Work-rest regimens for work in hot environments: A scoping review.

BACKGROUND: To limit exposures to occupational heat stress, leading occupational health and safety organizations recommend work-rest regimens to prevent core temperature from exceeding 38°C or increasing by ≥1°C. This scoping review aims to map existing knowledge of the effects of work-rest regimens in hot environments and to propose recommendations for future research based on identified gaps. METHODS: We performed a search of 10 databases to retrieve studies focused on work-rest regimens under hot conditions. RESULTS: Forty-nine articles were included, of which 35 were experimental studies. Most studies were conducted in laboratory settings, in North America (71%), on healthy young adults, with 94% of the 642 participants being males. Most studies (66%) employed a protocol duration ≤240 min (222 ± 162 min, range: 37-660) and the time-weighted average wet-bulb globe temperature was 27 ± 4°C (range: 18-34). The work-rest regimens implemented were those proposed by the American Conference of Governmental and Industrial Hygiene (20%), National Institute of Occupational Safety and Health (11%), or the Australian Army (3%). The remaining studies (66%) did not mention how the work-rest regimens were derived. Most studies (89%) focused on physical tasks only. Most studies (94%) reported core temperature, whereas only 22% reported physical and/or mental performance outcomes, respectively. Of the 35 experimental studies included, 77% indicated that core temperature exceeded 38°C. CONCLUSIONS: Although work-rest regimens are widely used, few studies have investigated their physiological effectiveness. These studies were mainly short in duration, involved mostly healthy young males, and rarely considered the effect of work-rest regimens beyond heat strain during physical exertion.

Eccentric cycling involves greater mental demand and cortical activation of the frontoparietal network.

Eccentric, compared to concentric exercise, is proposed to involve different neuro-motor processing strategies and a higher level of mental demand. This study compared eccentric and concentric cycling at matched perceived effort and torque for the mental demand and related-cortical activation patterns. Nineteen men (30 ± 6 years) performed four different 5-min cycling conditions at 30 RPM on a semi-recumbent isokinetic cycle ergometer: (1) concentric at a moderate perceived effort (23 on the CR100® scale) without torque feedback; (2) concentric and (3) eccentric at the same average torque produced in the first condition; and (4) eccentric at the same moderate perceived effort than the first concentric condition. The conditions two to four were randomized. After each condition, mental demand was monitored using the NASA Task Load Index scale. Changes in oxy-(O2 Hb) and deoxy-(HHb) hemoglobin during exercise were measured over both prefrontal cortices and the right parietal lobe from a 15-probe layout using a continuous-wave NIRS system. Mental demand was significantly higher during eccentric compared to concentric cycling (+52%, p = 0.012) and when the exercise intensity was fixed by the torque rather than the perceived effort (+70%, p < 0.001). For both torque- or perceived effort-matched exercises, O2 Hb increased significantly (p < 0.001) in the left and right prefrontal cortices, and right parietal lobe, and HHb decreased in the left, and right, prefrontal cortices during eccentric compared to concentric cycling. This study supports that acute eccentric cycling, compared to concentric cycling, involves a higher mental demand, and frontoparietal network activation.

Acute smartphone use impairs vigilance and inhibition capacities.

Smartphones are now in very widespread use, and concerns have arisen about potential detrimental effects, even with acute use. These adverse consequences are often linked to the emergence of mental fatigue. While the cognitive implications of fatigue are well-documented, knowledge about the specific influence of acute smartphone use on cognitive performance remains scarce. The aim of this study was therefore to investigate the impact of acute smartphone use on cognitive performance. It included two experiments: one designed to assess the impact of smartphone use on vigilance, and the other focusing on evaluating inhibition capacities. In Experiment 1, two groups of 40 participants completed a Psychomotor Vigilance Task (PVT) before and after using a smartphone for 45 min (experimental group), or before and after watching a documentary (control group). In Experiment 2, two groups of 40 participants were subjected to a similar experimental design but had to perform a Go/NoGo task instead of a PVT. Mental fatigue and drowsiness were evaluated with visual analog scales before and after smartphone use and watching a documentary. Results suggested that both watching a documentary and using a smartphone for 45 min increased subjective mental fatigue and drowsiness. Watching the documentary did not impair cognitive performance. Reaction times on the PVT and number of errors on NoGo trials in the Go/NoGo task were higher among the participants in the smartphone condition. These results indicate reduced vigilance and impaired inhibition capacities only after smartphone use. We conclude that acute smartphone use induces mental fatigue and decreases cognitive performance. Further research is needed to understand the mechanisms underlying this decline in cognitive performance.

"Ready-to-use" two-week home exercise program targeting depressive symptoms: pilot study.

Exercise is an evidence-based treatment for depressive symptoms, yet it often requires specialised knowledge, equipment, or professional supervision. Lay people in certain contexts, for example in remote locations or under pandemic restrictions, often lack these resources and thus cannot use exercise to manage their depressive symptoms. We developed a two-week home exercise program that bypasses these barriers and tested it in university students during pandemic restrictions. In an online study, we recruited 49 participants to complete a week of baseline symptom monitoring then follow the exercise program for 2 weeks (6 sessions) at home. The exercise program involved aerobic and resistance training; each session lasted approximately 45 min. After 2 weeks of the intervention, participants reported lower depressive (standardised ß = -0.71 [-1.05, -0.38]) and anxiety (ß = -0.87 [-1.19, -0.55]) symptoms. Although we cannot make causal conclusions, our results suggest that the brief home exercise program may have potential to reduce depressive symptoms in young adults.

Fatigue in elite fencing: Effects of a simulated competition.

The fatigue induced by fencing remains scarcely investigated. We aimed to investigate both objective (neuromuscular performance fatigability) and subjective (perceived fatigue, effort, and workload) manifestations of fatigue in elite fencers following a five-bout simulated competition. Changes in countermovement jump height, knee extensors maximal isometric torque, rate of torque development, voluntary activation, and contractile response to muscular electrical stimulation were measured in 29 elite fencers [12 epee (6 women), 11 saber (5 women), and 6 foil]. Perceived fatigue and effort were evaluated with visual analog scales, and the perceived workload with the NASA Task Load Index scale. During the competition, maximal torque and rate of torque development decreased by 1.6% (p = 0.017) and 2.4% (p < 0.001) per bout, respectively. Perceived fatigue before each bout increased (12% per bout), with similar values observed at the end of all bouts (bout × period interaction: p < 0.001). Perceived effort increased during the bouts (10% per period, p < 0.001) and during the competition (3% per bout, p = 0.011). Perceived mental demand increased during the competition (2% per bout, p = 0.024). These results suggest that elite fencers needed to increase the allocation of mental rather than physical resources to the task to counterbalance the deleterious effect of fatigue on performance.

[Conducting a multimodal exercise program in primary and secondary prevention of mobility disabilty in older adults at risk: guidelines and practical applications]. / Conduite d'un programme d'exercice multimodal en prévention primaire et secondaire de la perte de mobilité chez le senior à risque : recommandations et applications pratiques.

The implementation of strategies to prevent mobility disability in seniors at-risk with a strong focus on exercise is a public health imperative. These strategies must follow a pragmatic, structured and personalized approach. In order to obtain short, medium and long-term benefits, it is essential to consider the coordination of adapted physical exercise programs and to harmonize good practices. In support of national policies for the prevention of loss of autonomy, it is important to define clear guidelines to conduct effective programs. These programs should have a strong emphasis on evidence-based literature and should be validated by a consensus of multi-professional experts. The aim of this consensus is to outline the steps implementing these programs, to present their constituent elements and their practical application. Conception and elaboration of these programs should include frequency, intensity, duration, type of work, volume and individual progressiveness. Programs should also be focused on a personalised approach to develop participant health education, self-efficacy and empowerment for physical activity to ensure long-term health related behaviours. Moreover, trained professionals must supervise these programs in order to assure participants safety and program effectiveness. These guidelines will support policies for the prevention of loss of autonomy and mobility, throughout their development over the national territory.

Pharmacological Blockade of Muscle Afferents and Perception of Effort: A Systematic Review with Meta-analysis.

BACKGROUND: The perception of effort provides information on task difficulty and influences physical exercise regulation and human behavior. This perception differs from other-exercise related perceptions such as pain. There is no consensus on the role of group III/IV muscle afferents as a signal processed by the brain to generate the perception of effort. OBJECTIVE: The aim of this meta-analysis was to investigate the effect of pharmacologically blocking muscle afferents on the perception of effort. METHODS: Six databases were searched to identify studies measuring the ratings of perceived effort during physical exercise, with and without pharmacological blockade of muscle afferents. Articles were coded based on the operational measurement used to distinguish studies in which perception of effort was assessed specifically (effort dissociated) or as a composite experience including other exercise-related perceptions (effort not dissociated). Articles that did not provide enough information for coding were assigned to the unclear group. RESULTS: The effort dissociated group (n = 6) demonstrated a slight increase in ratings of perceived effort with reduced muscle afferent feedback (standard mean change raw, 0.39; 95% confidence interval 0.13-0.64). The group effort not dissociated (n = 2) did not reveal conclusive results (standard mean change raw, - 0.29; 95% confidence interval - 2.39 to 1.8). The group unclear (n = 8) revealed a slight ratings of perceived effort decrease with reduced muscle afferent feedback (standard mean change raw, - 0.27; 95% confidence interval - 0.50 to - 0.04). CONCLUSIONS: The heterogeneity in results between groups reveals that the inclusion of perceptions other than effort in its rating influences the ratings of perceived effort reported by the participants. The absence of decreased ratings of perceived effort in the effort dissociated group suggests that muscle afferent feedback is not a sensory signal for the perception of effort.

Web-Based Physical Activity Interventions Are Feasible and Beneficial Solutions to Prevent Physical and Mental Health Declines in Community-Dwelling Older Adults During Isolation Periods.

BACKGROUND: Periods of prolonged lockdown increase the risk of physical inactivity, which can contribute to physical decline among older adults. Online technology could be an innovative solution to promote physical activity (PA) habits in this context. The goal of this study was to examine and compare the acceptability, feasibility, and potential benefits of 2 modalities of web-based PA interventions in older adults during the coronavirus disease 2019 lockdown. METHODS: Eighty-three nonphysically active community-dwelling older adults (aged 60 and older) were randomized to a 12-week web-based PA intervention delivered either in a live group (LG; n = 38) or a recorded group (RG; n = 45). Acceptability, feasibility as well as functional capacities, physical performance, quality of life, and PA level were assessed pre and postintervention. RESULTS: There were fewer dropouts in the LG than RG (LG: 16% vs RG: 46%). However, adherence rate (LG: 89%; RG: 81%), level of satisfaction (LG: 77% vs RG: 64%), and enjoyment (LG: 68% vs RG: 62%) were similar across groups, even if the participants found the intervention slightly difficult (LG: 58% vs RG: 63%). Both groups significantly improved on functional capacities, physical performance, and quality of life. Only the LG showed significant improvements in perceived health and PA level. The LG showed greater improvements in physical performance and quality of life than the RG. CONCLUSION: Web-based PA interventions are feasible, acceptable, and beneficial for improving functional capacities and physical performance during periods of lockdown. However, the interactive web and live modalities appear to be more effective for promoting some of these outcomes than recorded and individual modalities.

Intermuscular coherence reveals that affective emotional pictures modulate neural control mechanisms during the initiation of arm pointing movements.

Introduction: Several studies in psychology provided compelling evidence that emotions significantly impact motor control. Yet, these evidences mostly rely on behavioral investigations, whereas the underlying neurophysiological processes remain poorly understood. Methods: Using a classical paradigm in motor control, we tested the impact of affective pictures associated with positive, negative or neutral valence on the kinematics and patterns of muscle activations of arm pointing movements performed from a standing position. The hand reaction and movement times were measured and electromyography (EMG) was used to measure the activities from 10 arm, leg and trunk muscles that are involved in the postural maintenance and arm displacement in pointing movements. Intermuscular coherence (IMC) between pairs of muscles was computed to measure changes in patterns of muscle activations related to the emotional stimuli. Results: The hand movement time increased when an emotional picture perceived as unpleasant was presented as compared to when the emotional picture was perceived as pleasant. When an unpleasant emotional picture was presented, beta (ß, 15-35 Hz) and gamma (γ, 35-60 Hz) IMC decreased in the recorded pairs of postural muscles during the initiation of pointing movements. Moreover, a linear relationship between the magnitude of the intermuscular coherence in the pairs of posturo-focal muscles and the hand movement time was found in the unpleasant scenarios. Discussion: These findings reveal that emotional stimuli can significantly affect the content of the motor command sent by the central nervous system to muscles when performing voluntary goal-directed movements.

Pain Perception in Contact Sport Athletes: A Scoping Review.

Contact sports athletes are regularly facing acute physical pain in part of their sport; however, the literature investigating pain perception in these athletes remains scarce. This scoping review aimed to explore the literature surrounding pain perception in contact sport athletes and to compile and understand how it is studied. The search strategy consisted of using index terms and keywords in the MEDLINE, EMBASE, SPORTDiscus, Web of Science, PsycINFO, CINAHL and ProQuest Dissertations & Theses Global search engines. Results from 11 studies revealed that a mix of team contact sports and combat sports are studied and are included under the umbrella of contact sports. These athletes are being compared with non-athletes as well as athletes from non-contact sports. The cold pressor test and the pain pressure test are the two predominant methods used to investigate physical pain. This review highlights the need to clearly define sports based on contact levels expected in play to better define the types of pain athletes are facing in their practice. Athletes' level of play as well as years of experience should also be more rigorously reported. While contact sport athletes seem to have a higher level of pain tolerance than both active controls and non-contact athletes, the methods of pain testing are not always justified and appropriate in relation to the pain induced during contact sports. Future experimental studies should use pain testing methods relevant to the pain experienced during contact sports and to better justify the rationale for the choice of these methods.

Hypnosis to manage musculoskeletal and neuropathic chronic pain: A systematic review and meta-analysis.

This systematic review and meta-analysis aims to identify and quantify the current available evidence of hypnosis efficacy to manage pain in patients with chronic musculoskeletal and neuropathic pain. Randomized Control Trials (RCTs) with hypnosis and/or self-hypnosis treatment used to manage musculoskeletal and/or neuropathic chronic pain in adults and assessing pain intensity were included. Reviews, meta-analyses, non-randomized clinical trials, case reports and meeting abstracts were excluded. Five databases, up until May 13th 2021, were used to search for RCTs using hypnosis to manage chronic musculoskeletal and/or neuropathic pain. The protocol is registered on PROSPERO register (CRD42020180298) and no specific funding was received for this review. The risk of bias asessement was conducted according to the revised Cochrane risk of bias tool for randomized control trials (RoB 2.0). Nine eligible RCTs including a total of 530 participants were considered. The main analyses showed a moderate decrease in pain intensity (Hedge's g: -0.42; p = 0.025 after intervention, Hedge's g: -0.37; p = 0.027 after short-term follow-up) and pain interference (Hedge's g: -0.39; p = 0.029) following hypnosis compared to control interventions. A significant moderate to large effect size of hypnosis compared to controls was found for at 8 sessions or more (Hedge's g: -0.555; p = 0.034), compared to a small and not statistically significant effect for fewer than 8 sessions (Hedge's g: -0.299; p = 0.19). These findings suggest that a hypnosis treatment lasting a minimum of 8 sessions could offer an effective complementary approach to manage chronic musculoskeletal and neuropathic pain. Future research is needed to delineate the relevance of hypnosis in practice and its most efficient prescription.

Long-Term Efficacy of a Home-Care Hypnosis Program in Elderly Persons Suffering From Chronic Pain: A 12-Month Follow-Up.

BACKGROUND: Pain is a major public health concern in the aging population. However, medication brings about negative effects that compel healthcare professionals to seek alternative management techniques to alleviate pain. Hypnosis has been recognized as an effective technique to manage pain, but its long-term efficacy has yet to be examined in older adults. AIMS: The aim was to assess the effectiveness, over a 12-month period, of home-care hypnosis in elderly participants suffering from chronic pain. DESIGN: Real-life retrospective one-arm study with a 12-month follow-up. SETTINGS: Elderly Persons Suffering From Chronic Pain enrolled in a clinical health care program that offered home medical follow-up. PARTICIPANTS/SUBJECTS: Fourteen elderly women (mean age 81 years) with chronic pain participated in the home-care hypnosis program. All participants presented chronic pain (≥6 months) with average pain score >4/10. METHODS: Participants took part in seven 15-minute hypnosis sessions within 12 months. The Brief Pain Inventory questionnaire was used to evaluate pain perception and pain interference at baseline and at 3-, 6-, and 12-month follow-up period. RESULTS: Hypnosis home-care program significantly decreased pain perception and pain interference compared to baseline after 3 months (-29% and -40%, p < .001), and remained lower at 6 (-31% and -54%, p < .001) and 12 (-31% and -47%, p < .001) months. CONCLUSIONS: Seven sessions of 15 minutes allocated throughout a 12-month period produced clinically significant decreases in pain perception and pain interference. Hypnosis could be considered as an optimal additional way for health practitioners to manage chronic pain in an elderly population with long-term efficacy. This study offers a new long-term option to improve chronic pain management at home in elderly populations through a low-cost nonpharmacological intervention.

Ischemic preconditioning of the muscle reduces the metaboreflex response of the knee extensors.

PURPOSE: This study investigated the effect of ischemic preconditioning (IP) on metaboreflex activation following dynamic leg extension exercise in a group of healthy participants. METHOD: Seventeen healthy participants were recruited. IP and SHAM treatments (3 × 5 min cuff occlusion at 220 mmHg or 20 mmHg, respectively) were administered in a randomized order to the upper part of exercising leg's thigh only. Muscle pain intensity (MP) and pain pressure threshold (PPT) were monitored while administrating IP and SHAM treatments. After 3 min of leg extension exercise at 70% of the maximal workload, a post-exercise muscle ischemia (PEMI) was performed to monitor the discharge group III/IV muscle afferents via metaboreflex activation. Hemodynamics were continuously recorded. MP was monitored during exercise and PEMI. RESULTS: IP significantly reduced mean arterial pressure compared to SHAM during metaboreflex activation (mean ± SD, 109.52 ± 7.25 vs. 102.36 ± 7.89 mmHg) which was probably the consequence of a reduced end diastolic volume (mean ± SD, 113.09 ± 14.25 vs. 102.42 ± 9.38 ml). MP was significantly higher during the IP compared to SHAM treatment, while no significant differences in PPT were found. MP did not change during exercise, but it was significantly lower during the PEMI following IP (5.10 ± 1.29 vs. 4.00 ± 1.54). CONCLUSION: Our study demonstrated that IP reduces hemodynamic response during metaboreflex activation, while no effect on MP and PPT were found. The reduction in hemodynamic response was likely the consequence of a blunted venous return.

Perception of effort and the allocation of physical resources: A generalization to upper-limb motor tasks.

Purpose: The perception of effort (PE) is widely used to prescribe and monitor exercise during locomotor and resistance tasks. The present study examines the validity of PE to prescribe and monitor exercise during upper-limb motor tasks under various loads and speed requirements. Methods: Forty participants volunteered in two experiments. In experiment 1, we used four PE intensities to prescribe exercise on a modified version of the box and block test (BBT) and a pointing task. We investigated the possibility of monitoring the exercise intensity by tracking changes in PE rating in response to three different tempos or additional weights. Experiment 2 replicated the possibility of prescribing the exercise with the PE intensity during the BBT and explored the impact of additional weights on performance and PE during the standardized version of the BBT. Muscle activation, heart rate, and respiratory frequencies were recorded. Results: In experiment 1, increasing the PE intensity to prescribe exercise induced an increased performance between each intensity. Increasing task difficulty with faster movement tempo and adding weight on the forearm increased the rating of PE. Experiment 2 replicated the possibility to use PE intensity for exercise prescription during the BBT. When completing the BBT with an additional weight on the forearm, participants maintained performance at the cost of a higher PE. In both experiments, changes in PE were associated with changes in muscle activation. Conclusion: Our results suggest that PE is a valid tool to prescribe and monitor exercise during upper-limb motor tasks.

Perception of effort during an isometric contraction is influenced by prior muscle lengthening or shortening.

PURPOSE: Following a shortening or lengthening muscle contraction, torque produced in the isometric steady state is lower (residual torque depression; rTD) or higher (residual torque enhancement; rTE), respectively, compared to a purely isometric contraction at the same final muscle length and level of activation. This is referred to as the history dependence of force. When matching a given torque level, there is greater muscle activation (electromyography; EMG) following shortening and less activation following lengthening. Owing to these differences in neuromuscular activation, it is unclear whether perception of effort is altered by the history dependence of force during plantar-flexion. METHODS: Experiment 1 tested whether perception of effort differed between the rTD and rTE state when torque was matched. Experiment 2 tested whether perception of effort differed between the rTD and rTE state when EMG was matched. Finally, experiment 3 tested whether EMG differed between the rTD and rTE state when perception of effort was matched. RESULTS: When torque was matched, both EMG and perception of effort were higher in the rTD compared to rTE state. When EMG was matched, torque was lower in the rTD compared to rTE state while perception of effort did not differ between the two states. When perception of effort was matched, torque was lower in the rTD compared to rTE state and EMG did not differ between the two states. CONCLUSION: The combined results from these experiments indicate that the history dependence of force alters one's perception of effort, dependent on the level of motor command.

Mental fatigue induced by prolonged motor imagery increases perception of effort and the activity of motor areas.

Recent literature suggests that when prolonged, motor imagery (MI) induces mental fatigue and negatively impacts subsequent physical exercise. The aim of this study was to confirm this possibility with neurophysiological and self-reported measures. Thirteen participants performed 200 imagined isometric knee extension contractions (Prolonged MI condition) or watched a documentary (Control condition), and then performed 150 actual isometric knee extensions. Electroencephalography was continuously recorded to obtain motor-related cortical potential amplitude at Cz electrode (MRCP, index of motor area activity) for each imagined and actual contraction. Electromyography of the vastus lateralis muscle as well as the perceived effort required to perform prolonged MI, watch the documentary, and perform the actual contractions were measured. During prolonged MI, mental fatigue level, the effort required to imagine the contractions and MRCP amplitude increased over time. The increase in the effort required to imagine the contractions was significantly correlated with the MRCP amplitude. During the physical exercise, a significant condition × time interaction revealed a greater increase over time in perceived effort in the prolonged MI condition compared to the control condition, as well as a specific alteration in EMG RMS of the vastus lateralis muscle. These alterations observed in the presence of mental fatigue during actual contractions, combined with those observed during prolonged MI, suggest that prolonged MI may impair the motor command required to perform imagined or actual contractions. While the observed effect of mental fatigue on MRCP amplitude was clear during MI, future studies should tailor the physical exercise to minimize the exercise-induced decrease in force production capacity and control for its confounding effects on MRCP amplitude in the presence of mental fatigue.