Does multisession cathodal transcranial direct current stimulation of the left dorsolateral prefrontal cortex prime the effects of cognitive behavioral therapy on fear of pain, fear of movement, and disability in patients with nonspecific low back pain? A randomized clinical trial study
- Ehsani, Fatemeh, Hafez Yousefi, Mohaddeseh, Jafarzadeh, Abbas, Zoghi, Maryam, Jaberzadeh, Shapour
- Authors: Ehsani, Fatemeh , Hafez Yousefi, Mohaddeseh , Jafarzadeh, Abbas , Zoghi, Maryam , Jaberzadeh, Shapour
- Date: 2023
- Type: Text , Journal article
- Relation: Brain Sciences Vol. 13, no. 10 (2023), p.
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- Description: Many studies have shown that low back pain (LBP) is associated with psychosomatic symptoms which may lead to brain changes. This study aimed to investigate the effect of the concurrent application of cognitive behavioral therapy (CBT) and transcranial direct electrical stimulation (tDCS) over the left dorsolateral prefrontal cortex (DLPFC) on fear of pain, fear of movement, and disability in patients with nonspecific LBP. This study was performed on 45 LBP patients (23 women, 22 men; mean age 33.00 ± 1.77 years) in three groups: experimental (2 mA cathodal tDCS (c-tDCS)), sham (c-tDCS turned off after 30 s), and control (only received CBT). In all groups, CBT was conducted for 20 min per session, with two sessions per week for four weeks. Fear of pain, fear of movement, and disability were evaluated using questionnaires at baseline, immediately after, and one month after completion of interventions. Results indicated that all three different types of intervention could significantly reduce fear and disability immediately after intervention (p > 0.05). However, improvement in the experimental group was significantly higher than in the other groups immediately after and at the one-month follow-up after interventions (p < 0.05). DLPFC c-tDCS can prime the immediate effects of CBT and also the lasting effects on the reduction in the fear of pain, fear of movement, and disability in LBP patients. © 2023 by the authors.
- Authors: Ehsani, Fatemeh , Hafez Yousefi, Mohaddeseh , Jafarzadeh, Abbas , Zoghi, Maryam , Jaberzadeh, Shapour
- Date: 2023
- Type: Text , Journal article
- Relation: Brain Sciences Vol. 13, no. 10 (2023), p.
- Full Text:
- Reviewed:
- Description: Many studies have shown that low back pain (LBP) is associated with psychosomatic symptoms which may lead to brain changes. This study aimed to investigate the effect of the concurrent application of cognitive behavioral therapy (CBT) and transcranial direct electrical stimulation (tDCS) over the left dorsolateral prefrontal cortex (DLPFC) on fear of pain, fear of movement, and disability in patients with nonspecific LBP. This study was performed on 45 LBP patients (23 women, 22 men; mean age 33.00 ± 1.77 years) in three groups: experimental (2 mA cathodal tDCS (c-tDCS)), sham (c-tDCS turned off after 30 s), and control (only received CBT). In all groups, CBT was conducted for 20 min per session, with two sessions per week for four weeks. Fear of pain, fear of movement, and disability were evaluated using questionnaires at baseline, immediately after, and one month after completion of interventions. Results indicated that all three different types of intervention could significantly reduce fear and disability immediately after intervention (p > 0.05). However, improvement in the experimental group was significantly higher than in the other groups immediately after and at the one-month follow-up after interventions (p < 0.05). DLPFC c-tDCS can prime the immediate effects of CBT and also the lasting effects on the reduction in the fear of pain, fear of movement, and disability in LBP patients. © 2023 by the authors.
Changes in cognition over a 16.1 km cycling time trial using think aloud protocol : preliminary evidence
- Whitehead, Amy, Jones, Hollie, Williams, Emily, Dowling, Christopher, Morley, David, Taylor, Jamie, Polman, Remco
- Authors: Whitehead, Amy , Jones, Hollie , Williams, Emily , Dowling, Christopher , Morley, David , Taylor, Jamie , Polman, Remco
- Date: 2019
- Type: Text , Journal article
- Relation: International Journal of Sport and Exercise Psychology Vol. 17, no. 3 (2019), p. 266-274
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- Description: Objectives: This study investigated cognitions of cyclists during a competitive time trial (TT) event using Think Aloud (TA) protocol analysis. Design: Single group, observational design. Method: Fifteen male and three female cyclists from the North West of England verbalised their thoughts throughout an outdoor competitive 16.1 km cycling TT (Level 2 TA). Verbalisations were recorded using iVue Horizon 1080P camera glasses. Data were transcribed verbatim, analysed using deductive content analysis and grouped into themes: (i) Pain And Discomfort (Fatigue, Pain), (ii) External Feedback (Time, Speed, Heart Rate), (iii) Environment (Surroundings, Traffic and Other Cyclists), and (iv) Pace and Distance (Pace, Distance). The number of verbalisations within each theme was analysed by distance quartile using Friedman tests to examine changes in cognitions over time. Results: Associative themes, including Fatigue and Pain, were verbalised more frequently in the earlier stages of the TT and less in the final quartile, whereas verbalisations about Distance significantly increased in the last quartile. Conclusions: This study demonstrates how a novel data collection method can capture in-event cognitions of endurance athletes. It provides an important extension to previous literature, showing how individuals may process and attend to information over time during an exercise bout. Future research should establish the relationship between performance and cognitive processes. © 2017, © 2017 International Society of Sport Psychology.
- Authors: Whitehead, Amy , Jones, Hollie , Williams, Emily , Dowling, Christopher , Morley, David , Taylor, Jamie , Polman, Remco
- Date: 2019
- Type: Text , Journal article
- Relation: International Journal of Sport and Exercise Psychology Vol. 17, no. 3 (2019), p. 266-274
- Full Text:
- Reviewed:
- Description: Objectives: This study investigated cognitions of cyclists during a competitive time trial (TT) event using Think Aloud (TA) protocol analysis. Design: Single group, observational design. Method: Fifteen male and three female cyclists from the North West of England verbalised their thoughts throughout an outdoor competitive 16.1 km cycling TT (Level 2 TA). Verbalisations were recorded using iVue Horizon 1080P camera glasses. Data were transcribed verbatim, analysed using deductive content analysis and grouped into themes: (i) Pain And Discomfort (Fatigue, Pain), (ii) External Feedback (Time, Speed, Heart Rate), (iii) Environment (Surroundings, Traffic and Other Cyclists), and (iv) Pace and Distance (Pace, Distance). The number of verbalisations within each theme was analysed by distance quartile using Friedman tests to examine changes in cognitions over time. Results: Associative themes, including Fatigue and Pain, were verbalised more frequently in the earlier stages of the TT and less in the final quartile, whereas verbalisations about Distance significantly increased in the last quartile. Conclusions: This study demonstrates how a novel data collection method can capture in-event cognitions of endurance athletes. It provides an important extension to previous literature, showing how individuals may process and attend to information over time during an exercise bout. Future research should establish the relationship between performance and cognitive processes. © 2017, © 2017 International Society of Sport Psychology.
An investigation of expertise in cycling : eye tracking, think aloud and the influence of a competitor
- Massey, Hollie, Whitehead, Amy, Marchant, David, Polman, Remco, Williams, Emily
- Authors: Massey, Hollie , Whitehead, Amy , Marchant, David , Polman, Remco , Williams, Emily
- Date: 2020
- Type: Text , Journal article
- Relation: Psychology of Sport and Exercise Vol. 49, no. (2020), p.
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- Description: Objectives: Two studies investigated expert-novice differences in information-seeking behaviour, cognitions and performance during cycling time trials (TT). Study 1 examined trained and novice cyclist's cognitions whilst performing a TT, using a Think Aloud (TA) protocol and eye-tracking techniques. Study 2 investigated expertise differences during alone and competitive TTs. Methods: in Study 1, six trained and seven novice cyclists performed a 16.1 km TT. In Study 2, eight trained and ten novice cyclists performed three 16.1 km TT; a baseline TT, an alone TT and a trial against a virtual competitor. In both studies, participants were asked to TA and in Study 1 they also wore mobile gaze-tracking glasses. Performance feedback and a simulated TT course were visually displayed during all trials, as was a virtual avatar during the competitor trial. Verbalisations were coded into primary and secondary themes. Cognitions and pacing strategies were compared between groups and across the duration of the TTs. In Study 1, eye-tracking data for total dwell time and gaze frequency were calculated for each area of interest (Time Elapsed, Power, Heart Rate, Cadence, Distance Covered, Speed and Course Scenery). Results: In Study 1, no significant differences were found in information-seeking behaviour between groups, however there were expertise differences in the cognitive strategies used. Trained cyclists’ verbalisations were more performance-relevant (i.e., power output), whereas the untrained group were more focused on task completion (i.e., distance and time) and irrelevant information. Both groups talked more about distance and motivational thoughts in the later stages of the trial, and dwell time on distance feedback also increased in this final 4 km. In Study 2, the trained group performed faster than the untrained group but there were no significant differences in pace or performance between alone and competitive TTs for either group. Differences in cognitions were found between groups and across the TT duration. Conclusion: Both studies demonstrate that cognitive processes differ as a function of expertise during self-paced cycling time trials. There were no differences in information-seeking behaviour between trained and untrained cyclists and there was no effect of an opponent on pace or performance. © 2020
- Authors: Massey, Hollie , Whitehead, Amy , Marchant, David , Polman, Remco , Williams, Emily
- Date: 2020
- Type: Text , Journal article
- Relation: Psychology of Sport and Exercise Vol. 49, no. (2020), p.
- Full Text:
- Reviewed:
- Description: Objectives: Two studies investigated expert-novice differences in information-seeking behaviour, cognitions and performance during cycling time trials (TT). Study 1 examined trained and novice cyclist's cognitions whilst performing a TT, using a Think Aloud (TA) protocol and eye-tracking techniques. Study 2 investigated expertise differences during alone and competitive TTs. Methods: in Study 1, six trained and seven novice cyclists performed a 16.1 km TT. In Study 2, eight trained and ten novice cyclists performed three 16.1 km TT; a baseline TT, an alone TT and a trial against a virtual competitor. In both studies, participants were asked to TA and in Study 1 they also wore mobile gaze-tracking glasses. Performance feedback and a simulated TT course were visually displayed during all trials, as was a virtual avatar during the competitor trial. Verbalisations were coded into primary and secondary themes. Cognitions and pacing strategies were compared between groups and across the duration of the TTs. In Study 1, eye-tracking data for total dwell time and gaze frequency were calculated for each area of interest (Time Elapsed, Power, Heart Rate, Cadence, Distance Covered, Speed and Course Scenery). Results: In Study 1, no significant differences were found in information-seeking behaviour between groups, however there were expertise differences in the cognitive strategies used. Trained cyclists’ verbalisations were more performance-relevant (i.e., power output), whereas the untrained group were more focused on task completion (i.e., distance and time) and irrelevant information. Both groups talked more about distance and motivational thoughts in the later stages of the trial, and dwell time on distance feedback also increased in this final 4 km. In Study 2, the trained group performed faster than the untrained group but there were no significant differences in pace or performance between alone and competitive TTs for either group. Differences in cognitions were found between groups and across the TT duration. Conclusion: Both studies demonstrate that cognitive processes differ as a function of expertise during self-paced cycling time trials. There were no differences in information-seeking behaviour between trained and untrained cyclists and there was no effect of an opponent on pace or performance. © 2020
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