Comparison of different telerehabilitation protocols for urogenital symptoms in females with multiple sclerosis: a randomized controlled trial.

Telerehabilitation has been suggested to be equally effective than in-person rehabilitation, and could be helpful to increase participation and reduce barriers. People with multiple sclerosis (MS) often present urogenital dysfunctions, impairing independence and quality of life (QoL). Since the different available telerehabilitation protocols, the present study aimed to compare a live video urogenital rehabilitation intervention protocol (REMOTE) with a home-based pre-recorded video protocol (SELF). A randomized-controlled trial was performed, with 14 females with MS being allocated in the REMOTE group (36 ± 9 y) and 14 females in the SELF group (37 ± 7 y). Both telerehabilitation protocols were identical in terms of contents (including pelvic floor training and relaxation exercises), frequency and duration, consisting of 10 sessions of 45 min each, every 5 days. Questionnaires were administered at the beginning and the end of the study: Short Form Health Survey 36 (SF-36), Beck Depression Inventory (BDI), Female Sexual Function Index (FSFI), International Consultation on Incontinence Questionnaire (ICIQ) symptoms and related QoL, the main outcome being ICIQ incontinence score. Despite most of the outcomes improved in both groups, REMOTE was found to be more effective than SELF in most of the SF-36 domains (from p < 0.001 pη2 0.555 to p = 0.044 pη2 0.147), FSFI (p = 0.001 pη2 0.373), ICIQ (p = 0.003 pη2 0.291). Despite the home-based pre-recorded videos could be effective in improving urogenital symptoms, live video urogenital rehabilitation results in larger improvements. Telerehabilitation should be encouraged for urogenital dysfunctions in females with MS, and pre-recorded videos could represent an alternative when live sessions are not available. Clinical trial registration This randomized controlled trial was registered on ClinicalTrials.gov with the number NCT05984095.

Efficacy of a dual task protocol on neurophysiological and clinical outcomes in migraine: a randomized control trial.

The main aim of this study was to investigate the efficacy of a dual task protocol in people with episodic migraine with respect to both active exercises only and cognitive task only treatments, concerning some neurophysiological and clinical outcomes. A randomized control trial was adopted in people with episodic migraine without aura. Some neurophysiological and clinical outcomes were collected (t0): resting motor threshold (rMT), short intracortical inhibition (SICI) and facilitation (ICF), pressure pain threshold (PPT), trail making test (TMT), frontal assessment battery (FAB), headache-related disability (MIDAS) and headache parameters. Then, participants were randomized into three groups: active exercise only (n = 10), cognitive task only (n = 10) and dual task protocol (n = 10). After 3 months of each treatment and after 1-month follow-up the same neurophysiological and clinical outcomes were revaluated. A significant time x group effect was only found for the trapezius muscle (p = 0.012, pη2 = 0.210), suggesting that PPT increased significantly only in active exercise and dual task protocol groups. A significant time effect was found for rMT (p < 0.001, pη2 = 0.473), MIDAS (p < 0.001, pη2 = 0.426), TMT (p < 0.001, pη2 = 0.338) and FAB (p < 0.001, pη2 = 0.462). A repeated measures ANOVA for SICI at 3 ms highlighted a statistically significant time effect for the dual task group (p < 0.001, pη2 = 0.629), but not for the active exercises group (p = 0.565, pη2 = 0.061), and for the cognitive training (p = 0.357, pη2 = 0.108). The dual task protocol seems to have a more evident effect on both habituation and sensitization outcomes than the two monotherapies taken alone in people with migraine.

Instrumental assessment of physiotherapy and onabolulinumtoxin-A on cervical and headache parameters in chronic migraine.

INTRODUCTION: The purpose of the present study is to compare the effect of the physiotherapy to onabolulinumtoxin-A, and their combination, in relation to cervical and headache parameters in patients with chronic migraine. METHODS: This is an observational cohort study conducted by a headache center and a physiotherapy degree course on 30 patients with chronic migraine. The patients were distributed in three groups of treatments for three months: onabolulinumtoxin-A only, physiotherapy only, and onabolulinumtoxin-A plus physiotherapy. The patients were evaluated, before and after each treatment, using the following: the postural assessment software SAPO for the forward head posture; the CROM goniometer for the cervical range of motion; the Migraine Disability Assessment Score for headache parameters. RESULTS: After 3 months of each treatment, the scores obtained for the headache-related disability and the frequency of migraine decreased significantly for all groups, but the pain intensity scores changed significantly only in the onabolulinumtoxin-A (p = 0.01) and in the onabolulinumtoxin-A plus physiotherapy groups (p = 0.007). On the other hand, the forward head posture was reduced significantly in the physiotherapy (p = 0.002) and in the onabolulinumtoxin-A plus physiotherapy groups (p = 0.003). The cervical range of motion increased significantly in certain directions in the physiotherapy group and in the onabolulinumtoxin-A plus physiotherapy groups. CONCLUSIONS: The physiotherapy improved the cervical parameters. The onabolulinumtoxin-A decreased pain intensity. As a consequence, it can be said that the combined treatment was more useful than a mono-therapy alone. From our results, it can be concluded that onabolulinumtoxin-A plus physiotherapy could be a good option in the management of chronic migraine.

SNARC-like compatibility effects for physical and phenomenal magnitudes: a study on visual illusions.

Both numerical and non-numerical magnitudes elicit similar Spatial-Numerical Association of Response Codes (SNARC) effects, with small magnitudes associated with left hand responses and large magnitudes associated with right hand responses (Dehaene et al., J Exp Psychol Gen 122(3), 371, 1993). In the present study, we investigated whether the phenomenal size of visual illusions elicits the same SNARC-like effect revealed for the physical size of pictorial surfaces. Four experiments were conducted by using the Delboeuf illusion (Experiment 1) and the Kanizsa triangle illusion (Experiments 2, 3 and 4). Experiment 1 suggests the presence of a SNARC-like compatibility effect for the physical size of the inducers, while this effect was not revealed for the phenomenal size of the induced elements, possibly masked by a stronger effect of the inducers. A SNARC-like effect for the phenomenal size of the Kanizsa triangle was revealed when participants directly compared the size of the triangles (Experiment 4). Conversely, when participants performed an indirect task (orientation judgment), the SNARC-like effect was present neither for the illusory nor for the physical displays (Experiments 2 and 3). The effect revealed for the size of illusory triangles was comparable to that of real triangles with physical contours, suggesting that both phenomenal and physical magnitudes similarly elicit SNARC-like effects.

Octave Bias in Pitch Perception: The Influence of Pitch Height on Pitch Class Identification.

Pitch height and pitch class are different, but strictly related, percepts of music tones. To investigate the influence of pitch height in a pitch class identification task, we systematically analyzed the errors-in terms of direction and amount-committed by a group of musicians. The aim of our study was to verify the existence of constant errors in the identification of pitch classes across consecutive octaves. Stimuli were single piano tones from the C major scale executed in two consecutive octaves. Participants showed different response patterns in the two octaves. The direction of errors revealed a constant tendency to underestimate pitch classes in the lowest octave and to overestimate pitch classes in the highest octave. Thus, pitch height showed to influence pitch class identification. We called this bias "pitch class polarization", since the same pitch class was judged to be respectively lower and higher, depending on relatively low or high pitch height.

Ecological sounds affect breath duration more than artificial sounds.

Previous research has demonstrated that auditory rhythms affect both movement and physiological functions. We hypothesized that the ecological sounds of human breathing can affect breathing more than artificial sounds of breathing, varying in tones for inspiration and expiration. To address this question, we monitored the breath duration of participants exposed to three conditions: (a) ecological sounds of breathing, (b) artificial sounds of breathing having equal temporal features as the ecological sounds, (c) no sounds (control). We found that participants' breath duration variability was reduced in the ecological sound condition, more than in the artificial sound condition. We suggest that ecological sounds captured the timing of breathing better than artificial sounds, guiding as a consequence participants' breathing. We interpreted our results according to the Theory of Event Coding, providing further support to its validity, and suggesting its possible extension in the domain of physiological functions which are both consciously and unconsciously controlled.

Enhancing Perceptual-Motor Skills in Sports: The Role of Ecological Sounds.

Starting approximately from the beginning of the new millennium, a series of studies highlighted that auditory information deriving from biological motion can significantly influence the behavioral, cognitive and neurophysiological processes involved in the perception and execution of complex movements. In particular, it was observed that an appropriate use of sounds deriving from one's own movement promotes improvements in the movement execution itself. Two main approaches can be used, namely the sonification one or the ecological sound one; the former is based on the conversion of physiological and/or physical movement data into sound, while the latter is based on the use of auditory recordings of movement sounds as models. In the present article, some of the main applications of both approaches-especially the latter-to the domains of sport and motor rehabilitation are reviewed, with the aim of addressing two questions: Is it possible to consider rhythm as a Gestalt of human movement? If so, is it possible to build up cognitive strategies to improve/standardize movement performance from this Gestalt? As with most topics in science, a definitive answer is not possible, yet the evidence leads us to lean toward a positive answer to both questions.

Neurophysiological and Clinical Outcomes in Episodic Migraine Without Aura: A Cross-Sectional Study.

OBJECTIVE: The aim of this study was to assess differences between people with episodic migraine and healthy controls in some neurophysiological and clinical outcomes, which, in turn, may highlight the differences in sensory processing, especially in cortical excitability, pain processing, and executive function. METHODS: A cross-sectional study was performed, including the following outcomes: pressure pain thresholds with algometry; resting motor threshold, short-interval intracortical inhibition, and intracortical facilitation with transcranial magnetic stimulation; and executive functions with the trail making test and the frontal assessment battery. RESULTS: Thirty adults with migraine (36 ± 10 years) and 30 healthy controls (29 ± 14 years) were included in this study. Compared with the healthy controls, participants with migraine presented lower pressure pain thresholds values in all the assessed muscles ( P < 0.001), lower resting motor threshold (-10.5% of the stimulator output, 95% CI: -16.8 to -4.2, P = 0.001, Cohen d = 0.869) and higher short-interval intracortical inhibition motor-evoked potential's amplitude at 3 ms (0.25, 95% CI: 0.05 to 0.46, P = 0.015, Cohen d = 0.662), and worse performances both in trail making test (7.1, 95% CI: 0.9 to 13.4, P = 0.027, Cohen d = 0.594) and frontal assessment battery (-1.1, 95% CI: -1.7 to -0.5, P = 0.001, Cohen d = 0.915). CONCLUSIONS: Participants with migraine presented significant differences in cortical excitability, executive functions, and pressure pain thresholds, compared with healthy controls.

The Acute Effects of Cold Water Immersion and Percussive Massage Therapy on Neuromuscular Properties and Muscle Soreness after Exercise in Young Male Soccer Players.

Cold water immersion (CWI) and percussive massage therapy (PMT) are commonly used recovery techniques in team sports. In particular, despite its wide use, PMT has been scarcely investigated in the literature, especially regarding neuromuscular measures and in comparison with other techniques. This study aimed to evaluate and compare the acute and short-term effects (24 h) of CWI and PMT on muscle strength, contractile properties, and soreness after exercise. A randomized crossover study was performed on sixteen male soccer players (22 years, 20-27) who participated in three experimental sessions involving a fatiguing protocol consisting of a Yo-Yo Intermittent Endurance Test followed by 3 × 10 squat jumps and a wall sit for 30 s, and 12 min of recovery including CWI (10 °C water), bilateral PMT on the anterior and posterior thigh, or passive resting. Outcomes were assessed immediately after the exercise protocol, after the recovery intervention, and at 24 h. Isometric knee extension (IKE) and flexion (IKF) and tensiomyography (TMG) were assessed. Muscle soreness and fatigue were scored from 0 to 10. PMT increased strength after the treatment (p = 0.004) and at 24 h (p = 0.007), whereas no significant differences were found for the other two recovery modalities. At post-recovery, compared to CON, CWI resulted in a longer TMG contraction time (p = 0.027). No significant differences were found at 24 h. Finally, PMT and CWI enhanced muscle soreness recovery compared to passive rest (F4,60 = 3.095, p = 0.022, pη2 = 0.171). Preliminary results from this study suggest that PMT might improve isometric strength after strenuous exercise, and both PMT and CWI reduce muscle soreness perception, while the effects on TMG parameters remain controversial.

Algometer Assessment of Pressure Pain Threshold After Onabotulinumtoxin-A and Physical Therapy Treatments in Patients With Chronic Migraine: An Observational Study.

The purpose of this study was to evaluate pain hypersensitivity in chronic migraine patients 3 months after undergoing onabotulinumtoxin-A therapy, physical therapy (PT), or the combination of the two. Pressure pain threshold (PPT) was assessed in accordance with Andersen's guidelines, focusing on five muscles in the trigeminocervical area (namely, trapezius, levator scapulae, temporalis, sub-occipitalis, and scalenus medius) and one muscle outside of the area, (i.e., tensor fasciae latae). Moreover, three headache parameters, namely, attack frequency, duration, and pain intensity, were recorded in an ad hoc diary kept by the patients. A total of 30 patients were included in three treatment groups: 1. onabotulinumtoxin-A therapy, 2. PT, and 3. a combination of onabotulinumtoxin-A and PT. The results show that, at the final assessment, the PPT was significantly reduced in the combined treatment group compared to the two single-therapy groups. As regards headache parameters, frequency and duration of the attacks were decreased significantly in all three treatment groups, whereas in pain intensity, the reduction was statistically significant in the combined treatment group and the onabotulinumtoxin-A therapy. Results suggest that a better pain modulation in patients with chronic migraine can be achieved with a combined treatment of onabotulinumtoxin-A and physical therapy. Indeed, the combination of both pharmacological and non-pharmacological treatments results in the reduction of both headache-related parameters and widespread pressure hyperalgesia.

Further Empirical Evidence on Patrick Hughes' Reverspectives: A Pilot Study.

Reverspectives are paintings created by the English artist Patrick Hughes. They are 3D structures, for example, pyramids or prisms, which elicit an illusory depth perception that corresponds to the reverse of the physical depth layout. Rogers and Gyani state that "the perspective information provided by a simple grid of vertical and horizontal lines on a slanting surface can be just as powerful as the information provided by a rich, naturalistic scene". The present experiment was aimed to further investigate this perspective reversal. Three independent variables were manipulated: (1) texture components (i.e., vertical, horizontal, and oblique lines components), (2) texture spatial arrangement (i.e., Hughes-type "perspective" grid vs. equidistant "no perspective" grid), and (3) illumination direction (i.e., homogeneous illumination, light from above, and light from below). The dependent variable was the "critical distance", namely, the distance between an approaching observer and the stimulus at which the illusory depth perception of concavity/convexity switched to the actual perception of convexity/concavity. The results showed that a stronger illusion is elicited by: (a) a Hughes-type texture spatial arrangement; (b) a complete grid texture composition, having both vertical and horizontal, and oblique components; and (c) illumination from below, as opposed to the condition in which light is coming from above.

Contrasting a Misinterpretation of the Reverse Contrast.

The reverse contrast is a perceptual phenomenon in which the effect of the classical simultaneous lightness contrast is reversed. In classic simultaneous lightness contrast configurations, a gray surrounded by black is perceived lighter than an identical gray surrounded by white, but in the reverse contrast configurations, the perceptual outcome is the opposite: a gray surrounded by black appears darker than the same gray surrounded by white. The explanation provided for the reverse contrast (by different authors) is the belongingness of the gray targets to a more complex configuration. Different configurations show the occurrence of these phenomena; however, the factors determining this effect are not always the same. In particular, some configurations are based on both belongingness and assimilation, while one configuration is based only on belongingness. The evidence that different factors determine the reverse contrast is crucial for future research dealing with achromatic color perception and, in particular, with lightness induction phenomena.

Former Road Cyclists Still Involved in Cycling Report Lower Burnout Levels Than Those Who Abandoned This Sport.

Despite the numerous benefits associated with sport practice, many children and adolescents end up quitting it year after year, with a stable dropout rate between 10 and 19 years of age. Among the causes of sport abandonment, the scientific literature highlights the presence of burnout as a fundamental factor. In this regard, the aim of the present study was to investigate the levels of the three components of sport burnout-emotional and physical exhaustion, reduced sense of accomplishment, and sport devaluation-reported by a sample of young (former) athletes, depending on whether their sport abandonment was relative (i.e., change to another sport modality) or definitive. In particular, participants were former agonist road cyclists, who have been divided into three groups on the basis of what they did after abandoning road bicycle racing, namely: (a) those still involved in cycling, either in a different specialty (e.g., mountain bike) or with a different role (e.g., coach for kids); (b) those who started practicing a different sport; and (c) those who definitively abandoned sports. The general hypothesis was that, with respect to those who changed sport and those who definitively abandoned it, those still involved in cycling would report experiencing lower levels of the three burnout components during the last year practicing it. To test this hypothesis, the Athlete Burnout Questionnaire (ABQ; Raedeke and Smith, 2001) was administered to 85 young former road cyclists. The results seem to support the hypothesis for two out of the three components, namely, emotional and physical exhaustion and sport devaluation; on the other hand, for reduced sense of accomplishment, no difference among the three groups emerged. Further research is needed to deepen the understanding of such processes, also in relation with other relevant constructs; yet, the results of the present study should already raise the awareness of sport organizations on the need to deal with this and related phenomena by adopting appropriate strategies to ensure the well-being of young athletes, thus trying to reduce early dropout.

Pressing Crowd Noise Impairs the Ability of Anxious Basketball Referees to Discriminate Fouls.

The decision-making processes of referees in sports are affected by many factors, including the pressure of spectators. While the home/visitor bias has been previously investigated, the role of crowd noise has been less studied. In the present study, we investigated how the crowd noise (calm vs. pressing) influence the decisions of basketball referees, when examining videos of potential fouls. In doing so, we also considered the level of competitive anxiety of referees (low vs. high anxiety), as factor potentially interacting with the pressure exerted by the spectators. A 2 × 2 ANOVA (Crowd noise x Anxiety) revealed a significant interaction [F (1,28) = 7.33; p < 0.05; η p 2 = 0.21; power = 0.74], with the highly anxious referees showing poorer performances in the pressing crowd condition [t (14) = 2.24; p < 0.05; d = 0.64]. The results indicate that the crowd noise does not seem to affect the referees' decisions, unless we consider the anxiety. The present findings suggest that the decisions of referees with high anxiety might be more easily influenced by external factors like crowd noise. Based on these results, referees' federations should consider the possibility to develop training protocols dedicated to highly anxious referees, to avoid their decisions from being biased by spectators' pressure.

Predicting the length of volleyball serves: The role of early auditory and visual information.

In light of the growing body of research that is revealing the significant role of the auditory domain in sport, the present study aims to investigate the contribution of early auditory and visual information to the prediction of volleyball serves' length. To this purpose, three within-subjects experiments were run, which differed among them in terms of stimuli (audiovisual congruent vs audiovisual incongruent; audio only vs video only) and/or in terms of number of possible answers. In particular, expert volleyball players were asked to predict the length of temporally occluded overhand serves, choosing among either two or three possible landing sectors. Response accuracy and response times were measured. For the incongruent stimuli, the results revealed that the percentage of predictions in line with early auditory information was significantly higher than the respective percentage of predictions in line with early visual information. For unimodal stimuli, prediction accuracy was significantly higher on the basis of auditory information than on the basis of visual information, without any difference on response times. Taken together, the results highlighted the relevance of early auditory information for the prediction of volleyball serves' length.

Modality and Perceptual-Motor Experience Influence the Detection of Temporal Deviations in Tap Dance Sequences.

Accurate temporal information processing is critically important in many motor activities within disciplines such as dance, music, and sport. However, it is still unclear how temporal information related to biological motion is processed by expert and non-expert performers. It is well-known that the auditory modality dominates the visual modality in processing temporal information of simple stimuli, and that experts outperform non-experts in biological motion perception. In the present study, we combined these two areas of research; we investigated how experts and non-experts detected temporal deviations in tap dance sequences, in the auditory modality compared to the visual modality. We found that temporal deviations were better detected in the auditory modality compared to the visual modality, and by experts compared to non-experts. However, post hoc analyses indicated that these effects were mainly due to performances obtained by experts in the auditory modality. The results suggest that the experience advantage is not equally distributed across the modalities, and that tap dance experience enhances the effectiveness of the auditory modality but not the visual modality when processing temporal information. The present results and their potential implications are discussed in both temporal information processing and biological motion perception frameworks.

Perceptual belongingness determines the direction of lightness induction depending on grouping stability and intentionality.

Contrast and assimilation are two opposite perceptual phenomena deriving from the relationships among perceptual elements in a visual field. In contrast, perceptual differences are enhanced; while, in assimilation, they are decreased. Indeed, if contrast or assimilation occurs depends on various factors. Interestingly, Gestalt scientists explained both phenomena as the result of perceptual belongingness, giving rise to an intriguing paradox. Benary suggested that belongingness determines contrast; conversely, Fuchs suggested that it determines assimilation. This paradox can be related both to the grouping stability (stable/multi-stable) and to the grouping intentionality (intentional/non-intentional). In the present work we ran four experiments to test whether the contrast/assimilation outcomes depend on the above-mentioned variables. We found that, intentionality and multi-stability elicit assimilation; while, non-intentionality and stability elicit contrast.

The phantom illusion.

It is well known that visible luminance gradients may generate contrast effects. In this work we present a new paradoxical illusion in which the luminance range of gradual transitions has been reduced to make them invisible. By adopting the phenomenological method proposed by Kanizsa, we have found that unnoticeable luminance gradients still generate contrast effects. But, most interestingly, we have found that when their width is narrowed, rather than generating contrast effects on the surrounded surfaces, they generate an assimilation effect. Both high- and low-level interpretations of this "phantom" illusion are critically evaluated.

A new effect of luminance gradient on achromatic simultaneous contrast.

A new effect in the domain of achromatic simultaneous contrast has been observed. A middle gray region placed at the center of an area filled by a linear achromatic gradient from black (outer part) to white (inner part) is perceived as being much darker than an identical middle gray region surrounded by a reversed gradient. By using a matching task in two experiments, it has been shown that this phenomenon is much stronger than the classical achromatic simultaneous contrast effect. The new effect is interpreted in terms of the albedo hypothesis.