@article{ChtourouEngelFakhfakhetal.2018, author = {Chtourou, Hamdi and Engel, Florian Azad and Fakhfakh, Hassen and Fakhfakh, Hazem and Hammouda, Omar and Ammar, Achraf and Trabelsi, Khaled and Souissi, Nizar and Sperlich, Billy}, title = {Diurnal Variation of Short-Term Repetitive Maximal Performance and Psychological Variables in Elite Judo Athletes}, series = {Frontiers in Physiology}, volume = {9}, journal = {Frontiers in Physiology}, issn = {1664-042X}, doi = {10.3389/fphys.2018.01499}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-189269}, pages = {1409}, year = {2018}, abstract = {Objectives: The aim of this study was to examine the effect of time of day on short-term repetitive maximal performance and psychological variables in elite judo athletes. Methods: Fourteen Tunisian elite male judokas (age: 21 ± 1 years, height:172 ± 7 cm, body-mass: 70.0 ± 8.1 kg) performed a repeated shuttle sprint and jump ability (RSSJA) test (6 m × 2 m × 12.5 m every 25-s incorporating one countermovement jump (CMJ) between sprints) in the morning (7:00 a.m.) and afternoon (5:00 p.m.). Psychological variables (Profile of mood states (POMS-f) and Hooper questionnaires) were assessed before and ratings of perceived exertion (RPE) immediately after the RSSJA. Results: Sprint times (p > 0.05) of the six repetition, fatigue index of sprints (p > 0.05) as well as mean (p > 0.05) jump height and fatigue index (p > 0.05) of CMJ did not differ between morning and afternoon. No differences were observed between the two times-of-day for anxiety, anger, confusion, depression, fatigue, interpersonal relationship, sleep, and muscle soreness (p > 0.05). Jump height in CMJ 3 and 4 (p < 0.05) and RPE (p < 0.05) and vigor (p < 0.01) scores were higher in the afternoon compared to the morning. Stress was higher in the morning compared to the afternoon (p < 0.01). Conclusion: In contrast to previous research, repeated sprint running performance and mood states of the tested elite athletes showed no-strong dependency of time-of-day of testing. A possible explanation can be the habituation of the judo athletes to work out early in the morning.}, language = {en} } @article{FlacheneckerBuresGawliketal.2020, author = {Flachenecker, Peter and Bures, Anna Karoline and Gawlik, Angeli and Weiland, Ann-Christin and Kuld, Sarah and Gusowski, Klaus and Streber, Ren{\´e} and Pfeifer, Klaus and Tallner, Alexander}, title = {Efficacy of an internet-based program to promote physical activity and exercise after inpatient rehabilitation in persons with multiple sclerosis: a randomized, single-blind, controlled study}, series = {International Journal of Environmental Research and Public Health}, volume = {17}, journal = {International Journal of Environmental Research and Public Health}, number = {12}, issn = {1660-4601}, doi = {10.3390/ijerph17124544}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-207863}, year = {2020}, abstract = {Background: Multimodal rehabilitation improves fatigue and mobility in persons with multiple sclerosis (PwMS). Effects are transient and may be conserved by internet-based physical activity promotion programs. Objective: Evaluate the effects of internet-based physical activity and exercise promotion on fatigue, quality of life, and gait in PwMS after inpatient rehabilitation. Methods: PwMS (Expanded Disability Status Scale (EDSS) ≤ 6.0, fatigue: W{\"u}rzburg Fatigue Inventory for Multiple Sclerosis (WEIMuS) ≥ 32) were randomized into an intervention group (IG) or a control group (CG). After rehabilitation, IG received 3 months of internet-based physical activity promotion, while CG received no intervention. Primary outcome: self-reported fatigue (WEIMuS). Secondary outcomes: quality of life (Multiple Sclerosis Impact Scale 29, MSIS-29), gait (2min/10m walking test, Tinetti score). Measurements: beginning (T0) and end (T1) of inpatient rehabilitation, 3 (T2) and 6 (T3) months afterwards. Results: 64 of 84 PwMS were analyzed (IG: 34, CG: 30). After rehabilitation, fatigue decreased in both groups. At T2 and T3, fatigue increased again in CG but was improved in IG (p < 0.001). MSIS-29 improved in both groups at T1 but remained improved at T2 and T3 only in IG. Gait improvements were more pronounced in IG at T2. Conclusions: The study provides Class II evidence that the effects of rehabilitation on fatigue, quality of life, and gait can be maintained for 3-6 months with an internet-based physical activity and exercise promotion program.}, language = {en} } @article{HaussmannSchmidtIllmannetal.2022, author = {Haussmann, Alexander and Schmidt, Martina E. and Illmann, Mona L. and Schr{\"o}ter, Marleen and Hielscher, Thomas and Cramer, Holger and Maatouk, Imad and Horneber, Markus and Steindorf, Karen}, title = {Meta-analysis of randomized controlled trials on yoga, psychosocial, and mindfulness-based interventions for cancer-related fatigue: What intervention characteristics are related to higher efficacy?}, series = {Cancers}, volume = {14}, journal = {Cancers}, number = {8}, issn = {2072-6694}, doi = {10.3390/cancers14082016}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-270753}, year = {2022}, abstract = {Cancer-related fatigue (CRF) is a burdensome sequela of cancer treatments. Besides exercise, recommended therapies for CRF include yoga, psychosocial, and mindfulness-based interventions. However, interventions conducted vary widely, and not all show a significant effect. This meta-analysis aimed to explore intervention characteristics related to greater reductions in CRF. We included randomized controlled trials published before October 2021. Standardized mean differences were used to assess intervention efficacy for CRF and multimodel inference to explore intervention characteristics associated with higher efficacy. For the meta-analysis, we included 70 interventions (24 yoga interventions, 31 psychosocial interventions, and 15 mindfulness-based interventions) with 6387 participants. The results showed a significant effect of yoga, psychosocial, and mindfulness-based interventions on CRF but with high heterogeneity between studies. For yoga and mindfulness-based interventions, no particular intervention characteristic was identified to be advantageous for reducing CRF. Regarding psychosocial interventions, a group setting and work on cognition were related to higher intervention effects on CRF. The results of this meta-analysis suggest options to maximize the intervention effects of psychosocial interventions for CRF. The effects of yoga and mindfulness-based interventions for CRF appear to be independent of their design, although the limited number of studies points to the need for further research.}, language = {en} } @article{KunzZinnerHolmbergetal.2019, author = {Kunz, Philipp and Zinner, Christoph and Holmberg, Hans-Christer and Sperlich, Billy}, title = {Intra- and post-match time-course of indicators related to perceived and performance fatigability and recovery in elite youth soccer players}, series = {Frontiers in Physiology}, volume = {10}, journal = {Frontiers in Physiology}, number = {1383}, issn = {1664-042X}, doi = {10.3389/fphys.2019.01383}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-195657}, year = {2019}, abstract = {PurposeOur aims were to examine (i) the internal load during simulated soccer match-play by elite youth players; and (ii) the time-course of subsequent recovery from perceived and performance fatigability. MethodsEleven male youth players (16 ± 1 years, 178 ± 7 cm, 67 ± 7 kg) participated in a 2 × 40-min simulated soccer match, completing 30 rounds (160 s each) with every round including multidirectional and linear sprinting (LS20m), jumping (CMJ) and running at different intensities. During each round, LS20m, CMJ, agility, heart rate (HR), oxygen uptake (VO2), energy expenditure (EE), substrate utilization and perceived exertion RPE were assessed. In addition, the blood level of lactate (Lac) was obtained after each of the five rounds. Creatine kinase (CK) concentration, maximal voluntary isometric knee extension and flexion, CMJ, number of skippings in 30 s, and subjective ratings on the Acute Recovery and Stress Scale (ARSS) were examined before and immediately, 24 and 48 h after the simulation. Results: During the game \%HR\(_{peak}\) (p < 0.05, d = 1.08), \%VO2\(_{peak}\) (p < 0.05; d = 0.68), Lac (p < 0.05, d = 2.59), RPE\(_{total}\) (p < 0.05, d = 4.59), and RPE\(_{legs}\) (p < 0.05, d = 4.45) all increased with time during both halves (all p < 0.05). Agility improved (p < 0.05, d = 0.70) over the time-course of the game, with no changes in LS20m (p ≥ 0.05, d = 0.34) or CMJ (p ≥ 0.05, d = 0.27). EE was similar during both halves (528 ± 58 vs. 514 ± 61 kcal; p = 0.60; d = 0.23), with 62\% (second half: 65\%) carbohydrate, 9\% (9\%) protein and 26\% (27\%) fat utilization. With respect to recovery, maximal voluntary knee extension (p ≥ 0.05, d = 0.50) and flexion force (p ≥ 0.05, d = 0.19), CMJ (p ≥ 0.05, d = 0.13), number of ground contacts (p ≥ 0.05, d = 0.57) and average contact time (p ≥ 0.05, d = 0.39) during 30-s of skipping remained unaltered 24 and 48 h after the game. Most ARSS dimensions of load (p < 0.05, d = 3.79) and recovery (p < 0.05, d = 3.22) returned to baseline levels after 24 h of recovery. Relative to baseline values, CK was elevated immediately and 24 h after (p < 0.05, d = 2.03) and normalized 48 h later. ConclusionIn youth soccer players the simulated match evoked considerable circulatory, metabolic and perceptual load, with an EE of 1042 ± 118 kcal. Among the indicators of perceived and performance fatigability examined, the level of CK and certain subjective ratings differed considerably immediately following or 24-48 h after a 2 × 40-min simulated soccer match in comparison to baseline. Accordingly, monitoring these variables may assist coaches in assessing a U17 player's perceived and performance fatigability in connection with scheduling training following a soccer match.}, language = {en} } @article{NeubertSchlechtMengetal.2023, author = {Neubert, Sven and Schlecht, Sina and Meng, Karin and Rabe, Antonia and Jentschke, Elisabeth}, title = {Effects of a video sequence based intervention on anxiety, fatigue and depression in cancer patients: results of a randomized controlled trial}, series = {Integrative Cancer Therapies}, volume = {22}, journal = {Integrative Cancer Therapies}, issn = {1552-695X}, doi = {10.1177/15347354231153172}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-304581}, year = {2023}, abstract = {Background: Cancer patients often suffer from psychological symptoms and need psychological support. Especially during the COVID-19 pandemic, eHealth interventions might be helpful to overcome the obstacles of the pandemic. This study evaluates the effectiveness of a video sequence-based eHealth intervention on anxiety, fatigue, and depression in cancer patients. Methods: Patients (N = 157) with different tumor entities were randomly assigned to the video intervention group (IG) and the waiting control group (CG). Patients in the IG received a video intervention comprising 8 video sequences over 4 weeks. The videos included psychoeducation on distress and psychological symptoms, Acceptance and Commitment Therapy elements, and Yoga and Qigong exercises. Patients' anxiety and fear of progression (primary outcomes) and secondary outcomes were assessed before randomization (T1) and after the end of the intervention for IG or the waiting period for CG (T2) using self-reported questionnaires (GAD-7, PA-F-KF, EORTC QLQ-FA12, PHQ-8). Results: Patients of the IG showed no significant improvement in anxiety (GAD-7; P = .75), fear of progression (FoP-Q-SF; P = .29), fatigue (EORTC QLQ-FA12; P = .72), and depression (PHQ-8; P = .95) compared to patients in the waiting CG. However, symptoms of anxiety, fatigue, and depression decreased in both groups. Exploratory subgroup analysis regarding sex, therapy status, therapy goal, and tumor entity showed no effects. Overall, the intervention had a high level of acceptance. Conclusions: The video intervention was ineffective in reducing the psychological burden compared to a waiting CG. The findings support prior observations of the value of therapeutic guidance and promoting self-management for improving patients' psychological burdens. Further studies are required to evaluate the effectiveness of psycho-oncological eHealth delivered through video sequences.}, language = {en} } @article{ScharbatkeBehrensSchmalzingetal.2016, author = {Scharbatke, Eva C. and Behrens, Frank and Schmalzing, Marc and Koehm, Michaela and Greger, Gerd and Gnann, Holger and Burkhardt, Harald and Tony, Hans-Peter}, title = {Association of improvement in pain with therapeutic response as determined by individual improvement criteria in patients with rheumatoid arthritis}, series = {Arthritis Care \& Research}, volume = {68}, journal = {Arthritis Care \& Research}, number = {11}, doi = {10.1002/acr.22884}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-186817}, pages = {1607-1615}, year = {2016}, abstract = {Objective To use statistical methods to establish a threshold for individual response in patient-reported outcomes (PROs) in patients with rheumatoid arthritis. Methods We used an analysis of variance model in patients on stable therapy (discovery cohort) to establish critical differences (d(crit)) for the minimum change associated with a significant individual patient response (beyond normal variation) in the PRO measures of pain (0-10), fatigue (0-10), and function (Funktionsfragebogen Hannover questionnaire; 0-100). We then evaluated PRO responses in patients initiating adalimumab in a noninterventional study (treatment cohort). Results In the discovery cohort (n=700), PROs showed excellent long-term retest reliability. The minimum change that exceeded random fluctuation was conservatively determined to be 3 points for pain, 4 points for fatigue, and 16 points for function. In the treatment cohort (n=2,788), 1,483 patients (53.2\%) achieved a significant individual therapeutic response as assessed by Disease Activity Score in 28 joints (DAS28)-d(crit) (1.8 points) after 12 months of adalimumab treatment; 68.5\% of patients with a DAS28-d(crit) response achieved a significant improvement in pain, whereas approximately 40\% achieved significant improvements in fatigue or function. Significant improvements in all 3 PROs occurred in 22.7\% of patients; 22.8\% did not have any significant PRO responses. In contrast, significant improvements in all 3 PROs occurred in only 4.4\% of 1,305 patients who did not achieve a DAS28-d(crit) response at month 12, and 59.1\% did not achieve any significant PRO responses. Conclusion The establishment of critical differences in PROs distinguishes true responses from random variation and provides insights into appropriate patient management.}, language = {en} } @phdthesis{Zetzl2021, author = {Zetzl, Teresa Margarete}, title = {Cancer-related fatigue intervention}, doi = {10.25972/OPUS-25166}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-251662}, school = {Universit{\"a}t W{\"u}rzburg}, year = {2021}, abstract = {The incidence of cancer cases is rising steadily, while improved early detection and new cancer-specific therapies are reducing the mortality rate. In addition to curing cancer or prolonging life, increasing the quality of life is thus an important goal of oncology, which is why the burdens of cancer and treatment are becoming more important. A common side effect of cancer and its therapy is cancer-related fatigue, a tiredness that manifests itself on physical, emotional and cognitive levels and is not in proportion to previous physical efforts. Since the etiology of fatigue has not yet been fully clarified, symptom-oriented therapy is preferable to cause-specific therapy. In addition to activity management, sleep hygiene, and cognitive behavioral therapy, mind-body interventions such as yoga are recommended for reducing fatigue. Previous studies with small sample sizes were able to examine the efficacy of yoga regarding fatigue predominantly in patients with breast cancer. Long-term effects of yoga have rarely been studied and there have been no attempts to increase long-term effects through interventions such as reminder e-mails. This dissertation takes a closer look at these mentioned aspects of the study sample and long-term effects. An 8-week randomized controlled yoga intervention was conducted, including patients with different cancer types reporting mild to severe fatigue. Following the 8-week yoga therapy, a randomized group of participants received weekly reminder e-mails for 6 months for regular yoga practice, whereas the control group did not receive reminder e-mails. The first paper is a protocol article, which addresses the design and planned implementation of the research project this dissertation is based upon. This serves to ensure better replicability and comparability with other yoga studies. Due to a very low consent rate of patients in the pilot phase, it was necessary to deviate from the protocol article in the actual implementation and the planned inclusion criterion of fatigue >5 was reduced to fatigue >1. The second paper examines the efficacy of the eight-week yoga intervention. Patients in the intervention group who participated in the yoga classes seven times or more showed a significantly greater reduction in general and physical fatigue than those who participated less often. The efficacy of yoga was related to the number of attended yoga sessions. Women with breast cancer who participated in yoga reported greater reductions in fatigue than women with other cancer types. There was also an improvement for depression and quality of life after eight weeks of yoga therapy compared to no yoga therapy. These results imply that yoga is helpful in reducing depression and cancer-related fatigue, especially in terms of physical aspects and improving quality of life. The third paper focuses on the efficacy of reminder e-mails in terms of fatigue and practice frequency. Patients who received reminder e-mails reported greater reductions in general and emotional fatigue, as well as significant increases in practice frequency, compared to patients who did not receive reminder e-mails. Compared to fatigue scores before yoga, significantly lower fatigue and depression scores and higher quality of life were reported after yoga therapy and at follow-up six months later. Weekly e-mail reminders after yoga therapy may have positive effects on general and emotional fatigue and help cancer patients with fatigue establish a regular yoga practice at home. However, higher practice frequency did not lead to higher improvement in physical fatigue as found in Paper 2. This may indicate other factors that influence the efficacy of yoga practice on physical fatigue, such as mindfulness or side effects of therapy. This research project provides insight into the efficacy of yoga therapy for oncology patients with fatigue. It is important that such interventions be offered early, while fatigue symptoms are not too severe. Regular guided yoga practice can reduce physical fatigue, but subsequent yoga practice at home does not further reduce physical fatigue. Reminder emails after completed yoga therapy could only reduce patients' emotional fatigue. It may be that physical fatigue was reduced as much as possible by the previous yoga therapy and that there was a floor effect, or it may be that reminder emails are not suitable as an intervention to reduce physical fatigue at all. Further research is needed to examine the mechanisms of the different interventions in more detail and to find appropriate interventions that reduce all levels of fatigue equally.}, subject = {Erm{\"u}dungssyndrom}, language = {en} } @article{ZetzlPittigRenneretal.2021, author = {Zetzl, Teresa and Pittig, Andre and Renner, Agnes and van Oorschott, Birgitt and Jentschke, Elisabeth}, title = {Yoga therapy to reduce fatigue in cancer: effects of reminder e-mails and long-term efficacy}, series = {Supportive Care in Cancer}, volume = {29}, journal = {Supportive Care in Cancer}, number = {12}, issn = {1433-7339}, doi = {10.1007/s00520-021-06345-z}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-268415}, pages = {7725-7735}, year = {2021}, abstract = {Objective To examine the efficacy of reminder e-mails to continue yoga therapy on practice frequency and fatigue in cancer patients and long-term effects of yoga on fatigue, depression, and quality of life. Methology One hundred two cancer patients who completed an 8-week yoga therapy were randomly allocated to two groups: reminder (N = 51) vs. no-reminder group (N = 51). After completing yoga therapy, the reminder group received weekly e-mails for 24 weeks, which reminded them of practicing yoga, whereas the no-reminder group did not. Primary outcomes were fatigue and practice frequency, and long-term outcomes were fatigue, depression, and quality of life. Data were assessed using questionnaires after yoga therapy (T1) and 6 months after completing yoga therapy (T2). Result A significantly stronger reduction of general (p = 0.038, d = 0.42) and emotional fatigue (p = 0.004, d = 0.59) and a higher increase of practice frequency (p = 0.015, d = 0.52) between T1 and T2 were found for the reminder group compared to the no-reminder group. In the mediation model, practice frequency as a mediator partially explained the changes in emotional fatigue (indirect effect B =  - 0.10). Long-term effects of yoga therapy regarding fatigue, depression, and quality of life were found (F > 7.46, p < 0.001, d > 0.54). Conclusion Weekly reminder e-mails after yoga therapy can positively affect general and emotional fatigue and help cancer patients with fatigue establish a regular yoga practice at home. However, higher practice frequency did not lead to higher physical or cognitive fatigue improvement, suggesting other factors that mediate efficacy on physical or cognitive fatigue, such as mindfulness or side effects of therapy.}, language = {en} } @article{ZetzlRennerPittigetal.2021, author = {Zetzl, Teresa and Renner, Agnes and Pittig, Andre and Jentschke, Elisabeth and Roch, Carmen and van Oorschot, Birgitt}, title = {Yoga effectively reduces fatigue and symptoms of depression in patients with different types of cancer}, series = {Supportive Care in Cancer}, volume = {29}, journal = {Supportive Care in Cancer}, issn = {0941-4355}, doi = {10.1007/s00520-020-05794-2}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-235415}, pages = {2973-2982}, year = {2021}, abstract = {Purpose Examine the effects of an 8-week yoga therapy on fatigue in patients with different types of cancer. Methods A total of 173 cancer patients suffering from mild to severe fatigue were randomly allocated to yoga intervention (n = 84) (IG) versus waitlist control group (CG) (n = 88). Yoga therapy consisted of eight weekly sessions with 60 min each. The primary outcome was self-reported fatigue symptoms. Secondary outcomes were symptoms of depression and quality of life (QoL). Data were assessed using questionnaires before (T0) and after yoga therapy for IG versus waiting period for CG (T1). Results A stronger reduction of general fatigue (P = .033), physical fatigue (P = .048), and depression (P < .001) as well as a stronger increase in QoL (P = .002) was found for patients who attended 7 or 8 sessions compared with controls. Within the yoga group, both higher attendance rate and lower T0-fatigue were significant predictors of lower T1-fatigue (P ≤ .001). Exploratory results revealed that women with breast cancer report a higher reduction of fatigue than women with other types of cancer (P = .016) after yoga therapy. Conclusion The findings support the assumption that yoga therapy is useful to reduce cancer-related fatigue, especially for the physical aspects of fatigue. Women with breast cancer seem to benefit most, and higher attendance rate results in greater reduction of fatigue. Trial registration German Clinical Trials Register DRKS00016034}, language = {en} }