Upper body compression wear improves muscle oxygenation following intense video game training: a randomized cross-over study among competitive gamers.

BACKGROUND: Esport players require a high number of action moves per minute to play, with substantial contractions of the wrist extensor muscles. Players frequently suffer from acute fatigue. The purpose of this study was to examine the use of below the elbow compression sleeves on Sm02 during intense aim training. Secondly, to examine players' performance and perception with and without compression. METHODS: This study was conducted at the New York Institute of Technology and enrolled fifteen collegiate esport players, 2 women and 13 men (age 21.2 ± 2.2). All subjects signed written consent. Participants performed 3 high intensity bouts of an aim trainer followed by a 15-minute rest before doing another 3 bouts of high intensity training conducting the other arm of the study. The compression wear order was randomized. The primary outcome included Sm02 of the extensor carpi radialis longus using near-infrared spectrometry. Secondary outcomes included Kills Per Second (KPS), Score, Total Time to Kill (TTK), accuracy, and perceived performance. RESULTS: Following 15 min of recovery, there was a significant rise in Sm02 while wearing the compression sleeve compared to no compression sleeve (p = 0.004). No change in Sm02 was seen while gaming. In trials 1 and 2, wearing the compression sleeve resulted in a significant increase in KPS and score when compared to not wearing it (p = 0.002,0.006). Although TTK and accuracy did not alter, 46.7% of participants believed the compression sleeve aided their performance. CONCLUSIONS: This study provides support that wearing below the elbow upper body compression sleeves while performing high intensity gaming may reduce fatigue, improve muscle recovery and gaming performance. TRIAL REGISTRATION: Clinicaltrials.gov identifier NCT05037071. Registered 08/09/2021. URL: Arm Compression on Muscle Oxygen Saturation - Full Text View - ClinicalTrials.gov.

Esports players, got muscle? Competitive video game players' physical activity, body fat, bone mineral content, and muscle mass in comparison to matched controls.

BACKGROUND: Esports players, like traditional athletes, practice for long hours and, thus, are vulnerable to the negative health effects of prolonged sitting. There is a lack of research on the physical activity and the health ramifications of prolonged sitting by competitive players. The purpose of this study was to investigate activity levels, body mass index (BMI), and body composition in collegiate esports players as compared to age-matched controls. METHODS: Twenty-four male collegiate esports players and non-esports players between 18 and 25 years of age signed a written consent to participate. Physical activity was examined using daily activity (step count) with a wrist-worn activity tracker. A questionnaire assessing physical activity was also administered. Secondary outcomes included body-fat percentage, lean-body mass, BMI, and bone mineral content measured using dual X-ray absorptiometry. RESULTS: The step count in the esports players was significantly lower than the age-matched controls (6040.2 ± 3028.6 vs. 12843.8 ± 5661.1; p = 0.004). Esports players exhibited greater body-fat percentage (p = 0.05), less lean body mass (p = 0.003), and less bone mineral content (p = 0.03), despite no difference in BMI between the esports and non-esports players. CONCLUSION: As compared to non-esports players, collegiate esports players were significantly less active and had a higher body-fat percentage, with lower lean body mass and bone mineral content. The BMIs showed no difference between the 2 groups. Esports athletes displayed significantly less activity and poor body composition, which are all correlated with potential health issues and risk of injury. BMI did not capture this difference and should not be considered as an accurate measure of health in competitive esports players.

Acute changes in sagittal plane kinematics while wearing a novel belt device during treadmill running.

Somatosensory feedback is used in walking retraining; however, its utility in running is less feasible due to the greater associated speeds. The purpose of this study was to examine the acute effects of wearing a novel running belt device on sagittal plane running kinematics. Ten healthy runners ran on a treadmill with and without the use of a running belt device within a repeated measures study design. Temporal-spatial characteristics and sagittal plane knee and ankle kinematics were recorded with three-dimensional motion analysis. Wilcoxon Signed-Rank Tests revealed significant decreases in centre of mass vertical displacement (z = -2.083, p = 0.003), tibial inclination at initial contact (z = -2.803, p = 0.003), and stance phase knee joint excursion (z = -2.701, p = 0.003), and greater knee flexion at initial contact (z = -2.803, p = 0.003) when the belt was donned. No differences were observed in step rate (z = -0.351, p = 0.363), foot inclination angle at initial contact (z = -2.090, p = 0.018), or peak knee flexion during stance (z = -1.172, p = 0.121). Findings suggest that donning a running belt can minimise specific high-risk biomechanical characteristics in runners with particular kinematic profiles.

Blood flow restriction resistance training in a recreationally active person with Parkinson's disease.

Background: Blood flow restriction (BFR) applied during low intensity resistance training (LIRT) exercise produces hypertrophy and strength gains equivalent to traditional training. The effectiveness of BFR-LIRT on persons with Parkinson Disease (PD) has not been investigated.Objective: To determine the effects of BFR-LIRT on a recreationally active person with PD in regards to function, strength, Restless Leg Syndrome (RLS) and safety. Methods: A single subject, A-B-A design was utilized. Each phase lasted 6 weeks. Outcome measures included: 30-second sit-to-stand; Timed Up and Go (TUG); RLS Questionnaire; 3-RM of Cybex Leg Press (LP); Leg Curl (LC); and Leg Extension (LE) measured every 3 weeks for 18 weeks. The intervention phase (B, weeks 6-12) included four lower extremity resistance exercises (LP, LC, LE, calf presses on the LP) with the addition of BFR. The two standard deviation band method was used to determine significance.Results: All outcome measures except the TUG improved significantly by the end of intervention phase.Conclusion: The combination of BFR with LIRT safely lead to an increase in lower extremity strength and function in a person with PD, while decreasing their RLS (improvement from moderate to mild symptoms) resulting in a better quality of life for the participant.

Utilizing wearable technology to increase physical activity in future physicians: A randomized trial.

This study examined the use of activity trackers alone or combined with weekly communication through email to improve activity and body composition over one academic year in medical students. This randomized clinical trial conducted at the New York Institute of Technology from July 7, 2016 through June 4, 2017 enrolled 120 medical students. The first group (Fitbit-Plus) wore activity trackers and received weekly emails offering fitness challenges and lifestyle modification challenges. The second group (Fitbit-Only) received only activity trackers and did not receive weekly emails. The third group (Control) was asked not to purchase an activity tracker of any kind throughout the study. All groups had a body composition analysis prior to the start of the academic year and at the end of the first academic year. Outcome measures included step count and body composition (body fat percentage and lean body mass). The results showed the overall mean daily steps were greater in the Fitbit-Plus group than the Fitbit-Only group for the academic year (7429 ±â€¯2833 vs. 6483 ±â€¯2359) with only months April and May showing a significant difference between the groups (p = 0.011; p = 0.044). Body fat percentage decreased in the Fitbit-Plus overweight women (2.1 ±â€¯1.6%) lean body mass increased in the Fitbit-Plus group in overweight men (2.4 ±â€¯4.6 lbs.). A subsequent finding of this study showed improved body composition in a small sub-group of over-weight students. Weekly behavioral challenges combined with an activity tracker increased step count in medical students compared to an activity tracker alone. Clinicaltrials.gov Identifier: NCT02778009.

Auditory and visual cueing modulate cycling speed of older adults and persons with Parkinson's disease in a Virtual Cycling (V-Cycle) system.

BACKGROUND: Evidence based virtual environments (VEs) that incorporate compensatory strategies such as cueing may change motor behavior and increase exercise intensity while also being engaging and motivating. The purpose of this study was to determine if persons with Parkinson's disease and aged matched healthy adults responded to auditory and visual cueing embedded in a bicycling VE as a method to increase exercise intensity. METHODS: We tested two groups of participants, persons with Parkinson's disease (PD) (n = 15) and age-matched healthy adults (n = 13) as they cycled on a stationary bicycle while interacting with a VE. Participants cycled under two conditions: auditory cueing (provided by a metronome) and visual cueing (represented as central road markers in the VE). The auditory condition had four trials in which auditory cues or the VE were presented alone or in combination. The visual condition had five trials in which the VE and visual cue rate presentation was manipulated. Data were analyzed by condition using factorial RMANOVAs with planned t-tests corrected for multiple comparisons. RESULTS: There were no differences in pedaling rates between groups for both the auditory and visual cueing conditions. Persons with PD increased their pedaling rate in the auditory (F 4.78, p = 0.029) and visual cueing (F 26.48, p < 0.000) conditions. Age-matched healthy adults also increased their pedaling rate in the auditory (F = 24.72, p < 0.000) and visual cueing (F = 40.69, p < 0.000) conditions. Trial-to-trial comparisons in the visual condition in age-matched healthy adults showed a step-wise increase in pedaling rate (p = 0.003 to p < 0.000). In contrast, persons with PD increased their pedaling rate only when explicitly instructed to attend to the visual cues (p < 0.000). CONCLUSIONS: An evidenced based cycling VE can modify pedaling rate in persons with PD and age-matched healthy adults. Persons with PD required attention directed to the visual cues in order to obtain an increase in cycling intensity. The combination of the VE and auditory cues was neither additive nor interfering. These data serve as preliminary evidence that embedding auditory and visual cues to alter cycling speed in a VE as method to increase exercise intensity that may promote fitness.

Learning effects of the sensory organization test as a measure of postural control and balance in Parkinson's disease.

INTRODUCTION: Recent experiments examining balance in Parkinson's disease (PD) have used the sensory organization test (SOT) to measure postural control and balance. Use of the SOT raises the question as to whether people will improve after undergoing the test multiple times or if there is a learning effect plateau after multiple trials. The objective of this study was to determine whether there is a learning effect using the SOT in subjects with PD both fallers and non-fallers, and healthy controls. METHODS: Nineteen subjects completed the study. Ten subjects with PD who were non-fallers (PD-Non-fallers), nine subjects with PD who were fallers (PD-Faller), and 10 healthy controls (Controls). Subjects completed 5 SOT testing sessions over a 3 week period. Those with PD were tested at the same time in their peak 'on' period. RESULTS: The PD-Faller groups SOT composite score improved from session 1 to session 4 and 5. In the Control group the composite score improved from session 1 to session 5. There was no change from session 1 to session 5 in the PD Non-faller group. The PD-Faller group had significantly lower composite scores than our PD Non-faller group and our Controls. Our PD-Non-faller group scores were similar to Controls. CONCLUSION: Multiple baseline measures are usually recommended for any task used as an outcome measure. Our findings suggest that in PD subjects who are considered fallers that by the fourth session any improvement may be due to a learning effect.

Effects of Tyrosine on Parkinson's Disease: A Randomized, Double-Blind, Placebo-Controlled Trial.

Individuals with Parkinson's disease (PD) can suffer from orthostatic hypotension (OH) resulting from reduced levels of norepinephrine (NE), which inhibits the sympathetic nervous system. Levodopa reduces NE levels even further, leading to a greater decrease in blood pressure (BP) and increased OH. Tyrosine is a nonessential amino acid that is the major precursor to NE. Reduced levels of tyrosine have been shown after administration of l-dopa. This study was a single-center, randomized, double-blind, placebo-controlled trial to test the effects of supplementing l-tyrosine on BP, plasma tyrosine, NE levels, and autonomic responses to exercise in PD. Thirty-six subjects with PD receiving l-dopa medication that suffer from OH participated. Random assignment was to a placebo group or l-tyrosine 1,000 mg (500 mg of 2× daily) group for 7 days. OH testing and exercise testing was performed pre- and postsupplementation. There was no effect of tyrosine on BP after OH testing postsupplementation (tyrosine, n = 17; placebo, n = 19). There was an increase in plasma tyrosine in the tyrosine group (P > 0.05). There were no significant changes in any of the secondary outcome measures. l-tyrosine at 1,000 mg (500 mg/2× day) for 7 days is safe and well tolerated in PD. Our results were inconclusive as to whether an increase in plasma tyrosine has an effect on OH in subjects with PD. An increase in plasma tyrosine had no effect on BP or autonomic responses in subjects with PD during acute exercise stress. (Trial registration: http://ClinicalTrials.gov.; identifier: NCT01676103).

Haptic feedback from manual contact improves balance control in people with Parkinson's disease.

Parkinson's disease (PD) degrades balance control. Haptic (touch and proprioception) feedback from light contact with a stationary surface inadequate to mechanically stabilize balance improves balance control in healthy people. In this study we tested whether PD impairs use of haptic cues independent of mechanical support to control balance. We measured postural sway in thirteen individuals with PD (H&Y 1-3, median=2, Q1=2, Q3=2) and thirteen age-matched controls balancing in a widened, sharpened Romberg stance in four conditions: eyes-closed, no manual contact; eyes-closed light-touch contact (<1N), eyes-closed, unrestricted contact; and eyes-open, no contact. To determine whether PD-severity affects any of these balance strategies, PD participants were tested on- and off-medication, and using the more- and less-affected body side in the stance and manual contact. Individuals with PD simultaneously maintained non-supportive fingertip contact and balance in this task without practice. PD participants swayed more than control participants (ML CP p=0.010; shoulder p<0.001), but manual contact reduced sway. Non-supportive manual contact stabilized balance more than vision (p<0.05). PD-severity factors had no significant effect (p>0.05). We conclude the effect of PD on balance is not specific to vision or haptic feedback. Nevertheless, haptic cues from manual contact, independent of mechanical support, improve balance control in individuals with PD. We discuss the implication that PD or associated dopaminergic pathways do not directly affect haptic feedback balance control mechanisms, including arm/posture coordination and proprioceptive integration.

Effects of exercise and B vitamins on homocysteine and glutathione in Parkinson's disease: a randomized trial.

BACKGROUND: Individuals with Parkinson's disease (PD) have decreased glutathione levels and elevated homocysteine levels. These substances are considered markers of health, and an inverse relationship has been suggested through the transsulfuration pathway. This experiment tested the effects of exercise and B vitamin supplementation on homocysteine and glutathione levels, and if a relationship was present between these two markers in those with PD. Secondary aims included examining the impact of the interventions on aerobic efficiency and strength. METHODS: Thirty-six subjects were randomly assigned to 4 groups. The Vit group received vitamins B(6), B(12) and folic acid daily for 6 weeks. The Ex group received aerobic and strength training twice weekly for 6 weeks. The Vit + Ex group received both interventions. A control group received no intervention. Subjects were tested prior to and after intervention on the following measures: glutathione and homocysteine levels, strength measures and oxygen consumption. RESULTS: Subjects who received 6 weeks of B vitamin supplementation had lowered homocysteine levels. Subjects who received 6 weeks of exercise training had increased glutathione levels, strength and aerobic capacity. The combination of vitamin and exercise did not yield greater changes than the separate intervention. The control subjects did not change on any measures. CONCLUSION: Positive results were realized with each intervention; however, the expected relationship between glutathione and homocysteine was not found in this sample of subjects with PD. Homocysteine and glutathione levels can be improved independently in individuals with PD with exercise or vitamins B(6), B(12) and folic acid supplementation.

Improving gait and promoting retention in individuals with Parkinson's disease: a pilot study.

We examined intensive walking practice using two instructional strategies on gait in Parkinson's disease (PD) before and after training and on delayed retention tests. During four training sessions (15 practice trials of walking per session), subjects (N = 6 per group) were given either verbal instruction (VI) to "take a big step" or VI plus augmented feedback (FB). For FB, videotape performance-feedback (from prior trial) supplemented by performance-cues (for subsequent trial) was given after each trial. On pre- and posttests (1 week after training), the only instructions were to "walk as well as you can." For available subjects (N = 7), retention was tested at 3, 6, or 12 months after training. Gait parameters were derived from kinematic analysis of walking during training and testing. From pre- to posttests, stride length, walking velocity and shoulder excursion increased significantly, with no change in cadence. Improvements in stride length and gait velocity above pretest levels were maintained on retention tests. During training and testing, no effects of VI versus VI + FB were found. Although the two instructional strategies did not differ, intensive practice walking with VI improved the gait pattern of individuals with PD and these gait improvements were maintained over an extended period of time.

Effects of exercise induced oxidative stress on glutathione levels in Parkinson's disease on and off medication.

Resting plasma glutathione (GSH) levels are lower in individuals with Parkinson's disease (PD) than any other neurological condition. Medications used to treat PD have also been shown to further decrease this depletion. Acute exercise has been shown to be an effective tool to produce oxidative stress in other populations as reflected in lowering levels of GSH. The purpose of this study was to determine how PD responds to acute exercise stress and how medication affects these responses. Fourteen men with PD and 14 men without PD underwent an exercise stress test. Subjects with PD performed the test once off PD medication (PD-Off-med) for 12 h then again 1 week later on PD medication (PD-On-med). GSH and glutathione disulfide (GSSG), were collected via blood draws at rest and after peak exercise along with peak VO(2). At rest and at peak exercise GSH levels and the GSH:GSSG ratio were significantly lower in the PD-On-med and PD-Off-med as compared to controls. GSSG levels were significantly higher in both medication conditions at rest and peak exercise compared to controls. When comparing PD-On-med vs. PD-Off-med at rest and peak exercise, the PD-On-med had lower GSH levels, a lower GSH:GSSG ratio and higher GSSG levels. VO(2) correlated positively with GSH levels. Subjects with PD have lower plasma GSH levels than healthy controls at rest and at peak exercise.

Norepinephrine and cardiovascular responses to maximal exercise in Parkinson's disease on and off medication.

The aim of this experiment is to understand how Parkinson's disease (PD) medication affects the autonomic responses of individuals during an acute exercise stress test. Fourteen people with PD and fifteen healthy individuals age-matched between 50 and 80 years performed a modified Bruce protocol. Subjects with PD performed the test once off medication (PD-off) and then 1 week later on medication (PD-on). Heart rate (HR), blood pressure (BP), VO(2), and norepinephrine (NE) levels were taken at rest and at peak exercise. At peak exercise HR, BP, and NE values for the PD-on and PD-off group were all significantly lower than healthy controls, regardless of whether subjects were on their medication. Autonomic abnormalities during exercise in this population appear to be disease manifested and not impacted by medications used to treat PD. We can assume, both on and off medication, this population will show markedly lower BP, HR, and NE responses.

Cardiovascular response to treadmill testing in Parkinson disease.

PURPOSE: Exercise has been recommended as a way to maintain quality of life in individuals with Parkinson disease (PD). Experiments examining the cardiovascular response to exercise, however, have yielded controversial results. This study was designed to determine if there is any difference in vital signs and Rate of Perceived Exertion (RPE) between a group of individuals (50-80 years old) with PD and a comparison group of healthy individuals during exercise on a treadmill. METHODS: Twenty seven volunteers (16 with PD and 11 healthy) participated in this study. Subjects with PD were divided into 2 groups; one that reached target heart rate and one that failed to reach it. In this study, heart rate (HR), systolic blood pressure (BP), and the RPE were measured during a Modified Bruce Protocol. We hypothesized that treadmill testing would result in differences between individuals with PD and healthy subjects when HR and systolic BP were compared at submaximal exercise (defined as Stage 2 of the Modified Bruce Protocol) and at peak exercise (defined as 85% of age predicted target heart rate). RESULTS: During submaximal exercise, no significant differences were found between the PD group and the control group for HR, BP, or RPE. At peak exercise, one half of the subjects with PD exhibited blunted cardiovascular responses, despite reaching a comparable intensity of exercise during a Modified Bruce Protocol. CONCLUSIONS: Although cardiovascular responses to exercise on a treadmill appear similar between individuals with PD and controls at lower levels of exercise, half the subjects with PD in the present study displayed abnormal cardiovascular responses at higher exercise intensities. Administering an exercise stress test will illustrate the expected cardiovascular responses for each individual, therefore guiding exercise prescription.