规推动的，而气候保护政策则是由各联合会的职能部门推动的。职能问题（相对于规范性论点）、发起人和成员的利益、其他联合会的做法以及社会发展都会进一步促进或阻碍各类环境政策的议程设置。讨论/结论 本研究为各国体育联合会制定环境政策议程的驱动因素提供了宝贵的见解。此外，本研究还概述了 Kingdon（1984 年）提出的多流方法在解释国家体育联合会议程设置过程中的适用性和局限性，并通过外部因素对其进行了扩展，以获得对这一现象的更全面的视角。了解国家体育联合会环境政策议程制定过程中的驱动因素尤为重要，因为它是后续决策和实施此类政策的先决条件，并有助于形成有组织的体育运动对环境挑战的回应。参考文献 Kingdon, J. W. (1984).议程、替代方案和公共政策》。Little Brown and Co.McCullough, B. P., Orr, M., & Watanabe, N. M. (2020).衡量外部性：体育可持续性评估势在必行的下一步。https://doi.org/10.1123/jsm.2019-0254 Thiel, A., & Mayer, J. (2009).志愿体育俱乐部管理的特点：社会学视角。欧洲体育管理季刊》，9（1），81-98。 https://doi.org/10.1080/16184740802461744
{"title":"What makes national sport federations consider environmental sustainability? A conceptual framework on the agenda setting process based on a multiple case study","authors":"Sara Piller, Siegfried Nagel","doi":"10.36950/2024.2ciss065","DOIUrl":"https://doi.org/10.36950/2024.2ciss065","url":null,"abstract":"Introduction \u0000In Europe, more than 60 million people practice sport in a club. Through the consumption behaviour of this large number of sport club members, organised sport not only has positive impacts, but can be deleterious to the environment, for example through travel behaviour or the destruction of natural habitats caused by sport activities and required infrastructure (McCullough et al., 2020). National sport federations, which represent sport clubs and engage in sport policy issues, could be crucial when it comes to taking measures concerning the environmental sustainability of and through organised sport. However, sport federations are traditionally committed to the interests of their members and sport as their core business (Thiel & Mayer, 2009). Therefore, this study addresses the extent to which environmental policies are set on agendas in national sport federations and which drivers are relevant for the agenda setting of such policies. \u0000Methods \u0000To gain a comprehensive and in-depth understanding of these questions, we conducted an explorative qualitative multiple case study with eight Swiss sport federations. To investigate the agenda-setting process in sport organisations, we employed the multiple streams approach by Kingdon (1984). \u0000Results \u0000The developed conceptual framework shows that whereas nature conservation policies were primarily driven by national regulations, climate protection policies were pushed by engaged functionaries of the federations. Functional issues (as opposed to normative arguments), sponsor and member interests, practices of other federations and societal developments could further facilitate or impede the agenda setting of all types of environmental policies. \u0000Discussion/Conclusion \u0000This study provides valuable insights into the drivers of the agenda setting of environmental policies in national sport federations. Furthermore, it outlines the fit and limitations of the multiple streams approach according to Kingdon (1984) to explain agenda setting processes in national sport federations and extends it by external factors to gain a more holistic perspective of the phenomenon. Understanding drivers in the agenda setting of environmental policies in national sport federations is especially important because it is a prerequisite for the subsequent decision making and implementation of such policies and can help to shape the response of the organised sport to environmental challenges. \u0000References \u0000Kingdon, J. W. (1984). Agendas, alternatives, and public policies. Little Brown and Co. \u0000McCullough, B. P., Orr, M., & Watanabe, N. M. (2020). Measuring externalities: The imperative next step to sustainability assessment in sport. Journal of Sport Management, 34(5), 393–402. https://doi.org/10.1123/jsm.2019-0254 \u0000Thiel, A., & Mayer, J. (2009). Characteristics of voluntary sports clubs management: A sociological perspective. European Sport Management Quarterly, 9(1), 81–98. https://doi.org/10.1080/16184740802461744","PeriodicalId":415194,"journal":{"name":"Current Issues in Sport Science (CISS)","volume":"97 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139858808","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Introduction The importance of teachers’ attitudes regarding the use of technology and media in schools and classrooms gains more recognition in the development of their professional competence. However, students often still hold limited views about digital media in educational settings. This limited perspective is likely due to the significant increase in media usage over the past two decades. It’s assumed that students also desire to use media for learning purposes, which is particularly questionable in the subject of physical education, where physical activity is of central importance. Therefore, understanding students' attitudes toward media use, both inside and outside of school, is crucial, and it's a focal point of media educational efforts. To comprehensively study this, the social-psychological construct of attitude, with its cognitive, affective, and behavioral components, is considered (Zimbardo & Gerrig, 1996). Key questions revolve around characterizing student attitudes toward media use in physical education, identifying relationships between attitude components, and determining external factors that can promote positive attitudes. Methods Following the Technology Acceptance Model (Park, 2009), a questionnaire was developed to assess attitudes and validated through a survey of eighth-grade students (N = 202). External variables, cognitive attitude, affective attitude, and behavioral attitude dimensions were examined as separate aspects. These dimensions were refined and validated through reliability analysis and factor analyses. Using these validated scales and collected data, a structural equation model was created to illustrate the relationships between external factors and attitudinal dimensions. Results The proposed model demonstrated satisfactory fit to the data (RMSEA = .06; χ2/df ratio = 1.72; CFI = 0.90). The findings indicate that the use of media in physical education and the related self-efficacy in using media have a positive impact on the cognitive aspect of attitude. However, the cognitive component of attitude does not directly influence the intention to use media in physical education. Instead, positive evaluations of media use mediate the relationship between the cognitive component and the intention to use media. The intention to use media in physical education is primarily increased through positive affective evaluations. Conclusion A negative attitude toward using media in physical education can be attributed to a lack of access and insufficient self-efficacy in utilizing it. Therefore, interventions at both the student and teacher levels should focus on effectively introducing the benefits of media-supported physical education, with the goal of enhancing self-efficacy and reducing negative attitudes. This model will be further validated at the teacher level in subsequent studies to identify external factors suitable for targeted interventions. References Park, S. Y. (2009). An analysis of the Technology
导言：在教师专业能力的发展过程中，教师对学校和课堂使用技术和媒体的态度的重要性日益得到认可。然而，学生对教育环境中的数字媒体往往仍然持有有限的看法。这种有限的观点很可能是由于过去二十年来媒体使用量的大幅增长造成的。人们假定学生也渴望将媒体用于学习目的，这在体育教育学科中尤其值得商榷，因为体育活动是该学科的核心。因此，了解学生对校内外媒体使用的态度至关重要，这也是媒体教育工作的一个重点。为了全面研究这一问题，我们考虑了态度这一社会心理学概念，其中包括认知、情感和行为三个部分（Zimbardo & Gerrig, 1996）。关键问题围绕着学生对体育教学中媒体使用的态度、确定态度各组成部分之间的关系以及确定能促进积极态度的外部因素。方法 按照技术接受模型（Park，2009 年），编制了一份问卷来评估学生的态度，并通过对八年级学生（N = 202）的调查进行了验证。外部变量、认知态度、情感态度和行为态度维度作为单独的方面进行了研究。通过信度分析和因子分析对这些维度进行了改进和验证。利用这些经过验证的量表和收集到的数据，建立了一个结构方程模型来说明外部因素和态度维度之间的关系。结果 所提出的模型与数据的拟合程度令人满意（RMSEA = .06；χ2/df 比 = 1.72；CFI = 0.90）。研究结果表明，在体育教学中使用媒体以及与此相关的使用媒体的自我效能感对态度的认知方面有积极影响。然而，态度的认知部分并不直接影响在体育教学中使用媒体的意向。相反，对媒体使用的积极评价在认知部分和媒体使用意向之间起到了中介作用。在体育教学中使用媒体的意愿主要是通过积极的情感评价来提高的。结论 在体育教学中使用媒体的消极态度可归因于缺乏使用媒体的机会和使用媒体的自我效能感不足。因此，学生和教师层面的干预措施应侧重于有效地介绍媒体支持体育教学的好处，目的是提高自我效能感和减少消极态度。该模型将在后续研究中进一步在教师层面进行验证，以确定适合进行有针对性干预的外部因素。参考文献 Park, S. Y. (2009).在理解大学生使用电子学习的行为意向方面的技术接受模型分析。教育技术与社会》，12（3），150-162。Zimbardo, P. G., & Gerrig, R. J. (1996).Psychologie.(7th transl. and rev. ed.).Springer.
{"title":"Attitudes of students towards the use of video-based media in physical education","authors":"Anne-Christin Roth, Maik Beege","doi":"10.36950/2024.2ciss067","DOIUrl":"https://doi.org/10.36950/2024.2ciss067","url":null,"abstract":"Introduction \u0000The importance of teachers’ attitudes regarding the use of technology and media in schools and classrooms gains more recognition in the development of their professional competence. However, students often still hold limited views about digital media in educational settings. This limited perspective is likely due to the significant increase in media usage over the past two decades. It’s assumed that students also desire to use media for learning purposes, which is particularly questionable in the subject of physical education, where physical activity is of central importance. Therefore, understanding students' attitudes toward media use, both inside and outside of school, is crucial, and it's a focal point of media educational efforts. To comprehensively study this, the social-psychological construct of attitude, with its cognitive, affective, and behavioral components, is considered (Zimbardo & Gerrig, 1996). Key questions revolve around characterizing student attitudes toward media use in physical education, identifying relationships between attitude components, and determining external factors that can promote positive attitudes. \u0000Methods \u0000Following the Technology Acceptance Model (Park, 2009), a questionnaire was developed to assess attitudes and validated through a survey of eighth-grade students (N = 202). External variables, cognitive attitude, affective attitude, and behavioral attitude dimensions were examined as separate aspects. These dimensions were refined and validated through reliability analysis and factor analyses. Using these validated scales and collected data, a structural equation model was created to illustrate the relationships between external factors and attitudinal dimensions. \u0000Results \u0000The proposed model demonstrated satisfactory fit to the data (RMSEA = .06; χ2/df ratio = 1.72; CFI = 0.90). The findings indicate that the use of media in physical education and the related self-efficacy in using media have a positive impact on the cognitive aspect of attitude. However, the cognitive component of attitude does not directly influence the intention to use media in physical education. Instead, positive evaluations of media use mediate the relationship between the cognitive component and the intention to use media. The intention to use media in physical education is primarily increased through positive affective evaluations. \u0000Conclusion \u0000A negative attitude toward using media in physical education can be attributed to a lack of access and insufficient self-efficacy in utilizing it. Therefore, interventions at both the student and teacher levels should focus on effectively introducing the benefits of media-supported physical education, with the goal of enhancing self-efficacy and reducing negative attitudes. This model will be further validated at the teacher level in subsequent studies to identify external factors suitable for targeted interventions. \u0000References \u0000Park, S. Y. (2009). An analysis of the Technology","PeriodicalId":415194,"journal":{"name":"Current Issues in Sport Science (CISS)","volume":"57 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139859128","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Jan Stutz, Philipp Eichenberger, Chiara Oetiker, Sacha Huber, Isabel Hirzel, Christina M. Spengler
Introduction Accurate measurement of physical activity (PA) in older adults is important, both in health research and personalized prevention. Accelerometers, used to overcome the limitations of self-reporting, were initially worn on the hips, but are increasingly worn on the non-dominant wrist. While this can improve wear compliance, the accuracy of PA intensity classification can be compromised. Given the high prevalence of mild to severe hearing loss in the older population, this study explores a novel approach: integrating an accelerometer into a hearing aid (ear sensor). We aimed to assess its accuracy and compare it to research-grade sensors worn at different locations. Methods 60 middle-aged to older adults (64.0 ± 8.0 years, 48% women) were included in this study. Each subject performed 12-13 different activities, which were pseudo-randomly selected from a list of 33 activities of daily living. Each activity lasted 8 min and included sedentary activities (e.g., lying, playing cards) low-intensity activities (e.g., hanging laundry), activities of changing intensity or without physical displacement (e.g., yoga, squats), indoor activities related to locomotion (e.g., walking, running), outdoor activities (e.g., walking uphill, cycling), and activities with aids (e.g., walking with a stroller). Oxygen consumption was measured via indirect calorimetry and used to classify activity intensity into sedentary behavior (SB, metabolic equivalent of task [MET] < 1.5), light intensity PA (LPA, 1.5 ≤ MET < 3.0), or moderate to vigorous intensity PA (MVPA, MET ≥ 3.0). The ear sensor was placed behind the left ear, while the research-grade sensors were placed on both wrists and ankles, on the hip, chest, and forehead. Estimation of PA intensity classes was done using mean amplitude deviations and ROC analyses. Contingency tables were used to determine classification accuracy. Results Overall accuracy of the ear sensor was 82.6%, performing better than both wrists (left 81.1%, right 76.0%) and both ankles (left 81.1%, right 81.9%), but worse than the forehead (83.6%), hip (85.6%) and the chest (85.9%). ROC analyses show that all sensors can effectively discriminate between sedentary vs. non-sedentary activities (AUC 0.97-0.98, exception ankles: AUC 0.95-0.96) and between MVPA vs. other (AUC 0.96-0.97, exception wrists: AUC 0.89-0.92). Discussion/Conclusion This study is the first to show that an accelerometer integrated into a hearing aid can accurately classify PA intensity and differentiate MVPA and sedentary behavior in older adults. It also confirms previous investigations showing that wrist-worn sensors – although increasingly being used to monitor PA – are less effective in capturing MVPA compared to sensors worn closer to the center of mass (including the head/ear in our study). Although the optimal wear site in older adults is a subject of ongoing debate, our data shows that a sensor integrated into a hearing aid offers a promising balance o
{"title":"Physical activity intensity classification during activities of daily living in older adults using accelerometers: Is the ear the new wrist?","authors":"Jan Stutz, Philipp Eichenberger, Chiara Oetiker, Sacha Huber, Isabel Hirzel, Christina M. Spengler","doi":"10.36950/2024.2ciss076","DOIUrl":"https://doi.org/10.36950/2024.2ciss076","url":null,"abstract":"Introduction \u0000Accurate measurement of physical activity (PA) in older adults is important, both in health research and personalized prevention. Accelerometers, used to overcome the limitations of self-reporting, were initially worn on the hips, but are increasingly worn on the non-dominant wrist. While this can improve wear compliance, the accuracy of PA intensity classification can be compromised. Given the high prevalence of mild to severe hearing loss in the older population, this study explores a novel approach: integrating an accelerometer into a hearing aid (ear sensor). We aimed to assess its accuracy and compare it to research-grade sensors worn at different locations. \u0000Methods 60 middle-aged to older adults (64.0 ± 8.0 years, 48% women) were included in this study. Each subject performed 12-13 different activities, which were pseudo-randomly selected from a list of 33 activities of daily living. Each activity lasted 8 min and included sedentary activities (e.g., lying, playing cards) low-intensity activities (e.g., hanging laundry), activities of changing intensity or without physical displacement (e.g., yoga, squats), indoor activities related to locomotion (e.g., walking, running), outdoor activities (e.g., walking uphill, cycling), and activities with aids (e.g., walking with a stroller). Oxygen consumption was measured via indirect calorimetry and used to classify activity intensity into sedentary behavior (SB, metabolic equivalent of task [MET] < 1.5), light intensity PA (LPA, 1.5 ≤ MET < 3.0), or moderate to vigorous intensity PA (MVPA, MET ≥ 3.0). The ear sensor was placed behind the left ear, while the research-grade sensors were placed on both wrists and ankles, on the hip, chest, and forehead. Estimation of PA intensity classes was done using mean amplitude deviations and ROC analyses. Contingency tables were used to determine classification accuracy. \u0000Results \u0000Overall accuracy of the ear sensor was 82.6%, performing better than both wrists (left 81.1%, right 76.0%) and both ankles (left 81.1%, right 81.9%), but worse than the forehead (83.6%), hip (85.6%) and the chest (85.9%). ROC analyses show that all sensors can effectively discriminate between sedentary vs. non-sedentary activities (AUC 0.97-0.98, exception ankles: AUC 0.95-0.96) and between MVPA vs. other (AUC 0.96-0.97, exception wrists: AUC 0.89-0.92). \u0000Discussion/Conclusion \u0000This study is the first to show that an accelerometer integrated into a hearing aid can accurately classify PA intensity and differentiate MVPA and sedentary behavior in older adults. It also confirms previous investigations showing that wrist-worn sensors – although increasingly being used to monitor PA – are less effective in capturing MVPA compared to sensors worn closer to the center of mass (including the head/ear in our study). Although the optimal wear site in older adults is a subject of ongoing debate, our data shows that a sensor integrated into a hearing aid offers a promising balance o","PeriodicalId":415194,"journal":{"name":"Current Issues in Sport Science (CISS)","volume":"99 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139859534","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Introduction In Switzerland, sporting activity among girls and young women has increased in recent years. In comparison, however, boys and young men continue to show a higher level of sporting activity at every age level and in all language regions (Lamprecht et al., 2021). As physical education (PE) lessons are an important socialisation factor for extracurricular sports activities, the question arises as to how PE is taught in Switzerland to do justice to the genders. To date, there has been little scientific research in Switzerland into which cantons implement coeducational PE and which legal or regulatory bases they rely on. Due to this research gap, this contribution will analyse which cantons implement coeducational PE and to what extent these can be linked to the legal bases or language-regional curricula. Methods With the help of a document analysis of the current legal and regulatory bases as well as the three language-regional curricula a national inventory of the existing guidelines is conducted. Furthermore, a qualitative survey of all cantonal school offices analyses the current situation regarding coeducational PE lessons in compulsory education in Switzerland. Results The results indicate that there are level-specific, cantonal, and language-regional differences. Language cultural differences are particularly evident at lower secondary school level, since in the German-speaking cantons PE lessons are mostly mono-educational and in the French and Italian-speaking cantons they are usually coeducational (Hayoz, under review). Discussion In the German-speaking cantons, especially for lower secondary level, the organisational recommendations given in these curricula are used by the municipalities and schools to make and legitimise their decisions. This recommendation can be critically reflected upon and discussed regarding the holistic educational goals of compulsory schooling, as the aim is to provide competence-orientated PE lessons and to promote interdisciplinary skills. According to Alfermann (1992), it must be questioned why precisely this differentiation feature – and no other heterogeneity feature – is used to divide the existing classes. Although performance is a constitutive characteristic for schools and for sport in general, performance is merely one “pedagogical perspective” among many for PE lessons (Frohn, 2019). Conclusion In order to analyse the specific didactic implementation of mono- and coeducational teaching in PE and to better understand the language-cultural differences, further national studies would be necessary at both local as well as school level. References Alfermann, D. (1992). Koedukation im Sportunterricht [Co-education in physical education]. Sportwissenschaft, 22(3), 323–343. Frohn, J. (2019). Geschlechter(re)konstruktionen im Sportunterricht aus Schüler*innensicht – eine Längsschnittstudie [Gender (re)constructions in physical education from the students’ perspective – A longitudinal study]. In J. Fro
导言近年来，瑞士女孩和年轻女性的体育活动有所增加。然而，相比之下，男孩和青年男子在各个年龄段和所有语言地区的体育活动水平仍然较高（Lamprecht 等人，2021 年）。由于体育课是课外体育活动的重要社会化因素，因此出现了这样一个问题：在瑞士，体育课是如何教授的，以实现两性公平？迄今为止，瑞士对哪些州实施男女同校体育课以及它们所依据的法律或法规基础几乎没有进行过科学研究。由于存在这一研究空白，本文将分析哪些州实施了男女同校体育，以及这些州在多大程度上与法律依据或语言地区课程相关联。方法通过对现行法律法规依据和三个语言地区课程的文件分析，对现有指导方针进行了全国性清点。此外，还对各州的学校办公室进行了一项定性调查，分析了瑞士义务教育中男女同校体育课的现 状。语言文化差异在初中阶段尤为明显，因为在德语州，体育课大多为单一教育，而在法语和意大利语州，体育课通常为男女同校（Hayoz，正在审查）。这项建议可以在义务教育的整体教育目标方面进行批判性的反思和讨论，因为其目的是提供以能力为导向的体育课和促进跨学科技能。Alfermann (1992)认为，必须质疑的是，为什么恰恰是这一差异特征--而不是其他异 质特征--被用来划分现有的班级。尽管成绩是学校和整个体育运动的一个构成特征，但成绩只是体育课众多 "教学视角 "中的一个（Frohn，2019 年）。结论为了分析体育单科教学和男女同校教学的具体教学实施情况，更好地理解语言文化差异，有必要在地方和学校层面开展进一步的国家研究。Koedukation im Sportunterricht [Co-education in physical education].Sportwissenschaft, 22(3), 323-343.Frohn, J. (2019).Geschlechter(re)konstruktionen im Sportunterricht aus Schüler*innensicht - eine Längsschnittstudie [Gender (re)constructions in physical education from the students' perspective - A longitudinal study].In J. Frohn, E. Gramespacher & J. Süßenbach (Eds.), Stand und Perspektiven der sportwissenschaftlichen Geschlechterforschung (Vol. 279, pp. 79-85).Feldhaus.Hayoz, C. (under review).Koedukation im Bewegungs- und Sportunterricht in der Schweiz - eine nationale Bestandsaufnahme der gesetzlichen Grundlagen und ihrer Implementation [瑞士体育课和运动课中的男女混合教育--对法律依据及其实施情况的全国性调查]。Zeitschrift für sportpädagogische Forschung.Lamprecht, M., Bürgi, R., Gebert, A., & Stamm, H. P. (2021).Sport Schweiz 2020：Kinder- und Jugendbericht [Sport Switzerland 2020: Report on Children and Young People]。Bundesamt für Sport.
{"title":"Coeducation in physical education in Switzerland – A national inventory of the legal basis and its implementation","authors":"Christelle Hayoz","doi":"10.36950/2024.2ciss007","DOIUrl":"https://doi.org/10.36950/2024.2ciss007","url":null,"abstract":"Introduction\u0000In Switzerland, sporting activity among girls and young women has increased in recent years. In comparison, however, boys and young men continue to show a higher level of sporting activity at every age level and in all language regions (Lamprecht et al., 2021). As physical education (PE) lessons are an important socialisation factor for extracurricular sports activities, the question arises as to how PE is taught in Switzerland to do justice to the genders.\u0000To date, there has been little scientific research in Switzerland into which cantons implement coeducational PE and which legal or regulatory bases they rely on. Due to this research gap, this contribution will analyse which cantons implement coeducational PE and to what extent these can be linked to the legal bases or language-regional curricula.\u0000Methods\u0000With the help of a document analysis of the current legal and regulatory bases as well as the three language-regional curricula a national inventory of the existing guidelines is conducted. Furthermore, a qualitative survey of all cantonal school offices analyses the current situation regarding coeducational PE lessons in compulsory education in Switzerland.\u0000Results\u0000The results indicate that there are level-specific, cantonal, and language-regional differences. Language cultural differences are particularly evident at lower secondary school level, since in the German-speaking cantons PE lessons are mostly mono-educational and in the French and Italian-speaking cantons they are usually coeducational (Hayoz, under review).\u0000Discussion\u0000In the German-speaking cantons, especially for lower secondary level, the organisational recommendations given in these curricula are used by the municipalities and schools to make and legitimise their decisions. This recommendation can be critically reflected upon and discussed regarding the holistic educational goals of compulsory schooling, as the aim is to provide competence-orientated PE lessons and to promote interdisciplinary skills. According to Alfermann (1992), it must be questioned why precisely this differentiation feature – and no other heterogeneity feature – is used to divide the existing classes. Although performance is a constitutive characteristic for schools and for sport in general, performance is merely one “pedagogical perspective” among many for PE lessons (Frohn, 2019).\u0000Conclusion\u0000In order to analyse the specific didactic implementation of mono- and coeducational teaching in PE and to better understand the language-cultural differences, further national studies would be necessary at both local as well as school level.\u0000References\u0000Alfermann, D. (1992). Koedukation im Sportunterricht [Co-education in physical education]. Sportwissenschaft, 22(3), 323–343.\u0000Frohn, J. (2019). Geschlechter(re)konstruktionen im Sportunterricht aus Schüler*innensicht – eine Längsschnittstudie [Gender (re)constructions in physical education from the students’ perspective – A longitudinal study]. In J. Fro","PeriodicalId":415194,"journal":{"name":"Current Issues in Sport Science (CISS)","volume":"166 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139859629","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Sabrina Köchli, Isabel Casso, Caroline Whyatt, Stefan Schmid, Marietta Ungerer, Yvonne Delevoye-Turrell, Dawn Rose
Background Parkinson’s disease (PD) is associated with motor impairments that negatively impact functional mobility (Armstrong & Okun, 2020). Functional mobility is “a person’s ability to move to accomplish activities of daily living” (Bouça-Machado et al., 2020). Whilst several assessment scales exist to evaluate PD, many focus on symptom severity or use speed as a proxy for quality of movement (e.g. Timed Up and Go; Buckley et al., 2019; Mirelman et al., 2019). Here we share the development of an integrated motion capture and pressure-sensitive gait mat sequence to assess functional mobility. Design/Methods To capture aspects of functional mobility accurately, we developed a new assessment protocol (FMA-P) to measure which aspects of movement differed between people with (n = 12) and without (n = 12) PD. The sequence involved rising from a chair, locomotion, turning, bending, picking up and placing an object (keys), and returning to sit down on the chair (mean of three trials). Results The mean age of our participants was 65.25 ± 7.8 years, 46% females. We found significant differences in locomotion such as a lower step ratio (p = 0.023), stride length (p < 0.001), and stride velocity (p = 0.019), as well as a higher double support time (p = 0.004), and stride length variability (p = 0.004) in people with PD (PwP) compared to aged-matched healthy participants. PwP showed a lower toe-off set angle (p = 0.042), lower foot height (p = 0.007), and a lower heel strike angle (p = 0.006) during locomotion. Further, a lower shoulder-elbow arm swing angular velocity (p=0.042), and a higher elbow-wrist arm swing angular velocity (p = 0.054) were observed in PwP compared to controls. Getting up from a chair was associated with a lower inclination amplitude in PwP compared to healthy controls (p = 0.047). In the turning section, we found a later onset of pelvis rotation in PwP (p = 0.034). More time was required for PwP to pick the keys up from the floor compared to controls (p = 0.002). Discussion The new measurement protocol could contribute to early diagnosis of PD, offering a quantitative evaluation of functional mobility. For example, reduced toe and heel offset angles may be early determinants of developing shuffling in later disease stages. Moreover, our findings provide objective and precise information about a variety of qualitative aspects of functional mobility. This approach can therefore be used to evaluate change over time thereby improving the evidence base of outcome variables for intervention studies. The FMA-P is of high clinical relevance to aid in the quantitative evaluation of clinical measures of motor impairment. References Armstrong, M. J., & Okun, M. S. (2019). Diagnosis and treatment of Parkinson disease. A review. JAMA, 232(6), 548-560. https://doi.org/10.1001/jama.2019.22360 Bouça-Machado, R., Duarte, G. S., Patriarca, M., Castro Caldas, A., Alarcão, J., Fernandes, R. M., Mestre, T. A.,, Matias, R., & Ferreira, J. J. (
背景 帕金森病（Parkinson's disease，PD）与运动障碍有关，运动障碍会对功能性活动能力产生负面影响（Armstrong & Okun，2020）。功能性移动能力是 "一个人完成日常生活活动的移动能力"（Bouça-Machado 等人，2020 年）。虽然有几种评估量表可用于评估帕金森病，但许多量表侧重于症状的严重程度，或使用速度作为运动质量的替代指标（例如，定时起床和走动；Buckley 等人，2019 年；Mirelman 等人，2019 年）。在此，我们分享了综合运动捕捉和压敏步态垫序列的开发过程，以评估功能移动性。设计/方法 为了准确捕捉功能移动性的各个方面，我们开发了一种新的评估方案（FMA-P），以测量有（n = 12）和无（n = 12）帕金森病患者在运动的哪些方面存在差异。评估顺序包括从椅子上站起来、移动、转身、弯腰、拿起并放置一个物品（钥匙），然后回到椅子上坐下（三次试验的平均值）。结果 参与者的平均年龄为 65.25 ± 7.8 岁，46% 为女性。我们发现，与年龄匹配的健康参与者相比，帕金森氏症患者（PwP）在运动方面存在明显差异，如步幅比（p = 0.023）、步长（p < 0.001）和步速（p = 0.019）较低，双支撑时间（p = 0.004）和步长变异性（p = 0.004）较高。在运动过程中，帕金森氏症患者表现出较低的脚尖起立角度（p = 0.042）、较低的脚高（p = 0.007）和较低的脚跟着地角度（p = 0.006）。此外，与对照组相比，患者的肩-肘手臂摆动角速度较低（p=0.042），肘-腕手臂摆动角速度较高（p=0.054）。与健康对照组相比，残疾人从椅子上站起来时的倾斜幅度较低（p = 0.047）。在翻身部分，我们发现残疾人骨盆旋转的开始时间较晚（p = 0.034）。与对照组相比，肢体残疾者从地上捡起钥匙所需的时间更长（p = 0.002）。讨论 新的测量方案可对功能活动度进行定量评估，有助于早期诊断帕金森病。例如，脚趾和脚跟偏移角度的减小可能是疾病晚期出现洗地动作的早期决定因素。此外，我们的研究结果还提供了有关功能活动度各种定性方面的客观而精确的信息。因此，这种方法可用于评估随时间推移而发生的变化，从而改善干预研究结果变量的证据基础。FMA-P具有很高的临床相关性，有助于对运动障碍的临床测量进行定量评估。参考文献 Armstrong, M. J., & Okun, M. S. (2019).帕金森病的诊断和治疗。综述。https://doi.org/10.1001/jama.2019.22360 Bouça-Machado, R., Duarte, G. S., Patriarca, M., Castro Caldas, A., Alarcão, J., Fernandes, R. M., Mestre, T. A.,, Matias, R., & Ferreira, J. J. (2020)。评估帕金森病患者功能活动能力的测量工具：系统综述。https://doi.org/10.1002/mdc3.12874 Buckely, C., Alcock, L., McArdle, R., Rana Zia Ur Rehman, R. Z. U., Del Din, S., Mazzà, C., Yarnall, A.J., & Rochester, L. (2019)。运动分析在诊断和监测神经退行性疾病中的作用：步态和姿势控制的启示。https://doi.org/10.3390/brainsci9020034 Mirelman, A., Bonato, P., Cmicioli, R., Ellis, T. D., Giladi, N., Hamilton, J. L., Hass, C. J., Hausdorff, J. M., Pelosin, E., & Almeida Q. J. (2019).帕金森病的步态障碍。柳叶刀神经学》，18（7），697-708。https://doi.org/10.1016/s1474-4422(19)30044-4
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