Martial Arts and Cognitive Control in Children with Attention-Deficit Hyperactivity Disorder and Children Born Very Preterm: A Combined Analysis of Two Randomized Controlled Trials.

INTRODUCTION: Very preterm birth and attention-deficit hyperactivity disorder (ADHD) are associated with impairments in response inhibition that often persist beyond childhood. Athletes skilled in martial arts show a neurocognitive profile that is associated with an improved inhibition processing stream, suggesting that engagement in this kind of sport has the potential to reduce impairments in this cognitive function. We investigated the behavioral and neurocognitive effects of judo training on response inhibition in children born very preterm and children with ADHD by a combined analysis of two randomized controlled trials. METHODS: In both the CHIPMANC ( n = 65) and JETPAC ( n = 63) studies, participants were randomly allocated to a waitlist or a 12-wk judo training program in a 1:1 ratio. At pretest and posttest, participants completed a Go/NoGo task, the Movement Assessment Battery for Children-2 and a physical work capacity test on a bicycle ergometer. During the cognitive task, event-related potentials (N2, P3a, P3b) were recorded via electroencephalography. RESULTS: The effects of the judo training were moderated by the study group. In contrast to children with ADHD (JETPAC), judo training reduced the commission error rate on the Go/NoGo task and increased the P3a amplitude in children born very preterm (CHIPMANC). No treatment effects were found for N2, P3b and physical fitness outcomes. CONCLUSIONS: The neurodevelopmental condition influences the cognitive benefits of judo training. Whereas judo may be ineffective in children with ADHD, children born very preterm can expect improved response inhibition due to a more effective engagement of focal attention to resolve the task-related response conflict.

The Flow-Clutch Scale: Translation and validation study of the Chinese version.

PURPOSE: The integrated model of flow and clutch provides a multistate perspective to the optimal experiences during physical exercises. Based on this model, the Flow-Clutch Scale (FCS) was developed. The current study is the first step to test the psychometric properties of a Chinese version of the FCS (FCS-C). METHOD: A confirmatory factor analysis (CFA) with Maximum Likelihood estimate was performed in Chinese athletes (N = 426) to explore the structural validity of the FCS-C . The Pearson correlations between the subscales of the FCS-C and "non-reactivity to inner experiences", "cognitive flexibility", and "self-consciousness" were explored to examine the concurrent validity. Cronbach's alpha coefficients were used to assess the internal consistency of the total scale and subscales. Moreover, the test-retest reliability was examined in a subsample (N = 53) using a two-week interval. RESULTS: The results of CFA suggested that the three-factor model showed an acceptable model fit (χ2 = 459.40, df = 120, CFI = 0.95, GFI = 0.90, SRMR = 0.03, RMSEA = 0.082 [90% CI = 0.074-0.09]). Concerning the correlations between the factor "characteristics of flow" and "self-consciousness", the concurrent validity was not satisfactory. Moreover, the test-retest coefficients ranged from 0.75 to 0.78 (p < .01) and Cronbach's alpha ranged from 0.87 to 0.96. CONCLUSION: Results indicated that the three-factor model of FCS-C is acceptable, whereas its validity is not satisfactory to appropriately examine flow and/or clutch states in Chinese athletes. In summary, the current translation and validation study of the FCS-C allows for future research on optimal exercise experiences in Chinese-speaking cohorts including a further cultural adaptation of the questionnaire.

Evaluation of a Physical Activity and Multi-Micronutrient Intervention on Cognitive and Academic Performance in South African Primary Schoolchildren.

Executive functions (EFs) are essential for optimal academic development. Appropriate nutrition and physical activity (PA) have been shown to facilitate optimal cognitive development. Therefore, this study examined whether a 12-week school-based PA and multi-micronutrient supplementation (MMNS) intervention would improve cognitive and academic performance. A cluster-randomized controlled trial (RCT) was conducted. Children from four schools located in a peri-urban area of South Africa were randomly assigned to (i) PA + MMNS, (ii) PA + placebo, (iii) MMNS or (iv) placebo. Information processing and inhibitory control were measured with a computerized Flanker task. End-of-year results provided insight into academic achievement. Anthropometric measures were used to determine nutritional status. Data were analyzed with linear mixed-models, adjusting for baseline scores, school classes and age; 932 children (458 girls (49.1%), Mage (mean age) = 8.42 ± 1.94 years) completed baseline and post-intervention assessments. Cognitive performance improved among all four groups, with no significant group × time effects. For academic achievement, there was no significant interaction effect between the combined intervention group and placebo. We encourage future studies in this neglected area in order to determine the most optimal design of school-based nutrition and PA programs to enhance overall cognitive performance.

Neurobehavioral mechanisms underlying the effects of physical exercise break on episodic memory during prolonged sitting.

BACKGROUND AND OBJECTIVE: Episodic memory is the ability that enables individuals to recall and re-experience previous events and usually includes information concerning the spatial and temporal context. This study examined the effects of a physical exercise break during a period of prolonged sitting on episodic memory. Furthermore, we aimed to investigate whether alterations of functional connectivity patterns might contribute to the exercise-induced changes in episodic memory. METHODS: Sixty healthy male college students were randomly assigned (1:1 ratio) to a prolonged-sitting group (PS group) or a physical-exercise-break group (PE group). The face-name paired-associate learning task was used to probe episodic memory. During the task, cortical hemodynamics in the prefrontal cortex were recorded using functional near-infrared spectroscopy (fNIRS). Changes in cortical hemodynamics were used to determine functional connectivity using graph-theoretical network analysis. RESULTS: There was no between-group difference in neurobehavioral outcomes at the pretest assessment. During the posttest assessment, compared with the PS group, higher nodal efficiency in the anterior prefrontal cortex (orbitofrontal and frontopolar cortices) was observed during the encoding phase (FDR corrected p values = 0.039), and higher nodal efficiency and degree centrality of orbitofrontal cortex were observed in the retrieval phase in the PE group (FDR corrected p values = 0.035). Moreover, the PE group showed closer temporal correlational interactions between the dorsolateral prefrontal cortex and the anterior prefrontal cortex in the left hemisphere during the episodic memory encoding phase (FDR corrected p values = 0.043), when compared to the PS group. Neither significant between-group difference in accuracy nor correlations between neural and behavioral outcomes were observed after the intervention. CONCLUSION: Our findings suggest that a physical exercise break during a prolonged sitting period has neither a beneficial nor a detrimental effect on behavioral performance concerning episodic memory. However, physical breaks do facilitate functional connectivity patterns of the prefrontal cortex while performing a episodic memory task.

The acute effects of physical exercise breaks on cognitive function during prolonged sitting: The first quantitative evidence.

PURPOSE: This systematic review and meta-analysis aims to investigate the cognitive benefits of breaking up prolonged sitting by acute physical exercises. METHODS: We developed a search protocol based on the Preferred Reporting Items for Systematic Reviews and Meta-Analysis checklist (PROSPERO, CRD42021224949). A systematic literature search was performed in six electronic databases (PubMed, Scopus, Web of Science, PsycINFO, SPORTDiscus, and Cochrane Library) to identify randomized controlled trials with a within-subjects cross-over and a pre-posttest design that examined the effects of physical exercise breaks during 3-5 h of prolonged sitting on cognitive performance (e.g., executive function, attention, and memory function). Additionally, study quality was rated using the Physiotherapy Evidence Database scale. RESULTS: Thirteen randomized controlled trials with a total of 295 participants (171 female and 124 male) were included in this systematic review. Of these studies, nine were included in our meta-analysis. The results indicated that during prolonged sitting, acute physical exercise breaks did not affect overall cognitive performance, with small between-study heterogeneity (I2<25%). This is further supported by the subgroup analyses showing no differences in effect sizes between cognitive domains and different exercise intensities. CONCLUSIONS: Our findings suggest that the current evidence on interrupting prolonged sitting by acute physical exercise breaks is not univocal and that some heterogeneity exists concerning the exercise protocols exists (e.g., exercise intensity, frequency of the acute physical exercise breaks). Thus, future studies are needed to investigate whether the effectiveness of acute physical exercise breaks on cognitive performance might change as a function of different mediators (e.g., exercise characteristics, age, sleep patterns). In summary, acute physical exercise breaks during prolonged sitting allow the integration of regular physical activity in daily routines (i.e., through acute physical exercise breaks) without compromising the performance of cognitively demanding tasks.

Effects of an exercise and sport intervention among refugees living in a Greek refugee camp on mental health, physical fitness and cardiovascular risk markers: study protocol for the SALEEM pragmatic randomized controlled trial.

BACKGROUND: Due to ongoing political and social conflicts, the number of international refugees has been increasing. Refugees are exposed to severe mental and physical strain, as well as traumatic experiences during their flight. Therefore, the risk of psychiatric disorders is markedly increased among international refugees. International organizations have criticized the lack of early interventions as a key problem, because untreated mental disorders are often difficult to cure at a later stage. Today, exercise and sport have been successfully employed to treat a wide range of psychiatric disorders. With patients with post-traumatic stress disorders (PTSD), very limited empirical evidence exists, and studies carried out with international refugees are nearly non-existent. METHODS: We intend to implement a pragmatic randomized controlled trial (RCT) with an exercise and sport intervention group (n = 68, 50% women) and a wait-list control group (n = 68, 50% women) in the Koutsochero refugee camp, located close to the city of Larissa (Greece). During the RCT, exercise and sport will be offered five times per week (60 min/session) for 10 weeks. Participants will be asked to participate in at least two sessions per week. The programme is developed according to the participants' needs and preferences and they will be able to choose between a range of activities. PTSD symptoms will serve as primary outcome, and several secondary outcomes will be assessed. Qualitative data collection methods will be used to gain a more in-depth appraisal of the participants' perception of the intervention programme. In the second year of study, the programme will be opened to all camp residents. A strategy will be developed how the programme can be continued after the end of the funding period, and how the programme can be scaled up beyond the borders of the Koutsochero camp. DISCUSSION: By moving towards the primary prevention of chronic physical conditions and psychiatric disorders, a relevant contribution can be done to enhance the quality and quantity of life of refugee camp residents in Greece. Our findings may also strengthen the evidence for exercise as medicine as a holistic care option in refugee camps, by helping camp residents to adopt and maintain a physically active lifestyle. TRIAL REGISTRATION: The study was registered prospectively on the 8 February 2021 with ISRCTN https://www.isrctn.com/ISRCTN16291983.

Effects of Judo on Neurocognitive Indices of Response Inhibition in Preadolescent Children: A Randomized Controlled Trial.

INTRODUCTION: Although exercise is suggested to benefit inhibitory control in children and adolescents, the current evidence is limited to exercise-induced improvements for its interference control subtype. In contrast, the potential of exercise to facilitate response inhibition still remains unclear. However, the neurocognitive profile of martial arts athletes suggests that this sports category promises benefits for cognitive control processes related to response inhibition. The present randomized controlled trial therefore examined the effects of judo on behavioral and neurocognitive indices of response inhibition (N2, P3a, P3b) in preadolescent children. METHODS: Participants (N = 44) were randomly allocated to a martial arts group, who completed 120-min judo per week over 3 months, and a wait-list control group. At baseline and follow-up, participants completed the Movement Assessment Battery for Children-2 and a physical work capacity test on a bicycle ergometer at 170 bpm (PWC170). In addition, a computerized Go/NoGo task with simultaneous electroencephalographic recordings was administered. RESULTS: In the martial arts group, a greater decrease in NoGo error rate and a higher increase in NoGo N2 amplitude were found in comparison to the control group. These behavioral and neurocognitive changes were correlated. In contrast to N2, the P3a/b amplitude, Movement Assessment Battery for Children-2, and physical work capacity test at 170 bpm did not change differently between groups over the intervention period. CONCLUSIONS: The present findings indicate that judo promises benefits for response inhibition that are independent of alterations in motor skills and cardiorespiratory fitness. A change toward more effective conflict monitoring seems to underlie this improvement in cognitive performance.

Agility Training to Integratively Promote Neuromuscular, Cognitive, Cardiovascular and Psychosocial Function in Healthy Older Adults: A Study Protocol of a One-Year Randomized-Controlled Trial.

Exercise training effectively mitigates aging-induced health and fitness impairments. Traditional training recommendations for the elderly focus separately on relevant physiological fitness domains, such as balance, flexibility, strength and endurance. Thus, a more holistic and functional training framework is needed. The proposed agility training concept integratively tackles spatial orientation, stop and go, balance and strength. The presented protocol aims at introducing a two-armed, one-year randomized controlled trial, evaluating the effects of this concept on neuromuscular, cardiovascular, cognitive and psychosocial health outcomes in healthy older adults. Eighty-five participants were enrolled in this ongoing trial. Seventy-nine participants completed baseline testing and were block-randomized to the agility training group or the inactive control group. All participants undergo pre- and post-testing with interim assessment after six months. The intervention group currently receives supervised, group-based agility training twice a week over one year, with progressively demanding perceptual, cognitive and physical exercises. Knee extension strength, reactive balance, dual task gait speed and the Agility Challenge for the Elderly (ACE) serve as primary endpoints and neuromuscular, cognitive, cardiovascular, and psychosocial meassures serve as surrogate secondary outcomes. Our protocol promotes a comprehensive exercise training concept for older adults, that might facilitate stakeholders in health and exercise to stimulate relevant health outcomes without relying on excessively time-consuming physical activity recommendations.

Effects of school-based physical activity and multi-micronutrient supplementation intervention on growth, health and well-being of schoolchildren in three African countries: the KaziAfya cluster randomised controlled trial protocol with a 2 × 2 factorial design.

BACKGROUND: In low- and middle-income countries, infectious diseases remain a key public health issue. Additionally, non-communicable diseases are a rapidly growing public health problem that impose a considerable burden on population health. One way to address this dual disease burden, is to incorporate (lifestyle) health promotion measures within the education sector. In the planned study, we will (i) assess and compare physical activity, physical fitness, micronutrient status, body composition, infections with soil-transmitted helminths, Schistosoma mansoni, malaria, inflammatory and cardiovascular health risk markers, cognitive function, health-related quality of life, and sleep in schoolchildren in Côte d'Ivoire, South Africa and Tanzania. We will (ii) determine the bi- and multivariate associations between these variables and (iii) examine the effects of a school-based health intervention that consists of physical activity, multi-micronutrient supplementation, or both. METHODS: Assuming that no interaction occurs between the two interventions (physical activity and multi-micronutrient supplementation), the study is designed as a cluster-randomised, placebo-controlled trial with a 2 × 2 factorial design. Data will be obtained at three time points: at baseline and at 9 months and 21 months after the baseline assessment. In each country, 1320 primary schoolchildren from grades 1-4 will be recruited. In each school, classes will be randomly assigned to one of four interventions: (i) physical activity; (ii) multi-micronutrient supplementation; (iii) physical activity plus multi-micronutrient supplementation; and (iv) no intervention, which will serve as the control. A placebo product will be given to all children who do not receive multi-micronutrient supplementation. After obtaining written informed consent from the parents/guardians, the children will be subjected to anthropometric, clinical, parasitological and physiological assessments. Additionally, fitness tests will be performed, and children will be invited to wear an accelerometer device for 7 days to objectively assess their physical activity. Children infected with S. mansoni and soil-transmitted helminths will receive deworming drugs according to national policies. Health and nutrition education will be provided to the whole study population independently of the study arm allocation. DISCUSSION: The study builds on the experience and lessons of a previous study conducted in South Africa. It involves three African countries with different social-ecological contexts to investigate whether results are generalisable across the continent. TRIAL REGISTRATION: The study was registered on August 9, 2018, with ISRCTN. https://doi.org/10.1186/ISRCTN29534081.

The effects of an acute bout of exercise on neural activity in alcohol and cocaine craving: study protocol for a randomised controlled trial.

BACKGROUND: Numerous studies suggest that exercise may be an effective adjunct treatment for substance use disorders. It has been suggested that exercise-induced improvements in inhibitory control may reduce craving for the substance of abuse. However, this potential mechanism has seldom been researched. OBJECTIVES: The aim of the ExAlCo Study is to examine how acute bouts of exercise, at varying intensities, impact on craving for cocaine or alcohol. Cerebral haemodynamic responses during cognitive tests of inhibitory control, and exposure to substance-related cue imagery, will also be assessed using functional near-infrared spectroscopy. DESIGN: The study is a crossover randomised controlled trial. Participants will be recruited from inpatient and outpatient psychiatric treatment centres, on the approval of their treating physician. A healthy control group will be recruited using online advertising. All participants will undergo each of three conditions in randomised order: 20 min of cycle ergometry at 50-60% of maximum heart rate; 20 min of exercise at 70-80% of maximum heart rate; and 20 min of quiet reading. Immediately before and after each condition, participants will be asked to complete a computerised Stroop test, watch a film containing substance-related images and self-report craving levels. During the Stroop test and film viewing, participants' neural activity will be measured via functional near-infrared spectroscopy. OUTCOMES: The primary outcome measures are self-reported craving, inhibitory control and cerebral haemodynamic response to the Stroop test and a substance-related film. It is hoped that the findings from this study will shed more light on the role of exercise in the treatment of substance use disorders, particularly its scope in preventing relapse through reduced craving severity. TRIAL REGISTRATION: ClinicalTrials.gov, NCT03502486 . Registered retrospectively on 5 April 2018.

Non-linear dynamics of cardiac autonomic activity during cycling exercise with varied cadence.

In recent years, complex models of cardiac regulation have integrated heart rate variability (HRV) as a measure of the cardiac autonomic activity during exercise. Using detrended fluctuation analysis (DFA) technique, the present study examines the influence of cycling cadence and exercise duration on non-linear dynamics of HRV. Sixteen trained cyclists performed a 60-minute exercise bout at 90% of the individual anaerobic threshold on a bicycle ergometer. Cadence was changed every 10 min (90-120-60-120-60-90 rpm). Heart rate (HR) and RR-intervals were recorded continuously during exercise. HRV time domain measures (meanRR, SDNN) and correlation properties were analyzed using short-term scaling exponent alpha1 of DFA. Moreover, blood lactate (La) and rating of perceived exertion (RPE) were recorded at regular intervals at the end of condition. HR, La and RPE increased significantly at 120 rpm compared to 60 rpm. In contrast, all analyzed HRV parameters (meanRR, SDNN, DFA-alpha1) showed a significant decrease during cycling at 120 rpm compared to 60 rpm. The comparison of the first and last 10 min with the same cadence indicates a significant increase in HR and RPE, but also a significant decrease in all analyzed HRV measures. The decrease of HRV values over time and in relation to the increase in cadence indicates a decrease in the overall variability as well as a reduction in complexity of the RR-interval-fluctuations due to the increased organismic demands. Therefore, the decrease of DFA-alpha1 might be associated with a withdrawal of the organismic system aiming at the maintenance of the homeostasis under the control of the central nervous system. In this context, non-linear HRV analyses provide a more systemic view of cardiac regulation during exercise.