HintergrundZur Bestimmung der therapeutischen Impulsrichtung bei der Atlastherapie nach Arlen gilt die Anfertigung einer a.-p.-Röntgenaufnahme des zervikookzipitalen Übergangs traditionell als ...unverzichtbar. Überlegungen zum Strahlenschutz sowie technische und ökonomische Aspekte förderten die Suche nach einer klinischen Methode, die in der Lage ist, die radiologische Untersuchung zu ersetzen. Zur Diskussion stand der manualdiagnostische 3-Zeichen-Test nach CoenenMethodikDie Zuverlässigkeit des 3-Zeichen-Tests wurde an 438 neurologisch gesunden Patienten mit Funktionsstörung der oberen Halswirbelsäule (HWS) untersucht. Das Testergebnis jedes einzelnen Patienten wurde mit der Analyse seiner Atlas-a.-p.-Röntgenaufnahme verglichen. Jeder Patient erhielt die Atlastherapie nach Arlen gemäß dem 3-Zeichen-Test-Ergebnis; die Bestimmung der Sensitivität des Tests erfolgte aus dem Therapieergebnis nach einmaliger Behandlung.ErgebnisseEine Übereinstimmung des 3-Zeichen-Tests mit der Röntgenbildanalyse ergab sich bei 84,6 % der untersuchten Patienten, keine Übereinstimmung fand sich bei 8,5 % und unklar blieben 6,3 %. Eine Bestätigung des Tests durch das Therapieergebnis nach einmaliger Behandlung wurde bei 94,5 % der Patienten ermittelt, bei 5,3 % fand sich keine Bestätigung.SchlussfolgerungBei der Bestimmung der atlastherapeutischen Impulsrichtung erwies sich der 3-Zeichen-Test als mindestens gleichwertig mit der Röntgenbildanalyse. Der Test kann somit die rein therapeutisch indizierte Röntgenuntersuchung des zervikookzipitalen Übergangs ersetzen und leistet einen wichtigen Beitrag zur Minderung der Strahlenexposition. Er ist kein Ersatz für eine diagnostische Röntgenaufnahme zum Ausschluss pathologischer Prozesse an der HWS bei auffälliger Anamnese und suspekter Symptomatik.
Statement of the Problem: Previous research has focused on mitigating head impacts to improve sport safety through rule changes and enforcing tackling techniques. However, there is limited ...information on pre-season factors that could be modified to further reduce head impact severity. We aimed to predict head impact biomechanics on factors such as: (1) head protection time, (2) cervical strength, and (3) anthropometric characteristics and helmet dimensions.Methods: Twenty-seven youth tackle football players (age=12.2±0.4yrs, height=161.5±9.7m, mass=55.5±15.2kg) participated in this study. Participants completed a pre-season protocol to analyze all objectives. The first objective included a motion capture analysis of a head protection reaction time and eye movement time protocol during a single- and dual-task performance using a light stimulus. The head protection time consisted of a player strategy, head turn, and hand reaction time (s) while eye movement time (s) was recorded using videography. The second objective used a Multi-Cervical Unit to assess cervical isometric strength (N/kg) and time to peak (s) in flexion, extension, left and right lateral flexion. We also captured time to peak in all 4 directions. The third objective captured anthropometric characteristics and helmet dimensions. We used univariate linear regression model with random intercepts to determine if there were associations between our predictors and head impact outcomes. We also performed separate linear regression models to determine the association of predictors and number of impacts.Results: Our results from the first aim suggests slower eye movement time is associated with an increase in rotational velocity. Our results for aim two indicated stronger cervical strength in the left and right lateral flexion were associated with decreased peak rotational velocity. Slower time to peak left lateral flexion was associated with increased linear acceleration. Lastly, slower time to peak flexion and extension were associated with increased rotational velocity. For our third aim we discovered several anthropometric characteristics and helmet dimensions to influence head impact severity and frequency.Conclusions: Several factors were found to be associated with increased head impact frequency and severity. Our study found potential modifiable factors, interventions, and designs to improve sport safety and mitigate head impacts among youth players.
Chapter 1: Molecular Mechanism of Mitochondrial Fragmentation and Glucose Metabolism under Disturbed Flow in Endothelial Cells: Focus on the Role of Dynamin-Related Protein 1. The luminal surface of ...the endothelium is continually exposed to dynamic blood flow patterns that is known to alter immunometabolic phenotypes of the endothelial cells (ECs). Recent literature reported that inhibition of the metabolic reprogramming to glycolysis or enhancement of oxidative phosphorylation (OXPHOS) is considered as an effective strategy to prevent EC proinflammatory activation and eventually the progression of vascular diseases. Endothelial mitochondria are highly dynamic organelles playing versatile roles in maintaining endothelial cell homeostasis working as bioenergetic, biosynthetic, and signaling organelles. The balance between fusion and fission processes modulates mitochondrial network, which is essential for maintaining mitochondrial homeostasis. Disruption of the orchestrated balance, especially toward excessive fission resulting in fragmented and dysfunctional mitochondria, has been shown to be associated with atheroprone phenotypes of ECs. However, there is a key knowledge gap with respect to morphology of EC mitochondria under different flow conditions and its role on EC immunometabolic phenotypes. In chapter 1, the purpose of this study was to investigate the effect of different flow patterns on mitochondrial morphology in ECs and its implication in immunometabolic endothelial phenotype. The overarching hypothesis of the Chapter 1 was that disturbed flow (DF) will increase mitochondrial fragmentation, which will facilitate glycolysis and inflammatory activation in ECs. In the study, mitochondrial morphology was analyzed in ECs at multiple segments of the aorta and arteries in EC-specific photo-activatable mitochondria (EC-PhAM) mice. Increased mitochondrial fragmentation was observed at atheroprone regions (e.g., lesser curvature of the aortic arch, LC) with increased dynamin-related protein 1 (Drp1) activity, compared with the atheroprotective regions (e.g., thoracic aorta, TA). The atheroprone regions also showed a higher level of endothelial activation and glycolysis. Carotid artery partial ligation surgery, as a surgical model of DF, significantly induced mitochondrial fragmentation with elevated Drp1 activity and increased EC activation. in vitro experiments recapitulated in vivo observations. Inhibition of Drp1 activity by mdivi-1 attenuated the DF-induced atheroprone EC phenotypes, showing the close relationship between mitochondrial morphology and atheroprone phenotypes of ECs. As for the molecular mechanism, hypoxia-inducible factor 1 α (HIF-1α) stabilization and its nuclear translocation was significantly increased under DF, which was attenuated by mdivi-1 treatment. Mitochondrial reactive oxygen species (mtROS) and succinate, which are known to reduce prolyl hydroxylase domain 2 (PHD2) activity thereby increasing HIF-1α stabilization, were significantly elevated under DF, but those were attenuated by mdivi-1 treatment. Finally, a 7-week voluntary wheel-running exercise training significantly decreased mitochondrial fragmentation with a down-regulation of VCAM-1 expression at the LC. In conclusion, our data suggest that DF induces mitochondrial fragmentation with increased Drp1 activity, which is associated with an atheroprone EC phenotype. In addition, regular practice of aerobic exercise reduces mitochondrial fragmentation and prevents ECs from an atheroprone endothelial phenotype at the atheroprone regions.Chapter 2: Molecular Mechanisms for Unidirectional Flow (UF)/Exercise-Induced improvement of Mitochondrial Integrity: Focus on phosphatase and tensin homolog (PTEN)-induced putative kinase 1 (PINK1) /PARKIN-Dependent Mitochondrial Autophagy (Mitophagy). Phosphatase and tensin homolog (PTEN)-induced putative kinase 1 (PINK1) is an essential molecule in the mitophagy process and known to act as a cytoprotective protein involved in several cellular mechanisms in mammalian cells. It has been documented that the loss of PINK1 expression in mice and various cell types enhance susceptibility to stress-induced cell damage, while the overexpression of PINK1 significantly attenuates stress-induced mitochondrial and cellular dysfunction. In chapter 2, the purpose of this study was to investigate PINK1 expression and its subcellular localization under an exercise-mimic laminar shear stress (LSS) condition in human primary endothelial cells and in exercizing mice, and its implications on endothelial homeostasis and cardiovascular disease (CVD) prevention. The overarching hypothesis of the Chapter 2 was that unidirectional flow (UF) will increase cytosolic PINK1 expression through which UF-preconditioned ECs will be more protective against an accumulation of dysfunctional mitochondria via a greater mitophagy induction. In this study, we measured the full-length PINK1 (FL-PINK1) mRNA and protein expression levels in ECs under unidirectional laminar shear stress (LSS). LSS significantly elevated both FL-PINK1 mRNA and protein expressions in ECs. Mitochondrial fractionation assays showed a decrease in FL-PINK1 accumulation in the mitochondria with an increase in the cytosolic FL-PINK1 level under LSS. Confocal microscopic analysis confirmed these subcellular localization patterns suggesting downregulation of mitophagy induction. Indeed, mitophagy flux was decreased under LSS, determined by a mtKeima probe. Mitochondrial morphometric analysis and mitochondrial membrane potential determined by tetraethylbenzimidazolylcarbocyanine iodide (JC-1) showed mitochondrial elongation and increased mitochondrial membrane potential under LSS respectively, suggesting that an elevation of cytosolic PINK1 is not related to an immediate induction of mitophagy. However, increased cytosolic PINK1 elevated mitophagic sensitivity toward dysfunctional mitochondria in pathological conditions. Preconditioned ECs with LSS showed lower mtDNA lesions under angiotensin II stimulation. Moreover, LSS-preconditioned ECs showed rapid Parkin recruitment and mitophagy induction in response to mitochondrial toxin (i.e., carbonyl cyanide chlorophenylhydrazone, CCCP) treatment compared to the control. We measured PINK1 expression at ECs of the thoracic aorta in exercised mice, a physiological LSS-enhanced model, which was significantly elevated compared to sedentary animals. In addition, exercise-preconditioned mice were more protective to angiotensin II-induced mtDNA lesion formation in the mouse abdominal aorta than sedentary mice, suggesting a potential protective mechanism of exercise in a PINK1-dependent manner. In conclusion, LSS increases a cytosolic pool of FL-PINK1, which may elevate the mitophagic sensitivity toward dysfunctional mitochondria or activate other cytoprotective mechanisms in ECs. Our data suggest that exercise may support mitochondrial homeostasis in vascular ECs by enhancing PINK1-dependent cell protection mechanisms.
BACKGROUND: Recent studies have shown that high intensity interval training (HIIT) can improve cardiometabolic health in individuals with spinal cord injury (SCI). Individuals with SCI experience a ...wide array of barriers to participate in exercise such as lack of time, accessible equipment, and transportation. It is imperative to identify modes of exercise that provide effective health benefits and are accessible while requiring low time commitment. Studies have demonstrated that HIIT has similar positive improvements in cardiometabolic health with 20% of total time commitment compared to moderate intensity exercise (MIT) in short term studies. OBJECTIVES: The purpose of this study is to assess changes in cardiometabolic health following 16-weeks of a home-based telehealth HIIT arm crank exercise program in individuals with long standing SCI. METHODS: Participants were randomly assigned to 16 weeks of HIIT arm crank exercise training or a no-exercise control group. Body composition via DXA, resting energy expenditure (REE), blood lipids, fasting insulin sensitivity, blood pressure, aerobic capacity, and muscular strength and endurance were assessed at baseline and at 16 weeks post intervention. Qualitative interviews were conducted for the HIIT group upon completion of intervention.RESULTS: Five participants (3 male, 2 female; n=3 in control, n=2 in HIIT exercise; mean age 53.5 ± 8.5) with longstanding SCI completed the exercise study. The preliminary data of this study shows significant group by time effects for gynoid % fat (p=0.015) and REE (p=0.006) showing improvement for body composition and REE in the HIIT group relative to control. Although not statistically significant, there were mean improvements in aerobic capacity and muscular endurance in HIIT group compared to control. CONCLUSION: These preliminary data demonstrate that 16 weeks of telehealth HIIT may improve body composition and REE in individuals with SCI. The qualitative results demonstrate that the participants reported enjoying the remote aspect, increases in energy levels, and increases daily quality of life. These preliminary results suggest that a long-term telehealth HIIT program to individuals with SCI and may show improvements in overall health; however, a larger sample size is needed in order to confirm these observations. We hope to demonstrate that home-based telehealth HIIT program will improve cardiometabolic health, can yield high adherence, and be an enjoyable form of exercise for individuals with SCI.
The double pole (DP) technique, which engages the upper and lower body, is the most often used technique in classic ski competitions. Races are often won on uphills, where the primary mechanical ...impediment is gravity. Therefore, research analyzing the relationship between both upper body strength/body mass and lower body strength/body mass and DP performance on flat and uphill terrain, using standard ratio, absolute and allometric ratio, is a worthy enterprise.Nine (9) athletes, 7 men and 2 women completed two rollerski double pole time trials, one on flat terrain (1200 m) and one on inclined terrain (1000 m), as well as three upper body strength tests and a test for lower body strength. Relationships between upper and lower body strength using absolute, standard ratio, and allometric scaling were analyzed using a Pearson’s product-moment correlation coefficient. The key findings were:1) There is a strong correlation between upper and lower body strength/mass relationships and double pole performance at incline and on the flat terrain using all three scalings. Using allometric scalings, the correlation between seated double pole and double pole performance was statistically significant on flat (r = -0.96) and inclined (r = -0.90) terrain. Absolute scalings of the seated double pole were also statistically significant on flat (r = -0.88) and inclined (r = -0.94) terrain. While the seated double pole is the most sport specific exercise to the double pole, the bench press also showed strong relationships with time trial performance on flat (absolute, r = -0.92; standard ratio, r = -0.81; allometric, r = -0.86) and incline (r = -0.93; standard ratio, r = -0.87; allometric, r = -0.89).Regarding lower body strength, all three scalings of leg press strength showed statistically significant (P < 0.05) or highly significant (P < 0.01) correlations with incline and flat double pole performance.2) The strongest correlation between lower body strength and double pole performance at inclines (r = -0.90) and on the flat (r = -0.93) came using absolute scalings of lower body strength. Allometric scaling on the flat (r = -0.88) and inclined (r = -0.89) terrains was also statistically significant (P < 0.05), as was standard ratio on flat (r = -0.75) and inclined terrain (r = -0.72).3) Allometric and standard ratio scalings of upper and lower body strength/body mass tended to have a stronger correlation with double pole performance on inclined terrain compared to flat terrain, suggesting that perhaps, when the effect of gravity increases, so too does the influence of strength in relation to body mass. Using standard ratio scaling, the correlation coefficient of the seated double to performance on flat terrain was r = -0.48, while on inclined terrain, the correlation coefficient was r = -0.68. There was a similar difference between flat (r = -0.59) and incline (r = -0.75) with bench pull and leg press (flat, r = -0.72; incline, r = -0.75). Using allometric scaling of the bench pull, correlations to flat (r = -0.79) performance was also lower than performance at an incline (-0.89). This was also true in the bench press (flat, r = -0.86; incline, r = -0.89).This confirms prior research supporting the importance of upper and lower body sport-specific strength development for cross-country ski performance, particularly with the double pole subtechnique. Practical applications exist primarily for long-distance skiing, where double pole is used exclusively, but recommendations for traditional classic and skate skiing, regarding upper and lower body strength development with respect to body mass, are also discussed.
The purpose of this study was to examine the influence of unstructured daily play participation on chronic and perceived stress patterns and obesity prevalence in elementary school children compared ...to children receiving standard recess time in elementary schools. Fourth grade students (n=130) from six north Texas public schools were assessed using the Stress in Children (SiC) Questionnaire, hair cortisol concentration, body fat percentage, and whether they engaged in 30 minutes or 45 minutes of unstructured play daily. Three schools of students (control; n=66) engaged in 30 minutes of recess daily and three schools of students (intervention; n=64) engaged in 45 minutes of recess daily. SiC questionnaires were administered to each participant on an electronic device via Qualtrics to obtain their perceived chronic stress level. Hair samples were collected to assess the actual chronic cortisol level in each child. The cortisol was analyzed using ELISA protocol following cortisol extraction procedures. Bioelectrical impedance scales were used to collect fat percentage of each student. Previous research shows the average 9-year-old will have a hair cortisol level of 6.7 pg/mg, and the average 10-year-old will have a hair cortisol level of 8.5 pg/mg. An independent samples t-test showed the intervention group was significantly less chronically stressed than the control group (p = .018). The intervention students showed below average levels of chronic stress (9-year-olds = 6.27 pg/mg and 10-year-olds = 3.67 pg/mg) while the control school children were at or above average levels of chronic stress (9-year-olds = 20.89 pg/mg and 10-year-olds = 13.16 pg/mg). No significant group differences were found in SiC scores or body fat percentages (>.05) of participants. Overall, findings suggest 45 minutes of unstructured, outdoor play has a positive impact on lowering chronic cortisol levels. For children participating in at least 30 minutes of unstructured, outdoor play, body fat levels, on average, will be healthy, but 45 minutes is significantly more beneficial for decreasing and managing chronic stress.
Many professional athletes have raised awareness about and publicly protested social injustices. Athlete activism research has generally supported that such activism results in harsh backlash against ...the athletes, stemming from beliefs that politics and social justice protests do not belong in sports; patriotic/nationalistic values leading individuals to view such protests as un-American; and racial beliefs and attitudes, especially towards African American athletes. While robust, much of this research is theoretical or qualitative in nature and mainly examined reactions towards Black football players, with less focus on White athletes or those in different sports. To address these gaps, the current research used quantitative methods to examine attitudes towards a Black or White athlete who advocates for social justice. Social Identity Theory was applied to explore the relationships between fans' own patriotic beliefs, level of sports identification, and their athlete activist attitudes. Participants' scores on the Modern Racism Scale were assessed to examine the influence of these racial beliefs on athlete activist evaluations. Results yielded no impact of athlete's race, sports league, or their interaction on participants' athlete attitudes. However, consistent with hypotheses, relationships were found between social justice beliefs, level of sports fandom, patriotic beliefs, and Modern Racism beliefs. Implications of these findings, limitations, and future research directions were discussed.
This study aims to improve a soccer player’s shot on goal by applying a core exercise intervention to determine its influence on balance, absolute strength, and shot accuracy. Collegiate soccer ...players (N=20) were tested at baseline and after twenty days. Balance was measured using the Star Excursion Balance Test (SEBT) and the Y Balance Test (YBT). Participant shot accuracy was measured using an accuracy net that includes multiple targets. Absolute strength was measured using a one repetition maximum (1RM) bench press test and squat test, and endurance measured using a plank hold test. The control group (CTRL, n=10) continued with activities of daily living (ADL), including regular soccer practices, without implementing a core exercise intervention. The intervention group (INT, n=10) completed a core exercise intervention program consisting of unilateral, dynamic balance exercises. Following the twenty-day intervention period, both groups were tested in all metrics again to determine if any changes occurred. Data were analyzed to determine if balance improved in the core intervention group in the posterior and lateral reaches, as well as their overall strength. Although the results did not indicate significant differences in shot accuracy, the study encourages further research because posterior balance significantly improved in the INT group but not CTRL in all balance tests. Future core intervention may include exercises to improve anterior and medial balance to determine if accuracy is improved by a core intervention program.
Approximately 1 out of 3 patients fail to return to previous levels of sport participation after anterior cruciate ligament reconstruction (ACLR), with injury-related fear identified as a potential ...barrier for return to sport. However, we do not know how injury-related fear is associated with other meaningful psychological responses to injury, or how patient perceptions of these psychological responses relate to their rehabilitation experiences. The purpose of this cross-sectional, explanatory sequential mixed-methods study was to explore how perceptions of self-determined motivation, athlete burnout, and injury-related fear affected psychological experiences during ACLR rehabilitation in patients between 4- and 6-months post-ACLR. 13 participants were recruited and completed questionnaires measuring self-determined motivation, athlete burnout, perceived stress, and injury-related fear. A sub-sample of 5 participants participated in a semi-structured interview to further underline patient experiences during ACLR rehabilitation. A strong, positive relationship was observed between perceived stress and injury-related fear (rho = 0.70, p = 0.008). Thematic analysis revealed five themes related to the rehabilitation experience: 1) struggling with the recovery process, 2) acknowledging negative emotional states, 3) drive to return to sport and normal life, 4) understanding and finding purpose in rehabilitation, and 5) successfully navigating the recovery process. These preliminary data suggest that negative emotional states, such as injury-related fear and athlete burnout, may be related to self-determined motivation and perceived stress after ACLR.
Fifteen participants ages 18 – 40 volunteered for this study. Inclusion criteria consisted of scoring 28 or higher on the motor imagery questionnaire- revised second version. Pre and post maximal ...contractions were performed during each intervention, kinesthetic motor imagery, visual motor imagery, and a control. Kinesthetic motor imagery: listening to an audio of what to imagine. Visual motor imagery: watching a video of what to image and a control: resting for 5 minutes. Results of two-way (3 x 2) Repeated Measures ANOVA condition (control, kinesthetic, visual) x time (pre x post) showed no significant interaction between the condition and the time. These results show that mental imagery does not have an acute effect on maximal torque.
