Feasibility of a combined intermittent theta-burst stimulation and video game-based dexterity training in Parkinson's disease.

BACKGROUND: Persons with Parkinson's disease (PD) often exhibit difficulties with dexterity during the performance of activities of daily living (ADL), inter alia due to dysfunctional supplementary motor area (SMA). Combined intermittent theta-burst stimulation (iTBS) over the SMA followed by video game-based training (VBT) may therefore improve dexterity related ADL. The VBT may induce high flow levels related to high performance during the training. The aim of this study is to evaluate the feasibility of a combined iTBS-VBT intervention in persons with PD. METHODS: A total of nine persons with PD (mean age 63.3 ± 8.76 years) with self-reported difficulties with dexterity related ADL were included in this pilot iTBS-VBT study. All participants received either iTBS or sham stimulation over the SMA followed by a 45-min VBT, three times a week for a total of three weeks. Feasibility was measured by means of the adherence rate and the system usability (System Usability Scale). Moreover, flow was measured after the last VBT session. RESULTS: Adherence rate was excellent with 100%. High system usability scores (i.e., mean 80%, range 55-97.5) and a significant Spearman's correlation with the Flow State Scale (r = .762, p = .017) further point to the high feasibility of the VBT. Neither demographic variables nor difficulties in dexterity related ADL affected the usability of the VBT. CONCLUSION: This study demonstrates the high feasibility of a combined iTBS-VBT intervention. Moreover, the level of self-reported usability was related to flow experience. Whether this kind of combined iTBS-VBT intervention improves dexterity will be evaluated in a randomized controlled trial. Trial registration clincaltrials.gov NCT04699149, date of registration 1. June 2021.

Puzzle game-based learning: a new approach to promote learning of principles of coronary artery bypass graft surgery.

INTRODUCTION: Since learning with high educational quality requires an advanced intervention. This study seeks to answer how many puzzles game-based training can improve knowledge and cognitive function of surgical technology students in CABG surgery and its sequence, as well as the tools and equipment used in each stage of surgery and the sequence of their preparation. MATERIALS AND METHODS: This study was carried out as a quasi-experimental single-group pre-test-post-test, during which, after designing a puzzle game including various stages of surgery (from the preparation of the patient for surgical sutures and the necessary equipment to perform each stage), 18 people from third-year surgical technology students who met the inclusion criteria were entered in the study by convenience sampling method and based on the sample size determined using a similar study and they participated in the test of knowledge and cognitive function, that the validity and reliability were measured, before the intervention and 14 days after the intervention (using a puzzle game). Data were analyzed using descriptive and Wilcoxon statistical tests. RESULTS: After the withdrawal of 2 people, 15 person (93.80 per cent) of the students were female, the average age of students was 21.87 ± 0.71 years, and 50% (8 people) of them were 22 years old. Also, the average score of the end-of-semester exam of the heart surgery technology course was 15.19 ± 2.30 (the lowest score was 11.25, and the highest score was 18.63), and the score of 43.80% (7 people) of them were in the range of 15.01-17.70, and their average of grade point average was 17.31 ± 1.10 (the lowest grade point average is 15 and the highest grade point average is 19.36) and grade point average 75% (11 people) of students were 16-18. The average scores of knowledge(5.75 ± 1.65 vs. 2.68 ± 0.79) and cognitive performance(6.31 ± 2.57 vs. 2.00 ± 1.09) of students in the post-intervention phase were significantly higher than the pre-intervention phase (P < 0.0001). CONCLUSION: The results of the present study showed that the use of puzzle games in CABG surgery training led to a significant improvement in the knowledge and cognitive performance of surgical technology students regarding the stages of CABG surgery and its sequence, as well as the tools and equipment used in each stage of surgery and the sequence of their preparation.

Effects of mental fatigue on the psychophysiological responses, kinematic profiles, and technical performance in different small-sided soccer games.

The purpose of this study was to assess the effects of mental fatigue (MF) on the psychophysiological responses, kinematic profiles, and technical performance of young soccer players in small-sided games (SSGs). Twenty-four young soccer players (age: 15.9 ± 1.0 years) played 2vs2, 3vs3, and 4vs4 SSGs consisting of four bouts (with two-minute passive rest periods between bouts) under two different playing conditions: MF+SSGs and SSGs. The heart rate, total distance covered, and technical performance of each player were monitored during all SSGs, and the rating of perceived exertion, visual analogue scale, and Rating Scale Mental Effort values were determined after each bout. The Physical Activity Enjoyment Scale (PACES) and Brunel Mood Scale (BRUMS) were also determined at the end of each SSG. The results demonstrated that all MF+SSGs induced higher psychophysiological responses (p ≤ 0.05) than SSGs, except regarding the PACES responses. By contrast, the SSGs group covered a greater total distance (p ≤ 0.05) than the MF+SSGs group. During SSGs, the players' technical performances (in terms of lost balls and unsuccessful passes) were negatively affected after MF (p ≤ 0.05). The results of this study indicate that both PACES scores and mood responses were negatively affected after the MF intervention. Coaches could use the MF intervention before SSGs to improve soccer-specific technical and decision-making performances in young soccer players.

Short-term effects of on-field combined core strength and small-sided games training on physical performance in young soccer players.

This study aimed to compare the effects of 6-weeks combined core strength and small-sided games training (SSGcore) vs. small-sided games (SSG) training on the physical performance of young soccer players. Thirty-eight amateur soccer players (age: 16.50 ± 0.51 years) were randomly assigned to either a SSGcore (n = 20) or a SSG group (n = 18). The SSGcore group performed upper and lower body core strength exercises combined with SSG including 2-, 3- and 4-a-sided soccer games third a week. The SSG group performed only the SSG periodization. Baseline and after the 6-week training period the Yo-Yo Intermittent Recovery Test level 1 (YYIRTL-1), 5-20-m sprint test, countermovement jump (CMJ), squat jump (SJ), triple-hop distance (THD), zigzag agility with ball (ZAWB) and without ball (ZAWOB), three corner run test (TCRT) and Y-balance test. The SSGcore group demonstrated meaningful improvements in 20 m sprint time (SSGcore: -9.1%, d = 1.42; SSG: -4.4%, d = 0.76), CMJ (SSGcore: 11.4%, d = 2.67; SSG: -7.7%, d = 1.43), SJ (SSGcore: 12.0%, d = 2.14; SSG: 5.7%, d = 1.28), THD (SSGcore: 5.0%, d = 1.39; SSG: 2.7%, d = 0.52) and TCRT (SSGcore: -3.7%, d = 0.69; SSG: -1.9%, d = 0.38). Furthermore, the SSGcore group demonstrated meaningfully higher improvement responses in both leg balance score (d = ranging from 2.11 to 2.75) compared with SSG group. These results suggest that the inclusion of core strength training to a SSG periodization is greatly effective to improve speed and strength-based conditioning in young soccer players.

Validation of new online game-based executive function tasks for children.

Numerous tasks are available to measure executive functions (EFs; working memory, inhibition, and flexibility) in children. However, they differ massively in the way they are presented and framed. Some contain child-friendly stimuli, feedback, or game elements likely to increase motivation and interest to perform the tasks, whereas others do not. Yet, it is unclear whether these apparent differences affect task performance. Therefore, the aim of our study was to develop and validate new game-based tasks assessing EFs in children. We designed three tasks for each dimension of EF and implemented them in a game version (based on the motivational framework proposed by Ryan and Deci (2000) and a standard version. The game-based tasks included elements designed to improve perceived competence (appealing feedback), autonomy (choosing how the protagonists proceed), and relatedness (a child-friendly cover story). To investigate whether adding these game elements influenced the motivation to engage in these tasks and task performance, 60 children (third and fourth graders) performed the game-based version and the standard version in two sessions (counterbalanced across participants). Because both the game-based and standard versions of the tasks should tap the same cognitive processes, we also tested whether performances in both versions were correlated. We found higher self-reported motivation in terms of interest, perceived competence, and relatedness after performing the game-based version as compared with the standard version. Performance on the game-based and standard versions of most of the tasks was significantly correlated, and there were no performance differences between the game-based and standard versions.

Effect of different number of players and training regimes on physiological and technical demands of ball-drills in basketball.

This study aimed to analyse the effects of two factors (number of players and training regimes) on players' physiological and technical demands in basketball ball-drills. Twenty-one young basketball players performed four different ball-drills (two levels for each factor). The number of players involved was 2vs2 and 4vs4, while ball-drill regimes were continuous and intermittent. Physiological demand was assessed using the percentage of maximal heart rate (%HRmax), Edwards' training load and rating of perceived exertion (RPE). Furthermore, the following technical actions were collected: dribbles, steals, rebounds, turnovers, passes (total, correct, wrong and % of correct pass) and shots (total, scored, missed and % of made shot). A 2 × 2 (number of players × regime) two-way ANOVA with repeated measures was applied for physiological parameters and technical actions. The 2vs2 condition showed higher %HRmax (P < 0.001), Edwards' training load (P < 0.001), RPE (P < 0.001), number of dribbles (P < 0.001), rebounds (P < 0.001), passes [total (P = 0.005) and correct (P = 0.005)] and shots [total (P < 0.001) scored (P < 0.001) and missed (P < 0.001)] than 4vs4. Moreover, the continuous regime revealed higher %HRmax (P < 0.001), Edwards' training load (P < 0.001), RPE (P = 0.006) and dribbles (P < 0.001) than the intermittent regime. This study showed that both number of players and regime are useful variables able to modify basketball ball-drills workload.

Effects of Different Recovery Duration on External and Internal Load Measures during Bouts of Small-Sided Games.

The aim of this study was to analyse the effects of different recovery times between bouts of small-sided games (SSG) on external and internal load variables in semi-professional soccer players. Sixteen male semi-professional soccer players performed three 4 vs. 4 + goalkeeper SSG training sessions, each with different recovery bout duration: short (1 min) (SSG1), medium (2 min) (SSG2), and long (4 min) (SSG4). Time motion and neuromuscular measures were collected during all SSGs, in addition, the rating of perceived exertion (RPE) was determined at the end of the last bout of each SSG. Results showed a significant increase in the total number of accelerations (p = 0.016, ES = 0.97, large) and decelerations (p = 0.022, ES = 0.81, large) in SSG4 compared to SSG1. In terms of the internal load, SSG2 showed significantly higher RPE values (p = 0.011, ES = 1.00, large) in comparison with SSG1. If the sessions' focus is on neuromuscular training, longer recovery times between SSG bouts should be used. Conversely, if the aim is to reach a higher total and running distance at different intensities, a 2-min recovery period between bouts may be more appropriate.

Commercial device-based hand rehabilitation systems for stroke patients: State of the art and future prospects.

Various hand rehabilitation systems have recently been developed for stroke patients, particularly commercial devices. Articles from 10 electronic databases from 2010 to 2022 were extracted to conduct a systematic review to explore the existing commercial training systems (hardware and software) and evaluate their clinical effectiveness. This review divided the rehabilitation equipment into contact and non-contact types. Game-based training protocols were further classified into two types: immersion and non-immersion. The results of the review indicated that the majority of the devices included were effective in improving hand function. Users who underwent rehabilitation training with these devices reported improvements in their hand function. Game-based training protocols were particularly appealing as they helped reduce boredom during rehabilitation training sessions. However, the review also identified some common technical drawbacks in the devices, particularly in non-contact devices, such as their vulnerability to the effects of light. Additionally, it was found that currently, there is no commercially available game-based training protocol that specifically targets hand rehabilitation. Given the ongoing COVID-19 pandemic, there is a need to develop safer non-contact rehabilitation equipment and more engaging training protocols for community and home-based rehabilitation. Additionally, the review suggests the need for revisions or the development of new clinical scales for hand rehabilitation evaluation that consider the current scenario, where in-person interactions might be limited.

External and Internal Training Loads for Intensive and Extensive Tactical-Conditioning in Soccer Small Sided Games.

This study aimed to investigate the external (ETLs; 15-Hz GPS unit coupled with a 100 Hz tri-axial accelerometer) and internal training loads (ITLs; session-RPE method) of 18 elite U20 soccer players (19 ± 1.0 years, 178 ± 8 cm, 71 ± 7 kg) undertaking a tactical-conditioning training program with special reference to small-sided games (SSGs). The SSGs used in this program were either extensive (SSG-extensive) or intensive (SSG-intensive) training sessions, that were alternated within the assessed weeks. Tactical principles of the game influenced the aim of the technical-tactical content. Total distance (TDR; ES: 1.17), and a very high-speed running distance (HSR; ES: 0.96) were greater in SSG-extensive vs. SSG-intensive. However, no meaningful difference was found for accelerations (ACC; ES: 0.12) and decelerations (DEC; ES: 0.08). However, a higher perceived intensity (session-RPE; ES: 0.62) and greater ITLs (ES: 0.27) were found for SSG-intensive. These findings suggest that coaches should prescribe SSG training sessions not only considering the usual variables (rules, player numbers, etc.). The current data indicate that the tactical objective of SSGs in relation to exercise bout duration and rest intervals should be considered, while implementing a multi-dimensional training monitoring program during SSG tactical-conditioning training sessions, integrating ETL and ITL variables to gain a better understanding of training responses.

The effect of video game-based training on postural control during gait initiation in community-dwelling older adults: a randomized controlled trial.

PURPOSE: The aim was to investigate the effect of video game training as compared to dual-task training on gait initiation (GI) which is a sensitive indicator of balance deficiency in older adults. METHOD: Sixty-six older adults were allocated to the video game-based training (intervention group) or the motor-cognitive dual-task training (active control group). The outcome measures were the mediolateral (ML)/anteroposterior (AP) displacement and velocity of COP during the phases of GI (anticipatory, weight transition, and locomotor). RESULTS: The results indicated in the anticipatory phase, the ML & AP COP displacement were significantly increased at post-training relative to pre-training across both groups (p < 0.041). In the weight transition phase, the AP COP displacement & ML COP velocity were significantly increased at post-training than pre-training (p < 0.032). However, in the locomotor phase, within the intervention group, the ML COP displacement & ML COP velocity were significantly increased at follow-up as compared to pre-training (p < 0.05), while no such differences were observed within the control group. CONCLUSION: Both treatments were effective in improving COP trajectory during the phases of anticipatory and weight transition, while the intervention group was more effective during the phase of locomotor. So, these treatments can be recommended for clinical settings.Implications for rehabilitationThe video game and dual task training were effective in improving COP trajectory during the phases of anticipatory and weight transition.The video game-based training was more effective during the phase of locomotor.The study findings could have useful implications to further introduce cognition-based rehabilitation programs such as video games for older adults.Rehabilitation professionals could use the video game to improve the postural control of older adults.

Simulated Game-Based Ice Hockey Match Design (Scrimmage) Elicits Greater Intensity in External Load Parameters Compared With Official Matches.

Objective: A limited number of studies have explored the external load experienced in indoor sports such as ice hockey, and few the link between training and match performance. As a paucity exists within this topic, this study explored whether a simulated match design (i.e., scrimmage) could be representative of official match demands and elicit similar external loads as in official matches in a group of elite youth male ice hockey players. Methods: A total of 26 players were monitored during eight official and four simulation matches using a Local Positioning System. Total distance, max velocity, slow (0-10.9 km/h), moderate (11-16.9 km/h), high (17.0-23.9 km/h), and sprint (>24 km/h) speed skating distance, distance per min, PlayerLoadTM, PlayerLoadTM per min, high-intensity events (HIEs) (>2.5 m/s-2), acceleration (ACCs), decelerations (DECs), and change of directions (CODs) were extracted from the tracking devices. A two-level regression analysis was conducted to compare the difference between match types when controlling for time on ice, match day, and position. Results: Between match-type results showed a credible difference in all variables except max velocity and ACCs. Distance per min was 27.3% higher during simulation matches and was explained by a 21.3, 24.1, and 14.8% higher distance in sprint-, high-, and moderate speed skating distance, while slow speed-skating distance was 49.2% lower and total distance only trivially different from official to simulation matches. Total PlayerLoadTM was 11.2% lower, while PlayerLoadTM per min was 8.5% higher during simulation matches. HIEs, CODs, and DECs were 10.0, 11.9, and 22.3% higher during simulation matches. Conclusion: The simulated match design is related to official match demands with comparable match-time, playing time, number of shifts, and shift duration. However, simulation matches provoked a higher external load output compared with official matches, possibly explained by a more continuous movement design. A game-based simulation match design can therefore be utilized when match-related actions at high intensity are warranted.

Effectiveness of an intensive, functional, gamified Rehabilitation program in improving upper limb motor function in people with stroke: A protocol of the EnteRtain randomized clinical trial.

INTRODUCTION: Game-based rehabilitation is an emerging therapeutic intervention that allows intensive, repetitive, task-based training to improve upper limb (UL) function following stroke, based on the principles of neuro-plasticity and motor (re)learning. Rehabilitation using commercial gaming system will be motivating, enjoyable, challenging and affordable. Therefore, the present study aims at assessing the effectiveness of an intensive, functional, gamified rehabilitation program using the ArmAble™ device in improving UL motor function in people with stroke. METHOD: In this single-blinded, multi-centric, randomized clinical trial, 120 adults with acute/sub-acute unilateral stroke will be randomized to receive an intensive, functional, gamified training program using the ArmAble™ or task-based training along with a conventional therapy for 2 h/day, 6 days/week for 2 weeks, followed by a home-based, functional rehabilitation program for another 4 weeks (~30 min/day, 6 days/week). Primary outcomes evaluated by a blinded assessor at the baseline, 2 weeks and 6 weeks' post-intervention will include the Fugl-Meyer assessment - upper extremity and the action research arm test. A linear mixed effect regression model or relevant non-parametric tests will be used to analyze the data for all outcomes. An intention-to-treat analysis will be used with missing data handled by multiple imputation. DISCUSSION: Rehabilitation provided with the ArmAble™ device, if found effective, can be used from the early stages post-stroke to provide intensive, repetitive, gamified training to improve UL motor function. TRIAL REGISTRATION NUMBER: CTRI/2020/09/027651.

Combining Repetitive Transcranial Magnetic Stimulation and Video Game-Based Training to Improve Dexterity in Parkinson's Disease: Study Protocol of a Randomized Controlled Trial.

Introduction: Patients with Parkinson's disease (PD) often exhibit difficulties with dexterity during the performance of activities of daily living (ADL) due to dysfunctional supplementary motor area (SMA). The aim of this clinical trial protocol work is to describe how the effectiveness of a combined repetitive transcranial magnetic stimulation (rTMS) over SMA and video-game-based skill training (VBT) in PD will be evaluated. The short and long-term benefits are assessed. Methods and analysis: A single-blind (patients) stratified (based on Hoehn & Yahr) parallel randomized sham-controlled rTMS-VBT study with a baseline and two follow-up measurements (3 and 12 weeks) is being conducted. These measurements include the dexterity questionnaire 24 (DextQ-24) as a primary outcome, and nine hole peg test and coin rotation task as main secondary dexterity outcomes. Further secondary outcomes will be the subscale II of the movement disorders society unified PD rating scale (MDS-UPDRS) to assess improvements on overall ADL and the Parkinson's Disease Questionnaire-39 to assess quality of life. Thirty-six outpatients (from one neurorehabilitation center) with PD (diagnosis based on brain bank criteria) will be recruited who report difficulties with dexterity in performing ADL. All PD patients will receive a 45-min VBT three times a week for 3 weeks. The PD patients randomized in the experimental group will receive VBT preceded by real rTMS, being intermittent theta burst (iTBS) stimulation sessions. The PD patients randomized to the control group receive a VBT with sham rTMS. Discussion: The study will provide evidence to determine whether a combined iTBS and VBT skill intervention is more effective than a VBT intervention alone to improve dexterity in PD. Ethics and dissemination: The study was approved by the Ethics Committee for Northwest and Central Switzerland (EKNZ), Switzerland 2019-00433. The study will be conducted in accordance with the Helsinki Declaration and the Guidelines of Good Clinical Practice. Informed consent will be signed prior to subject enrolment. Dissemination will include submission to international peer-reviewed professional journals and presentation at international congresses. The study protocol has been registered in the clinicaltrials.gov registry with the identification code: NCT04699149.

An Interactive Physical-Cognitive Game-Based Training System Using Kinect for Older Adults: Development and Usability Study.

BACKGROUND: Declines in physical and cognitive functions are recognized as important risk factors for falls in older adults. Promising evidence suggests that interactive game-based systems that allow simultaneous physical and cognitive exercise are a potential approach to enhance exercise adherence and reduce fall risk in older adults. However, a limited number of studies have reported the development of a combined physical-cognitive game-based training system for fall risk reduction in older adults. OBJECTIVE: The aim of this study is to develop and evaluate the usability of an interactive physical-cognitive game-based training system (game-based exercise) for older adults. METHODS: In the development phase (Part I), a game-based exercise prototype was created by integrating knowledge and a literature review as well as brainstorming with experts on effective fall prevention exercise for older adults. The output was a game-based exercise prototype that covers crucial physical and cognitive components related to falls. In the usability testing (Part II), 5 games (ie, Fruits Hunter, Where Am I?, Whack a Mole, Sky Falls, and Crossing Poison River) with three difficulty levels (ie, beginner, intermediate, and advanced levels) were tested in 5 older adults (mean age 70.40 years, SD 5.41 years). After completing the games, participants rated their enjoyment level while engaging with the games using the Physical Activity Enjoyment Scale (PACES) and commented on the games. Descriptive statistics were used to describe the participants' characteristics and PACES scores. RESULTS: The results showed that the average PACES score was 123 out of 126 points overall and between 6.66 and 7.00 for each item, indicating a high level of enjoyment. Positive feedback, such as praise for the well-designed interactions and user-friendly interfaces, was also provided. CONCLUSIONS: These findings suggest that it is promising to implement an interactive, physical-cognitive game-based exercise in older adults. The effectiveness of a game-based exercise program for fall risk reduction has yet to be determined.

Virtual reality training improves dynamic balance in children with cerebral palsy.

AIMS: The purpose of this study was to investigate the effects of Virtual reality training on dynamic balance of children with spastic hemiplegic cerebral palsy (SHCP). METHODS: 20 girls with SHCP (mean age =9.4; SD =1.48) were selected from special schools and divided into the experimental and control groups. Commercially available Kinect dance game (Microsoft Inc., Redmond, WA, U.S.A.) 'Just Dance 3' and Modified star excursion balance test (SEBT) were used for video game based training and dynamic balance tests, respectively. MANCOVA and ANCOVA Tests were performed at p < 0.05 to analyze the data. RESULTS: Based on MANCOVA test results, there was a significant difference between groups at least in one of the dynamic balance variables (anterior, posterolateral, and posteromedial) after controlling for pretest (F (3, 13) = 41.81, p < .005). Results of ANCOVA test showed a significant difference between the dynamic balance variables in the anterior (F = 52.80, p = 0.001), posterolateral (F = 117.86, p = 0.001), and posteromedial (F = 23.84, p = 0.001) directions in children with cerebral palsy. CONCLUSIONS: This paper proposes that video game based training can successfully guide children with cerebral palsy to improve their balance ability. This virtual system is therefore an interesting tool in the therapies related to the children with cerebral palsy.

Physical Performance During Soccer-7 Competition and Small-Sided Games in U12 Players.

The aim of this study was to compare the activity profile (external loads) during soccer-7 competition versus 6 vs 6 small-sided games ( SSGs) in U12 players. Peak velocity (Vmax), total distance completed (DT), total distance relative to match duration, the percentage of DT in acceleration (%DAC) and in deceleration (%DEA), and the percentage of DT at different speeds were recorded. Six types of SSGs were randomly implemented: without pitch orientation-delimitation and with a limit of three ball-contacts per player (3TOU), with no limit of ball-contacts (MAN), with a greater number of players as internal-offensive wildcard players (2WI) or external-offensive wildcard players (4WE); and with pitch orientation-delimitation and crossing the rival goal-line while dribbling the ball without goalkeepers (INV) or using official goalkeepers (GKP). The physical demands of SSGs were compared with the average of two soccer-7 match plays. During soccer-7 match plays a lower %DAC and %DEA (p < 0.05) were observed compared to 2WI, 4WE, INV and GKP, and to INV and GKP, respectively. The Vmax and %HI were greater (p < 0.05) in soccer-7 match plays compared to all SSGs. In conclusion, the demands imposed on U12 players during different formats of SSGs differ from the soccer-7 match play demands, presenting a low stimulation of the actions performed at high-speed and an adequate simulation of acceleration-deceleration actions.

Challenges in Creating a Mobile Digital Tutor for Clinical Communications Training.

Doctor-patient communication is a crucial element in effective medical care, and the striking health disparities evident in patients with Type II Diabetes may in part be caused by physicians' difficulties in establishing effective communication with patients who differ from them racially, culturally, and economically. REPEAT (Realizing Enhanced Patient Encounters through Aiding and Training) is a digital tutor developed to help solve this problem. REPEAT teaches and coaches learners to improve their general and disparities-focused clinical communication skills using simulated encounters with computer-generated Synthetic Standardized Patients (SSPs) and augments experiential learning in virtual encounters by applying customized, context-sensitive, learner-focused scaffolding. REPEAT authoring tools enable rapid development of learning content, allowing economical transferability to other domains. Key human factors challenges and their design solution in REPEAT are discussed.

Effect of Coach Encouragement on the Psychophysiological and Performance Responses of Young Tennis Players.

This study aimed to compare the effects of coach encouragement during the on-court tennis training drills (OTDs) on the psychophysiological and performance responses of young tennis players. Twenty-five young male tennis players (14.0 ± 0.3 years of age) performed six bouts of each of the four common OTDs; Star, Suicide, Box and Big X (30:60 s; 1:2 work to rest ratio). The heart rate (HR) and total distance covered were monitored using two portable multivariable integrated 10 Hz GPS monitoring devices during all OTDs, and the rating of perceived exertion (RPE-10) and short form Physical Activity Enjoyment Scale (PACES) values were determined after each OTDs bout. The results demonstrated that OTDs with coach encouragement induced significantly higher psychophysiological and performance responses compared to OTDs without coach encouragement (p < 0.05). The results of this study confirm that coach encouragement improves the intensity, performance and physical enjoyment level during OTDs. These findings might inform training practices in youth tennis players in order to improve tennis performance.

The effect of game-based karate training on the learning of basic techniques and enjoyment of physical activity in children / O efeito do treinamento de karatê baseado em jogos no aprendizado de técnicas básicas e no prazer da atividade física em crianças

ABSTRACT The purpose of this study was to investigate the effect of game-based karate training on learning basic karate skills and karate children's interest in physical activity. The statistical population of this research included all 6 to 8-year-old female karate players in Sowmeh Sara city, Iran and twenty subjects were randomly selected and divided into two experimental and control groups of 10. The experimental group practiced game-based karate training for eight weeks. The training program was designed based on the principles of the Fundamental stage of the Canadian model of long-term development of athletes (LTAD) for karate sport. Physical activity enjoyment scale in children was used to measure children's interest in physical activity and karate yellow belt test was used for measurement of learning basic karate tasks. ANCOVA test was used for data analysis using SPSS 24 software at a significance level of 0.05. The results showed that there was no significant difference in the learning of basic karate skills, but a significant effect was seen in the enjoyment of children in the experimental group for physical activity (sig<0.001). Therefore, game-based karate training can help children learn basic karate skills as much as the traditional method, and also increase their enjoyment in physical activity more effectively.

RESUMO O objetivo deste estudo foi investigar o efeito do treinamento de caratê baseado em jogos na aprendizagem de habilidades básicas de caratê e no interesse das crianças pelo esporte. A população estatística desta pesquisa incluiu todas as jogadoras de caratê do sexo feminino, com idades entre 6 e 8 anos, na cidade de Sowmeh Sara, Irã, e vinte participantes foram selecionados aleatoriamente e divididos em dois grupos experimentais e de controle, com 10 em cada grupo. O grupo experimental praticou o treinamento de caratê baseado em jogos por oito semanas. O programa de treinamento foi projetado com base nos princípios da fase fundamental do modelo canadense de desenvolvimento de longo prazo de atletas (LTAD) para o esporte de caratê. A Escala de Desfrute da Atividade Física em Crianças foi utilizada para medir o interesse das crianças na atividade física, e o teste da faixa amarela de caratê foi usado para medir a aprendizagem de tarefas básicas de caratê. O teste ANCOVA foi utilizado para a análise de dados, utilizando o software SPSS 24, com um nível de significância de 0,05. Os resultados mostraram que não houve diferença significativa na aprendizagem de habilidades básicas de caratê, mas um efeito significativo foi observado no desfrute das crianças no grupo experimental em relação à atividade física (sig<0,001). Portanto, pode-se concluir que o treinamento de caratê baseado em jogos pode ajudar as crianças a aprender habilidades básicas de caratê tanto quanto o método tradicional e também aumentar seu desfrute na atividade física de maneira mais eficaz.

Soccer Small-Sided Games Activities Vary According to the Interval Regime and their Order of Presentation within the Session.

In order to investigate the physical demands of widely used in soccer small-sided games (SSGs), we compared game variations performed under different interval (fixed or variable) and timing regimens (beginning or end of a training session). Twelve male players wore GPS devices during the SSGs to record total distance, relative distance, distance at different speeds, and maximum velocity variables. Four variations of SSGs (4x4) were randomly applied: beginning of a training session with fixed and variable recovery, or end of a training session with fixed and variable recovery. During the beginning or end of a training session settings with fixed recovery duration, 2-min of playing and 2-min of recovery were provided. During the beginning and end of a training session settings with variable recovery, athletes kept playing until a goal was scored, or up to 2-min if no goals were scored. Results were analysed using MANOVA. Total distance and relative distance were higher in the beginning compared to end of training sessions for both fixed and variable recovery duration (small to moderate effect sizes). Distance at various speed ranges (i.e., 13-18 km/h and >18 km/h) was higher (p ≤ 0.01) at the beginning than at the end of training sessions with variable recovery. In addition, distance >18 km/h was higher at the beginning of a training session with variable recovery than fixed recovery and at the end of a training session with variable recovery than fixed recovery. In conclusion, several physical demand characteristics are affected by the moment of SSG application, while others respond to the recovery regime during SSGs, thus providing indications to the coaches to prescribe the intended training intensity by manipulating the context.