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Background Balance training is considered an important means to decrease fall rates in seniors. Whether virtual reality training (VRT) might serve as an appropriate treatment strategy to improve neuromuscular fall risk parameters in comparison to alternative balance training programs (AT) is as yet unclear. Objective To examine and classify the effects of VRT on fall-risk relevant balance performance and functional mobility compared to AT and an inactive control condition (CON) in healthy seniors. Data Sources The literature search was conducted in five databases (CINAHL, EMBASE, ISI Web of Knowledge, PubMed, SPORTDiscus). The following search terms were used with Boolean conjunction: (exergam* OR exer-gam* OR videogam* OR video-gam* OR video-based OR computer-based OR Wii OR Nintendo OR X-box OR Kinect OR play-station OR playstation OR virtua* realit* OR dance dance revolution) AND (sport* OR train* OR exercis* OR intervent* OR balanc* OR strength OR coordina* OR motor control OR postur* OR power OR physical* OR activit* OR health* OR fall* risk OR prevent*) AND (old* OR elder* OR senior*). Study Selection Randomized and non-randomized controlled trials applying VRT as interventions focusing on improving standing balance performance (single and double leg stance with closed and open eyes, functional reach test) and functional mobility (Berg balance scale, Timed-up and go test, Tinetti test) in healthy community-dwelling seniors of at least 60 years of age were screened for eligibility. Data Extraction Eligibility and study quality (PEDro scale) were independently assessed by two researchers. Standardized mean differences (SMDs) served as main outcomes for the comparisons of VRT versus CON and VRT versus AT on balance performance and functional mobility indices. Statistical analyses were conducted using a random effects inverse-variance model. Results Eighteen trials (mean PEDro score: 6 ± 2) with 619 healthy community dwellers were included. The mean age of participants was 76 ± 5 years. Meaningful effects in favor of VRT compared to CON were found for balance performance [ p  < 0.001, SMD: 0.77 (95 % CI 0.45–1.09)] and functional mobility [ p  = 0.004, SMD: 0.56 (95 % CI 0.25–0.78)]. Small overall effects in favor of AT compared to VRT were found for standing balance performance [ p  = 0.31, SMD: −0.35 (95 % CI −1.03 to 0.32)] and functional mobility [p = 0.05, SMD: −0.44 (95 % CI: −0.87 to 0.00)]. Sensitivity analyses between “weaker” ( n  = 9, PEDro ≤5) and “stronger” ( n  = 9, PEDro ≥6) studies indicated that weaker studies showed larger effects in favor of VRT compared to CON regarding balance performance ( p  < 0.001). Conclusions Although slightly less effective than AT, VRT-based balance training is an acceptable method for improving balance performance as well as functional mobility outcomes in healthy community dwellers. VRT might serve as an attractive complementary training approach for the elderly. However, more high-quality research is needed in order to derive valid VRT recommendations compared to both AT and CON.

Background Mindfulness as a present-oriented form of mental training affects cognitive processes and is increasingly considered meaningful for sport psychological training approaches. However, few intervention studies have examined the effects of mindfulness practice on physiological and psychological performance surrogates or on performance outcomes in sports. Objective The aim of the present meta-analytical review was to examine the effects of mindfulness practice or mindfulness-based interventions on physiological and psychological performance surrogates and on performance outcomes in sports in athletes over 15 years of age. Data Sources A structured literature search was conducted in six electronic databases (CINAHL, EMBASE, ISI Web of Knowledge, PsycINFO, MEDLINE and SPORTDiscus). The following search terms were used with Boolean conjunction: (mindful* OR meditat* OR yoga) AND (sport* OR train* OR exercis* OR intervent* OR perform* OR capacity OR skill*) AND (health* OR adult* OR athlete*). Study Selection Randomized and non-randomized controlled studies that compared mindfulness practice techniques as an intervention with an inactive control or a control that followed another psychological training program in healthy sportive participants were screened for eligibility. Data Extraction Eligibility and study quality [Physiotherapy Evidence Database (PEDro)] scales were independently assessed by two researchers. A third independent researcher was consulted to achieve final consensus in case of disagreement between both researchers. Standardized mean differences (SMDs) were calculated as weighted Hedges’ g and served as the main outcomes in comparing mindfulness practice versus control. Statistical analyses were conducted using a random-effects inverse-variance model. Results Nine trials of fair study quality (mean PEDro score 5.4, standard deviation 1.1) with 290 healthy sportive participants (athletics, cyclists, dart throwers, hammer throwers, hockey players, hurdlers, judo fighters, rugby players, middle-distance runners, long-distance runners, shooters, sprinters, volleyball players) were included. Intervention time varied from 4 weeks to over 2 years. The practice frequency lasted from twice daily to just once a week, and the mean session time covered 50–60 min. In favor of mindfulness practice compared with the control condition, large effects with narrow confidence limits and low heterogeneity were found for mindfulness scores [SMD 1.03, 90% confidence interval (CI) 0.67–1.40, p  < 0.001, I 2  = 17%]. Physiological performance indices depicted wide confidence limits accompanied with very large heterogeneity. However, the effect sizes remained very large, with confidence limits that did not overlap zero (SMD 3.62, 90% CI 0.03–7.21, p  = 0.10, I 2  = 98%). Moderate to large effects were observed for both psychological performance surrogates (SMD 0.72, 90% CI 0.46–0.98, p  < 0.001, I 2  = 14%) and performance outcomes in shooting and dart throwing (SMD 1.35, 90% CI 0.61–2.09, p  = 0.003, I 2  = 82%). Conclusions Mindfulness practice consistently and beneficially modulates mindfulness scores. Furthermore, physiological and psychological surrogates improved to a meaningful extent following mindfulness practice, as well as performance outcomes in shooting and dart throwing. It seems reasonable to consider mindfulness practice strategies as a regular complementary mental skills training approach for athletes, at least in precision sports; however, more high-quality, randomized, controlled trials on mindfulness practice and performance improvements in diverse sport settings are needed.

Annually, one in three seniors aged over 65 years fall. Balance and strength training can reduce neuromuscular fall risk factors and fall rates. Besides conventional balance and strength training, explosive or high-velocity strength training, eccentric exercises, perturbation-based balance training, trunk strength, and trunk control have also been emphasized. In contrast, aerobic exercise has to date not been included in fall-prevention studies. However, well-developed endurance capacity might attenuate fatigue-induced declines in postural control in sports-related or general activities of daily living. Physical performance indices, such as balance, strength, and endurance, are generally addressed independently in exercise guidelines. This approach seems time consuming and may impede integrative training of sensorimotor, neuromuscular, and cardiocirculatory functions required to deal with balance-threatening situations in the elderly. An agility-based conceptual training framework comprising perception and decision making (e.g., visual scanning, pattern recognition, anticipation) and changes of direction (e.g., sudden starts, stops and turns; reactive control; concentric and eccentric contractions) might enable an integrative neuromuscular, cardiocirculatory, and cognitive training. The present paper aims to provide a scientific sketch of how to build such an integrated modular training approach, allowing adaptation of intensity, complexity, and cognitive challenge of the agility tasks to the participant’s capacity. Subsequent research should address the (1) link between agility and fall risk factors as well as fall rates, (2) benefit–risk ratios of the proposed approach, (3) psychosocial aspects of agility training (e.g., motivation), and (4) logistical requirements (e.g., equipment needed).

Background The promotion of sport and physical activity (PA) for children is widely recommended to support a healthy lifestyle, but being engaged in sport bears the risk of sustaining injuries. Injuries, in turn, can lead to a reduction in current and future involvement in PA and, therefore, may negatively affect future health as well as quality of life. Thus, sports injury prevention is of particular importance in youth. Objective The aim of this systematic review was to quantify the effectiveness of exercise-based injury prevention programs in child and adolescent sport in general, and with respect to different characteristics of the target group, injury prevention program, and outcome variables. Data Sources An Internet-based literature search was conducted in six databases (CINAHL, Cochrane, EMBASE, ISI Web of Science, PubMed, SPORTDiscus) using the following search terms with Boolean conjunction: (sport injur* OR athletic injur* OR sport accident*) AND (prevent* OR prophylaxis OR avoidance) AND (child* OR adolescent OR youth). Study Selection Randomized controlled trials and controlled intervention studies in organized sport, published in English in a peer-reviewed journal, analyzing the effects of an exercise-based injury prevention program in athletes younger than 19 years of age. Data Extraction Two reviewers evaluated eligibility and methodological quality. Main outcome extracted was the rate ratio (RR). Statistical analyses were conducted using the inverse-variance random effects model. Results Twenty-one trials, conducted on a total of 27,561 athletes (median age 16.7 years [range 10.7–17.8]), were included. The overall RR was 0.54 (95 % CI 0.45–0.67) [ p  < 0.001]. Girls profited more from injury prevention than boys ( p  = 0.05). Both prevention programs with a focus on specific injuries (RR 0.48 [95 % CI 0.37–0.63]) and those aiming at all injuries (RR 0.62 [95 % CI 0.48–0.81]) showed significant reduction effects. Pre-season and in-season interventions were similarly beneficial ( p  = 0.93). Studies on programs that include jumping/plyometric exercises showed a significant better ( p  = 0.002) injury preventive effect (RR 0.45 [95 % CI 0.35–0.57], Z  = 6.35, p  < 0.001) than studies without such exercises (RR 0.74 [95 % CI 0.61–0.90], Z  = 3.03, p  = 0.002). Conclusions The results provide good evidence and clearly demonstrate beneficial effects of exercise-based injury prevention programs in youth sports as they can result in statistically significant and practically relevant injury reduction. In particular, multimodal programs including jumping/plyometric exercises can be recommended. However, there is a considerable lack of data for children (under 14 years of age) and for individual sports in general. Future research should include these groups and focus on the effect of specific exercises and compliance.

Running power as measured by foot-worn sensors is considered to be associated with the metabolic cost of running. In this study, we show that running economy needs to be taken into account when deriving metabolic cost from accelerometer data. We administered an experiment in which 32 experienced participants (age = 28 ± 7 years, weekly running distance = 51 ± 24 km) ran at a constant speed with modified spatiotemporal gait characteristics (stride length, ground contact time, use of arms). We recorded both their metabolic costs of transportation, as well as running power, as measured by a Stryd sensor. Purposely varying the running style impacts the running economy and leads to significant differences in the metabolic cost of running (p < 0.01). At the same time, the expected rise in running power does not follow this change, and there is a significant difference in the relation between metabolic cost and power (p < 0.001). These results stand in contrast to the previously reported link between metabolic and mechanical running characteristics estimated by foot-worn sensors. This casts doubt on the feasibility of measuring running power in the field, as well as using it as a training signal.

•This work includes two multi-level meta-analyses (animal and human models).•Animal model: large effect, significant, high heterogeneity.•Human model: null effect, not significant, small heterogeneity.•Hippocampal subregions moderate the effect of the animal model.•Longer interventions, different intensity levels and better attendance are warranted. Hippocampal atrophy is a commonly observed structural impairment in depressive disorders. Conversely, physical exercise has demonstrated potential benefits for increasing hippocampal volume. Consequently, both animal and human studies have explored the effect of exercise on hippocampal volume in the context of depressive symptoms, although their findings have been inconsistent. This systematic review and meta-analysis aims to evaluate whether exercise reduces hippocampal decline in animal and human depression models and identify optimal exercise parameters for this potential effect. We searched Web of Science, SportDiscus, PubMed (MEDLINE), PsycINFO, Google Scholar, and Cochrane up to April 8th, 2025. Separate multi-level meta-analyses for animal and human studies were performed. Fourteen studies were included. In the animal model meta-analysis (k = 5, 6 effects, 99 animals), a large significant average effect was observed (g = 0.90, 95 % CI 0.23 to 1.58, p=.013), with very large heterogeneity (PI=-0.78 to 2.59, I2(2)+(3)=81 %). Hippocampal subregions was a significant moderator (p = .048), with the CA4 / dentate gyrus and whole hippocampus showing the largest effect sizes. Changes in depressive symptoms (p = .316), exercise duration (p = .354), and training volume (p = .134) were also tested but did not reach statistical significance. The human model meta-analysis (k = 9, 11 effects, 423 subjects) showed a very small and non-significant average effect (g = 0.05, 95 % CI -0.05 to 0.16, p=.312) with small heterogeneity (PI=-0.05 to 0.15, I2(2)+(3)=0 %). Because of heterogeneity limitations, no moderator analyses were conducted. GRADE quality of evidence was moderate in both meta-analyses. Our systematic review and multi-level meta-analysis partially confirmed the positive effects of physical exercise on hippocampal volume in animal models with depressive symptoms, but not in humans. Further research is needed, including longer intervention durations, varied intensity settings, and strategies to maximise attendance rates.

Running power is a popular measure to gauge objective intensity. It has recently been shown, though, that foot-worn sensors alone cannot reflect variations in the exerted energy that stems from changes in the running economy. In order to support long-term improvement in running, these changes need to be taken into account. We propose leveraging the presence of two additional sensors worn by the most ambitious recreational runners for improved measurement: a watch and a heart rate chest strap. Using these accelerometers, which are already present and distributed over the athlete’s body, carries more information about metabolic demand than a single foot-worn sensor. In this work, we demonstrate the mutual information between acceleration data and the metabolic demand of running by leveraging the information bottleneck of a constrained convolutional neural network. We perform lab measurements on 29 ambitious recreational runners (age = 28 ± 7 years, weekly running distance = 50 ± 25 km, V˙O2max = 60.3 ± 7.4 mL · min−1·kg−1). We show that information about the metabolic demand of running is contained in kinetic data. Additionally, we prove that the combination of three sensors (foot, torso, and lower arm) carries significantly more information than a single foot-worn sensor. We advocate for the development of running power systems that incorporate the sensors in watches and chest straps to improve the validity of running power and, thereby, long-term training planning.

The consideration of the temporal and electromyographic (EMG) characteristics of stretch-shortening cycles (SSC) are crucial for the conceptualization of discipline-specific testing and training. Since leg muscles are first stretched (eccentric) and then contracted (concentric) during rowing, it can be assumed that the entire muscle tendon complex performs a SSC. Thus, it should be elucidated whether the rowing cycle can be attributed to either a slow or fast SSC. Therefore, EMG of the vastus medialis and gastrocnemius were captured (n = 10, 22.8 ± 3.1 years, 190 ± 6 cm, 82.1 ± 9.8 kg) during ( single scull ) rowing and subsequently compared to typical slow (countermovement jump, CMJ) and fast (drop jump, DJ) SSCs. The elapsed time between the EMG onset and the start of the eccentric phase was monitored. The pre-activation phase (PRE, before the start of the eccentric phase) and the reflex-induced activation phase (RIA 30–120 ms after the start of the eccentric phase) have been classified. Notable muscular activity was observed during DJ before the start of the eccentric phase (PRE) as well as during RIA. In contrast, neither CMJ nor rowing revealed any EMG-activity in these two phases. Interestingly, CMJ and race-specific rowing showed an EMG-onset during the eccentric phase. We conclude that rowing is more attributable to a slow SSC and implies that fast SSC does not reflect discipline specific muscle action and could hamper rowing-performance-enhancement.

PurposeIncomplete maturation and aging-induced declines of the neuromuscular system affect postural control both in children and older adults and lead to high fall rates. Age-specific comparisons of the modulation of ankle muscle activation and behavioral center of pressure (COP) indices during upright stance have been rarely conducted. The objective of the present study was to quantify aging effects on a neuromuscular level. Thus, surface electromyography (SEMG) modulation and co-activity of ankle muscles during single-leg standing was compared in healthy children, young adults and seniors.MethodsPostural steadiness (velocity and mean sway frequency of COP), relative muscle activation (SEMG modulation) and co-activation of two ankle muscles (tibialis anterior, TA; soleus, SO) were examined during single-leg stance in 19 children [age, 9.7 (SD 0.5) years], 30 adults [23.3 (1.5) years] and 29 seniors [62.7 (6.1) years].ResultsVelocity of COP in medio-lateral and anterior–posterior directions, mean sway frequency in anterior–posterior direction, relative muscle activation (TA and SO) and co-activation revealed large age effects (P < 0.003, ηp2 > 0.14). Post-hoc comparisons indicated higher COP velocities, anterior–posterior frequencies, relative SO activation and co-activation in children and seniors when compared with adults. Relative TA activation was higher in children and adults compared with seniors (P < 0.001).ConclusionsIncreased postural sway in children and seniors seems to be counteracted with higher TA/SO co-activity and SO modulation. However, TA modulation is higher in children and adults, whereas seniors’ TA modulation capacity is diminished. An aging-induced decline of TA motor units might account for deteriorations of TA modulation in seniors.

Background Gait analysis serves as an important tool for clinicians and other health professionals to assess gait patterns related to functional limitations due to neurological or orthopedic conditions. The purpose of this study was to assess the validity of a body-worn inertial sensor system (RehaGait®) for measuring spatiotemporal gait characteristics compared to a stationary treadmill (Zebris) and the reliability of both systems at different walking speeds and slopes. Methods Gait analysis was performed during treadmill walking at different speeds (habitual walking speed (normal speed); 15 % above normal walking speed; 15 % below normal walking speed) and slopes (0 % slope; 15 % slope) in 22 healthy participants twice 1 week apart. Walking speed, stride length, cadence and stride time were computed from the inertial sensor system and the stationary treadmill and compared using repeated measures analysis of variance. Effect sizes of differences between systems were assessed using Cohen’s d, and limits of agreement and systematic bias were computed. Results The RehaGait® system slightly overestimated stride length (+2.7 %) and stride time (+0.8 %) and underestimate cadence (−1.5 %) with small effect sizes for all speeds and slopes (Cohen’s d ≤ 0.44) except slow speed at 15 % slope (Cohen’s d > 0.80). Walking speed obtained with the RehaGait® system closely matched the speed set on the treadmill tachometer. Intraclass correlation coefficients (ICC) were excellent for speed, cadence and stride time and for stride length at normal and fast speed at 0 % slope (ICC: .91–1.00). Good ICC values were found for stride length at slow speed at 0 % slope and all speeds at 15 % slope (ICC: .73–.90). Both devices had excellent reliability for most gait characteristics (ICC: .91–1.00) except good reliability for the RehaGait® for stride length at normal and fast speed at 0 % slope and at slow speed at 15 % slope (ICC: .80–.87). Conclusions Larger limits of agreement for walking at 15 % slope suggests that uphill walking may influence the reliability of the RehaGait® system. The RehaGait® is a valid and reliable tool for measuring spatiotemporal gait characteristics during level and inclined treadmill walking.