1. Neuromuscular assessment of force development, postural, and gait performance under cognitive-motor dual-tasking in healthy older adults and early Parkinson's disease patients : study protocol for a cross-sectional Mobile Brain/Body Imaging (MoBI) studyUroš Marušič, Manca Peskar, Maja Maša Šömen, Miloš Kalc, Aleš Holobar, Klaus Gramann, Bettina Wollesen, Anna Wunderlich, Christoph M. Michel, Aleksandar Miladinović, Mauro Catalan, Alex B. Stella, Miloš Ajčević, Paolo Manganotti, 2023, izvirni znanstveni članek Povzetek: Background: Neuromuscular dysfunction is common in older adults and more pronounced in neurodegenerative diseases. In Parkinson's disease (PD), a complex set of factors often prevents the effective performance of activities of daily living that require intact and simultaneous performance of the motor and cognitive tasks. Methods: The cross-sectional study includes a multifactorial mixed-measure design. Between-subject factor grouping the sample will be Parkinson’s Disease (early PD vs. healthy). The within-subject factors will be the task complexity (single- vs. dual-task) in each motor activity, i.e., overground walking, semi-tandem stance, and isometric knee extension, and a walking condition (wide vs. narrow lane) will be implemented for the overground walking activity only. To study dual-task (DT) effects, in each motor activity participants will be given a secondary cognitive task, i.e., a visual discrimination task for the overground walking, an attention task for the semi-tandem, and mental arithmetic for the isometric extension. Analyses of DT effects and underlying neuronal correlates will focus on both gait and cognitive performance where applicable. Based on an a priori sample size calculation, a total N = 42 older adults (55-75 years) will be recruited. Disease-specific changes such as laterality in motor unit behavior and cortical control of movement will be studied with high-density surface electromyography and electroencephalography during static and dynamic motor activities, together with whole-body kinematics. Discussion: This study will be one of the first to holistically address early PD neurophysiological and neuromuscular patterns in an ecologically valid environment under cognitive-motor DT conditions of different complexities. The outcomes of the study aim to identify the biomarker for early PD either at the electrophysiological, muscular or kinematic level or in the communication between these systems. Ključne besede: Parkinson's disease, mobile brain imaging, body brain imaging, MoBi, dual tasking, neuromuscular function, older adults Objavljeno v DiRROS: 15.09.2023; Ogledov: 65; Prenosov: 23
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2. Environmental enrichment through virtual reality as multisensory stimulation to mitigate the negative effects of prolonged bed restLuka Šlosar, Manca Peskar, Rado Pišot, Uroš Marušič, 2023, pregledni znanstveni članek Povzetek: Prolonged bed rest causes a multitude of deleterious physiological changes in the human body that require interventions even during immobilization to prevent or minimize these negative effects. In addition to other interventions such as physical and nutritional therapy, non-physical interventions such as cognitive training, motor imagery, and action observation have demonstrated efficacy in mitigating or improving not only cognitive but also motor outcomes in bedridden patients. Recent technological advances have opened new opportunities to implement such non-physical interventions in semi- or fully-immersive environments to enable the development of bed rest countermeasures. Extended Reality (XR), which covers augmented reality (AR), mixed reality (MR), and virtual reality (VR), can enhance the training process by further engaging the kinesthetic, visual, and auditory senses. XR-based enriched environments offer a promising research avenue to investigate the effects of multisensory stimulation on motor rehabilitation and to counteract dysfunctional brain mechanisms that occur during prolonged bed rest. This review discussed the use of enriched environment applications in bedridden patients as a promising tool to improve patient rehabilitation outcomes and suggested their integration into existing treatment protocols to improve patient care. Finally, the neurobiological mechanisms associated with the positive cognitive and motor effects of an enriched environment are highlighted. Ključne besede: physical inactivity, bed rest, nonphysical interventions, virtual reality Objavljeno v DiRROS: 11.09.2023; Ogledov: 106; Prenosov: 29
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3. Effects of digital-based interventions on muscular strength in adults : a systematic review, meta-analysis and meta-regression of randomized controlled trials with quality of evidence assessmentArmin Paravlić, Luka Šlosar, Ensar Abazović, Uroš Marušič, 2023, pregledni znanstveni članek Povzetek: Background: In the last three decades, both medical and sports science professionals have recognized the considerable potential of digital-based interventions (DBI) to enhance the health-related outcomes of their practitioners.Objectives: This study aimed to investigate the effectiveness and potential moderators of DBI on measures of muscular strength.Methods: Six databases (PubMed/MEDLINE, Web of Science, SportDiscus, Embase, Cochrane Register of Controlled Trials and Google Scholar) were searched for eligible studies up to June 2022. The GRADE, PEDRO, and TIDieR checklists were used to assess the quality of evidence, methodology, and completeness of intervention descriptions, respectively.Results: A total of 56 studies were included in the meta-analysis (n = 2346), and participants were classified as healthy (n = 918), stroke survivors (n = 572), diagnosed with other neurological disorders (n = 683), and frail (n = 173). The DBI showed a small effect (standardized mean difference [SMD] = 0.28, 95% CI 0.21 to 0.31; p < 0.001) on strength, regardless of the type of intervention, control group, or tested body part. More specifically, while splitting the studies into different subgroups, a meta-analysis of 19 studies (n = 918) showed a small effect (SMD = 0.38, 95% CI 0.12 to 0.63; p = 0.003) on strength in the asymptomatic population. Similarly, small but positive effects of DBI were observed for stroke survivors (SMD = 0.34, 95% CI 0.13 to 0.56; p = 0.002), patients diagnosed with other neurological disorders (SMD = 0.17, 95% CI 0.03 to 0.32; p = 0.021), and the frail population (SMD = 0.25, 95% CI 0.0 to 0.5; p = 0.051). Sub-group analysis and meta-regression revealed that neither variable modified the effects of the DBI on measures of strength.Conclusions: Overall, DBI may serve as an effective method to improve measures of strength in adults, regardless of their health status as well as the type of digital device, the presence of human-computer interaction, and the age of participants. In addition, the DBI was found to be more effective than traditional training or rehabilitation methods. Ključne besede: cognitive training, physical function, strength, neurodegenerative disorders, older adults Objavljeno v DiRROS: 07.08.2023; Ogledov: 105; Prenosov: 39
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4. Functional characteristics and subjective disease perception in patients with COVID-19 two months after hospital dischargeKaja Teraž, Boštjan Šimunič, Manca Peskar, Uroš Marušič, Saša Pišot, Luka Šlosar, Mladen Gasparini, Rado Pišot, 2023, izvirni znanstveni članek Povzetek: Introduction: Although early inpatient and post-hospital rehabilitation is recognized as necessary, not all COVID-19 patients have access to rehabilitation. There are no published reports in the literature that investigate the outcomes of patients who do not receive rehabilitation after COVID-19. Our aim was to evaluate possible improvements in determinate functional and psychological parameters in COVID19 patients two months after their hospital discharge. Methods: On both time points various motor, cognitive, and clinical measurements such as body composition, tensiomyography, blood pressure, spirometry, grip strength test, Timed Up and Go test, gait speed, 30-second chair-stand test, and Montreal Cognitive Assessment, were performed. Additionally, questionnaires such as the SARC-CalF test, Edmonton frail scale, International Physical Activity questionnaire andThe Mediterranean Lifestyle index were conducted to assess lifestyle characteristics. Results: A total of 39 patients (87.2% male; mean age of 59.1 ± 10.3 years), who were hospitalized due to COVID-19 at the Izola General Hospital (IGH), Slovenia between December 2020 and April 2021, were included. Patients were assessed at two time points (T1 and T2): T1 was taken after receiving a negative COVID-19 test and T2 was taken two months after T1. After two months of self-rehabilitation, we have detected a BMI increase (p < .001), fat free mass increase (p < .001), better Edmonton frail scale (p < .001), SARC-CalF score (p = .014) and MoCA score (p = .014). There were no detected changes in lifestyle habits nor in physical performance tests. Discussion: It is already known that COVID-19 has long-term negative consequences regardless of the stage of the disease. Our findings support the notion that patients cannot fully regain all their functions within a two-month period without receiving structured or supervised rehabilitation. Therefore, it is crucial to offer patients comprehensive and structured rehabilitation that incorporates clinical, cognitive, and motor exercises. Ključne besede: pandemics, coronavirus, functional improvement, hospital stay, health perception Objavljeno v DiRROS: 26.07.2023; Ogledov: 125; Prenosov: 56
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5. Moral disengagement in youth athletes : a narrative reviewAmbra Gentile, Ivana Milovanović, Saša Pišot, Antonino Bianco, Gioacchino Lavanco, 2022, pregledni znanstveni članek Povzetek: The sports environment can be considered as a context characterized by interactions typical of social groups, where children have the chance to learn good values. Positive and negative behaviours in sports, also called prosocial and antisocial behaviours, have been studied according to a moral perspective, as has doping behaviour, taking into consideration the concept of moral disengagement. Moral disengagement in children has been associated with maladaptive behaviours later in life, even though it should disappear with growth. Concerning the sports environment, previous reviews on the topic have extensively illustrated the role of moral variables in sport and their relation to antisocial behaviour and doping, positing some research questions that should be investigated in the future. Starting from these questions, the current narrative review aims to update literature about the effects of moral disengagement on youth athletes. Therefore, new studies about the predictors of moral disengagement are introduced, followed by contributions concerning the relationship between moral disengagement and doping and between moral disengagement and antisocial behaviour. Finally, the review summarizes which research questions have been solved in the last decade and which should be researched further on. Ključne besede: sport, physical activity, athletes, moral disengagement, aggression, cheating, moral development, children, adolescence Objavljeno v DiRROS: 18.07.2023; Ogledov: 97; Prenosov: 50
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6. Pathophysiological mechanisms of reduced physical activity : insights from the human step reduction model and animal analoguesFabio Sarto, Roberto Bottinelli, Martino V. Franchi, Simone Porcelli, Boštjan Šimunič, Rado Pišot, Marco Vicenzo Narici, 2023, pregledni znanstveni članek Povzetek: Physical inactivity represents a heavy burden for modern societies and is spreading worldwide, it is a recognised pandemic and is the fourth cause of global mortality. Not surprisingly, there is an increasing interest in longitudinal studies on the impact of reduced physical activity on different physiological systems. This narrative review focuses on the pathophysiological mechanisms of step reduction (SR), an experimental paradigm that involves a sudden decrease in participants’ habitual daily steps to a lower level, mimicking the effects of a sedentary lifestyle. Analogous animal models of reduced physical activity, namely the “wheel-lock” and the “cage reduction” models, which can provide the foundation for human studies, are also discussed. The empirical evidence obtained thus far shows that even brief periods of reduced physical activity can lead to substantial alterations in skeletal muscle health and metabolic function. In particular, decrements in lean/muscle mass, muscle function, muscle protein synthesis, cardiorespiratory fitness, endothelial function and insulin sensitivity, together with an increased fat mass and inflammation, have been observed. Exercise interventions seem particularly effective for counteracting these pathophysiological alterations induced by periods of reduced physical activity. A direct comparison of SR with other human models of unloading, such as bed rest and lower limb suspension/immobilisation, is presented. In addition, we propose a conceptual framework aiming to unravel the mechanisms of muscle atrophy and insulin resistance in the specific context of reduced ambulatory activity. Finally, methodological considerations, knowledge gaps and future directions for both animal and human models are also discussed in the review. Ključne besede: physical inactivity, cage reduction, insulin sensitivity, muscle atrophy Objavljeno v DiRROS: 29.06.2023; Ogledov: 113; Prenosov: 56
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7. Unleashing the potential of dance : a neuroplasticity-based approach bridging from older adults to Parkinson’s disease patientsCécil J. W. Meulenberg, Kathrin Rehfeld, Saša Jovanović, Uroš Marušič, 2023, pregledni znanstveni članek Povzetek: Parkinson’s disease (PD) is a neurodegenerative disorder that affects >1% of individuals worldwide and is manifested by motor symptoms such as tremor, rigidity, and bradykinesia, as well as non-motor symptoms such as cognitive impairment and depression. Non-pharmacological interventions such as dance therapy are becoming increasingly popular as complementary therapies for PD, in addition to pharmacological treatments that are currently widely available. Dance as a sensorimotor activity stimulates multiple layers of the neural system, including those involved in motor planning and execution, sensory integration, and cognitive processing. Dance interventions in healthy older people have been associated with increased activation of the prefrontal cortex, as well as enhanced functional connectivity between the basal ganglia, cerebellum, and prefrontal cortex. Overall, the evidence suggests that dance interventions can induce neuroplastic changes in healthy older participants, leading to improvements in both motor and cognitive functions. Dance interventions involving patients with PD show better quality of life and improved mobility, whereas the literature on dance-induced neuroplasticity in PD is sparse. Nevertheless, this review argues that similar neuroplastic mechanisms may be at work in patients with PD, provides insight into the potential mechanisms underlying dance efficacy, and highlights the potential of dance therapy as a non-pharmacological intervention in PD. Further research is warranted to determine the optimal dance style, intensity, and duration for maximum therapeutic benefit and to determine the long-term effects of dance intervention on PD progression. Ključne besede: dance, neurodegeneration, tremor, rhythm, sensorimotor integration Objavljeno v DiRROS: 29.06.2023; Ogledov: 116; Prenosov: 51
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8. The use of tensiomyography in older adults : a systematic reviewKatarina Puš, Armin Paravlić, Boštjan Šimunič, 2023, pregledni znanstveni članek Povzetek: Introduction: Aging of skeletal muscles results in a cascade of events negatively affecting muscle mass, strength, and function, leading to reduced mobility, increased risk of falls, disability, and loss of independence. To date, different methods are used to assess muscle mechanical function, tensiomyography (TMG) being one of them. The aim of this review was twofold: to summarize the evidence-based usefulness of tensiomyography in older adults and to establish reference values for the main tensiomyography parameters in older adults. Methods: The PubMed, Web of Science, SPORTDiscus, and tensiomyography databases were searched from inception until 25 December 2022. Studies investigating older adults (aged 60+ years) that reported tensiomyographyderived parameters such as contraction time (Tc) and/or maximal displacement (Dm) were included. Methodological quality was assessed using the Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies. Results: In total, eight studies satisfied the inclusion criteria. Tensiomyography has been used on different groups of older adults, including asymptomatic, master athletes, patients with peripheral arterial disease, and patients with end-stage knee osteoarthritis with a mean age of 71.5 ± 5.38 (55.7% male subjects). The most evaluated were leg muscles such as vastus lateralis (VL), gastrocnemius medialis (GM), and biceps femoris (BF). The present review demonstrates that tensiomyography is used to assess neuromuscular function in asymptomatic and diseased older adults. When compared to asymptomatic individuals, power master athletes, knee osteoarthritis patients, and patients diagnosed with peripheral arterial disease have the shortest Tc in BF, VL, and GM muscles, respectively. On the other hand, endurance master athletes showed the longest Tc in all three evaluated muscles. Less mobile, nursing-home residents showed higher Dm in VL and BF, while lower Dm in GM than the asymptomatic group. The knee osteoarthritis group showed the largest Dm in BF and VL while having the smallest Dm in GM. Conclusion: Tensiomyography can serve as a valuable tool for assessing neuromuscular function in older adults. The method is sensitive to muscle composition, architecture, and (pre) atrophic changes of the skeletal muscles and might be responsive to muscle quality changes in aging and diseased populations. Ključne besede: sport, muscle function, elderly, neuromuscular function, normative values, TMG Objavljeno v DiRROS: 27.06.2023; Ogledov: 103; Prenosov: 57
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9. Diagnostic accuracy of tensiomyography parameters for monitoring peripheral neuromuscular fatigueMiloš Kalc, Katarina Puš, Armin Paravlić, Jure Urbanc, Boštjan Šimunič, 2023, izvirni znanstveni članek Povzetek: The diagnostic accuracy of tensiomyography (TMG) parameters compared to the gold standard in neuromuscular fatigue evaluation using voluntary and electrically induced muscle activation is unclear. This study aimed to investigate the diagnostic accuracy of TMG parameters to detect individual changes after interventions that were designed to induce central or peripheral fatigue. Nineteen males (age: 32.2 ± 9.3 years) performed two interventions, consisting of maintaining 25% of maximal voluntary contraction (MViC25%) and a 30 s all-out cycling test (Wingate), respectively. TMG parameters, maximum voluntary contraction (PtMViC), voluntary activation (VA%) and electrically elicited double twitches (Dtw) were assessed on the knee extensors before (PRE), one minute (POST) and seven minutes after (POST7) the intervention. The diagnostic accuracy (AUC) of TMG parameters were evaluated in comparison to two criteria measures (PtMViC and Dtw). RM ANOVA revealed a significant interaction between the effects of intervention and time on VA% (p = 0.001) and Dtw (p < 0.001) but not for PtMViC (p = 0.420). AUC showed that TMG parameters had a good ability in detecting muscular fatigue assessed by Dtw but not by PtMViC. The results of the current study suggest that TMG parameters can be used to monitor peripheral neuromuscular fatigue. Ključne besede: tensiomyography, vastus lateralis, MVC, twitch Objavljeno v DiRROS: 13.06.2023; Ogledov: 132; Prenosov: 53
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10. Effects of COVID-19 on cognition and mood after hospitalization and at 2-month follow-upManca Peskar, Boštjan Šimunič, Luka Šlosar, Saša Pišot, Kaja Teraž, Mladen Gasparini, Rado Pišot, Uroš Marušič, 2023, izvirni znanstveni članek Povzetek: A plethora of evidence links SARS-CoV-2 infection with concomitant cognitive dysfunction, which often persists weeks to months after the acute stages of illness and affects executive function, attention, memory, orientation, and movement control. It remains largely unclear which conditions or factors exacerbate the recovery. In a cohort of N=37 Slovenian patients (5 females, aged M = 58, SD = 10.7 years) that were hospitalized because of COVID-19, the cognitive function and mood states were assessed immediately after discharge and 2-months later to investigate the early post-COVID recovery changes. We assessed the global Montreal Cognitive Assessment (MoCA), Simple and Choice Reaction Times, executive functions (Trail-Making Test – TMT-A and TMT-B), short-term memory (Auditory Verbal Learning Test – AVLT), and visuospatial memory. We monitored depressive and anxiety symptoms and applied general self-efficacy and cognitive complaints questionnaires. Our results showed a global cognitive impairment (MoCA, Z = 332.5; p = 0.012), poorer performance on executive functions (TMT-A, Z = 188; p = 0.014; and TMT-B, Z = 185; p = 0.012), verbal memory (AVLT, F = 33.4; p < 0.001), and delayed recall (AVLT7, F = 17.1; p < 0.001), and higher depressive (Z = 145; p = 0.015) and anxiety (Z = 141; p = 0.003) symptoms after hospital discharge compared to 2-month follow-up, indicating that SARS-CoV-2 may transiently impair cognitive function and adversely affect the mood. No improvement in MoCA was observed in 40.5% of the patients at follow-up, indicating possible long-term effects of COVID-19 on global cognitive performance. Medical comorbidities (p = 0.035) significantly predicted the change in MoCA score over time, while fat mass (FM, p = 0.518), Mediterranean diet index (p = .0.944), and Florida Cognitive Activities Score (p = 0.927) did not. These results suggest that the patients’ medical comorbidities at the time of SARS-CoV-2 infection could importantly contribute to the acute impairment of cognitive function and stress the importance of systemic implementation of countermeasures to limit the negative consequences on public health. Ključne besede: Coronavirus, recovery, acute respiratory sindrom, cognitive functions, cognitive impairment, MOCA, trail-making test Objavljeno v DiRROS: 01.06.2023; Ogledov: 169; Prenosov: 56
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