Hip contact forces can be predicted with a neural network using only synthesised key points and electromyography in people with hip osteoarthritis.

OBJECTIVE: To develop and validate a neural network to estimate hip contact forces (HCF), and lower body kinematics and kinetics during walking in individuals with hip osteoarthritis (OA) using synthesised anatomical key points and electromyography. To assess the capability of the neural network to detect directional changes in HCF resulting from prescribed gait modifications. DESIGN: A calibrated electromyography-informed neuromusculoskeletal model was used to compute lower body joint angles, moments, and HCF for 17 participants with mild-to-moderate hip OA. Anatomical key points (e.g., joint centres) were synthesised from marker trajectories and augmented with bias and noise expected from computer vision-based pose estimation systems. Temporal convolutional and long short-term memory neural networks (NN) were trained using leave-one-subject-out validation to predict neuromusculoskeletal modelling outputs from the synthesised key points and measured electromyography data from 5 hip-spanning muscles. RESULTS: HCF was predicted with an average error of 13.4 ± 7.1% of peak force. Joint angles and moments were predicted with an average root-mean-square-error of 5.3 degrees and 0.10 Nm/kg, respectively. The NN could detect changes in peak HCF that occur due to gait modifications with good agreement with neuromusculoskeletal modelling (r2 = 0.72) and a minimum detectable change of 9.5%. CONCLUSION: The developed neural network predicted HCF and lower body joint angles and moments in individuals with hip OA using noisy synthesised key point locations with acceptable errors. Changes in HCF magnitude due to gait modifications were predicted with high accuracy. These findings have important implications for implementation of load-modification based gait retraining interventions for people with hip OA in a natural environment (i.e., home, clinic).

Non-Synonymous Substitutions in Cadherin 13, Solute Carrier Family 6 Member 4, and Monoamine Oxidase A Genes are Associated with Personality Traits in Thoroughbred Horses.

Retraining retired racehorses for various purposes can help correct behavioral issues. However, ensuring efficiency and preventing accidents present global challenges. Based on the hypothesis that a simple personality assessment could help address these challenges, the present study aimed to identify genetic markers associated with personality. Eight genes were selected from 18 personality-related candidate genes that are orthologs of human personality genes, and their association with personality was verified based on actual behavior. A total of 169 Thoroughbred horses were assessed for their tractability (questionnaire concerning tractability in 14 types of situations and 3 types of impressions) during the training process. Personality factors were extracted from the data using principal component analysis and analyzed for their association with single nucleotide variants as non-synonymous substitutions in the target genes. Three genes, CDH13, SLC6A4, and MAOA, demonstrated significant associations based on simple linear regression, marking the identification of these genes for the first time as contributors to temperament in Thoroughbred horses. All these genes, as well as the previously identified HTR1A, are involved in the serotonin neurotransmitter system, suggesting that the tractability of horses may be correlated with their social personality. Assessing the genotypes of these genes before retraining is expected to prevent problems in the development of a racehorse's second career and shorten the training period through individual customization of training methods, thereby improving racehorse welfare.

Approach Bias and Tobacco Craving as Mechanisms of the Effect of Approach Bias Retraining on Smoking Cessation.

INTRODUCTION: Approach bias, the automatic tendency to advance toward, rather than move away from appetitive cues, has been associated with greater tobacco cravings, dependence, and likelihood of smoking relapse. Approach bias retraining (ABR) has emerged as one way to reduce approach bias and promote avoidance toward smoking cues. Yet, additional research is needed to identify the mechanisms that may help explain the effect of ABR on smoking cessation. METHODS: The current study uses data collected as part of a randomized controlled trial to test two unique mechanisms of action ([1] approach bias and [2] tobacco craving) for the efficacy of standard smoking cessation treatment (ST) augmented by ABR on smoking abstinence. Participants were 96 adult daily smokers (Mage=43.1, SD=10.7) motivated to quit smoking. RESULTS: Results showed that lower approach bias and lower cravings at a treatment session were significantly related to next session smoking abstinence (p's<.018). Further, deviations in approach bias partially mediated the effect of ABR on smoking abstinence (ab=-12.17, 95%CI: [-29.67, -0.53]). However, deviations in tobacco craving did not mediate this relation (ab=.40, 95%CI: [-.27, 1.34]). CONCLUSIONS: The current findings add to extant literature by identifying approach bias as a mechanism of action of the effect of ABR on smoking abstinence during smoking cessation treatment. IMPLICATIONS: The current study adds to our knowledge on the effectiveness of approach bias retraining (ABR) as a part of smoking cessation treatment. Results indicate that reductions in approach bias partially mediate the effect of ABR on smoking abstinence. These findings are consistent with previous research on alcohol-dependent adults and underline the potential of ABR to reduce approach bias and promote smoking cessation among smokers. Such findings could inform the development of future research exploring more targeted and effective smoking cessation interventions, ultimately improving outcomes for individuals attempting to quit smoking.

Effects of gait retraining using minimalist shoes on the medial gastrocnemius muscle-tendon unit behavior and dynamics during running.

The effects of a 12-week gait retraining program on the adaptation of the medial gastrocnemius (MG) and muscle-tendon unit (MTU) were investigated. 26 runners with a rearfoot strike pattern (RFS) were randomly assigned to one of two groups: gait retraining (GR) or control group (CON). MG ultrasound images, marker positions, and ground reaction forces (GRF) were collected twice during 9 km/h of treadmill running before and after the intervention. Ankle kinetics and the MG and MTU behavior and dynamics were quantified. Runners in the GR performed gradual 12-week gait retraining transitioning to a forefoot strike pattern. After 12-week, (1) ten participants in each group completed the training; eight participants in GR transitioned to non-RFS with reduced foot strike angles; (2) MG fascicle contraction length and velocity significantly decreased after the intervention for both groups, whereas MG forces increased after intervention for both groups; (3) significant increases in MTU stretching length for GR and peak MTU recoiling velocity for both groups were observed after the intervention, respectively; (4) no significant difference was found for all parameters of the series elastic element. Gait retraining might potentially influence the MG to operate at lower fascicle contraction lengths and velocities and produce greater peak forces. The gait retraining had no effect on SEE behavior and dynamics but did impact MTU, suggesting that the training was insufficient to induce mechanical loading changes on SEE behavior and dynamics.

Does Taking a Break Matter-Adaptations in Muscle Strength and Size Between Continuous and Periodic Resistance Training.

We aimed to compare the effects of periodic resistance training (RT) and continuous RT on muscle strength and size. Fifty-five healthy, untrained participants (age 32 ± 5 years) were randomized to periodic (PRT, n = 20 completed the study, 45% females) or continuous (CRT, n = 22 completed the study, 45% females) groups. PRT completed a 10-week RT, a 10-week detraining, and a second identical 10-week RT. CRT began with a 10-week non-RT, followed by a 20-week RT. RT included twice-weekly supervised whole-body RT sessions. Leg press (LP) and biceps curl (BC) one repetition maximum (1RM), countermovement jump (CMJ) height, muscle cross-sectional area (CSA) of vastus lateralis (VL), and biceps brachii (BB) using ultrasound imaging were measured twice at the beginning and every fifth week during the intervention. Both groups increased (p < 0.001) 1RM in LP and BC, CSA in VL and BB, and CMJ height with no differences between the groups. In PRT, 1RM in LP and BC, CSA in VL and BB, and CMJ height decreased during detraining (p < 0.05). During the first 5 weeks of retraining in PRT, increases in LP 1RM, and VL and BB CSA were greater than in CRT during Weeks 10-15 of their CRT (p < 0.01). PRT and CTR ended up in similar postintervention adaptations, as decreased muscle strength and size during detraining in PRT regained rapidly during retraining. Our results therefore suggest that trainees should not be too concerned about occasional short-term training breaks in their daily lives when it comes to lifelong strength training. Trial Registration: ClinicalTrials.gov identifier: NCT05553769.

An overview of rehabilitation approaches for focal hand dystonia in musicians: A scoping review.

OBJECTIVE: To provide a comprehensive overview of rehabilitation treatment strategies for focal hand dystonia (FHD) in musicians, examining their evolution and effectiveness. DATA SOURCES: A systematic search of five databases, PubMed, PEDro, Cochrane Library, Trip, and Google Scholar, to identify relevant articles on FHD rehabilitation. The last search was performed on 20 December 2023. METHODS: Inclusion criteria were applied to 190 initially identified articles, resulting in 17 articles for review. Exclusions were made for duplicates, irrelevant titles, abstracts, and non-rehabilitation interventions. RESULTS: Ten different rehabilitation approaches were identified over 20 years. While no definitive intervention protocol exists, a multimodal approach is commonly recommended. CONCLUSIONS: This scoping review underscores the diversity of rehabilitation strategies for FHD. It suggests the potential of multimodal approaches, emphasizing the need for further large-scale clinical efficacy studies.

How can imaginal retraining for modifying food craving be improved?

Imaginal retraining (IR) is an emerging intervention technique in which people imagine avoidance behaviors towards imagined foods or other substances, such as throwing them away. Although IR shows promise in reducing initial craving for a range of substances, including alcohol and tobacco, effects appear less robust for craving for energy-dense foods. This raises the question of how IR for food craving can be improved. Here, we address this question informed by emerging findings from IR dismantling studies and the field of regular cognitive bias modification training paradigms. Based on current insights, we suggest the most optimal 'craving-reduction' effects for energy-dense food can likely be expected for IR that includes an overt motor movement. While it is not yet clear what movement works best for food, we suggest a tailored movement or Go/No-Go-based stop movement has the potential to be most effective. The most likely mechanism in reducing craving is cue-devaluation of trained vivid craving images regarding specific energy-dense food products. Future work is needed that investigates and assess the underlying mechanisms (e.g., updating beliefs; cue-devaluation), task characteristics (e.g., IR instructions; specific motor movements) and individual characteristics (e.g., perceived craving; vividness of food imagination) that determine IR effects.

Effects of tinnitus retraining therapy on patients with tinnitus: a systematic review of randomized controlled trials.

PURPOSE: This review aims to explore the influences of tinnitus retraining therapy (TRT) on patients with tinnitus. METHODS: PubMed, MEDLINE, EMBASE, CINAHL, PEDro, SCOPUS, and Web of Science were screened for randomized controlled trials (RCTs) that explored the effects of TRT on patients with tinnitus from inception to June 30, 2024. The methodological quality of the included RCTs was evaluated using the physiotherapy evidence database (PEDro) scale. RESULTS: Fifteen studies met our eligibility criteria. A total of 2069 patients with tinnitus (mean age 52.93 years; 66% male) were involved in the present review. The quality of the selected studies ranged from 5 to 8 on the PEDro scale, with a median score of 7. TRT did not provide superior effects in treating patients with tinnitus compared to tinnitus masking (TM), tinnitus educational counselling (TED), TRT with open ear hearing aids, Tailor-made notched music training (TMNMT), partial TRT, usual care, and smart TRT. CONCLUSIONS: TRT intervention is considered a treatment option for patients with tinnitus. Combining TRT with other interventions, such as cognitive-behavioral therapy, pharmacotherapy, or tDS, may show even greater efficacy. Additional studies are strongly required to recognize the long-term effects of TRT on tinnitus, determine who most likely would benefit from the intervention regarding tinnitus type and severity, and identify the optimal treatment protocol.

Patterns and timing of recovery from facial nerve palsy after nerve-sparing parotid surgery: the role of neuromuscular retraining.

OBJECTIVES: Among the complications of parotid surgery, facial palsy is frequent and burdened by high functional and social impact for the patient. There are few data on the efficacy of facial neuromuscular retraining (FNR) in patients with facial palsy after parotid surgery, and no data exist on its impact in timing and extent of recovery. MATERIAL AND METHODS: A retrospective study was conducted on patients undergoing FN sparing parotid surgery and suffering from postoperative facial palsy. Among 400 patients undergoing surgery between July 2016 and May 2023, those with the preservation of the FN and onset of facial palsy were selected. Nerve function was evaluated during 2 years follow up using the House-Brackman (H&Bs) and Sunnybrook scales (SBs). RESULTS: A total of 46 patients undergoing partial or total parotidectomy were included. At discharge 18 patients (39,1%) had IV to VI grade paralysis according to the H&Bs and the mean SBs value was 54. At 2 and 6 months after surgery, the average value of Sunnybrook increased to 76.5 and 95.4 respectively. After 12 months no patients with IV to VI grade paralysis were represent in our cohort. Two years after surgery, only five patients (10.9%) had persistent grade II paralysis according to HBs. CONCLUSIONS: Our study supports the efficacy of FNR in the rehabilitation of facial paralysis after nerve-sparing parotidectomy. The greater functional improvement is achieved within the first 6 months of rehabilitation. A significant improvement is detected still after 18 months, supporting the importance of long rehabilitation for patients without complete recovery after the first year.

The effect of attentional cues on mechanical efficiency and movement smoothness in running gait: An interdisciplinary investigation.

The aim was to examine the effect of focus of attention cues on foot angle for retraining movement purposes. Twenty (females: 8) rearfoot-striking recreational runners (mass: 72.5 ± 11.8 kg; height: 1.73 ± 0.09 m; age: 32.9 ± 11.3 years) were randomly assigned to an internal focus (IF) (n = 10) or external focus (EF) (n = 10) verbal cue group. Participants performed 5 × 6 minute blocks of treadmill running (control run, 3 × cued running, retention run) at a self-selected running velocity (9.4 ± 1.1 km∙h-1) during a single laboratory visit. Touchdown foot angle, mechanical efficiency, internal and external work were calculated and, centre of mass (COM) and foot movement smoothness was quantified. Linear-mixed effect models showed an interaction for foot angle (p < 0.001, ηp2 = 0.35) and mechanical efficiency (p < 0.001, ηp2 = 0.40) when comparing the control to the cued running. Only the IF group reduced foot angle and mechanical efficiency during cued running, but not during the retention run. The IF group produced less external work during the 1st cued run than the control run. COM and foot smoothness were unaffected by cueing. Only an IF produced desired technique changes but at the cost of reduced mechanical efficiency. Movement smoothness was unaffected by cue provision. Changes to foot angle can be achieved within 6 minutes of gait retraining.

Systematic review of the effectiveness of innovative, gamified interventions for cognitive training in paediatric acquired brain injury.

Effectiveness of innovative, gamified interventions (i.e., Augmented Reality, Computer-Based Cognitive Retraining [CBCR], and Virtual Reality [VR] in conjunction with a Serious Game) for cognitive training in paediatric ABI was evaluated. Studies were identified on PsycINFO, PubMed and Scopus; last searched 4 January 2022. Eligibility criteria were participants diagnosed with ABI and aged ≤ 18 years, experimental intervention to train cognition, cognition assessed pre- and post-intervention at: (1) The level of function, or (2) The level of activity, and written in English. ROB 2 and ROBINS-I were utilised to assess risk of bias. Extracted study characteristics were methods, participants, interventions, outcomes, and results. Seven studies were included, comprising six CBCR studies and one VR study, with 182 participants. Following CBCR: (1) Improvements were observed in several cognitive functions, but there was inconsistent evidence; (2) Improvements were reported in attention and executive functions (EF) at home and at school. Following VR: (1) Improvements were observed in attention and EF; (2) Not evaluated. Due to the small number of included studies with (relatively) small and heterogeneous samples, only a cautious interpretation of the evidence was provided. There is a need for carefully designed studies with more attention to inter-individual differences and generalisation to daily life.

Psychological Service Utilization and its Impact on Return to Work in Vocational Retraining Centers: A Cohort Study.

PURPOSE: Vocational retraining centers in Germany provide retraining for adults who are unable to continue their previous occupation due to health conditions. In addition to education and training, the centers provide support services, including the psychological service that assists rehabilitees in maintaining or regaining their mental stability. This study investigated which socio-demographic, health-related, and rehabilitation-related factors are associated with return to work (RTW) and examined the use of the psychological service and its association with RTW. METHODS: Data consisted of administrative data and service records routinely collected at one vocational retraining center. A total of 1187 individuals who began vocational retraining between 2016 and 2018 were analyzed. Logistic models predicting RTW and including interaction terms were used. RESULTS: Several factors were associated with RTW (Nagelkerke's Pseudo-R2 = 0.173), including socio-demographic factors, e.g., age (OR 0.96, 95% CI [0.93, 0.98]), health-related factors, e.g., number of diagnoses (OR 0.85, 95% CI [0.77, 0.93]), and rehabilitation-related factors, e.g., discontinuation of training (OR 0.24, 95% CI [0.15, 0.38]). The proportion of women, rehabilitees attending boarding school, and rehabilitees pursuing a career in the commercial and administrative sector was higher among frequent users of the psychological service compared to non/occasional users. The proportion of rehabilitees diagnosed with ICD F was also higher among frequent users, as was the number of diagnoses. Moreover, an interaction was found between absence and psychological service utilization on RTW. CONCLUSION: The analysis of routinely collected data in a vocational retraining center is suitable to investigate individual-level factors associated with RTW. The interaction suggests a compensatory effect, i.e., that frequent use of the psychological service mitigates the negative effect of absence on RTW.

Corun: Concurrent Inference and Continuous Training at the Edge for Cost-Efficient AI-Based Mobile Image Sensing.

Intelligent mobile image sensing powered by deep learning analyzes images captured by cameras from mobile devices, such as smartphones or smartwatches. It supports numerous mobile applications, such as image classification, face recognition, and camera scene detection. Unfortunately, mobile devices often lack the resources necessary for deep learning, leading to increased inference latency and rapid battery consumption. Moreover, the inference accuracy may decline over time due to potential data drift. To address these issues, we introduce a new cost-efficient framework, called Corun, designed to simultaneously handle multiple inference queries and continual model retraining/fine-tuning of a pre-trained model on a single commodity GPU in an edge server to significantly improve the inference throughput, upholding the inference accuracy. The scheduling method of Corun undertakes offline profiling to find the maximum number of concurrent inferences that can be executed along with a retraining job on a single GPU without incurring an out-of-memory error or significantly increasing the latency. Our evaluation verifies the cost-effectiveness of Corun. The inference throughput provided by Corun scales with the number of concurrent inference queries. However, the latency of inference queries and the length of a retraining epoch increase at substantially lower rates. By concurrently processing multiple inference and retraining tasks on one GPU instead of using a separate GPU for each task, Corun could reduce the number of GPUs and cost required to deploy mobile image sensing applications based on deep learning at the edge.

Survey on caregiver competency and retraining needs.

OBJECTIVES: This study investigated caregivers' job image, abilities, and educational needs, which are rapidly increasing owing to an aging society. DESIGN: A self-administered written survey was conducted at 12 general hospitals in Korea from February 1, 2022 to March 15, 2023. SAMPLE: A total of 451 caregivers participated in the survey as subjects of analysis, and 560 nurses participated as external observers. MEASUREMENTS: The caregivers' self-assessment results regarding job performance, educational needs, and retraining needs were compared with those of external observers. RESULTS: Caregivers evaluated themselves significantly higher in all areas of job performance compared to the evaluations of external observers. In particular, the caregivers' self-evaluation of their abilities in "Recording and Reporting," "Basic Resuscitation," "Safety and Infection Control," and "Understanding Major Illnesses" was different from the evaluation of nurses. Both the caregivers and external observers agreed on the need for caregiver retraining, with 1-2 hours of supplementary training every 12 months being the most preferred amount of retraining. CONCLUSIONS: There was a significant difference between caregivers' self-evaluations of their capabilities and the external observers' evaluations. Therefore, systematic professional caregiver retraining is necessary.

Randomized Controlled Trial on Imaginal Retraining for Problematic Alcohol Use: A Dismantling Study.

Imaginal retraining (IR) is an approach-avoidance procedure that has shown promising results in previous studies. The aim of the present study was to dismantle the efficacy of IR's components in a randomized controlled trial (RCT). We conducted a RCT with nine conditions comprising eight intervention groups and a waitlist control group (WLC). Alcohol craving (primary outcome), consumption, depressive symptoms, quality of life, subjective appraisal, and side effects were assessed online at baseline, post intervention (6 weeks), and follow-up (12 weeks). The sample consisted of 426 participants (age: M = 47.22, SD = 11.82, women: 50.5%). The intervention groups received instructions for four different components of IR (mood induction, mental avoidance of unhealthy stimuli, motor avoidance of unhealthy stimuli, approach to healthy stimuli) that were each conveyed with or without prior psychoeducation (PE). The intervention was delivered online. At total of 163 individuals (42.9%) used the intervention at least once. No group differences were found for any primary or secondary outcome after Sidák correction. Uncorrected statistics showed effects of significantly decreased alcohol consumption for the approach + PE group in the intention-to-treat and the merged motor avoidance group in the per-protocol analyses at post assessment compared with the WLC. Exploratory moderation analyses revealed that individuals with high visualization skills benefited most. The authors conclude that visualization training and motivational components may increase the efficacy and adherence of IR.

Development, feasibility, and acceptability of a process based intervention to decrease internalized ageism.

A lifetime of exposure to ageism may be internalized in older adults, and these ageist beliefs that are directed inwards can have severe consequences. However, research on reducing internalized ageism is scarce. To address this, we designed and implemented a six-week online process-based intervention to reduce internalized ageism and to assess its feasibility. The intervention utilized a process-based therapy approach targeting psychological, behavioral, and physiological pathways through which internalized ageism negatively impacts health, as specified by stereotype embodiment theory. Intervention components included education, acceptance and commitment therapy techniques, and attributional retraining. A total of 81 older adult participants participated in the feasibility study. Most participants rated each session and the overall program as very useful after each session (average program usefulness rating of 4.54/5). Participants also attributed a wide range of novel behaviors to this intervention and stated that they felt it changed their perspectives on ageism and/or internalized ageism. Results from this study provide a promising foundation from which to advance research on interventions that address internalized ageism - a problem that has severe consequences on the health and well-being of growing numbers of older adults globally.

Reimagine Aging: A Process-Based Intervention to Decrease Internalized Ageism.

OBJECTIVES: Exposure to ageism may be internalized in older adults, and this can have severe consequences. However, little research has addressed reducing internalized ageism. Thus, Reimagine Aging, a 6-week process-based intervention to reduce internalized ageism, was designed and implemented, using education, acceptance and commitment therapy, and attributional retraining to target theoretically based mechanisms of change. METHODS: Seventy-two older adults (M = 70.4 years, SD = 6.4 years) participated in Reimagine Aging, consented to participate in this robust single-sample pilot study, and provided valid data. Participants completed questionnaires prior to, immediately following, and 2 months after the intervention. RESULTS: Participants' self-perceptions of aging (ηp2=0.37, p < .001) and perceptions of older adults (ηp2=0.27, p < .001) became significantly more positive, associated with large effect sizes. Furthermore, these positive gains were mediated by increases in psychological flexibility, mindfulness, and perceived control. DISCUSSION: This study provides initial support for this process-based intervention targeting a reduction of internalized ageism. CLINICAL IMPLICATIONS: This program has the potential to reduce the negative impact internalized ageism has on the health of older adults. Furthermore, it provides novel insights into intervention targets and tools that may be useful in achieving this reduction.

Neuromuscular retraining therapy for early stage severe Bell's palsy patients minimizes facial synkinesis.

OBJECTIVE: To explore whether early physical interventions, including neuromuscular retraining therapy, can minimize excessive movement or any unwanted co-contraction after a severe Bell's palsy. DATA SOURCES: From March 2021 to August 2022, the therapist treated Bell's palsy patients for the acute (<3 months, Group A), subacute (3-6 months, Group B) and chronic (> 6 months, Group C) stages of the condition. METHODS: We explored whether early physical interventions, including neuromuscular retraining therapy, can minimize facial synkinesis after a severe episode of Bell's palsy. Each patient was informed about the potential for synkinesis and the therapist explained that the main purpose of neuromuscular retraining therapy is to learn new patterns to minimize synkinesis. The facial function of Group A was compared to that of Groups B and C using the 'Synkinesis' scale of the Sunnybrook Facial Grading System. RESULTS: The final facial function score after neuromuscular retraining therapy was significantly associated with both the initial electroneuronographic degeneration rate and initial facial function. Early therapy did not prevent synkinetic movement in 84.7% of the patients. But, there was a significant difference between patients who started early neuromuscular retraining therapy and other groups in final facial function. CONCLUSION: Synkinesis in Bell's palsy patients can be minimized if physiotherapy commences before synkinesis develops; appropriate neuromuscular retraining therapy timing is essential. A patient with sudden severe Bell's palsy should receive oral steroids as soon as possible, along with physical therapy (including neuromuscular retraining therapy) within 3 months, to minimize synkinesis just before synkinesis onset.

Combination of Two Behavioral Techniques Reduces Craving in Problematic Alcohol Consumption by One Third: A Randomized Controlled Trial.

INTRODUCTION: Craving alcohol is a core symptom of alcohol use disorder (AUD) and an important target for treatment. A new line of treatment for AUD aims at overriding the urge to consume alcohol by changing implicit cognitions via approach bias modification (ApBM). In a prior study, we tested a variant of ApBM called imaginal retraining, which reduced craving. As addiction and body-focused repetitive behaviors (BFRBs) share important symptoms (e.g., inability to resist urges), for the present study we merged imaginal retraining with a technique aimed at BFRB, called decoupling, to augment treatment effects. We hypothesized that the new technique, which is called 3P, would lead to a greater reduction in craving relative to (active) control conditions. METHODS: The study was conducted online. Data from 227 participants were considered. Participants were randomized to 1 out of 5 conditions. Craving for alcohol before and after the brief intervention was the primary outcome. RESULTS: Only the 3P condition lessened craving by approximately one third at an almost medium effect size (improvement: 34.5%, p = 0.003, d = 0.458). Effects were significantly larger relative to the wait-list control and two active control conditions (p's < 0.02; greater reduction than imaginal retraining at a small but nonsignificant effect size). DISCUSSION/CONCLUSION: If replicated, the combination of imaginal retraining and decoupling (3P) represents a promising, easy-to-implement self-help technique to reduce immediate craving. Long-term effects in participants with formally diagnosed AUD have not yet been investigated.

The effectiveness of a 6-week biofeedback gait retraining programme in people with knee osteoarthritis: protocol for a randomised controlled trial.

BACKGROUND: Gait retraining is a common therapeutic intervention that can alter gait characteristics to reduce knee loading in knee osteoarthritis populations. It can be enhanced when combined with biofeedback that provides real-time information about the users' gait, either directly (i.e. knee moment feedback) or indirectly (i.e. gait pattern feedback). However, it is unknown which types of biofeedback are more effective at reducing knee loading, and also how the changes in gait affect pain during different activities of daily living. Therefore, this study aims to evaluate the acute (6 weeks of training) and chronic (1 month post training) effects of biofeedback based on personalised gait patterns to reduce knee loading and pain in people with knee osteoarthritis, as well as examine if more than one session of knee moment feedback is needed to optimise the gait patterns. METHODS: This is a parallel group, randomised controlled trial in a symptomatic knee osteoarthritis population in which participants will be randomised into either a knee moment biofeedback group (n = 20), a gait pattern biofeedback group (n = 20) or a control group (n = 10). Supervised training sessions will be carried out weekly for six continuous weeks, with real-time biofeedback provided using marker-based motion capture and an instrumented treadmill. Baseline, post-intervention and 1-month follow-up assessments will be performed to measure knee loading parameters, gait pattern parameters, muscle activation, knee pain and functional ability. DISCUSSION: This study will identify the optimal gait patterns for participants' gait retraining and compare the effectiveness of gait pattern biofeedback to a control group in reducing knee loading and index knee pain. Additionally, this study will explore how many sessions are needed to identify the optimal gait pattern with knee moment feedback. Results will be disseminated in future peer-reviewed journal articles, conference presentations and internet media to a wide audience of clinicians, physiotherapists, researchers and individuals with knee osteoarthritis. TRIAL REGISTRATION: This study was retrospectively registered under the International Standard Randomised Controlled Trial Number registry on 7th March 2023 (ISRCTN28045513).