Development and reliability of a test for assessing executive functions during exercise

Previous research suggests that performance on executive functions tests may be different at rest, versus when one is engaged in physical exercise. Therefore, the present study aimed to develop an integrated system that evaluates executive functions during exercise. We conducted two test-retest studies, with ten healthy male volunteers participating in each study. Participants visited the laboratory three (Study 1) or four (Study 2) times. During the first visit in both studies, questionnaires were administered, and a maximal cardiopulmonary exercise test (CPT) was performed. In Study 1, during the second and third visits, participants exercised on a cycle ergometer at a moderate intensity for 30 minutes before starting the Flanker/Reverse Flanker test while they were still cycling. In Study 2, during the second visit, participants performed three sets of the executive functions test while sitting on the bike, with a 5 min interval between each set. On visits 3 and 4, participants performed the same exercise protocol as the one described in Study 1. In summary, our results indicated that the Flanker/Reverse Flanker test that we developed and conducted in exercising individuals has similar elements to previous versions and can be considered a reliable test for executive functions assessment during exercise.

Revised Approach to the Role of Fatigue in Anterior Cruciate Ligament Injury Prevention: A Systematic Review with Meta-Analyses

BACKGROUND

Causes of anterior cruciate ligament (ACL) injuries are multifactorial. Anterior cruciate ligament injury prevention should thus be approached from a multifactorial perspective as well. Training to resist fatigue is an underestimated aspect of prevention programs given that the presence of fatigue may play a crucial role in sustaining an ACL injury.

OBJECTIVES

The primary objective of this literature review was to summarize research findings relating to the kinematic and kinetic effects of fatigue on single-leg landing tasks through a systematic review and meta-analysis. Other objectives were to critically appraise current approaches to examine the effects of fatigue together with elucidating and proposing an optimized approach for measuring the role of fatigue in ACL injury prevention.

METHODS

A systematic literature search was conducted in the databases PubMed (1978-November 2017), CINAHL (1992-November 2017), and EMBASE (1973-November 2017). The inclusion criteria were: (1) full text, (2) published in English, German, or Dutch, (3) healthy subjects, (4) average age ≥ 18 years, (5) single-leg jump landing task, (6) evaluation of the kinematics and/or kinetics of the lower extremities before and after a fatigue protocol, and (7) presentation of numerical kinematic and/or kinetic data. Participants included healthy subjects who underwent a fatigue protocol and in whom the effects of pre- and post-fatigue on three-dimensional lower extremity kinematic and kinetics were compared. Methods of data collection, patient selection, blinding, prevention of verification bias, and study design were independently assessed.

RESULTS

Twenty studies were included, in which four types of single-leg tasks were examined: the single-leg drop vertical jump, the single-leg drop landing, the single-leg hop for distance, and sidestep cutting. Fatigue seemed to mostly affect initial contact (decreased angles post-fatigue) and peak (increased angles post-fatigue) hip and knee flexion. Sagittal plane variables at initial contact were mostly affected under the single-leg hop for distance and sidestep cutting conditions whilst peak angles were affected during the single-leg drop jump.

CONCLUSIONS

Training to resist fatigue is an underestimated aspect of prevention programs given that the presence of fatigue may play a crucial role in sustaining an ACL injury. Considering the small number of variables affected after fatigue, the question arises whether the same fatigue pathways are affected by the fatigue protocols used in the included laboratory studies as are experienced on the sports field.