Cognitive reserve and executive functions in dual task gait performance in Parkinson's disease.

A higher level of education was correlated with less severe motor impairment in Parkinson's Disease (PD). Nevertheless, there is limited evidence on the relationship between cognitive reserve and motor performance in complex situations in PD. To investigate the association between cognitive reserve and the dual-task gait effect in PD. Additionally, we examined the relationship between executive function, clinical and sociodemographic variables and, dual-task gait effects. We conducted a cross-sectional study with 44 PD participants. We evaluated dual-task effect on cadence, stride length, and gait velocity. Dual-task effects were correlated with neurophysiological factors, including cognitive reserve (Cognitive Reserve Index Questionnaire), overall cognitive performance of executive functions, a specific executive function domain (Trail Making Test), and the global cognitive status (Montreal Cognitive Assessment and Mini-Mental State Examination). Age, gender, and disease severity were considered as variables to be examined for correlation. We found that cognitive reserve did not influence gait performance under dual-task conditions in this sample. However, executive functions, age, and disease severity were associated with the dual-task effect on gait. The overall cognitive performance with respect to the Trail Making Test showed an inverse relationship in the dual-task gait effect on cadence. Our study's findings have important implications for understanding the association between executive functions, age, and disease severity with the dual-task effect on gait in PD. Pre-life factors, such as education, occupation, and leisure activity, did not contribute to coping with complex gait situations in PD.

Dynamic valgus knee revealed with single leg jump tests in soccer players.

BACKGROUND: Dynamic valgus knee occurs in sports that involve jumps and landing such as soccer and pose an increased risk for anterior cruciate ligament injury. Visual estimation is biased by the athlete's body type, the experience of the evaluator and the movement phase at which the valgus is assessed - thus the result is highly variable. The aim of our study was to accurately assess dynamic knee positions during single and double leg tests through a video-based movement analysis system. METHODS: Young soccer players (U15, N.=22) performed single leg squat, single leg jump, and double leg jump tests while the knee medio-lateral movement was monitored with a Kinect Azure camera. Jumping and landing phases of the movement were determined within the continuous recording of the knee medio-lateral position over the ankle and the hip vertical position. Kinect measurements were validated by Optojump (Microgate, Bolzano, Italy). RESULTS: Soccer players retained their predominantly varus knee positions in all phases of double-leg jumps, which was far less prominent in single leg tests. Interestingly, a marked dynamic valgus was observed in athletes who participated in traditional strengthening exercises, while this valgus shift was mostly prevented in those who participated in antivalgus training regimes. All these differences were only revealed during single leg tests, while the double leg jump tests masked all valgus tendencies. CONCLUSIONS: We propose to use single-leg tests and movement analysis systems for evaluating dynamic valgus knee in athletes. These methods can reveal valgus tendencies even in soccer players who have a characteristic varus knee while standing.

Professional Athletes Maintain High TNF-Alpha or IFN-Gamma Related Inflammatory Status after Recovering from COVID-19 Infection without Developing a Neutralizing Antibody Response.

INTRODUCTION: Professional athletes are endangered by COVID-19 and belong to the high-risk population due to their lifestyle. To obtain information on the behavior of COVID-19 in professional athletes, serological, cytokine, and virus neutralization capacities were analyzed. MATERIALS AND METHODS: Hungarian national teams participated in international sports events during the early phases of the COVID-19 epidemic in 2020. Altogether, 29 professional athletes volunteered to donate plasma. Their serological status was evaluated by IgA, IgM, and IgG ELISAs and the highest virus neutralization titer in an in vitro live tissue assay. Plasma cytokine patterns were analyzed with a Bioplex multiplex ELISA system. RESULTS: Surprisingly, only one athlete (3%) had anti-SARS-CoV-2 IgG, while IgA was more common (31%). Neither plasma showed direct virus neutralization in a titer over 1:10; hence, they were not suitable for reconvalescent treatment. The 'cytokine storm' markers IL-6 and IL-8 were at baseline levels. In contrast, either the TNF-alpha-related cytokines or the IFN-gamma-associated cytokines were elevated. There was a strong negative correlation between the TNF-alpha- or IFN-gamma-related cytokines. CONCLUSIONS: Professional athletes are susceptible to the SARS-CoV-2 infection without developing long-term immunity through neutralizing immunoglobulins. Elevated secretory and cellular immunity markers indicate that these systems are probably responsible for virus elimination in this subpopulation.

Early Transfusion of Convalescent Plasma Improves the Clinical Outcome in Severe SARS-CoV2 Infection.

INTRODUCTION: Plasma harvested from convalescent COVID-19 patients (CCP) has been applied as first-line therapy in the early phase of the SARS-CoV2 pandemic through clinical studies using various protocols. METHODS: We present data from a cohort of 267 hospitalized severe COVID-19 patients who received CCP. No transfusion-related complications were reported, indicating the overall safety of CCP therapy. RESULTS: Patients who eventually died from COVID-19 received CCP significantly later (3.95 versus 5.22 days after hospital admission) and had higher interleukin 6 (IL-6) levels (28.9 pg/ml versus 102.5 pg/ml) than those who survived. In addition, CCP transfusion caused a significant reduction in the overall inflammatory status of the patients regardless of the severity of disease or outcome, as evidenced by decreasing C-reactive protein, IL6 and ferritin levels. CONCLUSION: We conclude that CCP transfusion is a safe and effective supplementary treatment modality for hospitalized COVID-19 patients characterized by better expected outcome if applied as early as possible. We also observed that IL-6 may be a suitable laboratory parameter for patient selection and monitoring of CCP therapy effectiveness.

Test-retest reliability of stride length-cadence gait relationship in Parkinson's disease.

INTRODUCTION: The gait pattern in Parkinson´s disease (PD) subjects is characterized by a specific deficit of the internal regulation of the stride length (SL), while the control of the cadence (Cad) remains intact. The purpose of the present study was to evaluate the reliability of the stride length-cadence relationship (SLCrel) in a group of PD subjects. METHODS: Thirty five PD subjects performed two sessions, separated by a three month resting period. In each session Gait speed, SL and Cad were evaluated at five different self-selected speed conditions: preferred, slow, very slow, fast and very fast. Linear regression analysis was used to explore the SLCrel and to determine the slope, intercept and coefficient of determination (R2) for each participant. Test-retest reliability for the slope and intercept was calculated using intra-class correlation coefficient (ICC), 95% confidence interval (CI), and standard error of mean (SEM). RESULTS: There were no significant differences in the slope and intercept between the two sessions. The overall speed was significantly faster in the second session compared with the first one (F = 4.60, p = 0.03). The SLCrel showed high reliability across the sessions (ICC = 0.89 and ICC = 0.91; 95% CI = 0.80-0.95 and 95% CI = 0.82-0.95; SEM = 0.002 and SEM = 0.073, for the slope and interception, respectively). CONCLUSIONS: The SLCrel in Parkinsonian gait is a reproducible measure across a period of three months, and may be a useful tool to explore the specificity of gait rehabilitation interventions in PD subjects.

Mechanical, hormonal, and hypertrophic adaptations to 10 weeks of eccentric and stretch-shortening cycle exercise training in old males.

The growth promoting effects of eccentric (ECC) contractions are well documented but it is unknown if the rate of stretch per se plays a role in such muscular responses in healthy aging human skeletal muscle. We tested the hypothesis that exercise training of the quadriceps muscle with low rate ECC and high rate ECC contractions in the form of stretch-shortening cycles (SSCs) but at equal total mechanical work would produce rate-specific adaptations in healthy old males age 60-70. Both training programs produced similar improvements in maximal voluntary isometric (6%) and ECC torque (23%) and stretch-shortening cycle function (reduced contraction duration [24%] and enhanced elastic energy storage [12%]) (p<0.05). The rate of torque development increased 30% only after SSC exercise (p<0.05). Resting testosterone and cortisol levels were unchanged but after each program the acute exercise-induced cortisol levels were 12-15% lower (p<0.05). Both programs increased quadriceps size 2.5% (p<0.05). It is concluded that both ECC and SSC exercise training produces favorable adaptations in healthy old males' quadriceps muscle. Although the rate of muscle tension during the SSC vs. ECC contractions was about 4-fold greater, the total mechanical work seems to regulate the hypetrophic, hormonal, and most of the mechanical adaptations. However, SSC exercise was uniquely effective in improving a key deficiency of aging muscle, i.e., its ability to produce force rapidly.