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Addiction (Abingdon, England) Jul 2022Cannabis and alcohol are frequently detected in fatal and injury motor vehicle crashes. While epidemiological meta-analyses of cannabis and alcohol have found... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND AND AIMS
Cannabis and alcohol are frequently detected in fatal and injury motor vehicle crashes. While epidemiological meta-analyses of cannabis and alcohol have found associations with an increase in crash risk, convergent evidence from driving performance measures is insufficiently quantitatively characterized. Our objectives were to quantify the magnitude of the effect of cannabis and alcohol-alone and in combination-on driving performance and behaviour.
METHODS
Systematic review and meta-analysis. We systematically searched Academic Search Complete, CINAHL, Embase, Scopus, Google Scholar, MEDLINE, PsycINFO, SPORTDiscus and TRID. Of the 616 studies that underwent full-text review, this meta-analysis represents 57 studies and 1725 participants. We extracted data for hazard response time, lateral position variability, lane deviations or excursions, time out of lane, driving speed, driving speed variability, speed violations, time speeding, headway, headway variability and crashes from experimental driving studies (i.e. driving simulator, closed-course, on-road) involving cannabis and/or alcohol administration. We reported meta-analyses of effect sizes using Hedges' g and r.
RESULTS
Cannabis alone was associated with impaired lateral control [e.g. g = 0.331, 95% confidence interval (CI) = 0.212-0.451 for lateral position variability; g = 0.198, 95% CI = 0.001-0.395 for lane excursions) and decreased driving speed (g = -0.176, 95% CI = -0.298 to -0.053]. The combination of cannabis and alcohol was associated with greater driving performance decrements than either drug in isolation [e.g. g = 0.480, 95% CI = 0.096-0.865 for lateral position variability (combination versus alcohol); g = 0.525, 95% CI = 0.049-1.002 for time out of lane (versus alcohol); g = 0.336, 95% CI = 0.036-0.636 for lateral position variability (combination versus cannabis; g = 0.475, 95% CI = 0.002-0.949 for time out of lane (combination versus cannabis)]. Subgroup analyses indicated that the effects of cannabis on driving performance measures were similar to low blood alcohol concentrations. A scarcity of data and study heterogeneity limited the interpretation of some measures.
CONCLUSIONS
This meta-analysis indicates that cannabis, like alcohol, impairs driving, and the combination of the two drugs is more detrimental to driving performance than either in isolation.
Topics: Accidents, Traffic; Automobile Driving; Blood Alcohol Content; Cannabinoid Receptor Agonists; Cannabis; Driving Under the Influence; Ethanol; Hallucinogens; Humans; Psychomotor Performance
PubMed: 35083810
DOI: 10.1111/add.15770 -
Journal of Pediatric Rehabilitation... 2018To evaluate evidence supporting physical and occupational therapy interventions used to improve sensory and motor outcomes for children 0-6 years with central hypotonia.
OBJECTIVE
To evaluate evidence supporting physical and occupational therapy interventions used to improve sensory and motor outcomes for children 0-6 years with central hypotonia.
METHODS
Four electronic databases were searched from 1996 to March 2017. Level of evidence and study conduct was evaluated using American Academy of Cerebral Palsy and Developmental Medicine criteria. Traffic lighting classification identified interventions that were green (proven effective), yellow (possibly effective) or red (proven ineffective or contraindicated).
RESULTS
Thirty-seven articles were included. Nine studies measured orthotic interventions while four distinct studies published over nine articles measured treadmill interventions. Remaining studies measured impact of compression garments, massage, motor and sensori-motor interventions, positioning and mobility interventions.
CONCLUSIONS
Green light evidence supports treadmill training (to promote ambulation and gait characteristics) and massage (to positively affect muscle tone, motor development and use of vision) for infants with Down syndrome. These interventions are considered Yellow (possibly effective) for other populations. Green light evidence supports impact of orthoses on foot alignment for ambulatory children with hypotonia, while impact on gait characteristics is Yellow light and motor development may be negatively impacted (Red light) in pre-ambulatory children. All other interventions rated Yellow (possibly effective) and therapists should monitor using sensitive outcome measures.
Topics: Adolescent; Child; Child, Preschool; Humans; Infant; Infant, Newborn; Muscle Hypotonia; Physical Therapy Modalities; Psychomotor Performance
PubMed: 29630564
DOI: 10.3233/PRM-170507 -
Medical Education Nov 2015The aim of this study was to conduct a systematic review and meta-analysis of the relationship between spatial abilities and technical skills performance in health care... (Meta-Analysis)
Meta-Analysis Review
OBJECTIVES
The aim of this study was to conduct a systematic review and meta-analysis of the relationship between spatial abilities and technical skills performance in health care in beginners and to compare this relationship with those in intermediate and autonomous learners.
METHODS
Search criteria included 'spatial abilities' and 'technical skills'. Keywords related to these criteria were defined. A literature search was conducted to 20 December, 2013 in Scopus (including MEDLINE) and in several databases on EBSCOhost platforms (CINAHL Plus with Full Text, ERIC, Education Source and PsycINFO). Citations were obtained and reviewed by two independent reviewers. Articles related to retained citations were reviewed and a final list of eligible articles was determined. Articles were assessed for quality using the Scottish Intercollegiate Guidelines Network-50 assessment instrument. Data were extracted from articles in a systematic way. Correlations between spatial abilities test scores and technical skills performance were identified.
RESULTS
A series of 8289 citations was obtained. Eighty articles were retained and fully reviewed, yielding 36 eligible articles. The systematic review found a tendency for spatial abilities to be negatively correlated with the duration of technical skills and positively correlated with the quality of technical skills performance in beginners and intermediate learners. Pooled correlations of studies were -0.46 (p = 0.03) and -0.38 (95% confidence interval [CI] -0.53 to -0.21) for duration and 0.33 (95% CI 0.20-0.44) and 0.41 (95% CI 0.26-0.54) for quality of technical skills performance in beginners and intermediate learners, respectively. However, correlations between spatial abilities test scores and technical skills performance were not statistically significant in autonomous learners.
CONCLUSIONS
Spatial abilities are an important factor to consider in selecting and training individuals in technical skills in health care.
Topics: Delivery of Health Care; Education, Medical; Humans; Learning; Psychomotor Performance; Spatial Processing
PubMed: 26494061
DOI: 10.1111/medu.12786 -
ANZ Journal of Surgery 2011Sleep deprivation and disturbances in circadian rhythms generally lead to poor performance, but is there a link in surgery? This review aimed to determine whether... (Review)
Review
BACKGROUND
Sleep deprivation and disturbances in circadian rhythms generally lead to poor performance, but is there a link in surgery? This review aimed to determine whether fatigue has an impact on surgeon performance or surgical outcomes.
METHODS
Studies were identified by searching EMBASE, CINAHL, PubMed, The Cochrane Library, Current Contents and clinical trials databases. Inclusion of relevant studies was by application of a predetermined protocol and independent assessment by two reviewers. Each included study was critically appraised for its study quality according to the methods used for Cochrane Reviews. Data from included studies were extracted by one researcher using standardized data extraction tables developed a priori and checked by a second researcher.
RESULTS
From 823 potentially relevant studies, a total of 16 studies were included in this review: two randomized controlled trials, five non-randomized comparative studies and nine case series. Of five studies that directly measure clinical performance, three studies reported no significant difference as a result of sleep deprivation, while two studies found increases in complications or errors. Eleven studies assessed psychomotor skill performance using a variety of simulation-based methods when a participant was rested and/or fatigued. Two randomized controlled trials reported no significant differences, while the nine remaining studies reported mixed results. Surgical residents with less surgical training/experience appeared to be more affected than more senior residents.
CONCLUSION
There is little evidence, as yet, to inform the issue of the effect of fatigue on surgical performance.
Topics: Clinical Competence; Fatigue; General Surgery; Humans; Internship and Residency; Psychomotor Performance; Sleep Deprivation
PubMed: 22295360
DOI: 10.1111/j.1445-2197.2010.05642.x -
Aerospace Medicine and Human Performance Aug 2016Cognitive performance is crucial during military operations. It is suggested that impaired cognitive performance accounts for most of the accidents during training... (Review)
Review
INTRODUCTION
Cognitive performance is crucial during military operations. It is suggested that impaired cognitive performance accounts for most of the accidents during training courses and actual battle. There is a need to define when soldiers' operational readiness becomes impaired. The objective of this systematic review was to investigate the effects of sustained military operations (SUSOPS) on vigilance, reaction time, working memory, and reasoning in order to select good indicators for performance impairment.
METHODS
A systematic literature search was performed using publicly accessible databases (IngentaConnect, PubMed, Science Direct, and Defense Technical Information Center online) that were screened until July 2015. Keywords were military, sustained operations, (cognitive) performance, soldier, and training.
RESULTS
Only 7 out of 589 studies met the inclusion criteria. Selected studies were difficult to compare due to different methodologies, cognitive tasks, and military courses. Vigilance, reaction time, and working memory were affected after only a few hours, showing severe impairment. They are linearly related to military stress up to 80 h of SUSOPS. These three indicators needed little recovery time to return to baseline levels. After more than 80 h of SUSOPS, no significant impairments of those indicators were observed. Reasoning becomes impaired after high stress levels of relatively short duration and can remain affected after more than 80 h of SUSOPS.
DISCUSSION
Vigilance, reaction time, and working memory are affected after only a few hours while little recovery time is needed. For reasoning to return to baseline values, longer recovery is needed than the time available during SUSOPS. Vrijkotte S, Roelands B, Meeusen R, Pattyn N. Sustained military operations and cognitive performance. Aerosp Med Hum Perform. 2016; 87(8):718-727.
Topics: Attention; Cognitive Dysfunction; Fatigue; Humans; Memory; Military Personnel; Reaction Time; Stress, Psychological; Task Performance and Analysis; Time Factors
PubMed: 27634607
DOI: 10.3357/AMHP.4468.2016 -
Psychological Bulletin Jun 2021Considerable literature on the role of attentional focus in motor performance and learning has accumulated for over two decades. We report the results of comprehensive... (Meta-Analysis)
Meta-Analysis
Considerable literature on the role of attentional focus in motor performance and learning has accumulated for over two decades. We report the results of comprehensive meta-analyses that address the impact of an external focus (EF, on intended movement effects) versus internal focus (IF, on movements of body parts) of attention on the performance and learning of motor skills. Values of effect sizes (ES) from 73 studies with 1,824 participants and 40 studies with 1,274 participants were used for examining the effects of EF versus IF on behavioral outcomes of motor performance and learning (separately for retention and transfer phases) respectively. The EF condition was more effective than the IF condition for performance, Hedges' g value = 0.264 (95% CI [0.217, 0.310]), retention learning, Hedges' g value = 0.583 (95% CI [0.425, 0.741]), and transfer learning, Hedges' g value = 0.584 (95% CI [0.325, 0.842]). Multivariable metaregression analyses on behavioral measures further indicated that neither age group, health status, or skill level, nor their two-way interactions, moderated the ES differences between EF and IF in performance, retention, and transfer models (all p > .100). A secondary analysis on 12 studies with 216 participants that examined the effects of EF versus IF on electromyographic outcomes of motor performance also indicated that EF was associated with more efficient neuromuscular processing, Hedges' g value = 0.833 (95% CI [0.453, 1.213]). From nine studies with 272 participants, performance measured by behavioral outcomes was found to be more effective when a more distal, rather than proximal, EF was used, Hedges' g value = 0.224 (95% CI [0.019, 0.429]). Overall, the meta-analytic results are consistent with prior narrative reviews and indicate that an external focus is superior to an internal focus whether considering tests of motor performance or learning, and regardless of age, health condition, and level of skill expertise. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
Topics: Attention; Humans; Learning; Motor Skills; Movement
PubMed: 34843301
DOI: 10.1037/bul0000335 -
European Journal of Sport Science May 2023Previous research has explored the demands of amateur boxing-specific activity; however, no holistic review of the acute responses to such activity currently exists.... (Meta-Analysis)
Meta-Analysis
Previous research has explored the demands of amateur boxing-specific activity; however, no holistic review of the acute responses to such activity currently exists. This paper aimed to provide a systematic review of the available literature on the acute physiological, endocrine, biochemical, and performance responses to amateur boxing-specific activity. Following a search of EBSCOhost, SPORTDiscus, PubMed and Google Scholar databases, 25 studies were identified as meeting the inclusion criteria for the review. The methodological quality of the included studies was assessed via a modified Downs and Black checklist. Random-effects meta-analysis of standardised mean differences (SMD) revealed large (SMD = 4.62) increases in pre-post blood lactate (BLa), cortisol (SMD = 1.33), myoglobin (Mb) (SMD = 1.43), aspartate transaminase (AST) (SMD = 1.37), and alanine aminotransferase (ALT) (SMD = 0.97), in addition to moderate increases in creatine kinase (CK) (SMD = 0.65). Small pre-post increases in counter-movement jump (CMJ) height (SMD = 0.33) were observed. Consistently greater pre-post alterations were observed in competitive bouts, followed by sparring, and less so in boxing-specific simulations. Considerable physiological, endocrine, and biochemical responses are elicited following amateur boxing. Interestingly, neuromuscular and task-specific performance may not deteriorate following boxing-specific activity. The findings of the review may assist in the designing and periodising of boxing-specific training, dependent on the desired physical adaptations, training phase, and recovery status of the amateur boxer.Amateur boxing elicits a considerable acute physiological, hormonal, and biochemical response.Such responses are typically greater in competitive bouts, followed by sparring, and less so in simulated activity.The considerable demands of amateur boxing-specific activity do not appear to negatively affect neuromuscular or task-specific performance.Amateur boxers may be conditioned to preserve performance despite the acute demands of the sport, or the lack of performance decrement may reflect the short duration of amateur boxing.
Topics: Humans; Boxing; Athletes; Physical Examination; Movement; Task Performance and Analysis
PubMed: 35380916
DOI: 10.1080/17461391.2022.2063072 -
European Journal of Pediatrics May 2018The NOMAS is by far the most used tool to screen early oral-motor skills in newborns. Here we provide an updated review of scientific literature on the use of the... (Review)
Review
UNLABELLED
The NOMAS is by far the most used tool to screen early oral-motor skills in newborns. Here we provide an updated review of scientific literature on the use of the Neonatal Oral Motor Assessment Scale (NOMAS) to screen early oral-motor skills in newborns. An integrative review has been carried out consistent with PRISMA guidelines and standardized qualitative appraisal. Data abstracting and synthesis were executed by two independent co-authors who solved disagreement in conference. Twenty records have been included and reviewed. The efficacy of the NOMAS in screening and identifying precocious oral-motor skills received inconsistent support. Moderate validity and low reliability emerged. Moreover, despite the NOMAS' adequately screen efficient and inefficient feeders, limited evidence emerged for predictive value of NOMAS score on feeding and psychomotor developmental trajectories during the first 2 years of age.
CONCLUSION
The present review highlights benefits and limitations of the NOMAS. Future research is needed to develop observational and clinically-relevant tools to better identify newborns which are at lower- and higher-risk of developing less-than-optimal feeding behaviors and to guide with greater precision the diagnostic and therapeutic journey of these newborns. What is Known: • The assessment of oral-motor skills in newborns and infants is critical for early intervention • The NOMAS is the most adopted tool to assess oral-motor skills in newborns and infants What is New: • The ability of the NOMAS to target newborn at risk for feeding disorders is confirmed • Nonetheless, the capacity to predict long-term developmental outcomes is limited.
Topics: Feeding Behavior; Feeding and Eating Disorders; Humans; Infant; Infant, Newborn; Motor Skills; Mouth; Neurologic Examination; Psychometrics; Reproducibility of Results
PubMed: 29564628
DOI: 10.1007/s00431-018-3130-1 -
American Journal of Public Health Mar 2014We conducted a systematic review and meta-analysis of the literature examining the relationship between driving performance and engaging in secondary tasks. We extracted... (Meta-Analysis)
Meta-Analysis Review
We conducted a systematic review and meta-analysis of the literature examining the relationship between driving performance and engaging in secondary tasks. We extracted data from abstracts of 206 empirical articles published between 1968 and 2012 and developed a logistic regression model to identify correlates of a detrimental relationship between secondary tasks and driving performance. Of 350 analyses, 80% reported finding a detrimental relationship. Studies using experimental designs were 37% less likely to report a detrimental relationship (P = .014). Studies examining mobile phone use while driving were 16% more likely to find such a relationship (P = .009). Quasi-experiments can better determine the effects of secondary tasks on driving performance and consequently serve to inform policymakers interested in reducing distracted driving and increasing roadway safety.
Topics: Attention; Automobile Driving; Humans; Risk-Taking; Safety; Task Performance and Analysis; United States
PubMed: 24432925
DOI: 10.2105/AJPH.2013.301750 -
Human Movement Science Feb 2022Muscle fatigue is represented as a reduction in force production capability; however, fatigue does not necessarily result in performance impairments. As the distal upper...
Muscle fatigue is represented as a reduction in force production capability; however, fatigue does not necessarily result in performance impairments. As the distal upper limb serves as the end effector when interacting or manipulating objects, it is important to understand how muscle fatigue may impact motor functionality. The aim of this study was to systematically review the literature to identify how various aspects of motor performance of the distal upper limb are impaired following muscle fatigue. Four databases were searched using 23 search terms describing the distal upper limb, muscle fatigue, and various performance metrics. A total of 4561 articles were screened with a total of 28 articles extracted and critically appraised. Evidence extracted indicates that muscle fatigue results in unique impairments based on the type of motor performance being evaluated. Furthermore, much data suggests that muscle fatigue does not result in consistent, predictable performance impairments, particularly while performing submaximal tasks. Additionally, magnitude of fatigue does not directly correlate with reductions in performance outcomes at the hand and wrist. Fatiguing protocols used highlighted the importance of fatigue specificity. When fatiguing and performance tasks are similar, performance impairment is likely to be observed. The numerous muscles found in the hand and wrist, often considered redundant, play a critical role in maintaining task performance in the presence of muscle fatigue. The presence of motor abundance (e.g. multiple muscles with similar function) is shown to reduce the impairment in multiple performance metrics by compensating for reduced function of fatigued muscles. Continued exploration into various fatiguing protocols (i.e. maximal or submaximal) will provide greater insights into performance impairments in the distal upper limb.
Topics: Humans; Muscle Contraction; Muscle Fatigue; Muscle, Skeletal; Task Performance and Analysis; Upper Extremity; Wrist; Wrist Joint
PubMed: 34929434
DOI: 10.1016/j.humov.2021.102912