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Mental health disorders (MHD) in elite athletes is a topic that has received increased attention in recent years. The overall aim of this position statement is to enhance awareness of this important topic and to critically discuss optimal service provision for athletes who suffer from MHD. In the first part of the paper a short overview of the research on MHD in elite athletes is provided. Elite athletes seem to have comparable prevalence rates for the most common MHD when compared to non-athletic peers, but there are still many disorders that have not been investigated in athletes. Sport specific situations such as injuries, periods of overtraining and career termination may put athletes at an increased risk of developing MHD. In the second part of the paper, models of service provision for elite athletes suffering from MHD from six European countries are presented, focusing on 1) professional service providers, 2) support systems, 3) diagnostic assessment, 4) clinical treatment, 5) performance during treatment, 6) screening, and 7) education systems. It emerges that competencies, certification issues, and professional boundaries of the involved service providers, as well as the structure of the National Health Care systems differ strongly across European countries, which makes defining a golden standard difficult. In the third part of this paper, the authors provide general recommendations for athletes and coaches, clubs, federations, organizations and scholars that hopefully will inspire stakeholders to optimize their support systems. [ABSTRACT FROM AUTHOR]

Context: Explanatory approaches for back pain (BP) in athletes focus on biomechanical factors while neglecting psychological perspectives. Psychological factors have gained importance in the prediction of injuries in athletes and BP in the general population, with stress and recovery emerging as central risk factors. However, scarce evidence exists regarding the role of these aspects for the prevalent burden of BP. Objective: To investigate the association between stress and recovery parameters and the presence of BP. Design: Cross-sectional design. Setting: The questionnaires were distributed after the training sessions. Participants: A total of 345 competitive athletes (mean age = 18.31 y [SD = 5.40]) were investigated. The classification of the athletes' competitive status was based on performance level. Interventions: Data were collected using questionnaires for the assessment of stress, recovery, and BP. Main Outcome Measures: The authors performed a multiple logistic regression to obtain odds ratios for stress and recovery parameters with regard to the outcome variable BP status. Results: For stress, the dimension "overall stress" (odds ratio = 1.83; 95% confidence interval, 1.30–2.59; P =.001) and the scale "physical complaints" (odds ratio = 1.68; 95% confidence interval, 1.25–2.25; P =.001) of the general version of the Recovery-Stress Questionnaire resulted to be significantly associated with BP. None of the recovery-related scales displayed a statistically significant relationship with BP. Conclusion: The outcomes of this study imply a modest association between stress and the presence of BP in competitive athletes. Practitioners may take these findings into account regarding the conception of training and for monitoring purposes. [ABSTRACT FROM AUTHOR]

Back pain (BP), a prominent problem for competitive athletes, is a primary reason for limitations in athletic performance and daily life restrictions. As studies on the relationship between psychological variables and BP in athletes are scarce, the aim of this study was to investigate stress and depression in competitive athletes with BP. In a cross-sectional design, data of 154 competitive athletes (51% female; Mage = 18.81 years, SDage = 5.05 years) were collected, assessing Performance stress, Socio-emotional stress, Risk for depression and Psychological well-being and the two BP parameters BP Intensity and Disability. Two multiple linear regressions were conducted to predict (1) BP Intensity and (2) Disability from Performance stress, Socio-emotional stress, Risk for depression and Psychological well-being. Multiple linear regressions demonstrated that Performance stress (β = .21, p = .01) was the only significant predictor of BP Intensity (F1,142 = 6.68, p = .01, R2 = .05), whilst Risk for depression (β = .24, p = .01) was the only significant predictor of Disability (F1,142 = 8.46, p = .01, R2 = .06). Neither gender nor age explained a significant amount of variance in the models. Study results showed that, as in the general population, the variables stress and depression are related to BP in competitive athletes. In particular, BP intensity was found to be associated with stress and BP-related disability was associated with depression, whereas age and gender showed no association with the BP parameters. A longitudinal investigation is warranted to determine the direction of the observed relationships. [ABSTRACT FROM AUTHOR]

Abstract: Background: Recovery describes a restoring process influencing the health conditions of individuals but a potential link to low back pain (LBP) has not been scrutinized so far. Psychological strategies to deal with LBP have been considered within the biopsychosocial approach but substantial evidence regarding specific psychological underpinnings remains elusive. The current study aimed to compare individuals with different recovery–stress patterns (i.e. specific combinations of recovery/stress) regarding their pain and disability in the lower back. Methods: Cross‐sectional data from 265 physically active individuals with non‐specific LBP were collected via standardized questionnaires. The participants engaged in prescribed exercise therapy provided by a healthcare professional owing to their back burden. A k‐means cluster analysis identified three clusters. Results: Cluster 1 entailed individuals with high recovery and low stress values, Cluster 2 represented participants with medium scores on both dimensions and Cluster 3 included participants with low recovery and high stress values. The statistical analyses for pain intensity using analyses of covariance indicated significantly higher values for Cluster 3 compared with Clusters 1 and 2 for worst pain intensity (p < 0.001 and p = 0.003, respectively) and mean pain intensity (p < 0.001 and p = 0.001, respectively). The disability comparisons using non‐parametric tests showed significantly higher LBP‐related disability in Cluster 3 than Cluster 1 on two disability measures. Conclusions: The findings indicate an association between detrimental recovery–stress patterns and LBP. Examining the role of recovery has innovative practical relevance for LBP prevention and rehabilitation through the implementation of approaches to enhance recovery in relevant programmes. [ABSTRACT FROM AUTHOR]

Introduction: Low back pain (LBP) is a major health issue in athletes and non-athletes often accompanied by considerable restrictions in everyday functioning. Knowledge about differences between those groups regarding LBP parameters (intensity, duration, and disability) and their influence on daily life is still lacking. Hence, the present study aimed at the comparison of those LBP parameters between athletes and non-athletes and the impact of these factors on sports activity. Methods: LBP patients receiving prescribed sport- or physiotherapeutic treatment ( N = 264) completed a questionnaire battery to determine their LBP pain intensity, duration, chronification, disability, and changes in sports activity. The categorization into athletes and non-athletes was based on performance level. Uni- and multivariate analyses of (Co-) variance and nonparametric group comparisons were executed to analyze group differences. Results: Disability was lower in the athlete's group, especially concerning work ability ( p < 0.05). Athletes rather continued with their sports activity despite LBP ( p < 0.001). The interaction between age and difference in training volume showed that non-athletes (<29 years) reported a greater reduction of training volume from a pain free to a LBP phase compared to athletes in the respective age group. Conclusions: The results imply that athletes with LBP perceive less impairment than non-athletes concerning disability and changes in training volume. Possible explanations can be inferred from different socialization processes and pain coping mechanisms among athletes. The outcomes contribute to the existing literature by adding specific knowledge about dissimilarities between athletes and non-athletes regarding the appraisal of LBP. [ABSTRACT FROM AUTHOR]

Abstract: Confinement studies are performed to simulate the psychological effects that may be experienced on a long-term space flight. A general psycho-physiological model assumes that mood and cognitive functioning are impaired during confinement as a result of an absence of physical activity. The aim of the MARS500 study initiated by the Institute of Biomedical Problems (IBMP) and the European Space Agency (ESA) is to gather data, knowledge and experience to help prepare for a real mission to Mars. A test run with 105 days of isolation was performed prior to 520 days of isolation. Psycho-physiological data of this study are presented here. We hypothesized that exercise, as it has been shown in laboratory settings, would be able to prevent and counteract mood changes during isolation. Electrocortical data (EEG) and a self report on current psychological and physical state were recorded several times prior to and after exercise during the isolation period. Data revealed a clear effect of exercise on mood and electrocortical activity. Moreover, it was shown that mood and brain cortical activity decreased during the first 11 weeks of isolation and reached baseline again in the last week of isolation. A correlation analysis revealed a significant relation between mood data and electrocortical activity. We conclude (1) that confinement is accompanied by psycho-physiological changes and (2) that exercise is a suitable method to counteract psycho-physiological deconditioning during confinement. [Copyright &y& Elsevier]

The purpose of this study was to analyze whether the social compensation of performance drops in a team setting depends on the relationship quality. Two experiments were conducted. Experiment 1: In a team-building condition, the relationship quality between subject and confederate was manipulated. The performance situation consisted of an isometric strength task. A joint team result had to be achieved in a second run, whereby the subject received manipulated feedback on the confederate's performance, hence suggesting a sudden drop. The results showed no compensation effect. Experiment 2: Given that one potential reason for the lack of effect appeared to be the isometric holding task, the study design was maintained, but the task was modified into a dynamic one. Performance drops were compensated for. However, the relationship quality did not affect compensation behavior. It is possible that implicit team building through the necessary joint agreement on goals interfered with the effect in both conditions., (© 2023 The Authors. PsyCh Journal published by Institute of Psychology, Chinese Academy of Sciences and John Wiley & Sons Australia, Ltd.)

Present research regarding interventions to change behavior suffers from insufficient communication of their theoretical derivation. This insufficient communication is caused by the restrictions imposed by most of the relevant scientific journals. This impedes further intervention development. In this article, a telephone-based health coaching (TBHC) intervention is introduced using a format outside these restrictions. This intervention is seen as a combination of (1) the activities performed with the target persons, i.e., its core, and (2) measures to ensure the quality of the intervention. The theoretical derivation of the core is presented. The core is seen to consist of (1) the style of coach-patient interaction and (2) the contents of this interaction. The style of coach-patient interaction was derived from self-determination theory and was concretized using motivational interviewing techniques. The contents of the coach-patient interaction were derived from the health action process approach and were concretized using behavior-change techniques. The derivation led to (1) a set of 16 coaching tools referring to the different states in which a patient might be and containing state-specific recommendations for performing the coaching session, and (2) guidelines for selecting the appropriate coaching tool for each session. To ensure the quality of the intervention, a coach-training program before and supervision sessions during the TBHC were added.

Previous research has indicated that social interactions and gaze behavior analyses in a group setting could be essential tools in accomplishing group objectives. However, only a few studies have examined the impact of social interactions on group dynamics in team sports and their influence on team performance. This study aimed to investigate the effects of game performance pressure on the gaze behavior within social interactions between beach volleyball players during game-like situations. Therefore, 18 expert beach volleyball players conducted a high and a low game performance pressure condition while wearing an eye tracking system. The results indicate that higher game performance pressure leads to more and longer fixation on teammates' faces. A higher need for communication without misunderstandings could explain this adaptation. The longer and more frequent look at the face could improve the receiving of verbal and non-verbal information of the teammate's face. Further, players showed inter-individual strategies to cope with high game performance pressure regarding their gaze behavior, for example, increasing the number of fixations and the fixation duration on the teammate's face. Thereby, this study opens a new avenue for research on social interaction and how it is influenced in/through sport., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Nicklas, Rückel, Noël, Varga, Kleinert, Boss and Klatt.)

Introduction: In the treatment of low back pain (LBP), passive regimens (e.g., relaxation) as opposed to active regimens (e.g., muscle training) may be a useful adjunct or, in certain cases, the only possible approach. Passive relaxation may be particularly useful for individuals who have lost the ability to adequately perceive relaxed muscles. The aim of the randomized controlled trial presented here was to investigate a specific and novel treatment for passive relaxation, namely, the Vitametik impulse (VI)., Methods: Participants (n = 135; 73.3% women; 26.7% men) were individuals with mild to moderate LBP aged from 19 to 76 years (M = 48.8). The participants were randomly assigned to one of four different groups (three different 8-week interventions, one control group). Pain, discomfort, and well-being were measured before and after the intervention period and at an 8-week follow-up., Results: In the VI group, the decrease in various pain variables and discomfort was higher compared to the control group and compared to an education program (EP). There were no differences between the VI group and a combined VI/EP group. The effects remained stable until follow-up., Conclusion: VI appears to be an effective approach in the treatment of LBP, although the underlying mechanism remains unproven. Future studies should compare VI treatment with specific relaxation techniques or active muscle training. In addition, the results of the study need to be replicated., (© 2022 S. Karger AG, Basel.)

Background: Type 2 diabetes mellitus (T2DM) and coronary heart disease (CHD) are two chronic diseases that cause a tremendous burden. To reduce this burden, several programmes for optimising the care for these diseases have been developed. In Germany, so-called disease management programmes (DMPs), which combine components of Disease Management and the Chronic Care Model, are applied. These DMPs have proven effective. Nevertheless, there are opportunities for improvement. Current DMPs rarely address self-management of the disease, make no use of peer support, and provide no special assistance for persons with low health literacy and/or low patient activation. The study protocol presented here is for the evaluation of a programme that addresses these possible shortcomings and can be combined with current German DMPs for T2DM and CHD. This programme consists of four components: 1) Meetings of peer support groups 2) Personalised telephone-based health coaching for patients with low literacy and/or low patient activation 3) Personalised patient feedback 4) A browser-based web portal METHODS: Study participants will be adults enrolled in a DMP for T2DM and/or CHD and living in North Rhine-Westphalia, a state of the Federal Republic of Germany. Study participants will be recruited with the assistance of their general practitioners by the end of June 2021. Evaluation will be performed as a pragmatic randomised controlled trial with one intervention group and one waiting control group. The intervention group will receive the intervention for 18 months. During this time, the waiting control group will continue with usual care and the usual measures of their DMPs. After 18 months, the waiting control group will also receive a shortened intervention. The primary outcome is number of hospital days. In addition, the effects on self-reported health-state, physical activity, nutrition, and eight different psychological variables will be investigated. Differences between values at month 18 and at the beginning will be compared to judge the effectiveness of the intervention., Discussion: If the intervention proves effective, it may be included into the DMPs for T2DM and CHD., Trial Registration: The study was registered in the German Clinical Trials Registry (Deutsches Register Klinischer Studien (DRKS)) in early 2019 under the number 00020592. This registry has been affiliated with the WHO Clinical Trials Network ( https://www.drks.de/drks&#95;web/setLocale&#95;EN.do ) since 2008. It is based on the WHO template, but contains some additional categories for which information has to be given ( https://www.drks.de/drks&#95;web/navigate.do?navigationId=entryfields&messageDE=Beschreibung%20der%20Eingabefelder&messageEN=Description%20of%20entry%20fields ). A release and subsequent number assignment only take place when information for all categories has been given., (© 2021. The Author(s).)

Context: Low back pain (LBP) is a serious health problem, both in the general population as well as in athletes. Research has shown that psychosocial aspects, such as dysfunctional pain responses, play a significant role in the chronification of LBP. Recent research supports the relevance of the multidisciplinary concept of body image in the interpretation of LBP., Objective: To examine the differences in 2 psychosocial aspects, body image and pain responses, between athletes and nonathletes with LBP., Design: Cross-sectional design., Setting: The questionnaires were distributed in the course of LBP treatment., Participants: Data from 163 athletes (mean age = 28.69 [9.6] y) and 75 nonathletes (mean age = 39.34 [12.63] y) were collected., Interventions: Data were collected by questionnaires assessing body image, pain behavior, training activity, and LBP., Main Outcome Measures: To examine group differences between athletes and nonathletes regarding body image and pain behavior, the authors performed 2-way analyses of variance with Bonferroni post hoc tests., Results: The results showed (1) a significant main effect regarding pain responses and body image, showing that participants with eustress endurance or adaptive pain behavior revealed a more positive body image in both groups compared with participants with distress endurance or fear-avoidance behavior, and (2) a significant main effect for the factor group in the body image dimension of physical efficacy, indicating a more positive body image for athletes., Conclusion: These results suggest that considering multiple risk factors for LBP, such as body image and dysfunctional pain behavior, as well as subgrouping, might be valuable for research and for broadening therapy options.

Objective: The aim of this study was to investigate the use of two types of dynamic workstations (Deskbike, activeLife Trainer) and their effects on physiological activation in an occupational setting., Methods: 30 employees were given access to the devices for 28 days. Frequency and duration of borrowing and use was recorded by a Chipcard-system. Physiological activation (energy expenditure, heart rate) while working in a seated position and using the workstations was measured with the activity tracker Fitbit Charge HR., Results: Participants used dynamic workstations on 40% of their working days for an average of 54.3 ± 23.9 min per day. Energy expenditure and heart rate increased significantly while using the workstations compared to working seated. The Deskbike was used more frequently and resulted in greater heart rate elevation., Conclusion: Both types of dynamic workstations were used by the employees and had positive effects on physiological activation. The implementation of either type can be recommended., (Copyright © 2018 Elsevier Ltd. All rights reserved.)

The present study investigates variations of physical well-being and physical self-concept during sport therapy in rehabilitation of patients with heart diseases. Additionally, interrelationships between physical self-concept and physical well-being were assumed. In a sample of 43 heart disease patients (aged 44-86), physical self-concept (PSK-scale) was assessed before and after a 3-week physical exercise treatment. Actual physical well-being was assessed with the Perceived Physical State adjective list (WKV) at 3 measuring points (beginning, mid, and end of sport therapy). Enhancements of physical self-concept and actual physical well-being could be found. Furthermore, relationships between both constructs could be revealed: The progression of one construct depends on the initial state of the respective other. Low initial states facilitate positive progression. These results are discussed both as a ceiling effect and as the consequence of a physical stimulation below threshold., (© Georg Thieme Verlag KG Stuttgart · New York.)

It was recently shown in humans that exercise affects the neurotrophic factors known to function as neurogenesis regulators. No data related to exercise and pregnancy, however, is yet available. Thus, we investigated the effects of acute exercise on pregnant women during late pregnancy and women postpartum, on the serum concentration of the brain-derived neurotrophic factor (BDNF), the insulin-like growth factor 1 (IGF-1), the vascular endothelial growth factor (VEGF), prolactin (PRL) and cortisol (COR). Twenty women with uncomplicated pregnancies underwent a graded submaximal exercise test during pregnancy (weeks 32-36 of gestation; T(1)) and postpartum (10-12 weeks after childbirth; T(2)). On two of these test days the women carried out an intensifying exercise test (25 W steps) on a cycle ergometer until a heart rate of 150 bpm was reached. Blood samples were taken in the rest period before beginning the exercise, immediately at the end of the exercise and after recovery periods of 5 and 10 min, respectively. Basal maternal IGF-1, PRL and COR were found to be higher during T(1) (p<.01), while the BDNF was higher during T(2) (p=.00). VEGF was not detectable in the serum of the pregnant women. During T(2), VEGF, which was found to be within the normal range before exercise, was at a higher level after exercise (p<.01). Exercise increased the BDNF and IGF-1 during T(1) and T(2) (p<.01). This study also shows that exercise increases the serum concentrations of IGF-1 and BDNF during pregnancy and postpartum as well as VEGF postpartum. Thus, exercise might be a beneficial lifestyle factor with therapeutic/public health implications i.e. with regard to maternal mood and cognitive performance., (Copyright © 2010 Elsevier Ltd. All rights reserved.)