Upper-body isometric horizontal strength in game sport athletes.

Imagine blocking the opposing defense linemen in American football to protect your quarterback or creating gaps in the opponents' defense by setting blocks as a pivot player in handball. Such movements require a pushing action away from the body with the arms and stabilizing the whole body in different postural positions. Upper-body strength obviously plays an important role during American football and handball as well as in other game sports with opponent contact such as basketball. Yet, the availability of appropriate tests to measure upper-body strength serving sport-specific requirements seems limited. Therefore, a whole-body setup to measure isometric horizontal strength in game sport athletes was developed. The purpose of the study was to verify validity and reliability of this setup and present empirical data from game sport athletes. In 119 athletes, isometric horizontal strength was measured in three game-like standing positions (upright, slightly leaning forward and clearly leaning forward), each in three weight-shift conditions (80% of body weight on the left leg, 50/50% on both legs, 80% on the right leg). Also, handgrip strength on both sides was measured in all athletes using a dynamometer. Linear regression indicated that handgrip strength is a significant predictor of upper-body horizontal strength in female (ß = 0.70, p = 0.043) but not in male athletes (ß = 0.31, p = 0.117). As an expertise-related factor, linear regression indicated that the number of years played at the top level is a predictor of the upper-body horizontal relative strength measure (ß = 0.05, p = 0.03). Reliability analyses showed high levels of within-test reliability (ICC > 0.90) as well as test-retest reliability between two separate measurements (r > 0.77). The results indicate that the setup used in this study could be a valid tool for measuring performance-relevant upper-body horizontal strength in different game-like positions in professional game sport athletes.

Stop it! Relationship between sport expertise and response inhibition in elite athletes.

Introduction: The dynamic structure of sport games forces players to make time-sensitive decisions and to initiate actions that may then have to be canceled in response to sudden changes in the game situation. Whether and up to which time already initiated movements can still be inhibited is an important criterion for game performance in elite sport. Research indicates that elite athletes show superior motor inhibition performance compared to recreational athletes. However, no study has examined whether differences also emerge among professional elite athletes themselves. Therefore, this study aimed to investigate whether motor inhibition performance is a differential feature among elite athletes, and whether inhibition performance increases with greater expertise. Methods: In total of 106 elite athletes (ice hockey, basketball, volleyball, American football, handball, and soccer) completed a PC-based procedure to determine motor inhibition performance using the stop-signal reaction time (SSRT) task for hands and feet. In addition, an expertise score was determined for each elite athlete. Multiple linear regression was used to calculate the relationship between expertise and SSRT. Results: Results showed that the expertise score of the elite athletes was between 3.7 and 11.7 out of 16 possible points (MExpertise = 6.8 points, SD = 1.76). The average SSRT of the hands was 224.0 ms (SD = 35.0); of the feet, 257.9 ms (SD = 48.5). Regression results showed a significant relationship between expertise and SSRT (F(2,101) = 9.38, p = 0.04, R2 = 0.06). SSRTs of the hands were significant predictors of expertise (b = -0.23, t = -2.1, p = 0.04). Discussion: Taken together, results suggest that elite athletes with higher expertise outperform elite athletes with lower expertise, indicating that it is possible to differentiate within elite athletes with respect to inhibition performance of the hands. However, whether expertise affects inhibition performance or vice versa cannot be answered at present.

Clinical determinants of hospital mortality in liver failure: a comprehensive analysis of 62,717 patients.

BACKGROUND: Liver failure (LF) is characterised by a loss of the synthetic and metabolic liver function and is associated with a high mortality. Large-scale data on recent developments and hospital mortality of LF in Germany are missing. A systematic analysis and careful interpretation of these datasets could help to optimise outcomes of LF. METHODS: We used standardised hospital discharge data of the Federal Statistical Office to evaluate current trends, hospital mortality and factors associated with an unfavourable course of LF in Germany between 2010 and 2019. RESULTS: A total of 62,717 hospitalised LF cases were identified. Annual LF frequency decreased from 6716 (2010) to 5855 (2019) cases and was higher among males (60.51%). Hospital mortality was 38.08% and significantly declined over the observation period. Mortality significantly correlated with patients' age and was highest among individuals with (sub)acute LF (47.5%). Multivariate regression analyses revealed pulmonary (ORARDS: 2.76, ORmechanical ventilation: 6.46) and renal complications (ORacute kidney failure: 2.04, ORhepatorenal syndrome: 2.92) and sepsis (OR: 1.92) as factors for increased mortality. Liver transplantation reduced mortality in patients with (sub)acute LF. Hospital mortality significantly decreased with the annual LF case volume and ranged from 47.46% to 29.87% in low- or high-case-volume hospitals, respectively. CONCLUSIONS: Although incidence rates and hospital mortality of LF in Germany have constantly decreased, hospital mortality has remained at a very high level. We identified a number of variables associated with increased mortality that could help to improve framework conditions for the treatment of LF in the future.

Effects of motor imagery training on skeletal muscle contractile properties in sports science students.

Background: Studies on motor imagery (MI) practice based on different designs and training protocols have reported changes in maximal voluntary contraction (MVC) strength. However, to date, there is a lack of information on the effects of MI training on contractile properties of the trained muscle. Methods: Forty-five physically active sport science students (21 female) were investigated who trained three times per week over a 4-week period in one of three groups: An MI group conducted MI practice of maximal isometric contraction of the biceps brachii; a physical exercise (PE) group physically practiced maximal isometric contractions of the biceps brachii in a biceps curling machine; and a visual imagery (VI) group performed VI training of a landscape. A MVC test of the arm flexors was performed in a biceps curling machine before and after 4 weeks of training. The muscular properties of the biceps brachii were also tested with tensiomyography measurements (TMG). Results: Results showed an interaction effect between time and group for MVC (p = 0.027, η 2 = 0.17), with a higher MVC value in the PE group (Δ5.9%) compared to the VI group (Δ -1.3%) (p = 0.013). MVC did not change significantly in the MI group (Δ2.1%). Analysis of muscle contractility via TMG did not show any interaction effects neither for maximal radial displacement (p = 0.394, η 2 = 0.05), delay time (p = 0.79, η 2 = 0.01) nor contraction velocity (p = 0.71, η 2 = 0.02). Conclusion: In spite of MVC-related changes in the PE group due to the interventions, TMG measurements were not sensitive enough to detect concomitant neuronal changes related to contractile properties.

Acute effects of real and imagined endurance exercise on sustained attention performance.

This study investigated acute effects of real and imagined endurance exercise on sustained attention performance in healthy young adults in order to shed light on the action mechanisms underlying changes in cognitive functioning. The neural similarities between both imagined and physically performed movements reveal that imagery induces transient hypofrontality, whereas real exercise reflects both transient hypofrontality effects and the global release of signaling factors (e.g., BDNF or serotonin) due to muscle contraction and the accompanying sensory feedback. We hypothesized improved cognitive functioning after both interventions (imagery and physical endurance exercise) with greater improvements for real exercise because it targets both mechanisms. Fifty-three sport science students completed two 25-min sessions of moderate endurance exercise in either a motor imagery modality or an executed bodily activity within the framework of an order-balanced crossover study. Assessments for sustained attention performance (d2-R) were performed before and after each endurance exercise condition. Statistical results showed improvements for both groups over time, which can mostly be explained by retest effects. However, we observed a significant interaction effect between group and time, F(1.6, 81.9) = 3.64, p = 0.04, η 2 = 0.07, with higher increases in the first session in case physical endurance exercise was performed compared to motor imagery exercise, t(51) = -2.71, p = 0.09, d = 0.75. This might suggest that the release of signaling factors due to muscle contractions with sensory feedback processing is an additional mediating mechanism alongside motor-related transient hypofrontality that improves cognitive performance.

Motor imagery and the muscle system.

Many studies have investigated the activation of cortical areas and corticospinal excitability during motor imagery (MI) in relation to motor execution. Similar activation of cortical areas during imagined and executed bodily movements and increased corticospinal excitability while imagining movements has been demonstrated. Despite these similarities on the central nervous system level, there is no overt movement during MI. This suggests that centrally generated signals must be inhibited at some level. Second, even in the absence of movement, some studies find behavioral effects of MI interventions. Most of the studies have investigated the role of MI on the cortical or spinal level, but less is known about the peripheral level, such as the muscle system. Testing muscular excitability during MI will give further hints whether and how low-threshold motor commands during MI reach the muscular system. Furthermore, the extent of the shown effects during imagery depends considerably on type of imagery, available proprioceptive information, and imagery ability. Therefore, this study investigates muscular excitability of the biceps brachii muscle manipulating imagery mode (MI vs. visual imagery) and proprioceptive information (with or without muscle effort). 40 participants were included in the analysis. The mechanical response of the muscle after a single electrical stimulus was assessed via tensiomyography. The corresponding variables maximal displacement, delay time, and contraction velocity were used to calculate 2 × 2 ANOVAs with repeated measurements. The absence of interaction effects shows that possible imagery effects on the muscle system are not increased by effort. MI altered time to contraction with lower delay time compared to control condition. Velocity and maximal displacement of the muscle belly during contraction did not differ between imagery conditions. This indicates that MI might impact on the initiation of muscle contraction but does not change the contraction itself. Thus, neuronal factors are moving further into focus in the context of MI research.