The link between emotions and motor function has been known for decades but is still not clarified. The Adaptive Force (AF) describes the neuromuscular capability to adapt to increasing forces and was suggested to be especially vulnerable to interfering inputs. This study investigated the influence of pleasant and unpleasant food imagery on the manually assessed AF of elbow and hip flexors objectified by a handheld device in 12 healthy women. The maximal isometric AF was significantly reduced during unpleasant vs. pleasant imagery and baseline (p < 0.001, dz = 0.98–1.61). During unpleasant imagery, muscle lengthening started at 59.00 ± 22.50% of maximal AF, in contrast to baseline and pleasant imagery, during which the isometric position could be maintained mostly during the entire force increase up to ~97.90 ± 5.00% of maximal AF. Healthy participants showed an immediately impaired holding function triggered by unpleasant imagery, presumably related to negative emotions. Hence, AF seems to be suitable to test instantaneously the effect of emotions on motor function. Since musculoskeletal complaints can result from muscular instability, the findings provide insights into the understanding of the causal chain of linked musculoskeletal pain and mental stress. A case example (current stress vs. positive imagery) suggests that the approach presented in this study might have future implications for psychomotor diagnostics and therapeutics.

Emotionally affective imaginations can influence the Adaptive Force (AF) in healthy participants as was recently shown in an exploratory study. The AF describes the neuromuscular holding capacity in reaction to an increasing external force, which was suggested to be especially vulnerable for interfering inputs. The present study investigated the influence of pleasant and unpleasant food imaginations on the manually assessed AF of elbow and hip flexors objectified by a handheld device in 12 healthy young women in an improved design. Baseline measurements, randomization of imagination tasks and single-blinding were implemented. The maximal isometric Adaptive Force was significantly reduced during unpleasant vs. pleasant imaginations and baseline (p < 0.001, dz = 0.98 to 1.61). During unpleasant imaginations muscle lengthening started at 59.00 ± 22.50% of the maximal AF, which was reached during eccentric muscle action. For baseline measurements and pleasant imaginations, this ratio amounted ~97.90 ± 5.00% for both muscles, indicating that the participant was able to maintain the isometric position during the entire external force increase. For those stable adaptations, oscillations arose in force signal at a level of ~72.26 ± 12.89% of AFmax, whereby they occurred under isometric conditions. For unpleasant imaginations, the onset of oscillation was at a force of 84.28 ± 14.03% of AFmax, which in most cases was after the muscle started to lengthen.In conclusion, healthy participants showed an impaired holding function triggered by unpleasant imaginations, which are assumed to be related to negative emotions. This muscular instability is suggested to lead to joint destabilization which can result in musculoskeletal complaints. Therefore, the findings might support the understanding of the causal chain of linked musculoskeletal pain and mental stress. A case example (current stress vs. positive imaginations) will be presented, underpinning the hypothesis this approach might support psychomotor diagnostics and therapeutics.

The influence of emotionally affective imaginations on the Adaptive Force (AF) in healthy participants was recently shown in an exploratory study. The AF describes the neuromuscular capacity to adapt to increasing forces, which was suggested to be especially vulnerable for interfering inputs. This study investigated the influence of pleasant and unpleasant food imaginations on the manually assessed AF of elbow/hip flexors objectified by a handheld device in 12 healthy women in an improved design. The maximal isometric AF was significantly reduced during unpleasant vs. pleasant imaginations and baseline (p < 0.001, dz=0.98–1.61). During unpleasant imaginations muscle lengthening started at 59.00 ± 22.50 % of maximal AF, in contrast to baseline and pleasant imaginations during which the isometric position could be maintained mostly during the entire force increase up to ~97.90 ± 5.00 % of maximal AF. Healthy participants showed an immediately impaired holding function triggered by unpleasant imaginations presumably related to negative emotions. Hence, the AF seems to be suitable to test instantaneously the effect of emotions on motor function. Since musculoskeletal complaints can result from muscular instability, the findings provide insights into the understanding of the causal chain of linked musculoskeletal pain and mental stress. A described case example (current stress vs. positive imaginations) underpins the hypothesis this approach might support psychomotor diagnostics and therapeutics.

Emotionally affective imaginations influence the Adaptive Force (AF) in healthy participants as was recently shown. The AF describes the neuromuscular holding capacity, suggested to be especially vulnerable for interfering inputs. The present study investigated the influence of neutral, pleasant, and unpleasant food imaginations on the manually assessed AF objectified by a handheld device of elbow and hip flexors in 12 healthy participants with improved design. Muscle lengthening started on a significantly lower maximal isometric AF (AFisomax) during unpleasant vs. neutral/pleasant imaginations (AFisomax/AFmax = 59 ± 22 % vs. 98 ± 5 %, p < 0.001), whereby oscillations (AFosc) occurred mainly after AFisomax (AFosc/AFisomax= 188 ± 121 % vs. 75 ± 16%). Thus, healthy participants show an impaired holding function due to negative imaginations. Assuming this leads to joint destabilization, musculoskeletal complaints might result. It could support understanding the causal chain of linked pain and mental issues. A case example (current stress vs. positive imaginations) will be presented, underpinning the hypothesis this approach might support psychomotor diagnostics and therapeutics.

Emotionally affective imaginations can influence the Adaptive Force (AF) in healthy participants as was recently shown in an exploratory study. The AF describes the neuromuscular holding capacity in reaction to an increasing external force, which was suggested to be especially vulnerable for interfering inputs. The present study investigated the influence of pleasant and unpleasant food imaginations on the manually assessed AF of elbow and hip flexors objectified by a handheld device in 12 healthy participants in an improved design. Baseline measurements, randomization of imagination tasks and single-blinding were implemented. The maximal isometric Adaptive Force (AFisomax) was significantly reduced during unpleasant vs. pleasant imaginations and baseline (p < 0.001, dz = 0.98 to 1.61). During unpleasant imaginations muscle lengthening started at 59.00 ± 22.50% of the maximal AF, which was reached during eccentric muscle action. For baseline measurements and pleasant imaginations, this ratio amounted ~97.90 ± 5.00% for both muscles, indicating that the participant was able to maintain the isometric position during the entire external force increase. For those stable adaptations, oscillations arose in force signal at a level of ~72.26 ± 12.89% of AFmax, whereby they occurred under isometric conditions. For unpleasant imaginations, the onset of oscillation was at a force of 84.28 ± 14.03% of AFmax, which in most cases was after the muscle started to lengthen.In conclusion, healthy participants showed an impaired holding function triggered by unpleasant imaginations, which are assumed to be related to negative emotions. This muscular instability is suggested to lead to joint destabilization which can result in musculoskeletal complaints. Therefore, the findings might support the understanding of the causal chain of linked musculoskeletal pain and mental stress. A case example (current stress vs. positive imaginations) will be presented, underpinning the hypothesis this approach might support psychomotor diagnostics and therapeutics.

ZusammenfassungDigitale Gesundheitsanwendungen (DiGA) als psychosoziale therapeutische Interventionen bringen großes Potenzial mit sich, da sie nachweislich einen medizinischen Nutzen oder patient*innenrelevante Struktur- und Verfahrensverbesserungen in der Versorgung bewirken. Ihre Anwendung als konservative Erstlinien- oder Begleittherapie wird von den gesetzlichen Krankenkassen erstattet. Um dauerhaft in das Verzeichnis für erstattungsfähige DiGA des Bundesinstituts für Arzneimittel und Medizinprodukte (BfArM) aufgenommen zu werden, muss ein patient*innenrelevanter Nutzen einer DiGA wissenschaftlich nachgewiesen werden. Ziel dieses Beitrags war die kritische Prüfung der Evidenz von dauerhaft aufgenommenen DiGA mittels der Methode des Critically Appraised Topic. Insgesamt ergab sich ein qualitativ hochwertiges Bild der Studienlage. Alle Studien zum Nachweis eines patient*innenrelevanten Nutzens erfüllten mindestens zwei Drittel der Evaluationskriterien.

IntroductionElderly patients after hospitalisation for acute events on account of age-related diseases (eg, joint or heart valve replacement surgery) are often characterised by a remarkably reduced functional health. Multicomponent rehabilitation (MR) is considered an appropriate approach to restore the functioning of these patients. However, its efficacy in improving functioning-related outcomes such as care dependency, activities of daily living (ADL), physical function and health-related quality of life (HRQL) remains unclarified. We outline the research framework of a scoping review designed to map the available evidence of the effects of MR on the independence and functional capacity of elderly patients hospitalised for age-related diseases in four main medical specialties beyond geriatrics.Methods and analysisThe biomedical databases (PubMed, Cochrane Library, ICTRP Search Platform, ClinicalTrials) and additionally Google Scholar will be systematically searched for studies comparing centre-based MR with usual care in patients ≥75 years of age, hospitalised for common acute events due to age-related diseases (eg, joint replacement, stroke) in one of the specialties of orthopaedics, oncology, cardiology or neurology. MR is defined as exercise training and at least one additional component (eg, nutritional counselling), starting within 3 months after hospital discharge. Randomised controlled trials as well as prospective and retrospective controlled cohort studies will be included from inception and without language restriction. Studies investigating patients <75 years, other specialties (eg, geriatrics), rehabilitation definition or differently designed will be excluded. Care dependency after at least a 6-month follow-up is set as the primary outcome. Physical function, HRQL, ADL, rehospitalisation and mortality will be additionally considered. Data for each outcome will be summarised, stratified by specialty, study design and type of assessment. Furthermore, quality assessment of the included studies will be performed.Ethics and disseminationEthical approval is not required. Findings will be published in a peer-reviewed journal and presented at national and/or international congresses.Trial registration numberhttps://doi.org/10.17605/OSF.IO/GFK5C.