An acute bout of high-intensity exercise affects nocturnal sleep and sleep-dependent memory consolidation.

Acute exercise has been shown to affect long-term memory and sleep. However, it is unclear whether exercise-induced changes in sleep architecture are associated with enhanced memory. Recently, it has been shown that exercise followed by a nap improved declarative memory. Whether these effects transfer to night sleep and other memory domains has not yet been studied. Here, we investigate the influence of exercise on nocturnal sleep architecture and associations with sleep-dependent procedural and declarative memory consolidation. Nineteen subjects (23.68 ± 3.97 years) were tested in a balanced cross-over design. In two evening sessions, participants either exercised (high-intensity interval training) or rested immediately after encoding two memory tasks: (1) a finger tapping task and (2) a paired-associate learning task. Subsequent nocturnal sleep was recorded by polysomnography. Retrieval was conducted the following morning. High-intensity interval training lead to an increased declarative memory retention (p = 0.047, d = 0.40) along with a decrease in REM sleep (p = 0.012, d = 0.75). Neither procedural memory nor NREM sleep were significantly affected. Exercise-induced changes in N2 showed a positive correlation with procedural memory retention which did not withstand multiple comparison correction. Exploratory analyses on sleep spindles and slow wave activity did not reveal significant effects. The present findings suggest an exercise-induced enhancement of declarative memory which aligns with changes in nocturnal sleep architecture. This gives additional support for the idea of a potential link between exercise-induced sleep modifications and memory formation which requires further investigation in larger scaled studies.

Exercising the Sleepy-ing Brain: Exercise, Sleep, and Sleep Loss on Memory.

We examine the novel hypothesis that physical exercise and sleep have synergistic effects on memory. Exercise can trigger mechanisms that can create an optimal brain state during sleep to facilitate memory processing. The possibility that exercise could counteract the deleterious effects of sleep deprivation on memory by protecting neuroplasticity also is discussed.

[New approaches in exercise therapy for Parkinson's disease]. / Neue Ansätze in der Bewegungstherapie bei Morbus Parkinson.

BACKGROUND: Exercise therapy is an important component in the treatment of motor symptoms in people with Parkinson's disease (PD). In this context, goal-based task-specific training has shown to be particularly effective compared to nonspecific approaches. OBJECTIVE: In this article two novel exercise interventions for targeted improvement of motor function in PD are presented: 1) task-specific training with perturbations and 2) combined task-specific and cardiovascular training. MATERIAL AND METHODS: Summary and discussion of the current evidence for both therapeutic approaches. RESULTS: First randomized controlled trials show that perturbation training is an effective task-specific training to improve gait and balance function and potentially reduce falls. Experimental findings on combined cardiovascular exercise and task-specific training suggest that processes of neuroplasticity are enhanced, thereby improving therapy outcomes. However, the quality of evidence for both therapeutic approaches is currently low. CONCLUSION: The presented exercise approaches show promising results in first randomized controlled studies and have the potential to improve treatment outcomes in PD. Further high-quality clinical studies are needed to ensure an effective transfer into practice.

Acute exercise following skill practice promotes motor memory consolidation in Parkinson's disease.

Acute cardiovascular exercise has shown to promote neuroplastic processes supporting the consolidation of newly acquired motor skills in healthy adults. First results suggest that this concept may be transferred to populations with motor and cognitive dysfunctions. In this context, Parkinson's disease (PD) is highly relevant since patients demonstrate deficits in motor learning. Hence, in the present study we sought to explore the effect of a single post-practice exercise bout on motor memory consolidation in PD. For this purpose, 17 patients with PD (Hoehn and Yahr: 1 - 2.5, age: 60.1 ± 7.9 y) practiced a whole-body skill followed by either (i) a moderate-intense bout of cycling, or (ii) seated rest for a total of 30 min. The motor skill required the participants to balance on a tiltable platform (stabilometer) for 30 s. During skill practice, participants performed 15 trials followed by a retention test 1 day and 7 days later. We calculated time in balance (platform within ± 5° from horizontal) for each trial and within- and between-group differences in memory consolidation (i.e. offline learning = skill change from last acquisition block to retention tests) were analyzed. Groups revealed similar improvements during skill practice (F4,60 = 0.316, p = 0.866), but showed differences in offline learning, which were only evident after 7 days (F1,14 = 5.602, p = 0.033). Our results suggest that a single post-practice exercise bout is effective in enhancing long-term motor memory consolidation in a population with motor learning impairments. This may point at unique promoting effects of exercise on dopamine neurotransmission involved in memory formation. Future studies should investigate the potential role of exercise-induced effects on the dopaminergic system.

Interindividual Balance Adaptations in Response to Perturbation Treadmill Training in Persons With Parkinson Disease.

BACKGROUND AND PURPOSE: Perturbation training is a promising approach to reduce fall incidence in persons with Parkinson disease (PwPD). This study aimed to evaluate interindividual differences in balance adaptations in response to perturbation treadmill training (PTT) and identify potential outcome predictors. METHODS: PwPD (n = 43, Hoehn & Yahr stage 1-3.5) were randomly assigned to either 8 weeks of PTT or conventional treadmill training (CTT) without perturbations. At baseline and following intervention, data from 4 domains of balance function (reactive, anticipatory, dynamic postural control, and quiet stance) were collected. Using responder analysis we investigated interindividual differences (responder rates and magnitude of change) and potential predictive factors. RESULTS: PTT showed a significantly higher responder rate in the Mini Balance Evaluation Systems Test (Mini-BESTest) subscore reactive postural control, compared with CTT (PTT = 44%; CTT = 10%; risk ratio = 4.22, confidence interval = 1.03-17.28). Additionally, while between-groups differences were not significant, the proportion of responders in the measures of dynamic postural control was higher for PTT compared with CTT (PTT: 22%-39%; CTT: 5%-10%). The magnitude of change in responders and nonresponders was similar in both groups. PTT responders showed significantly lower initial balance performance (4/8 measures) and cognitive function (3/8 measures), and were older and at a more advanced disease stage, based on descriptive evaluation. DISCUSSION AND CONCLUSIONS: Our findings suggest that PTT is beneficial to improve reactive balance in PwPD. Further, PTT appeared to be effective only for a part of PwPD, especially for those with lower balance and cognitive function, which needs further attention.Video Abstract available for more insights from the authors (see the Video, Supplemental Digital Content 1, http://links.lww.com/JNPT/A1).

Effects of Exercise Therapy on Postural Instability in Parkinson Disease: A Meta-analysis.

BACKGROUND AND PURPOSE: Exercise therapy is a common intervention for improving postural stability. The purpose of this meta-analysis was to assess the effect of exercise therapy on postural instability in persons with Parkinson disease (PD) based on the available literature, and to evaluate the efficacy across various types of exercise interventions. DATA SOURCES AND STUDY SELECTION: In January 2015, electronic databases (PubMed, Scopus, PEDro) and study reference lists were searched for randomized controlled trials with moderate or high methodological quality (PEDro score ≥ 5), investigating the effect of exercise on postural instability in persons with PD. DATA EXTRACTION AND SYNTHESIS: Three reviewers extracted data and assessed quality. MAIN OUTCOME AND MEASURE: Postural stability as measured using the Berg Balance Scale, postural sway, Timed Up and Go, or Functional Reach test. Standardized mean differences (SMDs) with 95% confidence intervals (CIs) were calculated. RESULTS: Twenty-two trials, with a total of 1072 participants, were eligible for inclusion. The pooled estimates of effects showed significantly improved postural instability (SMD, 0.23; 95% CI, 0.10-0.36; P < 0.001) after exercise therapy, in comparison with no exercise or sham treatment. Exercise interventions specifically addressing components of balance dysfunction demonstrated the largest efficacy, with moderate to high effect sizes (SMD, 0.43; 95% CI, 0.21-0.66; P < 0.001). Little or no beneficial effects were observed for interventions not specifically targeted at postural stability (SMD, 0.20; 95% CI -0.04 to 0.44; P = 0.11) or for home-based, multicomponent exercise programs (SMD, 0.02; 95% CI -0.20 to 0.25; P = 0.86). DISCUSSION AND CONCLUSIONS: Exercise therapies specifically addressing balance dysfunction are an important treatment option for improving postural stability in persons with PD. Future studies should investigate sustainability of the short-term effects and establish the dose-response relationship of balance training in persons with PD.Video abstract available for additional insights from the authors (see Video, Supplemental Digital Content 1, http://links.lww.com/JNPT/A121).

Time course and dimensions of postural control changes following neuromuscular training in youth field hockey athletes.

PURPOSE: Injury prevention effects of neuromuscular training have been partly attributed to postural control adaptations. Uncertainty exists regarding the magnitude of these adaptations and on how they can be adequately monitored. The objective was to determine the time course of neuromuscular training effects on functional, dynamic and static balance measures. METHODS: Thirty youth (14.9 ± 3 years) field hockey athletes were randomised to an intervention or control group. The intervention included a 20-min neuromuscular warm-up program performed twice weekly for 10 weeks. Balance assessments were performed at baseline, week three, week six and post-intervention. They included the star excursion balance test (SEBT), balance error scoring system (BESS), jump-landing time to stabilization (TTS) and center of pressure (COP) sway velocity during single-leg standing. RESULTS: No baseline differences were found between groups in demographic data and balance measures. Adherence was at 86%. All balance measures except the medial-lateral TTS improved significantly over time (p < 0.05) in both groups. Significant group by time interactions were found for the BESS score (p < 0.001). The intervention group showed greater improvements (69.3 ± 10.3%) after 10 weeks in comparison to controls (31.8 ± 22.1%). There were no significant group by time interactions in the SEBT, TTS and COP sway velocity. CONCLUSIONS: Neuromuscular training was effective in improving postural control in youth team athletes. However, this effect was not reflected in all balance measures suggesting that the neuromuscular training did not influence all dimensions of postural control. Further studies are needed to confirm the potential of specific warm-up programs to improve postural control.

The Effect of Different Types of Exercise on Sleep Quality and Architecture in Parkinson Disease: A Single-Blinded Randomized Clinical Trial Protocol.

OBJECTIVES: The purpose of this trial is to (1) determine the best exercise modality to improve sleep quality and sleep architecture in people with Parkinson disease (PD); (2) investigate whether exercise-induced improvements in sleep mediate enhancements in motor and cognitive function as well as other non-motor symptoms of PD; and (3) explore if changes in systemic inflammation after exercise mediate improvements in sleep. METHODS: This is a multi-site, superiority, single-blinded randomized controlled trial. One hundred fifty persons with PD and sleep problems will be recruited and randomly allocated into 4 intervention arms. Participants will be allocated into 12 weeks of either cardiovascular training, resistance training, multimodal training, or a waiting list control intervention. Assessments will be conducted at baseline, immediately after each intervention, and 8 weeks after each intervention by blinded assessors. Objective sleep quality and sleep architecture will be measured with polysomnography and electroencephalography. Motor and cognitive function will be assessed with the Unified PD Rating Scale and the Scale for Outcomes in PD-Cognition, respectively. Subjective sleep quality, fatigue, psychosocial functioning, and quality of life will be assessed with questionnaires. The concentration of inflammatory biomarkers in blood serum will be assessed with enzyme-linked immunosorbent assays. IMPACT: This study will investigate the effect of different types of exercise on sleep quality and architecture in PD, exploring interactions between changes in sleep quality and architecture with motor and cognitive function and other non-motor symptoms of the disease as well as mechanistic interactions between systemic inflammation and sleep. The results will provide important practical information to guide physical therapists and other rehabilitation professionals in the selection of exercise and the design of more personalized exercise-based treatments aimed at optimizing sleep, motor, and cognitive function in people with PD.

Feasibility, effectiveness and acceptability of two perturbation-based treadmill training protocols to improve reactive balance in fall-prone older adults (FEATURE): protocol for a pilot randomised controlled trial.

INTRODUCTION: Perturbation-based balance training (PBT) targets the mechanism of falls (eg, slipping, tripping) to specifically train the recovery actions needed to avoid a fall. This task-specific training has shown great promise as an effective and efficient intervention for fall prevention in older adults. However, knowledge about the dose-response relationship of PBT, as well as its feasibility and acceptability in older adults with increased risk of falling is still limited. Thus, the aim of this study is to compare the effectiveness of two different treadmill PBT protocols for improving reactive balance control in fall-prone older adults, and to evaluate the feasibility and acceptability of these protocols. METHODS AND ANALYSIS: The study is designed as a pilot randomised controlled trial with a 6-week intervention and 6-week follow-up period. Thirty-six community-dwelling, fall-prone (Timed Up and Go >12 s, habitual gait speed <1.0 m/s and/or fall history) older adults will be randomised (1:1) to receive six (weeks 1-6) or two treadmill PBT sessions (weeks 1+6) plus four conventional treadmill training sessions (weeks 2-5). Training sessions are conducted 1×/week for 30 min. Each PBT will include 40 perturbations in anterior-posterior and mediolateral directions. Reactive balance after perturbations in standing (Stepping Threshold Test (STT)) and walking (Dynamic Stepping Threshold Test (DSTT)) will be assessed as the primary outcome for effectiveness. Secondary outcomes are spatiotemporal and kinematic parameters collected during STT, DSTT and PBT, maximum perturbation magnitude for each PBT session, static and dynamic balance, physical capacity, physical activity, concerns with falling and executive functions. Feasibility will be assessed via training adherence, drop-out rate, perturbations actually performed and adverse events; and acceptability via self-designed questionnaire and focus groups. ETHICS AND DISSEMINATION: The study has been approved by the Ethics Committee of the Medical Faculty Heidelberg (S-602/2022). Findings will be disseminated through publications in peer-reviewed journals and conference presentations. TRIAL REGISTRATION NUMBER: DRKS00030805.

Motor Memory Consolidation Deficits in Parkinson's Disease: A Systematic Review with Meta-Analysis.

BACKGROUND: The ability to encode and consolidate motor memories is essential for persons with Parkinson's disease (PD), who usually experience a progressive loss of motor function. Deficits in memory encoding, usually expressed as poorer rates of skill improvement during motor practice, have been reported in these patients. Whether motor memory consolidation (i.e., motor skill retention) is also impaired is unknown. OBJECTIVE: To determine whether motor memory consolidation is impaired in PD compared to neurologically intact individuals. METHODS: We conducted a pre-registered systematic review (PROSPERO: CRD42020222433) following PRISMA guidelines that included 46 studies. RESULTS: Meta-analyses revealed that persons with PD have deficits in retaining motor skills (SMD = -0.17; 95% CI = -0.32, -0.02; p = 0.0225). However, these deficits are task-specific, affecting sensory motor (SMD = -0.31; 95% CI -0.47, -0.15; p = 0.0002) and visuomotor adaptation (SMD = -1.55; 95% CI = -2.32, -0.79; p = 0.0001) tasks, but not sequential fine motor (SMD = 0.17; 95% CI = -0.05, 0.39; p = 0.1292) and gross motor tasks (SMD = 0.04; 95% CI = -0.25, 0.33; p = 0.7771). Importantly, deficits became non-significant when augmented feedback during practice was provided, and additional motor practice sessions reduced deficits in sensory motor tasks. Meta-regression analyses confirmed that deficits were independent of performance during encoding, as well as disease duration and severity. CONCLUSION: Our results align with the neurodegenerative models of PD progression and motor learning frameworks and emphasize the importance of developing targeted interventions to enhance motor memory consolidation in PD.

Does Cardiorespiratory Fitness Protect Memory from Sleep Deprivation?

INTRODUCTION: Animal studies have demonstrated that physical exercise can protect memory from the effects of sleep deprivation (SD). We examined whether having a high cardiorespiratory fitness (V̇O 2peak ) is associated with an enhanced capacity to encode episodic memory after one night of SD. METHODS: Twenty-nine healthy young participants were allocated into either an SD group ( n = 19) that underwent 30 h of uninterrupted wakefulness, or a sleep control (SC) group ( n = 10) that followed a regular sleep routine. Following either the SD or SC period, participants were asked to view 150 images as the encoding part of the episodic memory task. Ninety-six hours after viewing the images, participants returned to the laboratory to perform the recognition part of the episodic memory task, which required the visual discrimination of the 150 images previously presented from 75 new images introduced as distractors. Cardiorespiratory fitness (V̇O 2peak ) was assessed with a bike ergometer graded exercise test. Group differences in memory performance were assessed with independent t tests and associations between V̇O 2peak and memory with multiple linear regression. RESULTS: The SD group showed a significant increase in subjective fatigue (mean difference [MD] [standard error {SE}] = 38.94 [8.82]; P = 0.0001) and a worse capacity to identify the original 150 images (MD [SE] = -0.18 [0.06]; P = 0.005) and discriminate them from distractors (MD [SE] = -0.78 [0.21] P = 0.001). When adjusted for fatigue, higher V̇O 2peak was significantly associated with better memory scores in the SD (R 2 = 0.41; ß [SE] = 0.03 [0.01]; P = 0.015) but not in the SC group ( R2 = 0.23; ß [SE] = 0.02 [0.03]; P = 0.408). CONCLUSIONS: These results confirm that SD before encoding impairs the capacity to create robust episodic memories and provide preliminary support to the hypothesis that maintaining high levels of cardiorespiratory fitness could have a protective effect against the disruptive effects of sleep loss on memory.

Length changes of human tibialis anterior central aponeurosis during passive movements and isometric, concentric, and eccentric contractions.

The behavior of aponeuroses during voluntary contractions is still poorly understood and results provided in the literature are controversial. Therefore, the aim of this study was to investigate the behavior of the tibialis anterior aponeurosis during passive movements and active isometric, concentric, and eccentric contractions in vivo. Based on previous findings, we hypothesized that the aponeurosis exhibits behavior that is not consistent with a serial alignment with the contractile element of the muscle. Nine subjects participated in the study and performed contractions on a Biodex-dynamometer. Two ultrasound probes were used to visualize the proximal and distal ends of the tibialis anterior aponeurosis from which length changes were calculated. The main findings were that: (1) During isometric contractions, aponeurosis lengths increased and decreased with increasing and decreasing forces by about 2.8 (±1.5) mm while tendon length changes were much greater and averaged 15 (±3.3) mm, (2) during passive movements, aponeurosis lengths did not change significantly, and (3) despite similar average torque changes during concentric and eccentric contractions, aponeurosis lengths changed by 2.2 mm in concentric but only by 1.2 mm in eccentric contractions. The results of this study did not provide clear evidence for or against a serial alignment of the aponeurosis with the contractile elements. However, at low activation levels during force ramp contractions, there was a small but consistent shortening of aponeuroses with increasing torque. Our findings suggest that aponeurosis length changes do not depend on force alone but depend critically on activation level and the type of contraction.

Effects of localized and general fatigue on static and dynamic postural control in male team handball athletes.

In team sports, sensorimotor impairments resulting from previous injuries or muscular fatigue have been suggested to be factors contributing to an increased injury risk. Although it has been widely shown that physical fatigue affects static postural sway, it is still questionable as to what extent these adaptations are relevant for dynamic, sports-related situations. The objective of this study was to determine the effects of whole-body and localized fatigue on postural control in stable and unstable conditions. Nineteen male team handball players were assessed in 2 sessions separated by 1 week. Treadmill running and single-leg step-up exercises were used to induce physical fatigue. The main outcome measures were center of pressure (COP) sway velocity during a single-leg stance on a force plate and maximum reach distances of the star excursion balance test (SEBT). The COP sway velocity increased significantly (p < 0.05) after general (+47%) and localized fatigue (+10%). No fatigue effects were found for the SEBT. There were no significant correlations between COP sway velocity and SEBT mean reach in any condition. The results showed that although fatigue affects static postural control, sensorimotor mechanisms responsible for regaining dynamic balance in healthy athletes seem to remain predominantly intact. Thus, our data indicate that the exclusive use of static postural sway measures might not be sufficient to allow conclusive statements regarding sensorimotor control in the noninjured athlete population.

Sex differences in injury rates in team-sport athletes: A systematic review and meta-regression analysis.

BACKGROUND: Team-sport players have a particularly high injury risk. Although female sex is considered a risk factor, it is still unknown whether female and male team-sport players, in fact, differ in their injury rates. We aimed to compare injury rates between female and male players by systematically reviewing and meta-analyzing injury surveillance studies of both sexes in order to evaluate sex-specific differences in team-sport injuries. METHODS: Studies that prospectively collected injury data for high-level female and male players (age ≥16 years) in basketball, field hockey, football (soccer), handball, rugby (union and sevens), and volleyball were included. Two reviewers (AZ and ALR) independently assessed study quality and extracted data for overall, match, training, and severe injuries (>28 days' time loss) as well as data regarding injury locations and types. Incidence rate ratios (IRRs) were pooled in a meta-analysis, and meta-regression analysis was performed when 10 or more studies were available. RESULTS: Of 20 studies, 9 studies reported injury data from football, 3 studies from rugby, 3 studies from handball, 1 study from basketball, 1 study from field hockey, 2 studies from volleyball, and 1 study from basketball and field hockey. For overall injuries, the pooled IRR = 0.86 (95% confidence interval (95%CI): 0.76-0.98) indicated significantly more injuries in male than in female players. For injury location, the pooled IRR showed higher injury rates in male athletes than in female athletes for upper extremity, hip/groin, thigh, and foot injuries. Female players had a significantly higher rate of anterior cruciate ligament injuries (IRR = 2.15, 95%CI: 1.27-3.62) than male players. No significant sex-specific differences in IRR were found for match, training, severe injuries, concussions, or ankle sprains. CONCLUSION: Our meta-analysis provides evidence for sex-specific differences in the injury rates in team sports. Further epidemiological studies including both sexes in sports other than football are needed in order to strengthen the evidence.

Functional muscle power testing in young, middle-aged, and community-dwelling nonfrail and prefrail older adults.

OBJECTIVE: To evaluate the stair climb (SC) and sit-to-stand (STS) transfer test for functional power assessment in young, middle-aged, and community-dwelling nonfrail and prefrail older adults. DESIGN: Cross-sectional study. SETTING: Sport science institute providing health-related exercise programs for older people. PARTICIPANTS: Participants (N=60; age, 22-81y) were divided into groups of young (n=15; 20-30y), middle-aged (n=16; 40-60y), nonfrail older (n=16; >65y), and prefrail older adults (n=13; >65y). INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: SC and STS transfer power were measured on 2 separate occasions. RESULTS: Age and height correlated positively (P<.001) with both power measures. Multiple linear regression analysis showed that 67.9% (R(2)) of the variance in SC power and 31.3% (R(2)) of the variance in STS transfer power can be attributed to age and height. Significant age-related subgroup differences were found for SC power (P=.001). Nonfrail and prefrail older adults differed significantly in both power measures (P<.001). CONCLUSIONS: The findings indicate that SC and STS transfer power are sensitive enough to distinguish between nonfrailty and prefrailty. This suggests that both tests are relevant clinical measures in older people.

Sex-Specific Differences in Running Injuries: A Systematic Review with Meta-Analysis and Meta-Regression.

BACKGROUND: Running is a popular sport with high injury rates. Although risk factors have intensively been investigated, synthesized knowledge about the differences in injury rates of female and male runners is scarce. OBJECTIVE: To systematically investigate the differences in injury rates and characteristics between female and male runners. METHODS: Database searches (PubMed, Web of Science, PEDro, SPORTDiscus) were conducted according to PRISMA guidelines using the keywords "running AND injur*". Prospective studies reporting running related injury rates for both sexes were included. A random-effects meta-analysis was used to pool the risk ratios (RR) for the occurrence of injuries in female vs. male runners. Potential moderators (effect modifiers) were analysed using meta-regression. RESULTS: After removal of duplicates, 12,215 articles were screened. Thirty-eight studies were included and the OR of 31 could be pooled in the quantitative analysis. The overall injury rate was 20.8 (95% CI 19.9-21.7) injuries per 100 female runners and 20.4 (95% CI 19.7-21.1) injuries per 100 male runners. Meta-analysis revealed no differences between sexes for overall injuries reported per 100 runners (RR 0.99, 95% CI 0.90-1.10, n = 24) and per hours or athlete exposure (RR 0.94, 95% CI 0.69-1.27, n = 6). Female sex was associated with a more frequent occurrence of bone stress injury (RR (for males) 0.52, 95% CI 0.36-0.76, n = 5) while male runners had higher risk for Achilles tendinopathies (RR 1. 86, 95% CI 1.25-2.79, n = 2). Meta-regression showed an association between a higher injury risk and competition distances of 10 km and shorter in female runners (RR 1.08, 95% CI 1.00-1.69). CONCLUSION: Differences between female and male runners in specific injury diagnoses should be considered in the development of individualised and sex-specific prevention and rehabilitation strategies to manage running-related injuries.

Effects of acute cardiovascular exercise on motor memory encoding and consolidation: A systematic review with meta-analysis.

Emerging evidence indicates that acute bouts of cardiovascular exercise promote motor memory formation. In this preregistered meta-analysis (CRD42018106288) we synthesize data from 22 studies published until February 2020, including a total of 862 participants. We calculated standardized mean differences (SMDs) with 95 % confidence intervals (CIs) to assess exercise effects on motor memory encoding and consolidation, respectively. The pooled data indicate that exercise mainly benefits the consolidation of memories, with exercise prior to motor practice improving early non-sleep consolidation (SMD, 0.58; 95 % CI, 0.30-0.86; p < 0.001), and post-practice exercise facilitating sleep-dependent consolidation (SMD, 0.62; 95 % CI, 0.34-0.90; p < 0.001). Strongest effects exist for high exercise intensities, and motor task nature appears to be another relevant modulator. We demonstrate that acute cardiovascular exercise particularly promotes the consolidation of acquired motor memories, and exercise timing, and intensity as well as motor task nature seem to critically modulate this relationship. These findings are discussed within currently proposed models of motor memory formation and considering molecular and systemic mechanisms of neural plasticity.

Exercise Intensity Does not Modulate the Effect of Acute Exercise on Learning a Complex Whole-Body Task.

High-intensity cardiovascular exercise prior to motor skill practice is postulated to enhance motor memory consolidation (offline learning), whereas moderate-intensity bouts may benefit skill acquisition (online learning). This study aimed at investigating this suggested intensity-dependent effect of exercise in a complex whole-body task. 50 healthy young adults were randomized into one of three groups performing a bout of either (1) high-intense, (2) moderate-intense, or (3) minimal-intense cycling for a total of 17 min immediately prior to skill practice. The motor task required participants to balance on a tiltable platform (stabilometer) for 30 s. During acquisition 15 practice trials were carried out, followed by a retention test 24 h later. Time in balance was calculated for each trial and within- and between-group differences in online (skill improvement during skill acquisition) and offline learning (skill change from last acquisition block to retention) were analyzed. All participants significantly improved balance time during acquisition, with no differences observed between experimental conditions. Similarly, there were no differences in offline learning between groups. Contrary to previous reports, the present data do not support an intensity-dependent effect on motor learning, when exercise is performed prior to task practice. One reason for this might be that similar muscle groups were involved in exercise and the motor task, potentially causing fatigue or interference effects. Further, the results indicate that the memory-promoting effects of acute exercise are task-dependent and may not apply equally for motor skills of different levels of complexity.

Ankle angle variability during running in athletes with chronic ankle instability and copers.

BACKGROUND: Individuals with chronic ankle instability (CAI) demonstrate altered ankle kinematics during running compared to uninjured individuals; however, little is known about differences between individuals with CAI and those who recover successfully from an index sprain (copers). METHODS: Thirty-two young male athletes with prior ankle sprain were investigated, eighteen with CAI and fourteen copers. Instrumented running analysis was performed on a treadmill at two velocities: moderate (2.63 ± 0.20 m/s, rate of perceived of exertion = 14/20); and high velocity (3.83 ± 0.20 m/s). Mean ankle kinematics and stride-to-stride variability were analyzed applying the statistical parametric mapping method. RESULTS: At both running velocities, no statistically significant differences in mean ankle kinematics were observed. At high running velocity, athletes with CAI demonstrated significantly increased frontal plane variability at 17-19% of the running gait cycle (p = 0.009). Additionally, large between-group effect sizes (Hedges' g ≥ 0.8) may potentially indicate increased frontal plane variability during initial contact and terminal swing, as well as decreased variability in sagittal plane at 34-35% in CAI. A similar tendency existed at moderate velocity, with large effect sizes indicating decreased dorsiflexion at 75-89% in CAI, as well as an increased frontal plane variability at 16-25%, and 97-99%. DISCUSSION: Compared to copers, individuals with CAI demonstrate increased variability of ankle kinematics - mainly in the frontal plane and particularly during stance phase - while mean ankle kinematics seems minimally affected. Increased ankle variability at high running velocity may best reflect persisting sensorimotor control deficits in athletes with chronically instable ankles.

Perturbation Treadmill Training Improves Clinical Characteristics of Gait and Balance in Parkinson's Disease.

BACKGROUND: Impaired gait and postural stability are cardinal motor symptoms in Parkinson's disease (PD). Treadmill training improves gait characteristics in PD. OBJECTIVE: This study investigates if postural perturbations during treadmill training improve motor performance and particularly gait and postural stability in PD. METHODS: This work presents secondary outcome measures of a pilot randomized controlled trial. PD patients (n = 43) recruited at the University Hospital Erlangen were randomly allocated to the experimental (perturbation treadmill training, PTT, n = 21) or control group (conventional treadmill training, CTT, n = 22). Outcome measures were collected at baseline, after 8 weeks of intervention, and 3 months follow-up. Motor impairment was assessed by the Unified Parkinson Disease Rating Scale part-III (UPDRS-III), Postural Instability and Gait Difficulty score (PIGD), and subitems 'Gait' and 'Postural stability' by an observer blinded to the randomization. Intervention effects were additionally compared to progression rates of a matched PD cohort (n = 20) receiving best medical treatment (BMT). RESULTS: Treadmill training significantly improved UPDRS-III motor symptoms in both groups with larger effect sizes for PTT (-38%) compared to CTT (-20%). In the PTT group solely, PIGD -34%, and items 'Gait' -50%, and 'Postural stability' -40% improved significantly in comparison to CTT (PIGD -24%, 'Gait' -22%, 'Postural stability' -33%). Positive effects persisted in PTT after 3 months and appeared to be beneficial compared to BMT. CONCLUSIONS: Eight weeks of PTT showed superior improvements of motor symptoms, particularly gait and postural stability. Sustainable effects indicate that PTT may be an additive therapy option for gait and balance deficits in PD.