KIN 1070 MID TERM
Williams and Anderson Model
personaily, history, and stess all are variable that add to the stress responce
Stress responce occurs when cognitive aprisial and physiological attention is not enought for the demands
In potentially stressful athletic situaitons the stress responce can lead to injury
intervetion can be put into place to adjust ones stress responce
Smith Study
Vaunerabilty and reseliance to adolsent injury: with facing diffrent levels of life stress, social support, and coping skills.
Highschool varisity athletes (diff sports + no contact )
Questionaire prior to season assessing LIFE EVENTS, SOCIAL SUPPORT, and COPING SKILLS
Injury data taken over the couse of the season
ATHLETES WITH BOTH LOW SOCIAL SUPPORT AND COPING ARE SHOWN 22% more likley to be affected by sports injury
Kerr and Goss
effects of stress management program on injuries and stress levels
COPING SKILLS deliverd biweekly over 8 months (1hr sessions)
male and female gymnast subjects
control group and experemental group
Assessed in pre season/intervention, mid-season, and peak season
Negative athletic stress scores were looked at in relatiohship to the dependent variable injury occurance
Experimental group showed less negaive stess pre season and peak season but not mid season
Experimental group showed less injury occurance thought the whole study
Evaluation of the effects of phychological prevention interventions on sport injuries: Meta-analysis
preventing sports injuries based on physiologcal interventions
FOREST PLOT
This meta Analysis shows That 5/7 experiments are confidently successful that stress reduction, management prevention intervention reduces negative athletictic stress & a reduces incident injuries
Cupal and Brewer Study
Effects of relaxation and guided on imagrey on knee strengh, reinjury anxity, and pain following ACL reconstuction
particiapnts completed ACL reconstuctive surgey having no evindend of previous lower exremity trauma; expected to ingage in 6 months post surgicsl rehab
study measued re-injuy anxisety, pain, knee strenght
treatment (sessions + physo) , placebo (attention clinicaly + physio) , and control group (physio)
Greatest to smallest amount
Knee strengh --> treatment, control, placebo
Reinjury Anxiety --> placebo, control, treatment
Pain --> conrol, placebo, treatment
Treamtment group showed best results in terms of knee strenght, reinjury anxiety, and pain
implaications - does not study why imagery works
Bandura's Model
Modeled act reqiores
- attention
- retention
- production
- modivation
to produce a responce
(in that order)
Newell - inofrmaitonal sources
availible prior, during, after action
White Coat Phenomenon
when individuals enter medical settings, mant are prone to exbit high anxiety
Kulik & Mahler 1987
exprosure to postoperative pt. and events through a coping model better prepared the observe by provididng accurate information on which cognitive apprasial of the situation can be made. Gives pt. a better idea of what to expect and to therefore be confident.
Flint 1991
- role of coping models compared to no coping models on physiological outcome following rehabilitation of ACL amond 10 female basketball players
- coping model video of female, simlar age, baketball position, and type of injury thoughought rehabiliation process
Functional milestone result for modeling group
less weeks rehab for - walking, run/jog, full
morw weeks rehb - extention
Phychological milestones for modeling group
- 3 weeks post-op had higher self-efficacy
- 2 months post-op higher percived athletic competence
Limitation
- small sample size
- did not provide an indication of its benfefit preoperativly
Extended reasherch testing effetivenes of coping model pre and post op
- Hypothesis athletes who recieved the coping modeling video intervetion would report lower pre-op anxiety, perceeption of pain, and greater selg-efficacy for rehab compared to non intervetion on group. Would show greater improvemens in funtional milestones: knee laxity, swelling, ROM, symptoms, difficulty preforming task, internation knee documentation commitee form IKDC
- 72 participants, male, diffrent sports
- DVD was developed
- pre-op anxiety and perception of actual pain had no effect, post-op perception of pain positive effect, self-efficanct measues had an early effect
- crutch walking and IKDC positive effect, ROM no effect
Topp (2002) Theory
prehab increases functioning
funtion decreses in responce to stress
But with prehab it takes way less time to bounce back and be better funtioning
Wang study
Meta Anaysis using forest plot
Pre-Hab study and intervention improvemetns on joints after replacement surgury
Pre Hab intervention included physiotherapty supervised exersise VS control group with usual care
results
- Overall 6% better pain score at 4 weeks by prehab group
- Overall 4% better function score at 6-8 weeks by prehab group
- Overall 5% better function score at 12 week from prehab group
**Pre hab group overall stayed one less day in hospital then the other group** (saving $$)
Strength- Converted outcomes to a standardized measurement of WOMAC (Western Ontario and McMaster Osteoarthritis Index)
Limitation- Compliance was not reported in a number of studies. No physical measure of function
Mosley study
Controled trial of arthoscopic surgury for osteo arthritic of the knee
KNEE SURGERY vs SHAM SURGERY
patients felt less pain and can funtiotn better becuse of the placebo effect not because of the surgury
ethical issues and surgical issues arise from this study
Meta analysis
Objective → Assess weather placebo controls serves as a valid and safe instrument of trials in surgery
Methods → meta analysis according to recommendations of PRISMA
Only 2/11 studies showed strong evidence of having a better effect than placebo (results favored placebo)
Shows that people with the placebo showed more adverse and serious side effects then those with actual treatment
Paffenbarger
Analytical cohort study
- daily phsycial activity (kcal/wk)
- follow up 6-10 years later
- # of HA
Rates of fatal, nonfatal, and all first heart attack were compared in each of the baseline physical activity exposure categories
If person had a physical activity index between 2000-2999 or greater they are much less likey to experiance all first heart attacks, non fatal heartacks, and fatal heart attacks
It does not make much a diffrence in HA incidence when using between more then 2000 kcal/wk and 4000 kcal/wk
Bernstein
case control study
invesigate effects of physical activity from adolescence to adultdood on the risk of breast cancer
took a group of women with breast cancer and without and assessed there levels of physical activity in hrs/wk
exersise reduced risk by 52% risk reduction for breast cancer
women who exerssed >3.8 hrs/wk were 58% less likley to have breasr cancer then those who expersiszed 0 hrs per week (data also tok into acount age of menarche, months breast feeding, oral constreceptive)
Meta Anaylsis by Kubitz Results
exercise has the biggest impact on sleep when the exercise is longer in duration and the exercise is completed earlier in the day
Effect of meditative movement intervention intervention on quality of sleep in the elderly
Meta analysis + systematic review
- 14 studies (12-24 weeks 3X per week)
- diff types of MMI
- 12 studies showed that the experimental group had a better night sleep the the contol (this was with exception to the sudies where the MMI intervetion was preformed less then 3X per week)
Effects of exercise training on sleep apnea: A systematic review and meta anaysis
study use of exercise on managment and treatmen of OSA in adults
- 8 studies
- 2-6 months, 2-7 days weekklt, 30-150 min per seession
Exersise was assoisated with loweing AHI and the underlying causes of OSA
Effects of exersise on sleep quililty and insomnia in middle aged women: A systematic review and meta analysis or randomised controlled trials
Meta anaylsis on effects of exersise on sleep qualilty and insommia on middle aged women
To assess the effects of short-term programmed exercise (PE) on sleep quality and insomnia in middle-aged women
• Moderate PE (aerobic exercise) = positive effect on sleep quality as compared to controls
• Low levels of PE (yoga) = no significant improvement on sleep quality
• Low-moderate PE = no significant reduction in severity of insomnia
sleep improved but not signigicant effect on the severity of insomnia
small # of studies therfore evidence should be taken with cautuion
Terry- Short
based on behavioral thoery
achieving positive consequences vs avoiding negative consequences
divided into postive perfectionsim and negative perfectionsism
Slade model
ED model and a physological mechanism to understand it
person with perfectionism and low self esteem
facing loss of control
may develop eating behavior
this model develops the " high risk profile"
Clin J Sport Med
Prevslance of ED in elite ethleses is higher then the general population
- two step study self reported questionaire and clinical review
- those who show to be at risk from self report will get a clinical interivew to detriming weather they have a ED
“at risk” after the questionnaire and those at risk subjects diagnosed with a ED follow similar patterns
Most to least at risk
- athlete females
-control females
- athlete male
- control male
Results
athletes competing in aesthetic sports such as gymnastics are 42% more likely to develop an ED, then observed in endurance, technical, and ball game sports
Conclusion
- affect female athletes more than male
- more common in those compete in lean dependent and weight dependent sports
- collaborative effort among coaches, trainers, parents, physicians, and athletes is optimal for recognizing preventing, and treating Eds in athletes
Perfectionism and Eating Additudes in Rowers: the moderating effects of body mass, wieght, and gender
- athletes in sports where leanness is emphisised may be at greater risk for ED
- perfectionsm and similar phycological charaterisitcs between ED pt. and athletes
- study takes into effect positive and negative perfectionism scale, eating additude test, and BMI (weight/height squared)
- 496 rowers both genders
Conclusion: Negative Perfectionism--disturbed eating attitudes relations are maximized for lightweight female rowers with greater body mass
- Not ALL perfectionism is bad
- Negative Perfectionism is positively related to disturbed eating attitudes.
- Positive Perfectionism is unrelated to disturbed eating attitudes.
- Body mass, weight classification and gender moderate relations between Negative Perfectionism and disturbed eating attitudes.
Design and Results
Mood- Linked Responses in Medial Prefrontal Cortex Predict Relapse in Patients with Recurrent Unipolar
- looked at using funtional magnetic resonance imaging (fMRI)
- formaly depresed pt.
- watching sad movie clips
- while examining the brain
- over th next year/yea and a half 9/16 pt. relaped
- compared to the brian activity of relapsing pt. agains another group who had never been depressed
- when faced with sadness relapsing pt. showed more brain activity in the area of the brain known as the medial prefontal gyrus
Role of translocator protein density, a maker of neuroinflamation in the brain during major depressive episodes
- 20 pt. MDE
- 20 under healhty conrol
- Elevated translocator density (sign of brain inflammation) vs. region
- People with depression showed much higher than the control
Levels of inflammation of the brain is related to how people score in depression symptoms
Therefore:
- More inflammation in the brain for depressed pt.
- Unable to determine whether neuroinflammation occurs prior to depression or because of it
- suggests treatment should be deisgned to reduce microgial activation
Caspi Study
- analyzed the 5-HTT gene that helps regulate seritonin
- two forms of the gene long and short
- invidivual can inherit two copies of long and short gene
- short version of 5-HTT is not as effective at contorling seritonin flow
- reahsersher focused on subjects who had tramuating life events over a 5 year perisos
- pt. with at least one copy of the short gene were 33% more likley to be dignosed with depression after experancing trauma
- pt. with only long gene where more resitant to depresion
Kirsch study
Initial severity and antidepressant benefits: A meta-analysis of data submitted to the food and drug administration
- Obtained data on all clinical trials submitted to the US Food and Drug Administration (FDA) for the licensing of the four new-generation antidepressants for which full datasets were available
- Meta analytic techniques to assess linear and quadratic effects of initial severity on improvement scores for drug and placebo groups and on drug-placebo difference scores
- Only a 1.8 drug-placebo difference! - not enough, fails to meet the 3 point drug-placebo criterion for clinical significance (NICE = 3)
Conclusion:
- anti depressent drug makes virtualy no diffrence in pt. with modeate levels ov depression and its theplacebo effect that cures them
- but for very severe depression the drug does actualy assist
The drugs used to treat depression are effective, but for many, it's not the active ingredient that's making people feel better. It's the placebo effect
Cipriani study
comparative efficact and acceptabililty of 21 antideprent drugs for the acute treatment of adults with major depressive disorder: a systematic review and network meta anysis
- all anti depressendt were more effectice than the placebo in adults with MDD
- seen via forest plot
Connor Liston Study
affects of ketamine on mice
baseline (day 0) - dendrite spines precent
- mice were subjected to intence stress
pre ketamine (day 21) - dendrite spinces gone
post ketamine (day 22) - dendrite spines reapear
Yoshiuchi study
crossectional study
concluding
daily step count and daily duration of moderate PA were significantly inversly correlated with depression
more active lessend depressive symptoms
Paffenbarger
- collage alumi
23-27 year follow up
- participants were split into diffrenet groups based on energy expenditure
1) <1000kcal/weekly
2) 1000-2499 kcal/weekly
3) 2500+ kcall/weekly
- highest weekly EE were 28% less likley to develop depression compred to those with low weekly EE
- those with moderate weekly EE were 17% less lilkey to develop depression compared to those with low weekly EE
Blumenthal Study
- Effects of exersise trining on older pt. with major depression
- asess the effectivnes od AEROBIC exersie to standard medication
- half group was on anti depresents other half was taking part in exersise program
-16 week long
- those who were in the exersice program followed the progrm proven by there VO2 max scores
- exersise was shown to improve depression much more then the medication
- exersice is alernative treatment to anti depressents
Physical activity and prenatal depression: Going beyond statistical significance and assessing the clinically reliable impact
determine if prenatal exersie during pregnancy can treat depression among women who enter pregnancy at risk for depression and to determinf if it is a clincaly reliable change on risk
- exersize group and standard control group
- baseline: 9-12 weeks to completion:36-38 weeks, aerobic training, resitance exersises, 3X per week
- assessed potenital cofunding variables ex. age, BMI,occupation ext..
- CES-D base line and post intervetino shows a >7 decresse and therefore is signifigant
- 61% of women had score decrease by 7 in exrersise intervention VS 32% showed a 7 point decrease from the control
An examination of potential mechanims for exercise as a treatment for depression: A pilot study
- had to screen people it was hard to find participants who where on stable mediction and only one type
- pool went form 200 --> 30
- put into steaching or areobic exeersise group
Measures:
depression --> Beck depression inventory and montgomery asberg
Coping efficacy
Episodic memory
Cortisol (saliva)
Cardio vascular fittness
Flexabililty
Attendance
- decrease in beck depression system score but the drop in aerobic exercise is greater then stretching
- MADRAS Favors aerobic exercise over stretching
- un-cued and cued recall both favored aerobic exersie
- cortisol awakening responce favored streaching
Exersise group was over an 8 point change making it clinicaly sigifigant
Not the streching group
- adherence for exercise group was better, people enjoyed and wanted to go to classes