The King-Devick test in mixed martial arts: the immediate consequences of knock-outs, technical knock-outs, and chokes on brain functions.

The aim of this prospective cohort study was to determine the effect of an 'event,' defined as a knock-out (KO), technical knock-out (TKO), choke, or submission, on King-Devick (K-D) test times in mixed martial arts (MMA) athletes. MMA athletes (28.3 ± 6.6 years, n = 92) underwent K-D testing prior to and following a workout or match. Comparison of baseline and post-workout/match K-D times to assess any significant change. K-D tests worsened (longer) in a majority of athletes following an 'event' (N = 21) (49.6 ± 7.8 s vs 46.6 ± 7.8 s, p = 0.0156, Wilcoxon signed-rank test). K-D tests improved (shorter) following a standard workout or match in which no 'event' occurred in a majority of cases (n = 69) (44.2 ± 7.2 s vs 49.2 ± 10.9 s, p = <0.0001, Wilcoxon signed-rank test). Longer duration (worsening) of post-match K-D tests occurred in most athletes sustaining an 'event'; K-D tests shortened (improved) in a majority of athletes not sustaining an 'event'. Our study suggests MMA athletes suffering an 'event' may have sustained a brain injury similar to a concussion.

A Case Study of Hypnosis for Phagophobia: It's No Choking Matter.

In this case study the author reviews the benefits of hypnosis for a 13-year-old female suffering from a specific phobia involving a fear of choking and generalized fear of swallowing that resulted in an episode of Restrictive Food Intake Disorder with associated significant weight loss. At the time of the initial consultation, three weeks after her choking episode, the patient weighed 93 pounds. Standing at 5'2", her Body Mass Index (BMI) was 17 (15th percentile) indicative of healthy weight for a child her age and height. She continued to lose weight over the course of 2 months and at her worst weighed 85 pounds (BMI = 15.5, 3rd percentile, classified as underweight). Prior to the incident, she weighed 105 pounds with a BMI of 19.2 (46th percentile). Treatment initially consisted of 12 hypnosis sessions (over a 5-month period), conducted on a weekly and eventually biweekly basis. A scheduled one-month follow-up visit was conducted following the 12th session, at which time the patient was consuming solid foods without fear of choking. Her BMI at that time was 18.7 (39th percentile). Two months after terminating treatment, the patient experienced a mild relapse triggered by conflicts with some female peers. After four additional hypnosis sessions, the patient's symptoms again remitted. During her last session we shared a pizza, providing clear and convincing evidence that she had overcome her fear of swallowing. She retained therapeutic benefits for at least 3 years following treatment.

Respiratory muscle tension as symptom generator in individuals with high anxiety sensitivity.

OBJECTIVE: Anxiety and panic are associated with the experience of a range of bodily symptoms, in particular unpleasant breathing sensations (dyspnea). Respiratory theories of panic disorder have focused on disturbances in blood gas regulation, but respiratory muscle tension as a source of dyspnea has not been considered. We therefore examined the potential of intercostal muscle tension to elicit dyspnea in individuals with high anxiety sensitivity, a risk factor for developing panic disorder. METHODS: Individuals high and low in anxiety sensitivity (total N=62) completed four tasks: electromyogram biofeedback for tensing intercostal muscle, electromyogram biofeedback for tensing leg muscles, paced breathing at three different speeds, and a fine motor task. Global dyspnea, individual respiratory sensations, nonrespiratory sensations, and discomfort were assessed after each task, whereas respiratory pattern (respiratory inductance plethysmography) and end-tidal carbon dioxide (capnography) were measured continuously. RESULTS: In individuals with high compared to low anxiety sensitivity, intercostal muscle tension elicited a particularly strong report of obstruction (M=5.1, SD=3.6 versus M=2.5, SD=3.0), air hunger (M=1.9, SD=2.1 versus M=0.4, SD=0.8), hyperventilation symptoms (M=0.6, SD=0.6 versus M=0.1, SD=0.1), and discomfort (M=5.1, SD=3.2 versus M=2.2, SD=2.1) (all p values<.05). This effect was not explained by site-unspecific muscle tension, voluntary manipulation of respiration, or sustained task-related attention. Nonrespiratory control sensations were not significantly affected by tasks (F<1), and respiratory variables did not reflect any specific responding of high-Anxiety Sensitivity Index participants to intercostal muscle tension. CONCLUSIONS: Respiratory muscle tension may contribute to the respiratory sensations experienced by panic-prone individuals. Theories and treatments for panic disorder should consider this potential source of symptoms.

[Stress-induced changes of attention during choking in judo]. / Stressinduzierte Aufmerksamkeitsänderungen beim Würgen im Judo.

The aim of the investigation is the registration and analysis of cognitive parameters in the alarm phase of the stress reaction during a conventional judo cross choking technique. 57 judoka (41 males, 16 females; mean age 23.1 +/- 6.7 years) underwent a standardized cross-choking maneuvre (juji-jime), which lasted for 6 - 8 s until giving up, carried out by a black belt physician. The Stroop inference test was performed before and twice after the intervention. The reading velocity of the interference task was reduced by an average of 77.4 s to a mean of 74.4 s (p < 0.01), and the number of reading errors decreased by a mean from 2.9 to 2.1 (p < 0.01), finally increasing to 2.4 s. The data show the most important improvement in performance in 25 s after choking in the male judoka. In the female judoka increasing performance started already 25 s before choking and continued 25 s after the intervention. The alarm reaction following the potential life threatening stressor with an attack upon the throat improves selective attention before (female subjects) and after choking (female and male subjects) depending on gender.

Treatment of specific phobias with Eye Movement Desensitization and Reprocessing (EMDR): protocol, empirical status, and conceptual issues.

This paper considers the current empirical status of Eye Movement Desensitization and Reprocessing (EMDR) as a treatment method for specific phobias, along with some conceptual and practical issues in relation to its use. Both uncontrolled and controlled studies on the application of EMDR with specific phobias demonstrate that EMDR can produce significant improvements within a limited number of sessions. With regard to the treatment of childhood spider phobia, EMDR has been found to be more effective than a placebo control condition, but less effective than exposure in vivo. The empirical support for EMDR with specific phobias is still meagre, therefore, one should remain cautious. However, given that there is insufficient research to validate any method for complex or trauma related phobias, that EMDR is a time-limited procedure, and that it can be used in cases for which an exposure in vivo approach is difficult to administer, the application of EMDR with specific phobias merits further clinical and research attention.

Experimenter expectancy in resistance to respiratory air flow.

OBJECTIVE: The effect of experimenter expectancy was investigated on the resistance to respiratory air flow, measured as total respiratory resistance (Rt) in healthy individuals. METHOD: Each of three naive experimental assistants collected air flow resistance responses from 30 subjects who they had been told were either likely or unlikely to respond to the suggestion of breathing difficulty. RESULTS: The subjects were assigned to the two conditions at random. The subjects who were described to the experimenters as being likely to respond exhibited greater Rt increases to bronchoconstriction suggestion than did the subjects who were described as unlikely to respond. CONCLUSIONS: These findings confirmed the presence of a source of variance that has not been considered previously in suggestion studies.

Nonorganic upper airway obstruction.

Two cases of severe dyspnea and stridor with upper airway obstruction of obscure origin are discussed. Complete medical evaluation could identify no organic cause for the symptoms, and functional upper airway obstruction was diagnosed. Treatment with psychotherapy and relaxation techniques was successful. Diagnosis can be made with pulmonary function studies. Flow-volume loops may show a lower inspiratory vital capacity than expiratory vital capacity and a discrepancy between inspiratory flow limitation and airway resistance. It is important to establish a functional etiology to prevent unnecessary treatment and provide proper care.