Determining V̇O2max in competitive swimmers: Comparing the validity and reliability of cycling, arm cranking, ergometer swimming, and tethered swimming.

OBJECTIVES: This study aims to identify the optimal method for determining V̇O2max in competitive swimmers in terms of validity and test-retest reliability. DESIGN: Controlled experiment. METHODS: Twenty competitive swimmers performed four maximal incremental exercise tests: cycling, arm cranking, ergometer swimming, and tethered swimming. Gas analysis was conducted to estimate V̇O2max. Validity was assessed in terms of the amount of variance of the performance on a 1500-m time trial explained by the estimated V̇O2max . Test-retest reliability was evaluated using the intraclass correlation coefficient (ICC). RESULTS: V̇O2max obtained from tethered swimming, ergometer swimming, and cycling explained a similar amount of variance of the 1500-m performance (R2 = 0.64, 0.64 and 0.65, respectively). However, ergometer swimming yielded significantly lower V̇O2max estimates (40.54 ±â€¯6.55 ml/kg/min) than tethered swimming (54.40 ±â€¯6.21 ml/kg/min) and cycling (54.39 ±â€¯5.63 ml/kg/min). Arm cranking resulted in both a lower explained variance (R2 = 0.41) and a significantly lower V̇O2max (43.14 ±â€¯7.81 ml/kg/min). Tethered swimming showed good reliability (ICC = 0.81). CONCLUSIONS: Bicycle and tethered swimming tests demonstrated high validity with comparable V̇O2max estimates, explaining a large proportion of differences in endurance performance. Choosing between these two methods involves a trade-off between a higher practical applicability and reliability of the bicycle test and the more sport-specific nature of the tethered swimming test.

How intrinsically motivating are swimming instructors/lessons in the Netherlands? An observational study through the lens of self-determination theory.

Background: It is desirable that (more) children continue swimming after having completed their swimming lessons to preserve their swimming skills and water safety, and as part of an active, healthy lifestyle. This may be encouraged by stirring children's intrinsic motivation for swimming during swimming lessons. However, it is currently unknown how intrinsically motivating swimming lessons are in Western countries. Purpose: This study examined to what extent swimming instructors in the Netherlands cater to the basic needs of autonomy, competence, and relatedness, which, according to Self-Determination Theory (SDT), promote intrinsic motivation. Additionally, it examined whether an SDT-based teaching program prompts instructors to better meet these needs, and to what extent the teaching program, the education and experience of the instructor, and the group size predict the employment of SDT in swimming lessons. Methods: A total of 128 swimming lessons given by equally many instructors were observed in the Netherlands and rated on a modified version of the SDT teaching style scale to assess autonomy, competence, and relatedness support. The swimming lessons referred to four teaching programs, one of which was explicitly based on SDT. Results: Instructors exhibited autonomy-thwarting, weakly competence-supportive, and relatedness-supportive behaviors. The SDT-based teaching program scored higher on the provision of autonomy, competence, and relatedness in lessons. This finding was significant for autonomy. Teaching program was the only significant predictor of SDT employment by instructors. Conclusion: Further improvement is desirable in catering to the basic needs, particularly autonomy, which can be achieved by deliberately implementing the principles of SDT into teaching programs for swimming.

A Muscle Load Feedback Application for Strength Training: A Proof-of-Concept Study.

Muscle overload injuries in strength training might be prevented by providing personalized feedback about muscle load during a workout. In the present study, a new muscle load feedback application, which monitors and visualizes the loading of specific muscle groups, was developed in collaboration with the fitness company Gymstory. The aim of the present study was to examine the effectiveness of this feedback application in managing muscle load balance, muscle load level, and muscle soreness, and to evaluate how its actual use was experienced. Thirty participants were randomly distributed into 'control', 'partial feedback', and 'complete feedback' groups and monitored for eight workouts using the automatic exercise tracking system of Gymstory. The control group received no feedback, while the partial feedback group received a visualization of their estimated cumulative muscle load after each exercise, and the participants in the complete feedback group received this visualization together with suggestions for the next exercise to target muscle groups that had not been loaded yet. Generalized estimation equations (GEEs) were used to compare muscle load balance and soreness, and a one-way ANOVA was used to compare user experience scores between groups. The complete feedback group showed a significantly better muscle load balance (ß = -18.9; 95% CI [-29.3, -8.6]), adhered better to the load suggestion provided by the application (significant interactions), and had higher user experience scores for Attractiveness (p = 0.036), Stimulation (p = 0.031), and Novelty (p = 0.019) than the control group. No significant group differences were found for muscle soreness. Based on these results, it was concluded that personal feedback about muscle load in the form of a muscle body map in combination with exercise suggestions can effectively guide strength training practitioners towards certain load levels and more balanced cumulative muscle loads. This application has potential to be applied in strength training practice as a training tool and may help in preventing muscle overload.

Body-and movement-oriented interventions for posttraumatic stress disorder: An updated systematic review and meta-analysis.

This study is an update of the meta-analysis we published in 2019 on the effectiveness of body- and movement-oriented interventions (BMOIs) for adults with posttraumatic stress disorder (PTSD) in decreasing PTSD symptoms and secondary outcomes of depressive symptoms, sleep disturbance, and interoceptive awareness. Search terms for BMOIs and PTSD were combined to identify eligible studies in four bibliographical databases. Articles were selected if they included adult participants with a primary diagnosis of PTSD, included BMOI as one of the investigated therapies, were designed as a comparative outcome trial with any control condition, and involved a standardized outcome measure for PTSD symptom severity. This resulted in the addition of 14 new studies compared to the 2019 study. The meta-analysis, which included 29 studies in total, resulted in a mean Hedges' g effect size of 0.50, 95% CI [0.22, 0.79], in decreasing PTSD symptoms, with very high heterogeneity, I2 = 89%. Meta-analyses of secondary outcomes resulted in Hedges' g effect sizes of 0.37, 95% CI [0.08, 0.66] for depressive symptoms; 0.62, 95% CI [0.42, 0.81] for sleep quality; and -0.10, 95% CI [-0.23, 0.43] for interoceptive awareness. The risk of bias analysis resulted in some concerns or high risk of bias in almost all included studies; only one study had a low risk of bias. We conclude that BMOIs may be valuable for patients with PTSD. There is, however, still a lack of high-quality studies with proper control conditions and long-term follow-up periods from which to draw conclusions.

Differences in swimming smoothness between elite and non-elite swimmers.

The aim of the study was to investigate whether jerk cost (JC) can discriminate between swimming levels. Nine elite and nine non-elite swimmers swam a 50-m front-crawl sprint wearing a 3D accelerometer on their back between the inferior angles of the scapulae. Lap times and JC were calculated from the acceleration signal and compared between groups and between swimmers within a group. The elite swimmers swam significantly faster lap times than the non-elite swimmers (p < 0.001). They did so with significantly lower levels of JC compared to the non-elite swimmers (p = 0.005). Furthermore, a stepwise multiple linear regression showed JC accounted for 32.9% of the variation in lap time of the elite swimmers. These results indicate that it is possible to discriminate elite from non-elite swimmers using JC: elite swimmers swim with lower JCs than non-elite swimmers. Additionally, swimming at higher speed is associated with more accelerations and decelerations in both elite and non-elite swimmers, which is reflected by higher JCs and lower smoothness. In sum, JC provides an index of swimming technique that is easy to use in training practice.

Implications of the choice of distance-based measures in assessing and investigating tumble turn performance.

Although the tumble turn in swimming has been studied extensively, no consensus exists about which measure is best suited to capture its performance. The aim of this study was to better understand the implications of choosing a particular distance-based performance measure for assessing and investigating tumble turn performance in freestyle swimming. To this end, a large set of retrospective turn data consisting of 2,813 turns performed by 160 swimmers was analyzed statistically in three steps. First, a mixed-effects model was derived for the entire data set, which showed that both performance level and sex had clear effects on the distance-based performance measures and performance determining variables studied in the literature. Second, repeated measures correlations were calculated for the entire data set and four performance level- and sex-based subgroups to determine the level of association between the performance measures. This analysis revealed that the performance measures were strongly correlated (r > 0.84 and p < 0.05 for all possible pairs), largely independent of performance level and sex. This finding implies that the choice of performance measure is not very critical when one is interested solely in the overall performance. In the third and last step, mixed-effects models were derived for the performance measures of interest to establish the importance of different turn-related actions for each measure, again for both the entire data set and the four subgroups separately. The results of this analysis revealed that performance measures with short(er) distances are more sensitive to changes in the adaptation time and reflect the wall contact time better than performance measures with long(er) distances, which in contrast are more useful if the focus is on the approach speed prior to the turn. In this final analysis, various effects of performance level and sex were found on the technical execution of the tumble turn.

Running-style modulation: Effects of stance-time and flight-time instructions on duty factor and cadence.

BACKGROUND: The duty factor (reflecting the ratio of stance to flight time) is an important variable related to running performance, economy, and injury risk. According to the dual-axis model, the duty factor and the cadence are sufficient to describe an individual's running style at a certain speed. To test this model, one should be able to modulate both variables independently. While acoustic pacing is an established method for cadence modulation, no such method is available for duty-factor modulation. RESEARCH QUESTIONS: Can people modulate their duty factor based on verbal instructions to change either their stance or flight time without changing their cadence? And, if so, which instruction is most effective? METHODS: Twelve participants ran on an instrumented treadmill and completed four training blocks starting with a baseline trial and ending with a performance trial in which they followed verbal instructions to both increase and decrease their stance and flight time. Acoustic pacing at their preferred cadence was present during the first part of each trial. We calculated the duty factor and cadence for paced and non-paced parts of each trial, assessed the effectiveness of the instructions aimed at changing the duty factor, and examined the effects of instructions and acoustic pacing on cadence using Bayesian statistics. RESULTS: The duty factor changed in intended directions with verbal instructions to increase and decrease the stance and flight time (18.04 ≤ BF10 ≤ 4954.42), without differences between the instructions or during and after acoustic pacing. The instructions and acoustic pacing did not result in a consistent change in cadence (0.40 ≤ BF10 ≤ 2.59). SIGNIFICANCE: Runners can change their duty factor through verbal instructions pertaining to stance or flight time, without clear concomitant effects on cadence. Running styles can thus be altered with verbal instructions to change stance or flight time for duty-factor modulation, optionally combined with acoustic pacing to prescribe cadence.

Improving tumble turn performance in swimming-the impact of wall contact time and tuck index.

Race time can be shortened by improving turn performance in competitive swimming, but this requires insight into the optimal turn technique. The aim of the present study was to examine the effect of Wall Contact Time (WCT) and Tuck Index on tumble turn performance and their interrelations by experimentally manipulating both variables, which has not been done in previous research. Eighteen Dutch national level swimmers (FINA points 552 ± 122) performed tumble turns with three different WCTs (shorter, preferred, longer) and three different Tuck Indices (higher, preferred, lower), which were recorded by four underwater cameras and a wall-mounted force plate. Linear kinematic and kinetic variables, including the approach velocity (Vin), wall adaptation time (Tadapt), percentage of active WCT (aWCT), peak push-off force (FPeak) and exit velocity (Vexit), were extracted from the recordings and analyzed statistically, using the 5 m round trip time (5mRTT) as performance measure. The results indicated that the WCT should be sufficiently long to generate a high push-off force at the end of wall contact when the body is in a streamlined position. This led to a significantly shorter 5mRTT than a shorter or longer WCT. A linear mixed effect model yielded negative significant effects of WCT (-4.22, p < 0.001), FPeak (-2.18, p = 0.04), Vin (-4.83, p = 0.02), Tadapt (-2.68, p = 0.002), and Vexit (-9.52, p < 0.001) on the 5mRTT. The best overall turning performance was achieved with a Tuck Index of 0.7, which suggests that some of the participating swimmers could benefit from adapting their distance to the wall while turning, as was exemplified by calculating the optimal Tuck Index for individual swimmers. These results underscore the importance of WCT and Tuck Index vis-à-vis tumble turn performance, as well as their interrelations with other performance determining variables in this regard.

Sprint Performance in Arms-Only Front Crawl Swimming Is Strongly Associated With the Power-To-Drag Ratio.

To date, optimal propulsion in swimming has been studied predominantly using physical or computational models of the arm and seldom during real-life swimming. In the present study we examined the contributions of selected power, technique and anthropometric measures on sprint performance during arms-only front crawl swimming. To this end, 25 male adult competitive swimmers, equipped with markers on their arms and hands, performed four 25-m sprint trials, which were recorded on video. For the fastest trial of each swimmer, we determined the average swim speed as well as two technique variables: the average stroke width and average horizontal acceleration. Each participant also swam 10-12 trials over a custom-made system for measuring active drag, the MAD system. Since the propelling efficiency is 100% while swimming over the MAD system, the power output of the swimmer is fully used to overcome the drag acting on the body. The resulting speed thus represents the ratio between power output and drag. We included this power-to-drag ratio, the power output and the drag coefficient of the fastest trial on the MAD system in the analysis. Finally, the body height and hand surface area of each swimmer were determined as anthropometric variables. A model selection procedure was conducted to predict the swim speed from the two technique variables, three power variables and the two anthropometric variables. The ratio between power output and the drag was the only significant predictor of the maximal swimming speed (v = 0.86·power/drag). The variations in this ratio explained 65% of the variance in swimming performance. This indicates that sprint performance in arms-only front crawl swimming is strongly associated with the power-to-drag ratio and not with the isolated power variables and the anthropometric and technique variables selected in the present study.

Reliability and Validity of Running Cadence and Stance Time Derived from Instrumented Wireless Earbuds.

Instrumented earbuds equipped with accelerometers were developed in response to limitations of currently used running wearables regarding sensor location and feedback delivery. The aim of this study was to assess test-retest reliability, face validity and concurrent validity for cadence and stance time in running. Participants wore an instrumented earbud (new method) while running on a treadmill with embedded force-plates (well-established method). They ran at a range of running speeds and performed several instructed head movements while running at a comfortable speed. Cadence and stance time were derived from raw earbud and force-plate data and compared within and between both methods using t-tests, ICC and Bland-Altman analysis. Test-retest reliability was good-to-excellent for both methods. Face validity was demonstrated for both methods, with cadence and stance time varying with speed in to-be-expected directions. Between-methods agreement for cadence was excellent for all speeds and instructed head movements. For stance time, agreement was good-to-excellent for all conditions, except while running at 13 km/h and shaking the head. Overall, the measurement of cadence and stance time using an accelerometer embedded in a wireless earbud showed good test-retest reliability, face validity and concurrent validity, indicating that instrumented earbuds may provide a promising alternative to currently used wearable systems.

Effects of acoustically paced cadence modulation on impact forces in running.

BACKGROUND: Increasing cadence in running has been advocated as a means to improve performance and reduce impact forces. Although acoustic pacing can be used for this purpose, it might by itself lead to an increased impact force, which would counteract the decrease in impact force that is being pursued by increasing the cadence with acoustic pacing and thus have a counterproductive effect. RESEARCH QUESTION: What are the effects of acoustic pacing and cadence on peak impact force and loading rate during running? METHODS: Unpublished data from a previous study, in which 16 participants ran on an instrumented treadmill with various forms of acoustic pacing, were analyzed to address the research question. Peak impact force and loading rate while running with and without pacing, at three different cadences were extracted from the ground reaction force data and compared statistically between these two main conditions. In addition, we compared step-based and stride-based pacing, and paced and unpaced steps within stride-based pacing conditions. RESULTS: As expected, increasing the cadence was accompanied by a significant reduction in peak impact force and instantaneous vertical loading rate, whereas acoustic pacing had no significant effect on the impact forces compared to unpaced running with similar cadence, both before and after pacing. There were also no significant differences in this regard between step-based and stride-based pacing. SIGNIFICANCE: Acoustic pacing does not adversely affect impact force when used to increase cadence in running with the aim of reducing the impact force and can thus be used for this purpose without introducing a counterproductive effect.

The biomechanics of running and running styles: a synthesis.

Running movements are parametrised using a wide variety of devices. Misleading interpretations can be avoided if the interdependencies and redundancies between biomechanical parameters are taken into account. In this synthetic review, commonly measured running parameters are discussed in relation to each other, culminating in a concise, yet comprehensive description of the full spectrum of running styles. Since the goal of running movements is to transport the body centre of mass (BCoM), and the BCoM trajectory can be derived from spatiotemporal parameters, we anticipate that different running styles are reflected in those spatiotemporal parameters. To this end, this review focuses on spatiotemporal parameters and their relationships with speed, ground reaction force and whole-body kinematics. Based on this evaluation, we submit that the full spectrum of running styles can be described by only two parameters, namely the step frequency and the duty factor (the ratio of stance time and stride time) as assessed at a given speed. These key parameters led to the conceptualisation of a so-called Dual-axis framework. This framework allows categorisation of distinctive running styles (coined 'Stick', 'Bounce', 'Push', 'Hop', and 'Sit') and provides a practical overview to guide future measurement and interpretation of running biomechanics.

Predicting dive start performance from kinematic variables at water entry in (sub-)elite swimmers.

The dive start is an important component of competitive swimming, especially at shorter race distances. Previous research has suggested that start performance depends on kinematic variables pertaining to the swimmer at water entry, notably the distance from the block, the horizontal velocity of the centre of mass and the angle between body and water surface. However, the combined and relative contributions of these variables to start performance remain to be determined. The aim of the present study was therefore to develop a model to predict start performance (time from take-off to reaching the 15-m line) from a set of kinematic variables that collectively define the swimmer's entry state. To obtain an appropriate database for this purpose, fifteen well-trained, (sub-)elite swimmers performed dive starts under different instructions intended to induce substantial variation in entry state. Kinematic data were extracted from video recordings of these starts, optimised and analysed statistically. A mixed effects analysis of the relation between entry state and start performance was conducted, which revealed a significant and robust dependence of start performance on entry state (χ2(3) = 88, p < .001), explaining 86.1% of the variance. Start time was reduced by 0.6 s (p < .001) when the horizontal displacement at water entry was 1 m further, by 0.3 s (p < .001) when the horizontal velocity of the centre of mass was 1 m/s higher, and by 0.5 s (p < .01) when the entry angle was 1 radian flatter. The robustness of the analysis was confirmed by a similar mixed effects analysis of the relation between entry state and time to the 5-m line. In conclusion, dive start performance can be predicted to a considerable extent from the swimmer's state at water entry. The implications of those findings for studying and improving block phase kinetics are discussed.

A Re-Appraisal of the Effect of Amplitude on the Stability of Interlimb Coordination Based on Tightened Normalization Procedures.

The stability of rhythmic interlimb coordination is governed by the coupling between limb movements. While it is amply documented how coordinative performance depends on movement frequency, theoretical considerations and recent empirical findings suggest that interlimb coupling (and hence coordinative stability) is actually mediated more by movement amplitude. Here, we present the results of a reanalysis of the data of Post, Peper, and Beek (2000), which were collected in an experiment aimed at teasing apart the effects of frequency and amplitude on coordinative stability of both steady-state and perturbed in-phase and antiphase interlimb coordination. The dataset in question was selected because we found indications that the according results were prone to artifacts, which may have obscured the potential effects of amplitude on the post-perturbation stability of interlimb coordination. We therefore redid the same analysis based on movement signals that were normalized each half-cycle for variations in oscillation center and movement frequency. With this refined analysis we found that (1) stability of both steady-state and perturbed coordination indeed seemed to depend more on amplitude than on movement frequency per se, and that (2) whereas steady-state antiphase coordination became less stable with increasing frequency for prescribed amplitudes, in-phase coordination became more stable at higher frequencies. Such effects may have been obscured in previous studies due to (1) unnoticed changes in performed amplitudes, and/or (2) artifacts related to inappropriate data normalization. The results of the present reanalysis therefore give cause for reconsidering the relation between the frequency, amplitude, and stability of interlimb coordination.

Cadence Modulation in Walking and Running: Pacing Steps or Strides?

A change in cadence during walking or running might be indicated for a variety of reasons, among which mobility improvement and injury prevention. In a within-subject study design, we examined whether walking or running cadences are modulated best by means of step-based or stride-based auditory pacing. Sixteen experienced runners walked and ran on a treadmill while synchronizing with step-based and stride-based pacing at slow, preferred and fast pacing frequencies in synchronization-perturbation and synchronization-continuation conditions. We quantified the variability of the relative phase between pacing cues and footfalls and the responses to perturbations in the pacing signal as measures of coordinative stability; the more stable the auditory-motor coordination, the stronger the modulating effect of pacing. Furthermore, we quantified the deviation from the prescribed cadence after removal of the pacing signal as a measure of internalization of this cadence. Synchronization was achieved less often in running, especially at slow pacing frequencies. If synchronization was achieved, coordinative stability was similar, and the paced cadence was well internalized for preferred and fast pacing frequencies. Step-based pacing led to more stable auditory-motor coordination than stride-based pacing in both walking and running. We therefore concluded that step-based auditory pacing deserves preference as a means to modulate cadence in walking and running.

Avoiding 3D Obstacles in Mixed Reality: Does It Differ from Negotiating Real Obstacles?

Mixed-reality technologies are evolving rapidly, allowing for gradually more realistic interaction with digital content while moving freely in real-world environments. In this study, we examined the suitability of the Microsoft HoloLens mixed-reality headset for creating locomotor interactions in real-world environments enriched with 3D holographic obstacles. In Experiment 1, we compared the obstacle-avoidance maneuvers of 12 participants stepping over either real or holographic obstacles of different heights and depths. Participants' avoidance maneuvers were recorded with three spatially and temporally integrated Kinect v2 sensors. Similar to real obstacles, holographic obstacles elicited obstacle-avoidance maneuvers that scaled with obstacle dimensions. However, with holographic obstacles, some participants showed dissimilar trail or lead foot obstacle-avoidance maneuvers compared to real obstacles: they either consistently failed to raise their trail foot or crossed the obstacle with extreme lead-foot margins. In Experiment 2, we examined the efficacy of mixed-reality video feedback in altering such dissimilar avoidance maneuvers. Participants quickly adjusted their trail-foot crossing height and gradually lowered extreme lead-foot crossing heights in the course of mixed-reality video feedback trials, and these improvements were largely retained in subsequent trials without feedback. Participant-specific differences in real and holographic obstacle avoidance notwithstanding, the present results suggest that 3D holographic obstacles supplemented with mixed-reality video feedback may be used for studying and perhaps also training 3D obstacle avoidance.

Body- and Movement-Oriented Interventions for Posttraumatic Stress Disorder: A Systematic Review and Meta-Analysis.

To assess the efficacy of body- and movement-oriented interventions (BMOIs) in traumatized adults with posttraumatic stress disorder (PTSD), we conducted a systematic review and meta-analysis of pertinent literature. Four bibliographical databases (PsycINFO, Ovid MEDLINE(R), EMBASE, and the Cochrane Central Register of Controlled Trials) were searched using keywords and text words for trials on BMOIs addressing PTSD. The search included articles published between October 2005 and August 2017. Studies were included if participants were adults suffering from PTSD, if BMOIs were the therapeutic strategy under investigation, and if a psychometrically evaluated standardized outcome measure for PTSD was used. No limitations for control conditions were applied. Hedges' g was computed as the effect size (ES) for the treatment versus control condition. The meta-analysis included 15 studies, which resulted in a mean ES of g = 0.85, 95% CI [0.31, 1.39], with very high heterogeneity, I2 = 91%. After removing one study as outlier, a mean effect size of g = 0.56, 95% CI [0.29, 0.82] (i.e., medium effect), still with considerable heterogeneity, I2 = 57%, was found. BMOIs seem to be effective in reducing symptoms of PTSD, but more research is needed to identify working mechanisms and to determine which types of intervention are most effective for various subgroups of patients.

Clinical characteristics of individuals with intellectual disability who have experienced sexual abuse. An overview of the literature.

BACKGROUND: Sexual abuse in individuals with average IQ or above is associated with a wide range of behavioural, psychological and body-related characteristics. It is unknown whether individuals with intellectual disability (ID) and a history of sexual abuse suffer from similar clinical characteristics. OBJECTIVE: The aim of the review is to provide an overview of the literature on the clinical characteristics of individuals with ID who have experienced sexual abuse. METHOD: PubMed, Embase, PsycInfo, CINAHL, Cochrane Library and Web of Sciences were searched for relevant publications using terms related to concepts of "intellectual disability" and "sexual abuse". Two independent reviewers screened and selected articles for inclusion in the study, resulting in seven studies. RESULTS: The studies mostly reported behavioural and psychological characteristics such as aggression, self-injury, or posttraumatic stress, anxiety or depressive symptoms associated with sexual abuse in individuals with ID. None mentioned body-related characteristics. CONCLUSIONS: Similar to individuals with average IQ or above, sexual abuse in individuals with ID is associated with a broad range of behavioural and psychological characteristics. Conduct disorders, self-injury, inappropriate sexualised talk and poor feelings of personal safety seem to be more indicative for the ID population. Anxiety, depression and PTSD are prevalent in individuals with and without ID who both have experienced sexual abuse. Whether individuals with ID experience body-related characteristics is unclear.

Automatized, Standardized, and Patient-Tailored Progressive Walking-Adaptability Training: A Proof-of-Concept Study.

BACKGROUND: Treadmill training augmented with visual images projected on the belt's surface can help improve walking adaptability. Moreover, patient-tailored automatization and standardization can increase the feasibility of walking-adaptability therapy. We developed C-Gait, a treadmill protocol consisting of a baseline walking-adaptability assessment involving 7 putatively distinct walking-adaptability tasks and a decision algorithm, to automatically update training content and execution parameters to a patients' performance and perceived challenge. OBJECTIVES: The main objective was to examine the feasibility, acceptability, and clinical potential of C-Gait training. The secondary objective was to evaluate the validity of the baseline assessment. DESIGN: This was a longitudinal proof-of-concept study with pretraining, posttraining, and retention tests encompassing baseline assessment and walking-related clinical measures. METHODS: Twenty-four healthy adults, 12 healthy older persons, and 28 patients with gait and/or balance deficits performed the baseline assessment; the gait deficit group received 10 C-Gait training sessions over a 5-week period. Baseline assessment scores and walking-related clinical measures served as outcome measures. RESULTS: C-Gait training exhibited significant progression in training content and execution, with considerable between-patient variation and minimal overruling by therapists. C-Gait training was well accepted and led to improvements in walking adaptability and general walking ability, which persisted after training cessation. Baseline assessment scores differed over groups and difficulty levels, had no-to-moderate correlations with walking-related clinical measures, and had limited correlations among walking-adaptability tasks. LIMITATIONS: C-Gait was evaluated in a small yet diverse cohort. More encompassing studies are required to further establish its apparent merits. The validity of treadmill-based walking-adaptability assessment against an overground standard remains to be established. CONCLUSIONS: C-Gait offers automatized, standardized, and patient-tailored walking-adaptability training that is feasible and well accepted, with good potential for improving task-specific and generic measures of walking.

Real-Time Feedback on Mechanical Power Output: Facilitating Crew Rowers' Compliance With Prescribed Training Intensity.

PURPOSE: Athletes require feedback in order to comply with prescribed training programs designed to optimize their performance. In rowing, current feedback parameters on intensity are inaccurate. Mechanical power output is a suitable objective measure for training intensity, but due to movement restrictions related to crew rowing, it is uncertain whether crew rowers are able to adjust their intensity based on power-output feedback. The authors examined whether rowers improve compliance with prescribed power-output targets when visual real-time feedback on power output is provided in addition to commonly used feedback. METHODS: A total of 16 crew rowers rowed in 3 training sessions. During the first 2 sessions, they received commonly used feedback, followed by a session with additional power-output feedback. Targets were set by their coaches before the experiment. Compliance was operationalized as accuracy (absolute difference between target and delivered power output) and consistency (high- and low-frequency variations in delivered power output). RESULTS: Multilevel analyses indicated that accuracy and low-frequency variations improved by, respectively, 65% (P > .001) and 32% (P = .024) when additional feedback was provided. CONCLUSION: Compliance with power-output targets improved when crew rowers received additional feedback on power output. Two additional observations were made during the study that highlighted the relevance of power-output feedback for practice: There was a marked discrepancy between the prescribed targets and the actually delivered power output by the rowers, and coaches had difficulties perceiving improvements in rowers' compliance with power-output targets.